bluuebunny/crossref_metadata_2025 huggingface dataset:
Oncogenic KRAS drives immunosuppression of colorectal cancer by impairing DDX60-mediated dsRNA accumulation and viral mimicry
Authors: Zhou Yi , Zhang Yaxin , Li Mingzhou , Ming Tian , Zhang Chao , Huang Chengmei , Li Jiexi , Li Fengtian , Li Huali , Zhao Enen , Shu Feng , Liu Lingtao , Pan Xingyan , Gao Yijun , Tian Lin , Song Libing , Huang Huilin , Liao Wenting
Published: October 2024

The interferon (IFN) response is vital for the effectiveness of immune checkpoint inhibition (ICI) therapy. Our previous research showed that KRAS (Kirsten rat sarcoma viral) mutation impairs the IFN response in colorectal cancer (CRC), with an unclear mechanism. Here, we demonstrate that KRAS accelerates double-stranded RNA (dsRNA) degradation, impairing dsRNA sensing and IFN response by down-regulating DExD/H-box helicase 6 (DDX60). DDX60 was identified as a KRAS target here and could bind to dsRNAs to protect against RNA-induced silencing complex (RISC)–mediated degradation. Overexpressing DDX60 induced dsRNA accumulation, reactivated IFN signaling, and increased CRC sensitivity to ICI therapy. Mechanistically, KRAS engaged the AKT (also known as protein kinase B)–GSK3β (glycogen synthase kinase-3 beta) pathway to suppress STAT3 phosphorylation, thereby inhibiting STAT3-driven DDX60 transcription. Our findings reveal a role for KRAS in dsRNA homeostasis, suggesting potential strategies to convert “cold” tumors to “hot” and to overcome ICI resistance in CRC with KRAS mutations.
Relative inhibitory activities of newly developed diazabicyclooctanes, boronic acid derivatives, and penicillin-based sulfone β-lactamase inhibitors against broad-spectrum AmpC β-lactamases
Authors: Le Terrier Christophe , Mlynarcik Patrik , Sadek Mustafa , Nordmann Patrice , Poirel Laurent
Published: October 2024

The relative inhibitory activities of diazabicyclooctanes (avibactam, relebactam, zidebactam, nacubactam, durlobactam), boronic acid derivatives (vaborbactam, taniborbactam, xeruborbactam), and penicillin-based sulfone derivative enmetazobactam were evaluated against several intrinsic and acquired class C β-lactamases. By contrast to vaborbactam and enmetazobactam, taniborbactam, xeruborbactam, and all diazabicyclooctanes demonstrated effective activities against most AmpC enzymes. Notably, durlobactam exhibited the most pronounced inhibitory effect. Interstingly, the chromosomal AmpC of
Acinetobacter baumannii
was the least sensitive enzyme to the newly developed β-lactamase inhibitors.
A dual program for CRP-mediated regulation in bacterial alarmone (p)ppGpp
Authors: Zhao Li , Zhou Shi-Yu , Fu Yu , Shen Jin-Long , Yin Bin-Cheng , You Di , Ye Bang-Ce
Published: October 2024

Gene expression and proper downstream cellular functions upon facing environmental shifts depend on the combined and cooperative regulation of genetic networks. Here, we identified cAMP receptor protein (CRP) as a master regulator of (p)ppGpp (guanosine tetra- and penta-phosphate) homeostasis. Via CRP-mediated direct transcriptional regulation of the (p)ppGpp synthetase/hydrolase RelA and SpoT, cAMP-CRP stimulates pervasive accumulation of (p)ppGpp under glucose-limiting conditions. Notably, CRP exerts a nonclassical property as a translational regulator through YfiQ-dependent acetylation of ribosome protein S1 at K247, which further enhances the translation of RelA, SpoT, and CRP itself. From a synthetic biology perspective, this self-activating feedback loop for (p)ppGpp synthesis highlights the function of

C

RP-

m

ediated

d

ual

e

nhancement (CMDE) in controlling bacterial gene expression, which enables stable activation of genetic circuits. CMDE applied in synthetic circuits leads to a stable increase in
p
-coumaric acid, cinnamic acid, and pinosylvin production. Our findings showed that CRP-mediated dual circuits for (p)ppGpp regulation enable robust activation that could address bioproduction and other biotechnological needs.

IMPORTANCE

Transcriptional–translational coordination is fundamental for rapid and efficient gene expression in most bacteria. Here, we uncovered the roles of cAMP-CRP in this process. We found that CRP distinctly increases RelA and SpoT transcription and translation, and that acetylation of S1 at K247 accelerates the self-activation of the leading CRP under glucose-limiting conditions. We further found that elevated (p)ppGpp significantly impedes the formation of the cAMP-CRP complex, an active form responsible for transcriptional activation. A model was created in which cAMP-CRP and (p)ppGpp cooperate to dynamically modulate the efficiency of transcriptional–translational coordination responses to stress. More broadly, productive activation in synthetic circuits was achieved through the application of

C

RP-

m

ediated

d

ual

e

nhancement (CMDE), promising to inspire new approaches for the development of cell-based biotechnologies.
Complete genome sequence of
Microbacterium
sp. che218, an endophyte isolated from
Vitis vinifera
cv. Chardonnay shoot xylem
Authors: Aoki Yoshinao , Asada Takayuki , Nojiri Masutoshi , Suzuki Shunji
Published: October 2024

