bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative biodegradation analysis of three compostable polyesters by a marine microbial community
Authors: Meyer Cifuentes Ingrid E. , Degenhardt Julius , Neumann-Schaal Meina , Jehmlich Nico , Ngugi David Kamanda , Öztürk Başak
Published: November 2023

Biodegradable plastics are one of the possible solutions for reducing plastic waste, yet the mechanisms and organisms involved in their degradation in the aquatic environment remain understudied. In this study, we have enriched a microbial community from North Sea water and sediment, capable of growing on the polyester poly(butylene succinate). This culture was grown on two other biodegradable polyesters, polycaprolactone and a poly(butylene adipate-co-terephthalate) blend. The differences between microbial community structure and biodegradation activity on these three polymers were determined by metagenomics, metaproteomics, and respirometry analysis. In this study, we observed that the polymer type drives the community structure and determines its biodegradation capability. When the PBS-enriched culture grew on the poly(butylene adipate-
co
-terephthalate) blend, the community was more diverse, yet showed the lowest biodegradation percentage, while poly(butylene succinate) and polycaprolactone resulted in a less diverse community but much higher biodegradation activity. The dominating species were
Alcanivorax
sp.,
Thalassobius
sp., or
Pseudomonas
sp., depending on the substrate. In general, we have observed that Gammaproteobacteria were more abundant and active within the biofilm on the polymers and Alphaproteobacteria within the free-living fraction of the enrichments. Three putative hydrolases were recombinantly expressed and their hydrolytic activity on all polymers tested was verified. In conclusion, we showed that all three plastics can be biodegraded by bacteria naturally occurring within the marine environment.

IMPORTANCE

Biodegradable plastics can be used in applications where the end product cannot be efficiently recycled due to high levels of contaminations, e.g., food or soil. Some of these plastics have a dedicated end of life, such as composting, but their degradation in the marine environment is poorly understood. In this study we showed that marine microbial communities can degrade a range of biodegradable polymers with different physical and chemical properties and use these as a sole carbon source for growth. We have also provided insights into the degradation mechanisms using a combined metagenomic and metaproteomic approach. In addition, we have identified three new enzymes that are capable of degrading both aliphatic polymers and aliphatic-aromatic copolymers, which can be used for biotechnological applications.
Production of carotenoids from aromatics and pretreated lignocellulosic biomass by
Novosphingobium aromaticivorans
Authors: Hall Benjamin W. , Kontur Wayne S. , Neri Jeanette C. , Gille Derek M. , Noguera Daniel R. , Donohue Timothy J.
Published: November 2023

Carotenoids are lipophilic compounds found in the membranes of various organisms. Individual carotenoids are also commodity chemicals, produced industrially for use as food additives, nutritional supplements, cosmetics, and pharmaceuticals. The alphaproteobacterium
Novosphingobium aromaticivorans
has previously been established as a potential platform microbe for converting aromatic compounds derived from lignocellulosic plant biomass into valuable extracellular products. Here, we show that
N. aromaticivorans
DSM 12444 cells naturally produce the carotenoid nostoxanthin, and we construct a set of gene deletion mutants that accumulate β-carotene, lycopene, or zeaxanthin, which are predicted intermediates in nostoxanthin biosynthesis as well as commodity chemicals. We also show that a mutant strain heterologously expressing a CrtW protein accumulates the carotenoid astaxanthin. When grown on vanillate as the carbon source, we find that the levels of carotenoids are not significantly affected by O
2
concentration in the tested range of 5% to 21% O
2
. We also show that these carotenoids are produced at comparable levels when strains are grown in liquor from alkaline pretreated sorghum biomass [sorghum alkaline pretreatment liquor (APL)], which contains a mixture of aromatics. Finally, we construct strains that produce zeaxanthin, β-carotene, or astaxanthin concurrently with 2-pyrone-4,6-dicarboxylic acid, a potential building block for biodegradable polymers, when grown in sorghum APL. Combined, our results show that
N. aromaticivorans
can simultaneously produce valuable intracellular and extracellular commodities when grown in the presence of either pure aromatics or pretreated lignocellulosic biomass.

IMPORTANCE

There is economic and environmental interest in generating commodity chemicals from renewable resources, such as lignocellulosic biomass, that can substitute for chemicals derived from fossil fuels. The bacterium
Novosphingobium aromaticivorans
is a promising microbial platform for producing commodity chemicals from lignocellulosic biomass because it can produce these from compounds in pretreated lignocellulosic biomass, which many industrial microbial catalysts cannot metabolize. Here, we show that
N. aromaticivorans
can be engineered to produce several valuable carotenoids. We also show that engineered
N. aromaticivorans
strains can produce these lipophilic chemicals concurrently with the extracellular commodity chemical 2-pyrone-4,6-dicarboxylic acid when grown in a complex liquor obtained from alkaline pretreated lignocellulosic biomass. Concurrent microbial production of valuable intra- and extracellular products can increase the economic value generated from the conversion of lignocellulosic biomass-derived compounds into commodity chemicals and facilitate the separation of water- and membrane-soluble products.
Viral enumeration using cost-effective wet-mount epifluorescence microscopy for aquatic ecosystems and modern microbialites
Authors: Bellanger Madeline , Visscher Pieter , White Richard Allen
Published: November 2023

