bluuebunny/crossref_metadata_2025 huggingface dataset:
Needs Assessment of Residents and Nurses for Interprofessional Cross‐Cultural Curriculum
Authors: Torres Carlos , James Aisha , Lamour Karen , Dzara Kristina , Frey‐Vogel Ariel
Published: December 2023

Background

Clinicians must learn to care for patients from different cultures. They must also work in teams for optimal outcomes. Few studies have analysed the intersection of cross‐cultural care and interprofessional education. We completed a needs assessment to determine what paediatric residents and nurses view as essential cross‐cultural components.

Methods

We led a sequential mixed‐methods study of residents and nurses at an urban tertiary care centre. We administered the ‘Residency Training in Cross Cultural Care’ instrument. Survey results informed focus group interview guide development. Thematic analysis of qualitative data was conducted following the five stages to qualitative research framework.

Findings

Thirty‐five residents (70%) and 46 nurses (66%) completed the survey. Five residents and six nurses attended a focus group. Five themes resulted: 1) lack of clinician diversity and cross‐cultural training, 2) effective cross‐cultural care not always delivered, 3) multiple challenges for delivery of effective cross‐cultural care, 4) call to action for enhanced cross‐cultural education and 5) different cross‐cultural educational needs between nurses and residents.

Discussion

Residents and nurses conveyed that meaningful cross‐cultural care education is imperative, lacking, and must offer skills to improve patient care. They call for a robust cross‐cultural curriculum that is up to date and teaches about intersectionality.

Conclusion

We have used this data to implement interprofessional interventions to meet their unique learning needs and enhance upstander skills by using facilitated discussions of techniques, case studies and role plays. Ultimately, teaching all clinicians to care for patients of other cultures may lead to more equitable care.
Functional coupling between Piezo1 and TRPM4 influences the electrical activity of HL‐1 atrial myocytes
Authors: Guo Yang , Cheng Delfine , Yu Ze‐Yan , Schiatti Teresa , Chan Andrea Y. , Hill Adam P. , Peyronnet Rémi , Feneley Michael P. , Cox Charles D. , Martinac Boris
Published: December 2023

The transient receptor potential melastatin 4 (TRPM4) channel contributes extensively to cardiac electrical activity, especially cardiomyocyte action potential formation. Mechanical stretch can induce changes in heart rate and rhythm, and the mechanosensitive channel Piezo1 is expressed in many cell types within the myocardium. Our previous study showed that TRPM4 and Piezo1 are closely co‐localized in the t‐tubules of ventricular cardiomyocytes and contribute to the Ca2+‐dependent signalling cascade that underlies hypertrophy in response to mechanical pressure overload. However, there was no direct evidence showing that Piezo1 activation was related to TRPM4 activation in situ. In the present study, we employed the HL‐1 mouse atrial myocyte‐like cell line as an in vitro model to investigate whether Piezo1–TRPM4 coupling can affect action potential properties. We used the small molecule Piezo1 agonist, Yoda1, as a surrogate for mechanical stretch to activate Piezo1 and detected the action potential changes in HL‐1 cells using FluoVolt, a fluorescent voltage sensitive dye. Our results demonstrate that Yoda1‐induced activation of Piezo1 changes the action potential frequency in HL‐1 cells. This change in action potential frequency is reduced by Piezo1 knockdown using small intefering RNA. Importantly knockdown or pharmacological inhibition of TRPM4 significantly affected the degree to which Yoda1‐evoked Piezo1 activation influenced action potential frequency. Thus, the present study provides in vitro evidence of a functional coupling between Piezo1 and TRPM4 in a cardiomyocyte‐like cell line. The coupling of a mechanosensitive Ca2+ permeable channel and a Ca2+‐activated TRP channel probably represents a ubiquitous model for the role of TRP channels in mechanosensory transduction.

image

Key points

The transient receptor potential melastatin 4 (TRPM4) and Piezo1 channels have been confirmed to contribute to the Ca2+‐dependent signalling cascade that underlies cardiac hypertrophy in response to mechanical pressure overload. However, there was no direct evidence showing that Piezo1 activation was related to TRPM4 activation in situ.

We employed the HL‐1 mouse atrial myocyte‐like cell line as an in vitro model to investigate the effect of Piezo1–TRPM4 coupling on cardiac electrical properties.

The results show that both pharmacological and genetic inhibition of TRPM4 significantly affected the degree to which Piezo1 activation influenced action potential frequency in HL‐1 cells.

Our findings provide in vitro evidence of a functional coupling between Piezo1 and TRPM4 in a cardiomyocyte‐like cell line.