Microbacterium
species are bacterial endophytes that live inside plants. We report the complete genome sequence of
Microbacterium
sp. che218, an endophyte isolated from the shoot xylem of the wine grape
Vitis vinifera
cv. Chardonnay.
Genomic evidence of
Escherichia coli
gut population diversity translocation in leukemia patients
Authors: Marin Julie , Walewski Violaine , Braun Thorsten , Dziri Samira , Magnan Mélanie , Denamur Erick , Carbonnelle Etienne , Bridier-Nahmias Antoine
Published: October 2024

Escherichia coli,
a commensal species of the human gut, is an opportunistic pathogen that can reach extra-intestinal compartments, including the bloodstream and the bladder, among others. In non-immunosuppressed patients, purifying or neutral evolution of
E. coli
populations has been reported in the gut. Conversely, it has been suggested that when migrating to extra-intestinal compartments,
E. coli
genomes undergo diversifying selection as supported by strong evidence for adaptation. The level of genomic polymorphism and the size of the populations translocating from gut to extra-intestinal compartments is largely unknown. To gain insights into the pathophysiology of these translocations, we investigated the level of polymorphism and the evolutionary forces acting on the genomes of 77
E. coli
isolated from various compartments in three immunosuppressed patients. Each patient had a unique strain, which was a mutator in one case. In all instances, we observed that translocation encompasses much of the genomic diversity present in the gut. The same signature of selection, whether purifying or diversifying, and as anticipated, neutral for mutator isolates, was observed in both the gut and bloodstream. Additionally, we found a limited number of non-specific mutations among compartments for non-mutator isolates. In all cases, urine isolates were dominated by neutral selection. These findings indicate that substantial proportions of populations are undergoing translocation and that they present a complex compartment-specific pattern of selection at the patient level.

IMPORTANCE

It has been suggested that intra and extra-intestinal compartments differentially constrain the evolution of
E. coli
strains. Whether host particular conditions, such as immunosuppression, could affect the strain evolutionary trajectories remains understudied. We found that, in immunosuppressed patients, large fractions of
E. coli
gut populations are translocating with variable modifications of the signature of selection for commensal and pathogenic isolates according to the compartment and/or the patient. Such multiple site sampling should be performed in large cohorts of patients to gain a better understanding of
E. coli
extra-intestinal diseases.
BvgR is important for virulence-related phenotypes in
Bordetella bronchiseptica
Authors: Gutierrez Maria de la Paz , Damron F. Heath , Sisti Federico , Fernández Julieta
Published: October 2024

Bordetella bronchiseptica
is a pathogenic bacterium that causes respiratory infections in mammals. Adhesins, toxins, and secretion systems necessary for infection are regulated by the two-component system BvgAS. When the BvgAS system is inactive, there is no transcription of virulence-activated genes, and virulence-repressed genes (
vrg
) are expressed. The regulation of some
vrgs
in
B. bronchiseptica
is dependent upon the virulence-activated gene
bvgR
. Although having a regulatory role, no DNA-binding domain is described for BvgR. Instead, it contains an EAL domain, usually found in cyclic-di-GMP (c-di-GMP)-specific phosphodiesterases. c-di-GMP is a bacterial second messenger that regulates multiple phenotypes in bacteria, including
B. bronchiseptica
. The current study aimed to deepen our knowledge about BvgR. We employed RNA-seq analysis to define the BvgR regulon, and then we investigated the phenotypes in which BvgR regulation might be involved such as biofilm formation, cytotoxicity, and virulence. Our result revealed that BvgR inhibits biofilm formation and flagellin expression in virulent phase. Although BvgR has long been considered a repressor protein, our results show that it also upregulates almost 100 genes. This regulation is likely indirect, as BvgR lacks a DNA-binding domain. Notably, among the upregulated genes, we identified 15 associated with the type three secretion system. Consistent with these findings, a
B. bronchiseptica
strain deficient in
bvgR
was less cytotoxic than the wild-type strain, elicited a milder immune response, and was less able to persist in the lower respiratory tract of mice.

IMPORTANCE

Bordetella bronchiseptica
is a harmful bacterium responsible for respiratory infections in mammals. Its ability to cause disease is tightly regulated by a system called BvgAS. In this study, we focused on understanding the role of a specific gene called
bvgR
in regulating
B. bronchiseptica
’s virulence factors. Our findings revealed that BvgR, previously thought to primarily repress gene expression, actually plays a complex role in both activating and inhibiting various genes involved in bacterial virulence. This newfound understanding sheds light on the intricate mechanisms underlying
B. bronchiseptica
’s ability to cause infections, providing valuable insights for developing strategies to combat these infections in humans and animals.
rRNA operon improves species-level classification of bacteria and microbial community analysis compared to 16S rRNA
Authors: Won Sohyoung , Cho Seoae , Kim Heebal
Published: October 2024