Enumeration is a fundamental measure of community ecology in which viruses represent the most numerous biological identities. Epifluorescence microscopy (EFM) has been the gold standard method for environmental viral enumeration for over 25 years. Currently, standard EFM methods using the Anodisc filters are no longer cost-effective (>$15 per slide) and have yet to be applied to modern microbialites. Microbialites are microbially driven benthic organosedimentary deposits that have been present for most of Earth’s history. We present a cost-effective method for environmental viral enumeration from aquatic samples, microbial mats, and exopolymeric substances (EPSs) within modern microbialites using EFM. Our integrated approach, which includes filtration, differential centrifugation, chloroform treatment, glutaraldehyde fixation, benzonase nuclease treatment, probe sonication (EPS and mat only), SYBR Gold staining, wet mounting, and imaging, provides a robust method for modern microbialites and aquatic samples. Viral abundances of modern microbialites and aquatic samples collected from Fayetteville Green Lake (FGL) and Great Salt Lake (GSL) did not differ across ecosystems by sample type. EPS and microbial mat samples had an order of magnitude higher viral-like particle abundance when compared to water regardless of the ecosystem (10
7
vs 10
6
). Viral enumeration allows for estimates of total viral numbers and weights. The entire weight of all the viruses in FGL and GSL are ~598 g and ~2.2 kg, respectively. Further development of EFM methods and software is needed for viral enumeration. Our method provides a robust and cost-effective (~$0.75 per sample) viral enumeration within modern microbialites and aquatic ecosystems.

IMPORTANCE

Low-cost and robust viral enumeration is a critical first step toward understanding the global virome. Our method is a deep drive integration providing a window into viral dark matter within aquatic ecosystems. We enumerated the viruses within Green Lake and Great Salt Lake microbialites, EPS, and water column. The entire weight of all the viruses in Green Lake and Great Salt Lake are ~598 g and ~2.2 kg, respectively.
Diagnosis and management of cryptococcal meningitis in HIV-infected adults
Authors: McHale Thomas C. , Boulware David R. , Kasibante John , Ssebambulidde Kenneth , Skipper Caleb P. , Abassi Mahsa
Published: November 2023

Cryptococcal meningitis is a leading cause of morbidity and mortality globally, especially in people with advanced HIV disease. Cryptococcal meningitis is responsible for nearly 20% of all deaths related to advanced HIV disease, with the burden of disease predominantly experienced by people in resource-limited countries. Major advancements in diagnostics have introduced low-cost, easy-to-use antigen tests with remarkably high sensitivity and specificity. These tests have led to improved diagnostic accuracy and are essential for screening campaigns to reduce the burden of cryptococcosis. In the last 5 years, several high-quality, multisite clinical trials have led to innovations in therapeutics that have allowed for simplified regimens, which are better tolerated and result in less intensive monitoring and management of medication adverse effects. One trial found that a shorter, 7-day course of deoxycholate amphotericin B is as effective as the longer 14-day course and that flucytosine is an essential partner drug for reducing mortality in the acute phase of disease. Single-dose liposomal amphotericin B has also been found to be as effective as a 7-day course of deoxycholate amphotericin B. These findings have allowed for simpler and safer treatment regimens that also reduce the burden on the healthcare system. This review provides a detailed discussion of the latest evidence guiding the clinical management and special circumstances that make cryptococcal meningitis uniquely difficult to treat.
Neisseria gonorrhoeae
drives
Chlamydia trachomatis
into a persistence-like state during
in vitro
co-infection
Authors: Ball Louise M. , Bronstein Ellis , Liechti George W. , Maurelli Anthony T.
Published: November 2023

Chlamydia trachomatis
and
Neisseria gonorrhoeae
are the most prevalent bacterial sexually transmitted infections (STIs) globally. Despite frequent co-infections in patients, few studies have investigated how mono-infections may differ from co-infections. We hypothesized that a symbiotic relationship between the pathogens could account for the high rates of clinical co-infection. During
in vitro
co-infection, we observed an unexpected phenotype where the
C. trachomatis
developmental cycle was impaired by
N. gonorrhoeae. C. trachomatis
is an obligate intracellular pathogen with a unique biphasic developmental cycle progressing from infectious elementary bodies (EB) to replicative reticulate bodies (RB), and back. After 12 hours of co-infection, we observed fewer EBs than in a mono-infection. Chlamydial genome copy number remained equivalent between mono- and co-infections. This is a hallmark of Chlamydial persistence. Chlamydial persistence alters inclusion morphology but varies depending on the stimulus/stress. We observed larger, but fewer,
Chlamydia
during co-infection. Tryptophan depletion can induce Chlamydial persistence, but tryptophan supplementation did not reverse the co-infection phenotype. Only viable and actively growing
N. gonorrhoeae
produced the inhibition phenotype in
C. trachomatis
. Piliated
N. gonorrhoeae
had the strongest effect on
C. trachomatis
, but hyperpiliated or non-piliated
N. gonorrhoeae
still produced the phenotype. EB development was modestly impaired when
N. gonorrhoeae
were grown in transwells above the infected monolayer.
C. trachomatis
serovar L2 was not impaired during co-infection. Chlamydial impairment could be due to cytoskeletal or osmotic stress caused by an as-yet-undefined mechanism. We conclude that
N. gonorrhoeae
induces a persistence-like state in
C. trachomatis
that is serovar dependent.
The clinical epidemiology, management, and outcomes of patients diagnosed with encephalitis in North Carolina, 2015–2020
Authors: Fellner Anuva , White Samuel , Rockwell Emmanuel , Giandomenico Dana , Diaz Monica M. , Weber David J. , Miller Melissa B. , Boyce Ross M.
Published: November 2023