The coupling of a mechanosensitive Ca2+ permeable channel and a Ca2+‐activated TRP channel probably represents a ubiquitous model for the role of TRP channels in mechanosensory transduction in various (patho)physiological processes.
A Foundry Cost and Accounting System
Authors: Bird William W.
Published: December 2023

In this paper the author outlines the foundry cost and accounting system which has been developed as a result of experiments carried on in connection with the commercial foundry at the Worcester Polytechnic Institute.

The system, it is stated, is giving good satisfaction, the results being fairly accurate and the comparative monthly data which it keeps before the foundry officials having been found to be thoroughly reliable as a signal system. All of the work involved can be done by the regular clerical force in a small amount of extra time, and the services of an expert accountant are not required.
A Self-Adjusting Spring Thrust Bearing
Authors: Reist H. G.
Published: December 2023

A careful study of the difficulties experienced with the types of thrust bearings used in supporting the heavy loads of water wheels and the electric generators driven by them, led the author to design the flexible bearing described in the paper.

This bearing consists of a runner of a special grade of cast iron resting on a thin steel ring with a babbitted surface. The babbitted stationary ring, in turn, rests on a large number of short helical springs (ordinarily wound of ½-in. wire, 2 in. in diameter and 1½ in. long) and is held against rotation by dowel pins. A saw cut through one side does away with any tendency to dish with a change in temperature. This construction prevents the possibility of undue pressure at any point and compels each element of the surface to carry its share of the load.

Advantages to be derived from the use of such bearings are set forth and figures are given showing a reduction in friction accompanying increased unit pressure. Two designs are described and illustrated.
The Chemical and Physical Control of Boiler Operation: Including the Application of Simple Formulae for Estimating the Heat-Loss Items, etc.
Authors: Uehling E. A.
Published: December 2023

The economical status of a boiler plant can be approximately determined by either of two methods: (a) the mechanical method, based on the heat utilized; and (b) the chemical and physical method, based on the heat wasted. In the former, reliance is placed on the coal weigher and the water meter or steam-flow meter; in the latter the CO2 meter and pyrometer are used.

The author discusses the advantages and disadvantages of both methods and shows that while each is necessary for complete results, the chemical and physical method gives more directly useful information. He emphasizes the facts that no wholesale method is adequate; that every boiler must be treated individually and that it must be known what every boiler is doing all the time and adjustments made to keep the results right.

Examples are given of the application of information shown by charts from recording instruments to control of firing. The reliability of the chemical method of control is discussed at length. The author then shows by actual numerical examples the application of formulas which he has derived to data taken from autographic records of CO2.
Standards for Large Taper Shanks and Sockets
Authors: Burlingame Luther D.
Published: December 2023

War needs have demanded the construction of machine tools embodying taper shanks and sockets of larger dimensions than it has been customary to use. Most of the tapers established in the early days present irregular variations in size and in depth, even within the same system, and the application to the large sizes of the rules followed in proportioning these early types does not give the dimensions required to meet the new conditions. To supply this deficiency, the Brown & Sharpe Mfg. Co., after a careful study of the present established tapers and of the experience of several prominent manufacturers, has developed the set of “Magnum” standard tapers described at length in the paper.

In these tapers the diameters at the large end vary from 4 to 14 in. and those at the small end from 3¼ to 12 in. The depth of taper is made equal to twice the diameter of the large end plus 4 in. The selected standard taper is ¾ in. per ft.
Advantages of High Pressure and Superheat as Affecting Steam-Plant Efficiency
Authors: Berg Eskil
Published: December 2023

After pointing out that steam turbines having a thermodynamic efficiency of nearly 90 per cent are available and that this figure permits of but slight increase through improvement, the author gives calculations showing the gains in fuel economy that may be obtained by the use of higher steam pressures and by the application of superheat. He further shows that a combination of both will give the best results and that, assuming a turbine efficiency of 85 per cent, a boiler (oil-fired) efficiency of 88 per cent, 800 lb. pressure and a steam temperature of 800 deg. fahr., the steam process compares very favorably with the results obtained with Diesel engines when it is considered that fuel for the latter is 50 per cent higher in price than that which can be satisfactorily burned under a boiler.
Machine-Shop Organization
Authors: Kent Fred G.
Published: December 2023

This paper seeks to set forth the fundamentals of a typical machine-shop organization.

It begins with a discussion of the methods for introducing changes in the way of reorganization, has something to say about the kind of man who does the job and how he gets started; then goes on to an analysis of the organization by departments.