Precise identification of species is fundamental in microbial genomics and is crucial for understanding the microbial communities. While the 16S rRNA gene, particularly its V3-V4 regions, has been extensively employed for microbial identification, however has limitations in achieving species-level resolution. Advancements in long-read sequencing technologies have highlighted the rRNA operon as a more accurate marker for microbial classification and analysis than the 16S rRNA gene. This study aims to compare the accuracy of species classification and microbial community analysis using the rRNA operon versus the 16S rRNA gene. We evaluated the species classification accuracy of the rRNA operon,16S rRNA gene, and 16S rRNA V3-V4 regions using a BLAST-based method and a k-mer matching-based method with public data available from NCBI. We further performed simulations to model microbial community analysis. We accessed the performance using each marker in community composition estimation and differential abundance analysis. Our findings demonstrate that the rRNA operon offers an advantage over the 16S rRNA gene and its V3-V4 regions for species-level classification within the genus. When applied to microbial community analysis, the rRNA operon enables a more accurate determination of composition. Using the rRNA operon yielded more reliable results in differential abundance analysis as well.

IMPORTANCE

We quantitatively demonstrated that the rRNA operon outperformed the 16S rRNA and its V3-V4 regions in accuracy for both individual species identification and species-level microbial community analysis. Our findings can provide guidelines for selecting appropriate markers in the field of microbial research.
Dietary amino acids, macronutrients, vaginal birth, and breastfeeding are associated with the vaginal microbiome in early pregnancy
Authors: Corbett Gillian A. , Moore Rebecca , Feehily Conor , Killeen Sarah Louise , O'Brien Eileen , Van Sinderen Douwe , Matthews Elizabeth , O'Flaherty Roisin , Rudd Pauline M. , Saldova Radka , Walsh Calum J. , Lawton Elaine M. , MacIntyre David A. , Corcoran Siobhan , Cotter Paul D. , McAuliffe Fionnuala M.
Published: October 2024

The vaginal microbiome is a key player in the etiology of spontaneous preterm birth. This study aimed to illustrate maternal environmental factors associated with vaginal microbiota composition and function in pregnancy. Women in healthy pregnancy had vaginal microbial sampling from the posterior vaginal fornix performed at 16 weeks gestation. After shotgun metagenomic sequencing, heatmaps of relative abundance data were generated. Community state type (CST) was assigned, and alpha diversity was calculated. Demography, obstetric history, well-being, exercise, and diet using food frequency questionnaires were collected and compared against microbial parameters. A total of 119 pregnant participants had vaginal metagenomic sequencing performed. Factors with strongest association with beta diversity were dietary lysine (adj-
R
2
0.113,
P
= 0.002), valine (adj-
R
2
0.096,
P
= 0.004), leucine (adj-
R
2
0.086,
P
= 0.003), and phenylalanine (adj-
R
2
0.085,
P
= 0.005, Fig. 2D). Previous vaginal delivery and breastfeeding were associated with vaginal beta diversity (adj-
R
2
0.048,
P
= 0.003; adj-
R
2
0.045,
P
= 0.004), accounting for 8.5% of taxonomy variation on redundancy analysis. Dietary fat, starch, and maltose were positively correlated with alpha diversity (fat +0.002 SD/g,
P
= 0.025; starch +0.002 SD/g,
P
= 0.043; maltose +0.440 SD/g,
P
= 0.013), particularly in secretor-positive women. Functional signature was associated with CST, maternal smoking, and dietary phenylalanine, accounting for 8.9%–11% of the variation in vaginal microbiome functional signature. Dietary amino acids, previous vaginal delivery, and breastfeeding history were associated with vaginal beta diversity. Functional signature of the vaginal microbiome differed with community state type, smoking, dietary phenylalanine, and vitamin K. Increased alpha diversity correlated with dietary fat and starch. These data provide a novel snapshot into the associations between maternal environment, nutrition, and the vaginal microbiome.

IMPORTANCE

This secondary analysis of the MicrobeMom randomized controlled trial reveals that dietary amino acids, macronutrients, previous vaginal birth, and breastfeeding have the strongest associations with vaginal taxonomy in early pregnancy. Function of the vaginal niche is associated mainly by species composition, but smoking, vitamin K, and phenylalanine also play a role. These associations provide an intriguing and novel insight into the association between host factors and diet on the vaginal microbiome in pregnancy and highlight the need for further investigation into the complex interactions between the diet, human gut, and vaginal microbiome.
Epidemiology of pediatric meningitis and encephalitis in Japan: a cross-sectional study
Authors: Mizuno Shinsuke , Kusama Yoshiki , Otake Shogo , Ito Yusuke , Nozaki Masatoshi , Kasai Masashi
Published: October 2024

Information on the epidemiology and cause-specific clinical features of pediatric meningitis and encephalitis is limited, owing to conventional laboratory methods' limitations in identifying causative pathogens. The FilmArray Meningitis/Encephalitis (FA-M/E) panel, a molecular diagnostic tool, can detect 14 pathogens within 1 hour. We investigated meningitis and encephalitis epidemiology among children in Japan and FA-M/E panels' utility in their clinical management. This cross-sectional study was conducted among children aged 0–18 years admitted to seven regional hospitals in western Japan between October 2022 and September 2023. Cerebrospinal fluid (CSF) samples were collected from 221 children and tested using the FA-M/E panel. Clinical and microbiological data were reviewed retrospectively. Fifty-eight patients tested positive using the FA-M/E panel. Viral and bacterial pathogens were detected in 49 and nine cases, respectively. Human parechovirus and enterovirus occurred mainly in epidemic clusters during the summer and were primarily detected in young infants. Patients who tested positive for human parechovirus had a significantly higher frequency of sepsis-like manifestations and a lower frequency of CSF pleocytosis than did those who tested positive for enterovirus. CSF pleocytosis was absent in 30 patients who tested positive using the FA-M/E panel. Among the patients who tested positive for bacteria, three of the nine were not diagnosed using conventional culture methods, owing to prior antimicrobial therapy. The FA-M/E panel can identify bacterial and viral pathogens causing pediatric meningitis and characterize the epidemiology in local communities.