Historically, the underlying cause of encephalitis was often not identified, even though the condition was responsible for substantial morbidity and mortality. The past decade, however, has witnessed the establishment of consensus case definitions and management guidelines, accompanied by rapid advances in molecular diagnostic techniques. The objective of this study was to describe the epidemiology of and routine care practices for patients diagnosed with encephalitis at a large academic tertiary referral hospital. A retrospective analysis of adults and children admitted to the University of North Carolina Medical Center between 2015 and 2020 was conducted. Cases of interest were identified by ICD9 and ICD10 codes with a diagnosis of encephalitis confirmed through record review. One-third (82, 31.6%) of the cohort did not have a lumbar puncture performed. Of the 177 patients who had a diagnostic lumbar puncture performed, 87 (49.2%) cases were a result of a confirmed infectious pathogen. Herpes simplex virus (HSV)-1 (
n
= 9) and HSV-2 (
n
= 12) were the most common infectious causes, followed by varicella zoster virus (VZV) (
n
= 16) and
Toxoplasma gondii
(
n
= 5). There were no confirmed cases of enterovirus or arboviral diseases, but less than half of patients were tested for these pathogens. The case fatality rate was 10.7% (
n
= 19) overall and 12.6% (
n
= 11) in those with infectious causes. Despite advances in diagnostics, a high proportion of cases (
n
= 75, 42.0%) were still classified as idiopathic. The use of order sets and/or multiplex testing (i.e., “encephalitis panel”) may improve the diagnosis of infectious encephalitis.

IMPORTANCE

Despite the relatively high mortality and the difficulty in diagnosis, nearly one-third of patients hospitalized with a documented diagnosis of encephalitis did not undergo a lumbar puncture (LP). When an LP was performed, pathogen-specific testing was greatly underutilized. Infectious etiologies were most common, but over 40% of cases were idiopathic at discharge. These findings suggest that there is a substantial opportunity to improve the quality of care through more accurate and timely diagnosis.
Trichophyton indotineae
and other terbinafine-resistant dermatophytes in North America
Authors: Lockhart Shawn R. , Smith Dallas J. , Gold Jeremy A. W.
Published: November 2023

Dermatophyte infections (a.k.a. ringworm, tinea) affect an estimated 20%–25% of the world’s population. In North America, most dermatophytoses are caused by
Trichophyton rubrum
or
Trichophyton mentagrophytes
species complexes. Severe and antifungal-resistant dermatophytoses are a growing global public health problem. A new species of the
T. mentagrophytes
species complex,
Trichophyton indotineae
, has recently emerged and is notable for the severe infections it causes, its propensity for antifungal resistance, and its global spread. In this issue of the
Journal of Clinical Microbiology
, C. F. Cañete-Gibas, J. Mele, H. P. Patterson, et al. (J Clin Microbiol 61:e00562-23, 2023,
https://doi.org/10.1128/JCM.00562-23
) summarize the results of speciation and AFST performed on North American dermatophyte isolates received at a fungal diagnostic reference laboratory. Within their collection, 18.6% of isolates were resistant to terbinafine (a first-line oral antifungal for dermatophytoses), and similar proportions of
T. rubrum
and
T. indotineae
demonstrated terbinafine resistance. The authors also found that
T. indotineae
has been present in North America since at least 2017. These findings highlight the importance of increased surveillance efforts to monitor trends in severe and antifungal-resistant dermatophytoses and the need for antifungal stewardship efforts, the success of which is contingent upon improving laboratory capacity for dermatophyte speciation and AFST.
DYRK-family kinases regulate
Candida albicans
morphogenesis and virulence through the Ras1/PKA pathway
Authors: MacAlpine Jessie , Liu Zhongle , Hossain Saif , Whitesell Luke , Robbins Nicole , Cowen Leah E.
Published: November 2023

Candida albicans
is an opportunistic human fungal pathogen that causes common superficial mycoses in healthy populations and invasive disease in immunocompromised individuals. The fungus employs several virulence traits to cause disease in humans, including its ability to transition from yeast to filamentous morphologies. Previous work found that genetic or pharmacological inhibition of the dual-specificity tyrosine-phosphorylation regulated kinase (DYRK) Yak1 blocks
C. albicans
morphogenesis and biofilm formation. Here, we expand on this work to provide mechanistic insights into how Yak1 governs this important virulence trait. First, we establish that Yak1 acts either downstream or parallel to protein kinase A (PKA) to regulate filamentation in response to diverse inducing cues. Furthermore, its importance in governing filamentous growth is dependent on core transcriptional regulators, such as Efg1 and Flo8. We also report that hyperactivation of the Ras1/cAMP/PKA pathway under elevated, host-relevant concentrations of CO
2
bypasses the requirement for Yak1 in the yeast-to-filament transition. Seeking to identify the factor(s) that mediates filamentation under elevated CO
2
, we found that in a
yak1-
mutant background, homozygous deletion of a predicted, but previously uncharacterized DYRK,
POM1,
blocks filamentation. Finally, we demonstrate that Yak1 is required for morphogenesis in a dermatitis model of
C. albicans
infection and that pharmacological inhibition of Yak1 with a beta-carboline also attenuates filamentation in the dermal tissue. Overall, this work characterizes the role of Yak1 in regulating
C. albicans
morphogenesis, identifies an undescribed role for Pom1 in the yeast-to-filament transition, and suggests that inhibition of Yak1 may serve as a therapeutic strategy to combat
C. albicans
dermatitis.