Each department is described so as to show its importance, its special duties and responsibilities, and its relation to the whole.

Fig. 1 shows how this analysis is developed.
The Relation of Port Area to the Power of Gas Engines and its Influence on Regulation
Authors: Du Priest J. R.
Published: December 2023

Any system of connecting up the governor of a gas engine to the throttle valve which gives equal changes in port area for equal changes in the governor speed, will make the regulation of the engine very sensitive at light loads and too slow at heavy loads.

The object of this paper is to present a method of determining the port area required for any fractional load on a throttling gas engine operating on the four-stroke cycle, and to suggest a means of admitting the fuel so as to get the same degree of speed regulation throughout the full range of load.

The author has made an extended study of the working of a 16½ × 24-in. horizontal double-acting tandem throttling engine, running on natural gas at 180 r.p.m., and from a consideration of the data obtained in tests and the characteristic curve of the governor used, has devised a method by means of which the relation between the travel of the governor collar and port area for a given power can be determined. A governing mechanism may then be designed which will give equal changes of load for equal movements of the collar, or the ports may be so shaped that equal changes in governor-collar travel will give equal movements of the valve, but at the same time give the proper port area for equal changes in power delivered.
The Steam Motor in the Automotive Field
Authors: Adams E. T.
Published: December 2023

The tremendous increase in the demand for automotive power has outdistanced the ability of the gasoline engine to meet this demand, chiefly on account of the condition that the supply of fuel is not now equal to the requirements.

The steam unit has many advantages for automotive service. Its high torque at low speed, its overload capacity, its smooth, flexible speed and power control have remained the standards of excellence, reached for but never attained by any gasoline motor.

The design of the steam unit is simple and many features of construction have been introduced which tend toward long life and low cost of upkeep.

Numbers of new steam trucks, tractors and pleasure cars are in service, or in process of manufacture or design. This effect and this demand will have a profound influence on the automotive industry.
The Engineer, the Cripple and the New Education
Authors: Gilbreth Frank B. , Gilbreth L. M.
Published: December 2023

This paper is a progress report and states definitely the work that the engineer should do to help the cripple to be independent of all charity. It states how the cripple can be enabled to compete successfully with normal workers in the trades at the present time. It calls attention to the fact that the cripple after receiving intensive education by means of micromotion study is able to earn more than normal workers who have not received such education.

The war has made an upheaval in many methods, particularly those of education. After the war the intensive methods now used in our emergency will be used permanently. These methods are not transitory. They will remain because they are more efficient.

The intensive education in motion study of the one best way to do work, now being done for the cripple, is the model for all the intensive training of the nation’s workers after peace comes — that they may become more efficient and more productive and suffer less fatigue. The military cripple will thus have served his country doubly.
Critical Thinking Assessment in Engineering Education: A Scopus-Based Literature Review
Authors: Deo Saurabh , Hölttä-Otto Katja
Published: December 2023

Critical Thinking (CT) skills are highly valued by employers, leading to their integration into engineering education through various design- and problem-based approaches. Despite their recognized importance, the varying perceptions of CT present challenges in achieving a unified approach to its development and assessment. This paper reviews CT assessment in engineering education, particularly mapping Facione's CT skills with assessment approaches to discern how CT is evaluated. We conducted a systematic keyword search in the SCOPUS database and identified 462 articles from 2010 to March 2023. These were reviewed and distilled down to 80 articles included in this study. We find that CT has been recognized as an essential skill set, but there are no consistent definitions or means to assess it. Further, while CT is a multifaced skill, we find that very few assessment methods assess CT holistically. We identify three goals for CT assessment: (1) understand and recognize CT, (2) demonstrate CT, and (3) identify if CT has changed due to intervention. We discuss how different assessment approaches, including rubrics, surveys, standardized tests, and customized assessments, have been used and propose recommendations to support reaching a better understanding of CT assessment in engineering education. Further research is needed to understand better how these skills can be taught and assessed as part of engineering education to meet the needs of employers.
Optimization of Tooth Profile Modification Amount and Manufacturing Tolerance Allocation for Rotate Vector Reducer Under Reliability Constraint
Authors: Li Yutao , Su Yuewen , Wang Shaohu
Published: December 2023