IMPORTANCE

Culture and polymerase chain reactions have traditionally been used to identify microorganisms causing pediatric meningitis and encephalitis. However, the methods currently used to identify the causative microorganisms are limited, particularly in general hospitals. The FilmArray Meningitis/Encephalitis (FA-M/E) panel, a fully automated genetic testing system, can detect 14 pathogens using the multiplex polymerase chain reaction method. This study described the epidemiology of pediatric meningitis and encephalitis in Japan. The microorganisms causing acute meningitis and encephalitis in children in Japan were identified using the FilmArray Meningitis/Encephalitis panel. Testing cerebrospinal fluid using the FA-M/E panel is useful for the identification of the pathogen in children with community-acquired acute meningitis and encephalitis. This increases knowledge on the epidemiology and clinical manifestations of acute meningitis and encephalitis caused by specific pathogens and can be used to facilitate optimal patient management.
The microbiota of moon snail egg collars is shaped by host-specific factors
Authors: Piedl Karla , Aylward Frank O. , Mevers Emily
Published: October 2024

Moon snails (Family: Naticidae) lay eggs using a mixture of mucus and sediment to form an egg mass commonly referred to as an egg collar. These egg collars do not appear to experience micro-biofouling or predation, and this observation led us to hypothesize that the egg collars possess a chemically rich microbiota that protect the egg collars from pathogens. Herein, we sought to gain an understanding of the bacterial composition of egg collars laid by a single species of moon snails,
Neverita delessertiana
, by amplifying and sequencing the 16S rRNA gene from the egg collar and sediment samples collected at four distinct geographical regions in southwest Florida. Relative abundance and non-metric multidimensional scaling plots revealed distinct differences in the bacterial composition between the egg collar and sediment samples. In addition, the egg collars had a lower α-diversity than the sediment, with specific genera being significantly enriched in the egg collars. Analysis of microorganisms consistent across two seasons suggests that
Flavobacteriaceae
make up a large portion of the core microbiota (36%–58% of 16S sequences). We also investigated the natural product potential of the egg collar microbiota by sequencing a core biosynthetic gene, the adenylation domains (ADs), within the gene clusters of non-ribosomal peptide synthetase (NRPS). AD sequences matched multiple modules within known NRPS gene clusters, suggesting that these compounds might be produced within the egg collar system. This study lays the foundation for future studies into the ecological role of the moon snail egg collar microbiota.

IMPORTANCE

Animals commonly partner with microorganisms to accomplish essential tasks, including chemically defending the animal host from predation and/or infections. Understanding animal–microbe partnerships and the molecules used by the microbe to defend the animals from pathogens or predation has the potential to lead to new pharmaceutical agents. However, very few of these systems have been investigated. A particularly interesting system is nutrient-rich marine egg collars, which often lack visible protections, and are hypothesized to harbor beneficial microbes that protect the eggs. In this study, we gained an understanding of the bacterial strains that form the core microbiota of moon snail egg collars and gained a preliminary understanding of their natural product potential. This work lays the foundation for future work to understand the ecological role of the core microbiota and to study the molecules involved in chemically defending the moon snail eggs.
Leveraging investments, promoting transparency and mobilising communities: a qualitative analysis of news articles about how the Ebola outbreak informed COVID-19 response in five African countries
Authors: Courtney Lauren P , Billaud Manon , Paulenich Alex , Chew Rob , Alidina Zainab , Pinto Meredith
Published: October 2024

Background

The WHO declared the novel COVID-19 outbreak a pandemic in March 2020. While the COVID-19 pandemic was unprecedented, prior experiences with diseases such as Middle East respiratory syndrome, severe acute respiratory syndrome and Ebola shaped many countries’ preparedness and response strategies. Although lessons learnt from outbreak responses have been documented from a variety of sources, news media play a special role through their dissemination of news to the general public. This study investigated news media to explore how lessons learnt from the West African Ebola outbreak in 2014–2016 informed the COVID-19 responses in several African countries.

Methods

We conducted qualitative analysis on a dataset of previously compiled COVID-19-related news articles published from 1 March 2020 to 31 August 2020. This dataset included 34,225 articles from 6 countries. We filtered the dataset to only include articles with the keyword ‘Ebola’. We used a machine-learning text classification model to identify relevant articles with clear and specific lessons learnt. We conducted inductive and deductive coding to categorise lessons learnt and identify emergent themes.

Results

Of the 861 articles containing the word ‘Ebola’, 18.4% (N=158) with lessons learnt from Ebola were included across five of the countries: Ethiopia, Ghana, Kenya, Liberia and Sierra Leone. News articles highlighted three emergent themes: the importance of leveraging existing resources and past response system investments, promoting transparency in public health messaging and engaging community leaders in all phases of the response.