IMPORTANCE

Candida albicans
is an opportunistic human fungal pathogen that frequently causes life-threatening infections in immunocompromised individuals. To cause disease, the fungus employs several virulence traits, including its ability to transition between yeast and filamentous states. Previous work identified a role for the kinase Yak1 in regulating
C. albicans
filamentation. Here, we demonstrate that Yak1 regulates morphogenesis through the canonical cAMP/PKA pathway and that this regulation is environmentally contingent, as host-relevant concentrations of CO
2
bypass the requirement of Yak1 for
C. albicans
morphogenesis. We show a related kinase, Pom1, is important for filamentation in the absence of Yak1 under these host-relevant conditions, as deletion of both genes blocked filamentous growth under all conditions tested. Finally, we demonstrate that Yak1 is required for filamentation in a mouse model of
C. albicans
dermatitis using genetic and pharmacological approaches. Overall, our results expand our understanding of how Yak1 regulates an important virulence trait in
C. albicans
.
Whole-genome sequence of
Bacillus velezensis
strain R22 isolated from
Oryza sativa
rhizosphere in Bulgaria
Authors: Petrova Penka , Gerginova Maria , Arsov Alexander , Armenova Nadya , Tsigoriyna Lidia , Gergov Emanoel , Petrov Kaloyan
Published: November 2023

Bacillus velezensis
R22 was isolated from a rice rhizosphere in Bulgaria. Its genome (assembled into 14 scaffolds) has a size of 4.08 Mbp and a G + C content of 46.35%. Nine full biosynthetic clusters for antimicrobials were predicted, among them two new gene clusters probably encoding polyketides named macrolactin R22 and velezensin.
Genome sequences of cluster GA phages Phonegingi and Dropshot
Authors: McLean Natalie , Jackson Tabitha , Govardhan Yajat , Dharanendiran Aditi , Bost Caden , Brown Frederick , Cowen Benjamin , Deselem Jenna , Parkhurst Nico , Stewart Jacob , Leonard Justin , Collins D. Parks
Published: November 2023

Bacteriophages Phonegingi and Dropshot were isolated from soil in North Carolina using the host
Microbacterium foliorum
. Both phages have siphovirus morphologies. Based on gene content similarity to one another and to other actinobacteriophages, both phages are assigned to phage cluster GA.
Elucidating the impact of bacterial lipases, human serum albumin, and FASII inhibition on the utilization of exogenous fatty acids by
Staphylococcus aureus
Authors: Pruitt Emily L. , Zhang Rutan , Ross Dylan H. , Ashford Nathaniel K. , Chen Xi , Alonzo Francis , Bush Matthew F. , Werth Brian J. , Xu Libin
Published: November 2023

Staphylococcus aureus
only synthesizes straight-chain saturated fatty acids (SCFAs) or branched-chain saturated fatty acids via the type II fatty acid synthesis (FASII) pathway, but as a highly adaptive pathogen,
S. aureus
can also utilize host-derived exogenous fatty acids (eFAs), including SCFAs and unsaturated fatty acids (UFAs).
S. aureus
secretes three lipases, glycerol ester hydrolase (Geh),
S. aureus
lipase 1, and SAUSA300_0641, which could release fatty acids from host lipids. Once released, the FAs are phosphorylated by the fatty acid kinase and incorporated into the bacterial lipids. In this study, we determined the substrate specificity of
S. aureus
secreted lipases, the effect of human serum albumin (HSA) on eFA incorporation, and the effect of FASII inhibitor AFN-1252 on eFA incorporation using comprehensive lipidomics. When grown with major donors of fatty acids, cholesteryl esters (CEs) and triglycerides (TGs), Geh was found to be the primary lipase responsible for hydrolyzing CEs, but other lipases could compensate for the function of Geh in hydrolyzing TGs. Lipidomics showed that eFAs were incorporated into all major
S. aureus
lipid classes and that fatty acid-containing HSA can serve as a source of eFAs. Furthermore,
S. aureus
grown with UFAs displayed increased membrane fluidity and increased production of reactive oxygen species (ROS). Exposure to AFN-1252 enhanced UFAs in the bacterial membrane, even without a source of eFAs, indicating the inhibition of double bond reduction by FabI. Thus, the incorporation of eFAs alters the
S. aureus
lipidome, membrane fluidity, and ROS formation, which could affect host-pathogen interactions and susceptibility to membrane-targeting antimicrobials.