Rotate vector (RV) reducer is mainly applied in high-precision transmission. Its manufacturing errors strongly influence transmission accuracy. In order to select the optimal gear profile parameters and manufacturing accuracy to meet the transmission conditions in actual machining, a model of gear tooth contact analysis of involute and cycloid transmission considering tooth profile modification and manufacturing errors was established according to the principle of coordinate transformation and conjugate contact of gear. The sensitivity of different manufacturing errors to transmission errors was analyzed. At the same time, the optimization method of gear tooth profile modification parameters and manufacturing accuracy configuration under transmission reliability constraints was designed. The results showed that based on the optimization calculation of samples by the DIRECT algorithm, it was possible to obtain a set of RV reducer modification parameters and manufacturing tolerance bands with the lowest manufacturing cost under the condition of transmission accuracy. The selected parameters had high-reliability characteristics. Therefore, this method provides a theoretical optimization reference for manufacturing high-reliability RV reducer.
Data-Driven Modeling of the Nonlinear Dynamics of Passive Lower-Limb Prosthetic Systems
Authors: Donahue Seth , Kingsbury Trevor , Takahashi Kota , Major Matthew J.
Published: December 2023

Modeling the nonlinear dynamics of prosthetic feet is an important tool for linking prosthesis mechanical properties to end-user outcomes. There has been a renewed interest in data-driven modeling of dynamical systems, with the development of the Extended Dynamic Mode Decomposition with control (eDMDc) and the Sparse Identification of Nonlinear Dynamics with Control (SINDYc). These algorithms do not require prior information about the system, including mechanical configuration, and are data-driven. The aim of this study was to assess the feasibility and accuracy of applying these data-driven algorithms to model prosthesis nonlinear load response dynamics. Different combinations of a dynamic response foot, a hydraulic ankle unit, and three shock-absorbing pylons of varying resistance were tested loaded and unloaded at three orientations reflecting critical positions during the stance phase of walking. We tested two different data-driven algorithms, the eDMDc, with two different kernels, and the SINDYc, which regresses the coefficients for a nonlinear ordinary differential equation. Each algorithm was able to model the nonlinear prosthesis dynamics, but the SINDYc outperformed the eDMDc methods with a root mean square error across orientations < 1.50 mm and a maximum error in peak displacement of 1.28 mm or 4% relative error. From the estimated SINDYc governing equation of the system dynamics, we were able to simulate different mechanical behavior by systematically varying parameter values, which offers a novel foundation for designing, controlling, and classifying prosthetic systems ultimately aimed at improving prosthesis user outcomes.
The magmatic system under Hunga volcano before and after the 15 January 2022 eruption
Authors: Le Mével Hélène , Miller Craig A. , Ribó Marta , Cronin Shane , Kula Taaniela
Published: December 2023

One of the largest explosive eruptions instrumentally recorded occurred at Hunga volcano on 15 January 2022. The magma plumbing system under this volcano is unexplored because of inherent difficulties caused by its submarine setting. We use marine gravity data derived from satellite altimetry combined with multibeam bathymetry to model the architecture and dynamics of the magmatic system before and after the January 2022 eruption. We provide geophysical evidence for substantial high–melt content magma accumulation in three reservoirs at shallow depths (2 to 10 kilometers) under the volcano. We estimate that less than ~30% of the existing magma was evacuated by the main eruptive phases, enough to trigger caldera collapse. The eruption and caldera collapse reorganized magma storage, resulting in an increased connectivity between the two spatially distinct reservoirs. Modeling global satellite altimetry–derived gravity data at undersea volcanoes offer a promising reconnaissance tool to probe the subsurface for eruptible magma.
Light-induced ultrafast spin transport in multilayer metallic films originates from
sp
-
d
spin exchange coupling
Authors: Chen Zhanghui , Luo Jun-Wei , Wang Lin-Wang
Published: December 2023

Ultrafast interaction between the femtosecond laser pulse and the magnetic metal provides an efficient way to manipulate the magnetic states of matter. Numerous experimental advancements have been made on multilayer metallic films in the last two decades. However, the underlying physics remains unclear. Here, relying on an efficient ab initio spin dynamics simulation algorithm, we revealed the physics that can unify the progress in different experiments. We found that light-induced ultrafast spin transport in multilayer metallic films originates from the
sp
-
d
spin-exchange interaction, which can induce an ultrafast, large, and pure spin current from ferromagnetic metal to nonmagnetic metal without charge carrier transport. The resulting trends of spin demagnetization and spin flow are consistent with most experiments. It can explain a variety of ultrafast light-spin manipulation experiments with different systems and different pump-probe technologies, covering a wide range of work in this field.
Drosophila
Amus and Bin3 methylases functionally replace mammalian MePCE for capping and the stabilization of U6 and 7SK snRNAs
Authors: Peng Qiu , Wang Yiqing , Xiao Ying , Chang Hua , Luo Shishi , Wang Danling , Rong Yikang S.
Published: December 2023