Conclusions

Findings suggest fostering trust prior to and throughout an outbreak facilitates timely implementation and compliance of mitigation strategies. Trust can be built by leveraging existing resources, being communicative and transparent about their funding allocation and decision-making and engaging communities.
The impact of a multi-faceted intervention on non-prescription dispensing of antibiotics by urban community pharmacies in Indonesia: a mixed methods evaluation
Authors: Ferdiana Astri , Mashuri Yusuf Ari , Wulandari Luh Putu Lila , Rahayu Ihsanti Dwi , Hasanah Miratul , Ayuningsih Zulfa , Batura Neha , Khan Mishal , Liverani Marco , Guy Rebecca , Schierhout Gill , Kaldor John , Law Matthew , Day Richard , Jan Stephen , Wibawa Tri , Probandari Ari , Yeung Shunmay , Wiseman Virginia
Published: October 2024

Introduction

Non-prescription antibiotic dispensing is prevalent among community pharmacies in several low- and middle-income countries. We evaluated the impact of a multi-faceted intervention to address this challenge in urban community pharmacies in Indonesia.

Methods

A pre-post quasi-experimental study was carried out in Semarang city from January to August 2022 to evaluate a 7-month long intervention comprising: (1) online educational sessions for pharmacists; (2) awareness campaign targeting customers; (3) peer visits; and (4) pharmacy branding and pharmacist certification. All community pharmacies were invited to take part with consenting pharmacies assigned to the participating group and all remaining pharmacies to the non-participating group. The primary outcome (rate of non-prescription antibiotic dispensing) was measured by standardised patients displaying symptoms of upper respiratory tract infection, urinary tract infection (UTI) and seeking care for diarrhoea in a child. χ2tests and multivariate random-effects logistic regression models were conducted. Thirty in-depth interviews were conducted with pharmacists, staff and owners as well as other relevant stakeholders to understand any persistent barriers to prescription-based dispensing of antibiotics.

Findings

Eighty pharmacies participated in the study. Postintervention, non-prescription antibiotics were dispensed in 133/240 (55.4%) consultations in the participating group compared with 469/570 (82.3%) in the non-participating group (p value <0.001). The pre-post difference in the non-prescription antibiotic dispensing rate in the participating group was 20.9% (76.3%–55.4%) compared with 2.3% (84.6%–82.3%) in the non-participating group (p value <0.001).

Non-prescription antibiotics were less likely to be dispensed in the participating group (OR=0.19 (95% CI 0.09 to 0.43)) and more likely to be dispensed for the UTI scenario (OR=3.29 (95% CI 1.56 to 6.94)). Barriers to prescription-based antibiotic dispensing included fear of losing customers, customer demand, and no supervising pharmacist present.

Interpretation

Multifaceted interventions targeting community pharmacies can substantially reduce non-prescription antibiotic dispensing. Future studies to evaluate the implementation and sustainability of this intervention on a larger scale are needed.
Satisfaction survey on graduates of standardised training for resident doctors in Guizhou Province, China
Authors: Zhu Haijian , Zhang Chanchan , Li Na , Yang Zhe , Qian Xin , Ji Min , Yang Jing , Liu Mingkun , Yang Wei , Li Dongdong , Sun Jiangling
Published: October 2024

Objectives

This study aimed to investigate the satisfaction levels of graduate residents in Guizhou Province and analyse the factors influencing their satisfaction.

Methods

A cross-sectional survey was conducted using a simple random sampling method with all graduate residents from 24 hospitals in Guizhou Province. The survey covered the residents’ demographic information, information about the training hospitals and satisfaction survey responses. Statistical analyses were performed using SPSS 29.0, including descriptive statistics using component ratios, binomial distribution tests for specific satisfaction situations,X2tests for between-group comparisons and binary logistic regression analyses to analyse the associations between residency satisfaction and related factors. The significance level was set at α=0.05.

Results

The survey included 1070 graduate residents of Guizhou Province, China, including 500 males (46.7%) and 570 females (53.3%). The satisfaction questionnaire revealed that 23.8% were very satisfied; 45.4% were somewhat satisfied; and 26.4%, 2.3% and 2.1% were average, somewhat dissatisfied and very dissatisfied, respectively. Factors influencing residency satisfaction included gender, age, training base level, identity type, training participation year and average monthly income.

Conclusion

Based on this study, the satisfaction of graduate residents in Guizhou Province, China, is relatively lower than that in other countries and provinces. Therefore, Guizhou Province should take appropriate measures to address these influencing factors and enhance residency training satisfaction, thereby improving the residency training quality.
Virtual simulation for teaching cardiology in nursing: a scoping review protocol
Authors: Carvalho Sabrina de Oliveira , Paz Ana Beatriz Barbosa , da Silva Machado Raylane , da Luz Phellype Kayyaã , Andrade Elaine Maria Leite Rangel , Luctkar-Flude Marian
Published: October 2024

Introduction

Virtual simulation (VS) can be an effective learning strategy in the context of nursing education on cardiovascular disease; however, its use in teaching cardiology in nursing is less studied. The objective of this scoping review is to map the use of VS for teaching cardiology in nursing.