IMPORTANCE

Incorporation of host-derived exogenous fatty acids (eFAs), particularly unsaturated fatty acids (UFAs), by
Staphylococcus aureus
could affect the bacterial membrane fluidity and susceptibility to antimicrobials. In this work, we found that glycerol ester hydrolase (Geh) is the primary lipase hydrolyzing cholesteryl esters and, to a lesser extent, triglycerides and that human serum albumin (HSA) could serve as a buffer of eFAs, where low levels of HSA facilitate the utilization of eFAs but high levels of HSA inhibit it. The fact that the type II fatty acid synthesis (FASII) inhibitor, AFN-1252, leads to an increase in UFA content even in the absence of eFA suggests that membrane property modulation is part of its mechanism of action. Thus, Geh and/or the FASII system look to be promising targets to enhance
S. aureus
killing in a host environment by restricting eFA utilization or modulating membrane properties, respectively.
Tectonophysical Zoning of Seismogenic Faults in Eastern Anatolia and February 6, 2023 Kahramanmaraş Earthquakes
Authors: Rebetsky Yu. L.
Published: November 2023

Abstract—The results of the tectonophysical reconstruction of stresses in the crust of Eastern Anatolia, obtained from the analysis of data on earthquake focal mechanisms, have shown that a significant restructuring of the stress state has occurred here in the last 20 years. It was largely confined to the southern and southwestern sectors of the region, covering hundreds of kilometers along the East Anatolian Fault. The data obtained from tectonophysical monitoring not only on the orientation of principal stresses, but also on their normalized values made it possible to calculate Coulomb stresses on faults. The results of fault zoning by intensity and sign of these stresses helped identify both hazardous sections close to the limit state and safe sections with negative Coulomb stress values. It has been established that in the region of the source of the first strong Pazarcık earthquake, which had a complex structure (three segments), there were extended sections with a critically high Coulomb stress level, separated by zones with low and even negative values of these stresses. The epicenter of this earthquake was located on the echelon fault within a section (first segment) with a high Coulomb stress level. The source of the second strong Elbistan earthquake was located on a fault with negative Coulomb stresses. The conducted analysis shows that this second Turkey earthquake may have been caused by stress changes that occurred in the crust of the region after the first strong earthquake. The research results show that Coulomb stresses in systems of closely located and differently oriented faults may be prone to sudden changes during the development of the earthquake on one of hazardous sections.
Whole brain radiation therapy resulting in radionecrosis: a possible link with radiosensitising chemoimmunotherapy
Authors: Ngu Sam , Werner Cassidy , D' Amico Randy S , Wernicke A. Gabriella
Published: November 2023

Radionecrosis describes a rare but serious complication of radiation therapy. In clinical practice, stereotactic radiosurgery (SRS) is increasingly used in combination with systemic therapy, including chemotherapy, immune checkpoint inhibitor and targeted therapy, either concurrently or sequentially. There is a paucity of literature regarding radionecrosis in patients receiving whole brain radiation therapy (WBRT) alone (without additional SRS) in combination with immunotherapy or targeted therapies. It is observed that certain combinations increase the overall radiosensitivity of the tumorous lesions. We present a rare case of symptomatic radionecrosis almost 1 year after WBRT in a patient with non-squamous non-small cell lung cancer on third-line chemoimmunotherapy. We discuss available research regarding factors that may lead to radionecrosis in these patients, including molecular and genetic profiles, specific drug therapy combinations and their timing or increased overall survival.
Early use of intravitreal triamcinolone to inhibit traumatic proliferative vitreoretinopathy: a randomised clinical trial
Authors: Guo Haixia , Yu Jinguo , He Tiangeng , Chen Song , Sun Zhuoyu , Zhang Jingkai , Sun Zhiyong , Yang Wenhui , Yao Baoqun , Yang Xueli , Liu Yuanyuan , Zhang Mingxue , Meng Yu , Yang Likun , Yan Hua
Published: November 2023

Aims

To evaluate the efficacy and safety of intravitreal triamcinolone acetonide (TA) injection at the end of emergency surgery for open globe injury (OGI) to suppress traumatic proliferative vitreoretinopathy (TPVR).

Methods

A single-centre, participant-masked, prospective, randomised controlled clinical trial. A total of 68 globe rupture patients with zone III were randomised to the control group (n=34) or the TA group (n=34) in 1:1 allocation ratio. Patients were treated with 0.1 mL TA in the TA group and 0.1 mL balanced salt solution in the control group at the end of emergency surgery. The primary outcome was the assessment of TPVR during vitrectomy 10±3 days later. Secondary outcomes included visual acuity (VA), retinal attachment rate, macular attachment rate, proliferative vitreoretinopathy (PVR) recurrent rate, side effects 6 months after vitrectomy.

Results

During vitrectomy, the TPVR grade of the control group was significantly more severe than the TA group (p=0.028). The TPVR score was significantly better in the TA group (9.30±0.82) than in the control group (6.44±1.06) (p=0.036). The final VA improved in 23 eyes (92%) in the TA group and in 14 eyes (63.64%) in the control group (p=0.008). The retinal attachment rates were 88% and 63.64% in the TA and control group, respectively (p=0.049). The two groups showed no significant difference in macular repositioning and PVR recurrent rate (p=0.215, 0.191). Temporary intraocular pressure elevation occurred in one eye in the TA group after emergency surgery.