U6 and 7SK snRNAs have a 5′ cap, believed to be essential for their stability and maintained by mammalian MePCE or
Drosophila
Bin3 enzymes. Although both proteins are required for 7SK stability, loss of neither destabilizes U6, casting doubts on the function of capping U6. Here, we show that the
Drosophila
Amus protein, homologous to both proteins, is essential for U6 but not 7SK stability. The loss of U6 is rescued by the expression of an Amus-MePCE hybrid protein harboring the methyltransferase domain from MePCE, highlighting the conserved function of the two proteins as the U6 capping enzyme. Our investigations in human cells establish a dependence of both U6 and 7SK stability on MePCE, resolving a long-standing uncertainty. While uncovering a division of labor of Bin3/MePCE/Amus proteins, we found a “Bin3-Box” domain present only in enzymes associated with 7SK regulation. Targeted mutagenesis confirms its importance for Bin3 function, revealing a possible conserved element in 7SK but not U6 biology.
Food web structure for high carbon retention in marine plankton communities
Authors: Kang Hee Chang , Jeong Hae Jin , Ok Jin Hee , Lim An Suk , Lee Kitack , You Ji Hyun , Park Sang Ah , Eom Se Hee , Lee Sung Yeon , Lee Kyung Ha , Jang Se Hyeon , Yoo Yeong Du , Lee Moo Joon , Kim Kwang Young
Published: December 2023

Total annual net primary productions in marine and terrestrial ecosystems are similar. However, a large portion of the newly produced marine phytoplankton biomass is converted to carbon dioxide because of predation. Which food web structure retains high carbon biomass in the plankton community in the global ocean? In 6954 individual samples or locations containing phytoplankton, unicellular protozooplankton, and multicellular metazooplankton in the global ocean, phytoplankton-dominated bottom-heavy pyramids held higher carbon biomass than protozooplankton-dominated middle-heavy diamonds or metazooplankton-dominated top-heavy inverted pyramids. Bottom-heavy pyramids predominated, but the high predation impact by protozooplankton on phytoplankton or the vertical migration of metazooplankton temporarily changed bottom-heavy pyramids to middle-heavy diamonds or top-heavy inverted pyramids but returned to bottom-heavy pyramids shortly. This finding has profound implications for carbon retention by plankton communities in the global ocean.
Draft genomes of 12
Bifidobacterium
isolates from human IBD fecal samples
Authors: Souza Cole E. , Jacobson Nicole E. , An Michelle A. , Droit Lindsay , Vega Alejandro A. , Rosales Mariel , Mihindukulasuriya Kathie A. , Pastrana Karina , Handley Scott A. , Parkes Miles , Rimmer Joanna , Wang David , Dinsdale Elizabeth A. , A. Edwards Robert , Segall Anca M.
Published: December 2023

Twelve
Bifidobacterium
strains were isolated from fecal samples of inflammatory bowel disease patients and matched “household control” individuals. These include the species
Bifidobacterium adolescentis
,
Bifidobacterium animalis
,
Bifidobacterium breve
,
Bifidobacterium catenulatum
,
Bifidobacterium longum
, and
Bifidobacterium pseudocatenulatum
.
A high-quality whole-genome sequence, assembly, and gene annotation of
Fusarium oxysporum
f. sp.
vasinfectum
(Fov) race 1 from California
Authors: Jobe Timothy O. , Ulloa Mauricio , Ellis Margaret L.
Published: December 2023

Fusarium wilt [
Fusarium oxysporum
f. sp.
vasinfectum
(FOV)] in cotton is a widespread soilborne pathogen that causes vascular plant disease and is responsible for substantial crop losses worldwide. FOV race 1 (FOV1) is well established across almost all cotton production regions, especially in the USA. Herein, we report a high-quality whole-genome sequence, assembly, and gene annotation of a FOV1 isolate from California.
Draft genome sequences of two
Salmonella
Uzaramo isolates from poultry in South Africa
Authors: Karama Musafiri , Lawal Opeyemi U. , Parreira Valeria R. , Soni Mitra , Chen Yanhong , Cenci-Goga Beniamino T. , Grispoldi Luca , Greyling Janita , Goodridge Lawrence
Published: December 2023