Methods and analysis

This scoping review will be conducted according to the Joanna Briggs Institute methods, and the results will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Eight databases will be searched: MEDLINE (NCBI/PubMed), Cumulative Index to Nursing and Allied Health Literature, Web of Science, Latin American and Caribbean Literature in Health Sciences, Spanish Bibliographic Index of Health Sciences, Database of Nursing, EMBASE and Google Scholar from inception to 31 July 2024. This study will include any existing peer-reviewed literature and grey literature. There will be no time or language restrictions. Two reviewers will screen and select the articles independently, and when there are differences, they will be resolved with a third opinion. When appropriate, broad themes and categories derived from the review questions will be accompanied by other illustrative formats (eg, tables or graphs, word clouds and infographics).

Ethics and dissemination

This research project does not require ethical committee approval. The study is part of a cooperative research project between researchers from the Federal University of Piauí, Northeast of Brazil, and Queen’s University, Ontario, Canada, to develop and seek evidence of content validity of a VS game about valvular heart disease. The protocol and review will be published in peer-reviewed journals.

Registration details

Open Science Framework (https://doi.org/10.17605/OSF.IO/S3UMH).
Effect of telemonitoring on the rate of dropout during home non-invasive ventilation: a retrospective study using a home care provider database
Authors: Le Mao Raphael , Gut Gobert Christophe , Texereau Joelle B , Kremer Frédérique , Goret Marion , Chekroun Martinot Aurélie , Rosé Mathieu , Trzepizur Wojciech , Gagnadoux Frédéric
Published: October 2024

Objectives

Telemonitoring (TM) of home non-invasive ventilation (NIV) has been shown to facilitate home/outpatient therapy set-up. However, the impact of long-term TM on therapy dropouts, compliance and leak control has not yet been clearly determined. This study evaluated whether the NIV dropout rate was reduced by TM combined with remote patient support compared with a non-telemonitoring (NTM) pathway.

Design

Retrospective cohort study.

Setting

Data were obtained from all agencies of a single home care provider in France.

Participants

Adults with chronic respiratory failure (n=659) who started nocturnal NIV between January 2017 and December 2019 and had ≥8 days of NIV therapy (51% male; mean age 68.5±13.8 years; 35.5% on long-term oxygen therapy) were included. The TM group included 275 patients who spent ≥80% of the follow-up using TM, and the NTM group included 384 patients who had 0 to ≤10 days of telemonitoring during follow-up.

Primary and secondary outcome measures

The primary outcome was the rate of NIV dropouts at 1 year (ie, treatment discontinuation, excluding deaths). Secondary outcomes included therapy compliance and leaks.

Results

82 patients died during follow-up. Significantly fewer patients in the TM vs NTM group had dropped out of NIV therapy at 1 year (13% vs 34%; p<0.001). After adjustment for age, sex, NIV usage at 1-month follow-up and the main underlying respiratory disease, TM was significantly associated with a lower risk of dropout (HR 0.33, 95% CI 0.23 to 0.49; p<0.001). At 1, 4, 8 and 12 months, a greater proportion of patients in the TM vs NTM group had NIV usage of >4 hours/day and control of leaks.

Conclusions

In patients starting home NIV, TM with home care provider first-line support was associated with a lower therapy dropout rate at 1 year, and better compliance and leak control, compared with standard follow-up.
Determinants of access to primary healthcare for formerly incarcerated women transitioning into the community: a systematic review of the literature
Authors: Agbaria Nisreen , Wirth Margit , Winkler Volker , Moazen Babak , Van Hout Marie Claire , Stöver Heino
Published: October 2024

Background

Women with a history of incarceration experience significantly poorer health outcomes and encounter barriers to accessing healthcare, both during incarceration and after release. These challenges are more pronounced compared with both their male counterparts and women in the general population. We conducted a systematic literature review to respond to the following research questions: (1) what are the determinants of primary healthcare uptake and retention among formerly incarcerated women transitioning into the community? and (2) what are the barriers and facilitators for their access to primary healthcare postrelease?

Methods

Following the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and drawing on Levesques’ Patient-Centered Access to Healthcare Model, we searched and identified relevant publications from 2012 onwards in the following databases: PubMed, CINAHL, PsychInfo, Web of Science databases and Google Scholar. Records were included if they reported primary healthcare among formerly incarcerated women. Findings from the included studies were extracted and arranged under relevant themes using convergent-integrated approach.

Findings

A total of 3524 records were identified and reviewed, from which 37 publications were included in the review. Five main themes emerged as follows: (1) trends and predisposing factors, (2) barriers and facilitators to care, (3) continuity of care and arrangement between the prison and community health providers, (4) prescriptions and health insurance enrolment and (5) interventions to improve primary healthcare utilisation postrelease. Additional sub-themes, such as perceived discrimination in the healthcare system and delays in cancer screening, were identified and discussed.