Conclusions

Early intravitreal TA injection for OGI effectively reduces TPVR, increases surgical success and improves visual prognosis.
Reconceptualising the commercial determinants of health: bringing institutions in
Authors: Ralston Rob , Godziewski Charlotte , Brooks Eleanor
Published: November 2023

The concept of the ‘commercial determinants of health’ (CDOH) has been developed by public health researchers as a way to describe the political economy of corporations and the impact of their practices on health, social inequalities and climate change. In this analysis, we assess the conceptual work that has developed this field and the influence of the more established ‘social determinants of health’ models. We highlight the dominance of epidemiologic and biomedical concepts on understandings of structure and agency in the CDOH literature and argue that the terminology of ‘risk factors’, ‘drivers’ and ‘pathways’ reflects an agent-centred approach. We suggest that, as a result, there is a tendency to overlook the importance of political institutions in shaping the exercise of corporate power. Our analysis seeks to ‘bring institutions in’ to CDOH research, using the empirical cases of Health in All Policies and Better Regulation in the European Union to highlight how institutional contexts shape political legitimacy and accountability, and in turn the strategies of corporate actors. Institutionalist approaches, we argue, have the potential to develop and expand understandings of CDOH by opening the black box between agency and structure.
Improving cognition in people with multiple sclerosis: study protocol for a multiarm, randomised, blinded trial of multidomain cognitive rehabilitation using a video-serious game (E-SEP cognition)
Authors: Lenne Bruno , Degraeve Béatrice , Davroux Jessy , Norberciak Laurène , Kwiatkowski Arnaud , Donze Cécile
Published: November 2023

Introduction

Multiple sclerosis (MS) is a prevalent neurological disease characterised by disseminated areas of demyelination and atrophy within the central nervous system, inducing cognitive disorders in 45%–65% of persons with MS (PwMS). Neuropsychology and neuroimaging studies provide evidence of the effectiveness of cognitive rehabilitation interventions, including memory and attention. Recently, serious game therapy (SGT) has been used in rehabilitation to improve cognitive processing speed. The aim of this study is to describe the protocol of a randomised controlled trial (RCT) to test the efficacy of a tablet-based cognitive home intervention among ambulatory PwMS, in comparison to a standardised neuropsychological rehabilitation.

Methods and analysis

This will be a parallel-assignment, double-blinded, RCT. One hundred and fifty (75 per arm) PwMS will be randomly assigned to receive cognitive rehabilitation session over 4 months (four 20-min sessions/week) of either: (1) tablet-based SGT or (2) conventional cognitive exercises. The same assessor will evaluate outcome measures at three points: at baseline (T0), after the 16 therapy sessions weeks (T1), and 6 months after the end of treatment (T2). The primary outcomes were the scores from theBrief International Cognitive Assessment for Multiple Sclerosis(BICAMS). Data analysis will be performed to compare the efficacy of the two treatments. We expect superior efficiency of tablet-based SGT in contrast to conventional cognitive exercises, based on BICAMS measures of speed processing information and episodic memory.

Ethics and dissemination

The trial protocol is registered on ClinicalTrials.Gov (NCT04694534) and benefits from a favourable opinion from an ethics committee (RC-P0066-2018-A00411-54).
Relationship between individual-level social capital and non-communicable diseases among adults in Honiara, Solomon Islands
Authors: Tsuchiya Chihiro , Pitakaka Frida , Daefoni Julia , Furusawa Takuro
Published: November 2023

Objective

Solomon Islands is experiencing a change in disease burden, from communicable to non-communicable diseases (NCDs). Urgent action is necessary to reduce the risk of high economic and personal costs associated with NCDs. Social capital refers to the trust, norms and networks that provide social benefits and it is related to health. Despite the strong social bonds among Solomon Islanders, research on the association between social capital and health is lacking. Therefore, this study examines the state of individual social capital and its connection to NCD-related factors in the capital of the Solomon Islands.

Method

In 2019, we conducted a cross-sectional study on 200 adults aged 20–80 years in urban and periurban settlements of the capital. Anthropometric measurements, questionnaires and interview surveys were conducted.

Results

This study identified higher prevalence of obesity, blood glucose levels and blood pressure compared with previous studies in both study areas. Multiple linear regression analysis reported that in the periurban area, cognitive social capital was negatively associated with body mass index (BMI) (p=0.005), whereas joining a group was positively associated with BMI (p=0.01). In the urban area, social support from individuals and cognitive social capital were negatively associated with blood glucose levels (p=0.03, p=0.007). Moreover, cognitive social capital was negatively associated with systolic blood pressure and diastolic blood pressure (p=0.03, p=0.006). However, joining citizenship activity was positively associated with glucose levels (p=0.04).

Conclusion

This study observed that participants living with people of the same linguistic group had high trust in each other. Furthermore, higher cognitive social capital and social support may reduce the risk of NCD-related factors, unlike joining group activities.

Public health implications

Findings suggest that health professionals should consider the influence of social capital on health promotion and interventions to be effective.
Association between the stage of labour during caesarean delivery with adverse maternal and neonatal outcomes among referred mothers to tertiary centres in resource-limited settings
Authors: Zewdu Dereje , Tantu Temesgen , Degemu Fikretsion , Abdlwehab Mukerem
Published: November 2023

Objective

Although the caesarean delivery (CD) rate has substantially increased, little is known about its impacts when performed in the first and second stages of labour on fetomaternal outcomes, especially among referred mothers. Thus, this study aimed to investigate the association between CDs performed during the first and second stages of labour and poor maternal and neonatal outcomes among mothers referred to tertiary centres.

Setting

This retrospective cohort study analysed medical records of mother–infant pairs from September 2020 to May 2023 in Southern Ethiopia.

Participants

We retrospectively collected data from 848 participants who underwent emergency CD on a referral basis during the study period.

Primary outcome measure

The primary outcomes of interest were adverse maternal and neonatal outcomes. Data were analysed using descriptive and inferential statistics.