Salmonella enterica
is a zoonotic pathogen and a leading cause of foodborne gastroenteritis in humans. Here, we report the draft genome sequences of two
Salmonella
Uzaramo isolates, which were isolated from poultry organs during routine post-mortem examination in South Africa. Currently, whole-genome sequences on
Salmonella
Uzaramo are scanty.
CSFV restricts necroptosis to sustain infection by inducing autophagy/mitophagy-targeted degradation of RIPK3
Authors: Wu Keke , Li Bingke , Zhang Xiaoai , Fang Yiqi , Zeng Sen , Hu Wenshuo , Liu Xiaodi , Liu Xueyi , Lu Zhimin , Li Xiaowen , Chen Wenxian , Qin Yuwei , Zhou Bolun , Zou Linke , Zhao Feifan , Yi Lin , Zhao Mingqiu , Fan Shuangqi , Chen Jinding
Published: December 2023

As an essential component of host defense against infection, necroptosis is a novel highly regulated mode of cell death that is mediated by signaling complexes containing receptor-interacting protein kinase 1 (RIPK1) and RIPK3. Lymphocyte depletion and immunosuppression are typical clinical features of pigs infected with classical swine fever virus (CSFV). Here, we provide the first evidence for the involvement of necroptosis in the necrosis of T lymphocytes in the spleen and peripheral blood of pigs infected
in vivo
with CSFV. However, it is true for some viruses with non-cytopathic effects, including CSFV, to balance host defense against infection.
In vitro
, the induction of autophagy by CSFV at a later stage of infection clearly restricts necroptosis. Mechanistic studies revealed that CSFV NS4A protein promoted tripartite motif-containing 25 expression, synergistically induced the occurrence of mitophagy, targeted the autophagic degradation of RIPK3 to block the progression of necroptosis occurrence, and achieved persistent viral infection. Interestingly, we found that RIPK3 was able to specifically localize at the outer mitochondrial membrane, and the autophagy receptor NDP52 was most likely involved in the autophagic degradation of RIPK3 during CSFV infection. Our findings provide evidence supporting that the CSFV-induced autophagy pathway plays an important role in counteracting host cell necrosis, enriching our knowledge of pathogens that may subvert and evade necroptosis this host defense, and shedding new light on understanding the mechanisms of T lymphocyte exhaustion and immunosuppression during CSFV infection.

IMPORTANCE

CSFV infection in pigs causes persistent high fever, hemorrhagic necrotizing multi-organ inflammation, and high mortality, which seriously threatens the global swine industry. Cell death is an essential immune response of the host against pathogen invasion, and lymphopenia is the most typical clinical feature in the acute phase of CSFV infection, which affects the initial host antiviral immunity. As an “old” virus, CSFV has evolved mechanisms to evade host immune response after a long genetic evolution. Here, we show that necroptosis is a limiting host factor for CSFV infection and that CSFV-induced autophagy can subvert this host defense mechanism to promote its sustained replication. Our findings reveal a complex link between necroptosis and autophagy in the process of cell death, provide evidence supporting the important role for CSFV in counteracting host cell necrosis, and enrich our knowledge of pathogens that may subvert and evade this host defense.
Genome sequence-based identification of
Enterobacter
strains and description of
Enterobacter pasteurii
sp. nov.
Authors: Rahi Praveen , Mühle Estelle , Scandola Cyril , Touak Gerald , Clermont Dominique
Published: December 2023

Members of the
Enterobacter cloacae
complex (ECC) are almost ubiquitous in nature and can act as pathogens. In this study, we used a polyphasic taxonomy approach to establish the accurate taxonomic position of six strains within the ECC. Notably, the 16S rRNA gene-based phylogeny failed to group all
Enterobacter
species into a monophyletic cluster. As an alternative to this, we explored genome sequence-based phylogenetic approaches. The bac120 gene-based phylogeny successfully grouped all
Enterobacter
species into a monophyletic cluster, although some species-level clustering conflicted with average nucleotide identity (ANI) values. Furthermore, the
Enterobacter
-specific core gene phylogeny resolved all species, aligning with ANI results. Three strains were identified as
Enterobacter asburiae
, while strain P99 was classified as “
Enterobacter xiangfangensis
” and strain C45 as
Enterobacter quasihormaechei
. Conversely, strain A-8
T
formed a distinct cluster in all phylogenies, with ANI and digital DNA-DNA hybridization (dDDH) values below the species threshold (<92% and <44%, respectively) with all known
Enterobacter
species. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry biotyper results confirmed that all strains belonged to the ECC. However, the comparison of mean spectrum profile of strain A-8
T
with those of other strains revealed the presence of 18 unique peaks, highlighting its distinct protein profile. Based on comprehensive genotypic and phenotypic characterizations, we propose that strain A-8
T
is a new species of the genus
Enterobacter
, which is named
Enterobacter pasteurii
sp. nov. The type strain is A-8
T
(CIP 103550
T
; ATCC 23355
T
; DSM 26481
T
; and WDCM 00082
T
). This study advances our understanding of the ECC, emphasizing the need for multidimensional taxonomic techniques and contributing to the better management of microbial resource centers.