Conclusion

The findings of the systematic review underscore the ongoing challenges women face in accessing primary care when transitioning from incarceration to the community. Enhancing coordination efforts between prison services and community healthcare providers requires a comprehensive assessment of women’s healthcare needs during this transition, alongside evaluating the availability of transitional programmes. Further research is required to explore the long-term impact of such programmes and to address the gaps in evidence from low- and middle-income countries.
Research priorities to support typhoid conjugate vaccine decision-making in India: evidence assessment and stakeholder survey
Authors: Mogasale Vijayalaxmi V , Sinha Anish , John Jacob , Hasan Farooqui Habib , Ray Arindam , Chantler Tracey , Mogasale Vittal , Dhoubhadel Bhim Gopal , Edmunds W John , Clark Andrew , Abbas Kaja
Published: October 2024

Background

India has a high typhoid fever burden. In 2022, the National Technical Advisory Group on Immunisation recommended introducing typhoid conjugate vaccine (TCV) into the Universal Immunisation Programme. Our study aims to identify research priorities to support ongoing TCV decision-making in India.

Methods

We identified 45 evidence factors for TCV decision-making in India by adapting WHO’s Evidence-to-Recommendation framework. We assigned an evidence gap score for each evidence factor from 0 (low) to 4 (high) based on the availability and sufficiency, quality, breadth and applicability of evidence identified in a literature review (end date 30 November 2023). We assigned each evidence factor an importance score based on the results of an online survey conducted among national immunisation stakeholders (n=22, 1 July 2023–31 October 2023), where they ranked the importance of seven WHO’s Evidence-to-Recommendation criteria and several evidence factors within them. We rescaled mean stakeholder rankings into importance scores from 0 (low) to 4 (high). Finally, we added the evidence gap score to the importance score and used the overall scores to identify research priorities to support ongoing TCV decision-making in India.

Results

We estimated the highest evidence priority scores for public perception of typhoid fever, vaccination budget impact, vaccine availability, socioeconomic impact, fiscal space, antimicrobial resistance tracking, typhoid fever mortality, public perception of TCV, immunisation managers’ acceptance and vaccine schedule preferences among caregivers.

Conclusion

By adapting WHO’s Evidence-to-Recommendation framework to the Indian context, we systematically identified several research priorities to support ongoing decision-making on TCV in India. These priorities will evolve as new research studies and questions emerge about the optimal scheduling, roll-out and implementation of TCV in India.
Association between bike-sharing systems and the blood pressure of local citizens: a cross-sectional study in China
Authors: Agarwal Sumit , Li Bing , Qian Wenlan , Ren Yuan , Sun Rongju
Published: October 2024

Introduction

Globally, hypertension stands as the foremost preventable risk factor for cardiovascular disease and premature death. However, scalable approach to lowering blood pressure (BP) at the population level remains lacking. We investigated whether shared bikes, a sustainable method of transportation gaining increasing popularity across the world, can serve as a supplemental instrument to combat the increasing prevalence of hypertension.

Methods

Based on 8 107 363 physical examination visits to one of the largest medical examination centres in China during the period of June 2016 to August 2017, we perfermed a staggered difference-in-differences (DiD) analysis that exploited the roll-out of bike-sharing systems across different cities. The main outcome was the blood pressure among adult participants who were likely to adopt shared bikes (age <45), measured by (1) systolic blood pressure (SBP), (2) diastolic blood pressure (DBP) and (3) a binary indicator of hypertension status (SBP≥130 or DBP≥80 mm Hg).

Results

Blood pressure showed a decreasing trend after a bike-sharing platform entered the local city. After 6 months post an entry event, SBP reduced by 0.67 mm Hg (β (SE), −0.672 (0.245); 95% CI, −1.154 to −0.191); the prevalence of hypertension reduced by 1.4 percentage points (β (SE), −0.014 (0.007); 95% CI, −0.027 to −0.000); the reduction in DBP was statistically insignificant (β (SE), −0.193 (0.193); 95% CI, −0.572 to 0.187). Participants less likely to adopt shared bikes (age ≥45) showed no significant response. The number of visits and the age of participants were also unaffected by the entry events. Reduction in blood pressure was more pronounced in male, younger and non-obese participants.

Conclusion

The findings of this study suggest that bike-sharing systems in China may be associated with lowered blood pressure, and thus may serve as a supplemental instrument to combat the increasing prevalence of hypertension, especially among young adults.
Utility of respiratory viral testing in the risk stratification of young febrile infants presenting to emergency care settings: a protocol for systematic review and meta-analysis
Authors: Evans Jordan , Norman-Bruce Hannah , Mills Clare , Umana Etimbuk , Roe Jennie , Mitchell Hannah , McFetridge Lisa , Waterfield Thomas
Published: October 2024

Introduction

Febrile infants under 3 months of age are at risk of invasive bacterial infection (IBI). It is currently unclear if testing for respiratory viruses may have a role in IBI risk stratification. If found to be associated with the likelihood of IBI, respiratory viral point-of-care testing may improve patient and caregiver experience, reduce costs and enhance antimicrobial stewardship.

Methods and analysis

This is a study protocol for a systematic review and meta-analysis that aims to answer the following question:In young febrile infants presenting to emergency care settings does a positive respiratory viral test for RSV, Influenza or SARS-CoV2 (relative to a negative test) add value to current risk stratification pathways for the exclusion of invasive bacterial infection, subsequently enabling safe de-escalation of investigation and treatment?

A search strategy will include MEDLINE, EMBASE, Web of Science, The Cochrane Library and grey literature. Abstracts and then full texts will be independently screened for selection. Data extraction and quality assessment will be completed by two independent authors.