Results

Of the 848 CDs, 722 (85.2%) and 126 (14.8%) were performed at the first and second stages of labour, respectively. Caesarean sections performed at the second stage were higher with nulliparity, increased maternal age, and birth weight. Compared with the first-stage CD, the second-stage CD was associated with a significantly increased risk of adverse maternal (OR 3.7, 95% CI 2.4 to 5.7) and neonatal outcomes (OR 2.0; 95% CI 1.3 to 2.9), including neonatal death.

Conclusion

Second-stage CDs have an increased risk of adverse maternal and neonatal outcomes. Strengthening and improving obstetric emergency surgical services and intensive neonatal care for those populations would help decrease the maternal and fetal negative consequences.
Connecting pathogen transmission and healthcare worker cognition: a cognitive task analysis of infection prevention and control practices during simulated patient care
Authors: Mumma Joel M , Weaver Bradley W , Morgan Jill S , Ghassemian Golpar , Gannon Paige R , Burke Kylie B , Berryhill Brandon A , MacKay Rebecca E , Lee Lindsay , Kraft Colleen S
Published: November 2023

Background

Relatively little is known about the cognitive processes of healthcare workers that mediate between performance-shaping factors (eg, workload, time pressure) and adherence to infection prevention and control (IPC) practices. We taxonomised the cognitive work involved in IPC practices and assessed its role in how pathogens spread.

Methods

Forty-two registered nurses performed patient care tasks in a standardised high-fidelity simulation. Afterwards, participants watched a video of their simulation and described what they were thinking, which we analysed to obtain frequencies of macrocognitive functions (MCFs) in the context of different IPC practices. Performance in the simulation was the frequency at which participants spread harmless surrogates for pathogens (bacteriophages). Using a tertiary split, participants were categorised into a performance group: high, medium or low. To identify associations between the three variables—performance groups, MCFs and IPC practices—we used multiblock discriminant correspondence analysis (MUDICA).

Results

MUDICA extracted two factors discriminating between performance groups. Factor 1 captured differences between high and medium performers. High performers monitored the situation for contamination events and mitigated risks by applying formal and informal rules or managing their uncertainty, particularly for sterile technique and cleaning. Medium performers engaged more in future-oriented cognition, anticipating contamination events and planning their workflow, across many IPC practices. Factor 2 distinguished the low performers from the medium and high performers who mitigated risks with informal rules and sacrificed IPC practices when managing tradeoffs, all in the context of minimising cross-contamination from physical touch.

Conclusions

To reduce pathogen transmission, new approaches to training IPC (eg, cognitive skills training) and system design are needed. Interventions should help nurses apply their knowledge of IPC fluidly during patient care, prioritising and monitoring situations for risks and deciding how to mitigate risks. Planning IPC into one’s workflow is beneficial but may not account for the unpredictability of patient care.
Incidence of community-acquired pneumonia hospitalisation in persons with bronchiectasis during the COVID-19 lockdown in Denmark: a retrospective cohort study
Authors: Rømer Valdemar , Fosgaard Martina Bjørka , Sivapalan Pradeesh , Eklöf Josefin , Saeed Mohamad Isam , Toennesen Louise Lindhardt , Svorre Jordan Alexander , Gissel Tina , Johansson Sofie Lock , Jensen Jens-Ulrik Stæhr
Published: November 2023

Background

Persons with bronchiectasis have a high risk of community-acquired pneumonia. Social distancing measures, implemented to prevent the spreading of SARS-CoV-2, could potentially reduce the incidence of other infectious diseases.

Research question

Was the COVID-19 lockdown period, along with accompanying social distancing measures, associated with reduced hospital admissions for community-acquired pneumonia and decreased overall mortality rates among individuals with bronchiectasis?

Methods

Social distancing measures were introduced in Denmark by 12 March 2020 and were preserved until 20 May 2020 (social distancing period), after which the measures were gradually dismissed. The study included all adults (≥18 years) with bronchiectasis residing in Denmark. Confirmed cases of SARS-CoV-2 infection were excluded. We retrospectively investigated the incidence of community-acquired pneumonia hospital admission, death of all causes and respiratory antibiotic treatment in the 10-week social distancing period in 2020, compared with the same dates in 2019. 9344 persons were included in the study.

Results

In the social distancing period, the incidence rate of pneumonia-hospitalisation per 10 000 person-weeks was 9.2 compared with 13.8 in the reference period. This reduction corresponds to an incidence rate ratio (IRR) of 0.67 (95% CI 0.51 to 0.88, p<0.01). Mortality was unchanged (IRR 0.90, 95% CI 0.61 to 1.32, p=0.58). Fewer persons received respiratory antibiotics (IRR 0.85, 95% CI 0.78 to 0.94, p<0.001).

Conclusion

The social distancing period was associated with a lower incidence of community-acquired pneumonia hospitalisations and respiratory antibiotic treatments in persons with bronchiectasis while all-cause mortality remained unchanged.
Dupilumab demonstrated efficacy and was well tolerated regardless of prior use of swallowed topical corticosteroids in adolescent and adult patients with eosinophilic oesophagitis: a subgroup analysis of the phase 3 LIBERTY EoE TREET study
Authors: Bredenoord Albert J , Dellon Evan S , Hirano Ikuo , Lucendo Alfredo J , Schlag Christoph , Sun Xian , Glotfelty Lila , Mannent Leda , Maloney Jennifer , Laws Elizabeth , Mortensen Eric , Shabbir Arsalan
Published: November 2023

Objective

To assess the effect of long-term dupilumab on histological, symptomatic and endoscopic aspects of eosinophilic oesophagitis (EoE) in adolescent and adult patients with and without prior use of swallowed topical corticosteroids (STC) or prior inadequate response, intolerance or contraindication to STC.