IMPORTANCE

Accurate taxonomy is essential for microbial biological resource centers, since the microbial resources are often used to support new discoveries and subsequent research. Here, we used genome sequence data, alongside matrix-assisted laser desorption/ionization time-of-flight mass spectrometer biotyper-based protein profiling, to accurately identify six
Enterobacter cloacae
complex strains. This approach effectively identified distinct species within the
E. cloacae
complex, including
Enterobacter asburiae
, “
Enterobacter xiangfangensis
,” and
Enterobacter quasihormaechei
. Moreover, the study revealed the existence of a novel species within the
Enterobacter
genus, for which we proposed the name
Enterobacter pasteurii
sp. nov. In summary, this study demonstrates the significance of adopting a genome sequence-driven taxonomy approach for the precise identification of bacterial strains in a biological resource center and expands our understanding of the
E. cloacae
complex.
Klebsiella pneumoniae
OmpR facilitates lung infection through transcriptional regulation of key virulence factors
Authors: Janssen Axel B. , de Bakker Vincent , Aprianto Rieza , Trebosc Vincent , Kemmer Christian , Pieren Michel , Veening Jan-Willem
Published: December 2023

Bacteria must adapt to the stresses of specific environmental conditions to survive. This adaptation is often achieved by altering gene expression through two-component regulatory systems (TCSs). In Gram-negative bacteria, the response to environmental changes in osmolarity and pH is primarily mediated by the EnvZ/OmpR TCS. Although the functioning of EnvZ/OmpR has been well characterized in
Escherichia coli
,
Salmonella enterica
, and the
Yersinia
genus, the importance of EnvZ/OmpR TCS in the opportunistic human pathogen
Klebsiella pneumoniae
has been limitedly studied. Here, we investigated the importance of EnvZ/OmpR in
K. pneumoniae
for fitness, gene regulation, virulence, and infection. Through the generation of a markerless
ompR
-deletion mutant, we show that overall fitness of
K. pneumoniae
is not impacted
in vitro
. Using dual RNA sequencing of
K. pneumoniae
co-incubated with human lung epithelial cells, we demonstrate that the
K. pneumoniae
OmpR regulon includes important virulence factors but shows otherwise limited overlap with the regulons of other Gram-negative bacteria. In addition, we show that deletion of
ompR
in
K. pneumoniae
leads to a stronger antibacterial transcriptional response in human lung epithelial cells. Lastly, we show that OmpR is crucial for
K. pneumoniae
virulence and infection through a murine lung infection model. As the adaptation of commensal bacteria to specific niches is mediated by TCSs, we show that EnvZ/OmpR plays a crucial role in successful lung infection, as well as in virulence. These results suggest that OmpR is an interesting target for anti-virulence drug discovery programs.

IMPORTANCE

Bacteria use two-component regulatory systems (TCSs) to adapt to changes in their environment by changing their gene expression. In this study, we show that the EnvZ/OmpR TCS of the clinically relevant opportunistic pathogen
Klebsiella pneumoniae
plays an important role in successfully establishing lung infection and virulence. In addition, we elucidate the
K. pneumoniae
OmpR regulon within the host. This work suggests that
K. pneumoniae
OmpR might be a promising target for innovative anti-infectives.
Comparative Analysis of Weld Microstructure in Ti-6Al-4V Samples Produced by Rolling and Wire-Feed Electron Beam Additive Manufacturing
Authors: Panin A. V. , Kazachenok M. S. , Krukovsky K. V. , Kazantseva L. A. , Martynov S. A.
Published: December 2023

The microstructure and phase composition of electron beam welded Ti-6Al-4V titanium alloy were studied by optical and scanning electron microscopy, backscattered electron diffraction, and X-ray diffraction analysis. Deep-penetration electron beam welds were made in a single pass on rectangular Ti-6Al-4V samples obtained by rolling and wire-feed electron beam additive manufacturing. It was found that the weld width in the 3D printed Ti-6Al-4V samples is greater than in the rolled material. The influence of the vapor capillary on the size, shape and structure of primary β grains formed in the fusion zone was shown. The variation of the penetration coefficient, volume fraction of the residual β phase, and residual stresses along the weld length was studied for Ti-6Al-4V samples obtained by both rolling and 3D printing.
‘Far Away from Home’: adolescent inpatient admissions far from home, out of area or to adult wards: a national surveillance study
Authors: Holland Josephine , Roe James , Guo Boliang , Dasilva-Ellimah Morenike , Burn Anne-Marie , Dubicka Bernadka , Ford Tamsin , Wagner Adam P , Nazir Saeed , James Anthony , Morriss Richard , Sayal Kapil
Published: December 2023

Background

The increasing prevalence and acuity of mental disorders among children and adolescents have placed pressure on services, including inpatient care, and resulted in young people being admitted at-distance or to adult wards. Little empirical research has investigated such admissions.