The primary objective is to analyse the ability of a positive respiratory viral test to identify the overall risk of IBI. The secondary objective is to perform a subgroup analysis to investigate how the risk stratification alters based on other variables including virus type, patient characteristics and the presence of an identified source of fever.

Bivariate random-effects meta-analysis will be undertaken. Diagnostic odds ratios (OR), sensitivity, specificity and positive and negative likelihood ratios will be calculated. The degree of heterogeneity and publication bias will be investigated and presented.

Ethics and dissemination

Ethical approval is not required. We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to disseminate the study results through publication and conference presentations.

PROSPERO registration number

This protocol is registered in PROSPERO—ID number: CRD42023433716.
Point prevalence, characteristics and treatment variations for preterm infants with bronchopulmonary dysplasia in China: a ‘snapshot’ study
Authors: Wang Jianhua , Yang Ge , Cai Zhiqiang , Zhang Huayan
Published: October 2024

Objective

The incidence of bronchopulmonary dysplasia (BPD) is increasing, but data on its prevalence and management variations remain insufficient in China. The study aims to investigate its point prevalence and variations in BPD care.

Setting, patients and interventions

A multicentre cross-sectional study was conducted in 37 NICUs. ‘Snapshot’ clinical data on 18 June 2021 for individual patients born at <32 weeks gestation age (GA) were collected. BPD was defined based on the National Institute of Child Health and Human Development (NICHD) 2001 criteria and two newer criteria (NICHD 2018 and Jensen 2019).

Results

A total of 1044 infants born at <32 weeks GA were included, of which 72% were born at ≥28 weeks GA and 95.8% were born at ≥750 g. At the time of ‘snapshot’, 563 were ≥28 days old and 281 were ≥36 weeks postmenstrual age (PMA). The prevalence of BPD was 78.2% per NICHD 2001 definition. Infants with BPD were more likely to be born earlier with a lower birth weight and to have complications. Among infants who reached 36 weeks PMA, the point prevalence and severity of BPD differed across BPD definitions. Respiratory support and treatments for BPD also significantly varied.

Conclusion

Point prevalence of BPD is remarkably high in China. The prevalence of BPD was lowest according to the NICHD 2018 definition, whereas the NICHD 2001 definition classified most patients with severe BPD. We found infants with BPD have more complications and significant differences in BPD treatments between centres. Efforts to prevent BPD and standardise care are warranted in China.
WHO research agenda on the role of the institutional safety climate for hand hygiene improvement: a Delphi consensus-building study
Authors: Tartari Ermira , Storr Julie , Bellare Nita , Kilpatrick Claire , McGuckin Maryanne , Schwaber Mitchell J , Pittet Didier , Allegranzi Benedetta
Published: October 2024

Background

Creating and sustaining an institutional climate conducive to patient and health worker safety is a critical element of successful multimodal hand hygiene improvement strategies aimed at achieving best practices. Repeated WHO global surveys indicate that the institutional safety climate consistently ranks the lowest among various interventions.

Methods

To develop an international expert consensus on research agenda priorities related to the role of institutional safety climate within the context of a multimodal hand hygiene improvement strategy, we conducted a structured consensus process involving a purposive sample of international experts. A preliminary list of research priorities was formulated following evidence mapping, and subsequently refined through a modified Delphi consensus process involving two rounds. In round 1, survey respondents were asked to rate the importance of each research priority. In round 2, experts reviewed round 1 ratings to reach a consensus (defined as ≥70% agreement) on the final prioritised items to be included in the research agenda. The research priorities were then reviewed and finalised by members of the WHO Technical Advisory Group on Hand Hygiene Research in Healthcare.

Results

Of the 57 invited participants, 50 completed Delphi round 1 (88%), and 48 completed round 2 (96%). Thirty-six research priority statements were included in round 1 across five thematic categories: (1) safety climate; (2) personal accountability for hand hygiene; (3) leadership; (4) patient participation and empowerment and (5) religion and traditions. In round 1, 75% of the items achieved consensus, with 9 statements carried forward to round 2, leading to a final set of 31 prioritised research statements.

Conclusion

This research agenda can be used by researchers, clinicians, policy-makers and funding bodies to address gaps in hand hygiene improvement within the context of an institutional safety climate, thereby enhancing patient and health worker safety globally.
Drug-target Mendelian randomisation applied to metabolic dysfunction-associated steatotic liver disease: opportunities and challenges
Authors: Luo Shan , Zheng Ming-Hua , Wong Vincent Wai-Sun , Au Yeung Shiu Lun
Published: October 2024

Metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as the most prevalent cause of chronic liver disease worldwide affecting over one-third of the adult population. Despite the recent evolution of new nomenclature and diagnostic criteria for MASLD, progress in drug development for this condition remains limited. This review highlights the potential of drug-target Mendelian randomisation (MR), a study design that leverages human genetics and genomics, for the discovery, repositioning and safety assessment of drug targets in MASLD. We summarised key aspects of designing and appraising a drug-target MR study, discussing its inherent assumptions and considerations for instrument selection. Furthermore, we presented real-world examples from studies in MASLD which focused on opportunities and challenges in identifying novel drug targets, repositing existing drug targets, informing adjunctive treatments and addressing issues in paediatric MASLD.