Design

Pre-specified analysis of data from the phase 3 LIBERTY EoE TREET study on patients who received dupilumab 300 mg once a week or placebo for 24 weeks (W24) in parts A and B, and an additional 28 weeks (W52) in part C. Patients were categorised as with/without prior STC use and with/without inadequate/intolerance/contraindication to STC. The proportion of patients achieving ≤6 eosinophils per high-power field (eos/hpf), absolute change in Dysphagia Symptom Questionnaire (DSQ) score, mean change in Endoscopic Reference Score and Histologic Scoring System grade/stage scores were assessed for each subgroup.

Results

Regardless of prior STC use, dupilumab increased the proportion of patients achieving ≤6 eos/hpf and improved DSQ score versus placebo at W24, with improvements maintained or improved at W52. The DSQ score and the proportion of patients achieving ≤6 eos/hpf after switching from placebo to dupilumab at W24 were similar to those observed in the dupilumab group at W24, regardless of prior STC use or inadequate/intolerance/contraindication to STC. Improvements in other outcomes with dupilumab were similar in patients with/without prior STC use or inadequate/intolerance/contraindication to STC.

Conclusion

Dupilumab 300 mg once a week demonstrated efficacy and was well tolerated in patients with EoE regardless of prior STC use or inadequate response, intolerance and/or contraindication to STC.

Trial registration number

NCT03633617.
Lattice Green functions for pedestrians: Exponential decay
Authors: Dybalski Wojciech , Stottmeister Alexander , Tanimoto Yoh
Published: November 2023

The exponential decay of lattice Green functions is one of the main technical ingredients of the Bałaban’s approach to renormalization. We give here a self-contained proof, whose various ingredients were scattered in the literature. The main sources of exponential decay are the Combes–Thomas method and the analyticity of the Fourier transforms. They are combined using a renormalization group equation and the method of images.
A single assignment of numbers for square divisor cordial and cube divisor cordial labelings on the generalized Petersen graphs GP (n,3)
Authors: Ignatius Fredrick , Kaspar S
Published: November 2023

In this paper, a work on the generalized Petersen graph GP [Formula: see text] is done, proving Generalized Petersen graph GP [Formula: see text] to be both Square Divisor Cordial Graphs and Cube Divisor Cordial Graphs by a single assignment of numbers on the same graph. Few conditions are provided to label the graphs in single assignment to prove two different labelings. A rule is developed to label the graphs and the results obtained are tabulated by actual verification for [Formula: see text] to [Formula: see text] but the rule holds good for all [Formula: see text] 4. Further, a few illustrations are provided to justify the rule given to label the graphs in a single assignment.
Exact Foldy–Wouthuysen transformation for a Dirac equation describing the interaction of spin-1/2 relativistic particles with an external electromagnetic field
Authors: Gonçalves Bruno , Dias Júnior Mário M. , Eleotério Larissa F.
Published: November 2023

The Thomas–Bargmann–Michel–Telegdi (TBMT) equation is derived using the Exact Foldy–Wouthuysen transformation. Extra new terms were found, and we discuss their possible physical applications. The main point of this work is to detail the procedure to get the general result. We explicitly present the choice of parametrization we used on the initial Hamiltonian and the motivations to take it. We emphasize that the final equations can depend on this choice, and it is possible to prevent the manipulations of the quadratic Hamiltonian that become extremely cumbersome. More importantly, it is done in such a way that the transformed equations allow the direct separation into mass, kinetic, and interaction correction terms to the original TBMT equation.
Two innovative derivation methods of the Nernst equation without any additional assumptions
Authors: Su Shanhe , Xia Shihao , Liang Tao , Chen Jincan
Published: November 2023

It is found that without any additional assumptions, Nernst’s equation can be re-deduced from the experimental data obtained from the thermodynamic systems at ultra-low temperatures, which is different from the derivation processes in textbooks and literature, and consequently, the physical content included by Nernst’s equation should not be referred to as Nernst’s postulate or Nernst’s theorem. It should be renamed as the Nernst statement. This discovery will play an important role in improving the theoretical framework of thermodynamics. It can effectively prevent some artificial assumptions into the third law of thermodynamics, making it a true reflection of the objective world. It solves the awkward problem caused by using a thermodynamic theorem as the core contents of a thermodynamic law for over one hundred years.
Phase parameters of orthogonal arrays and special maximally multi-qubit entangled states
Authors: Zha Xin-Wei , Ahmed Irfan , Imran Muhammad , Ahmed Rizvi Syed Maaz , Magsi Hina , Zhang Yanpeng
Published: November 2023

Quantum orthogonal arrays are combinatorial designs with a remarkable class of genuinely multipartite highly entangled states. In this paper, we propose the method for constructing maximally multi-qubit entangled state through phase parameters of orthogonal arrays. Using this method, we not only determine that maximally n-qubit entangled state, but also find the [Formula: see text] orthogonal array that gives maximally [Formula: see text] entangled states. Such states play an important role in quantum theory with a high degree of multipartite entanglement.