Objective

To determine the incidence, clinical characteristics and 6-month outcomes of patients aged 13–17 years old admitted at-distance (>50 miles from home or out of region) to general adolescent psychiatric wards or to adult psychiatric wards.

Methods

Surveillance over 13 months (February 2021–February 2022) using the Child and Adolescent Psychiatry Surveillance System including baseline and 6-month follow-up questionnaires.

Findings

Data were collected about 290 admissions (follow-up rate 99% (288 of 290); sample were 73% female, mean age 15.8 years). The estimated adjusted yearly incidence of at-distance admission was 13.7–16.9 per 100 000 young people 13–17 years old. 38% were admitted >100 miles from home and 8% >200 miles. The most common diagnoses at referral were depression (34%) and autism spectrum disorder (20%); other common referral concerns included suicide risk (80%), emotional dysregulation (53%) and psychotic symptoms (22%). Over two-fifths (41%) waited ≥1 week for a bed, with 55% waiting in general hospital settings. At 6-month follow-up, 20% were still in hospital, the majority in at-distance placements.

Conclusions

At-distance and adult ward admissions for patients aged <18 remain an ongoing challenge for healthcare provision and have an impact on acute hospital resource use.

Clinical implications

Long waits in non-specialist settings increase pressure across the healthcare system, highlighting the need to improve local service provision and commissioning to reflect identified clinical needs.
Impact of an Acceptance and Commitment Therapy programme on HbA1c, self-management and psychosocial factors in adults with type 1 diabetes and elevated HbA1c levels: a randomised controlled trial
Authors: Wijk Ingrid , Amsberg Susanne , Johansson Unn-Britt , Livheim Fredrik , Toft Eva , Anderbro Therese
Published: December 2023

Objective

To evaluate the impact of an Acceptance and Commitment Therapy (ACT) programme, tailored for people living with type 1 diabetes, on glycated haemoglobin (HbA1c), self-management and psychosocial factors among individuals with HbA1c>60 mmol/mol compared with treatment as usual (TAU).

Setting

An endocrinologic clinic in Sweden.

Participants

In this randomised controlled trial, 81 individuals with type 1 diabetes, aged 18–70 years with HbA1c>60 mmol/mol, were randomly assigned to either an ACT group intervention or TAU. Exclusion criteria were: unable to speak Swedish, untreated or severe psychiatric disease, cortisone treatment, untreated thyroid disease and newly started insulin pump therapy. At the 2-year follow-up, HbA1c was measured in 26 individuals.

Intervention

The ACT programme comprised seven 2-hour sessions held over 14 weeks and focused on acceptance of stressful thoughts and emotions, and to promote value-based committed action.

Outcomes

The primary outcome was HbA1c, and the secondary outcomes were measures of depression, anxiety, general stress, fear of hypoglycaemia, diabetes distress, self-care activities, psychological flexibility (general and related to diabetes) and quality of life. The primary endpoint was HbA1c 2 years after the intervention programme. Linear mixed models were used to test for an interaction effect between measurement time and group.

Results

Likelihood ratio test of nested models demonstrated no statistically significant interaction effect (χ2=0.49, p=0.485) between measurement time and group regarding HbA1c. However, a statistically significant interaction effect (likelihood ratio test χ2=12.63, p<0.001) was observed with improved scores on The Acceptance and Action Questionnaire in the intervention group after 1 and 2 years.

Conclusions

No statistically significant difference was found between the groups regarding the primary outcome measure, HbA1c. However, the ACT programme showed a persistent beneficial impact on psychological flexibility in the intervention group. The dropout rate was higher than expected, which may indicate a challenge in this type of study.

Trial registration number

NCT02914496.
NIMBUS study protocol: a single-centre feasibility study of non-invasive monitoring with bowel ultrasound in paediatric inflammatory bowel disease
Authors: Green Zachary , Mayberry Ella , Ashton James John , Beattie R Mark , Evans Alison , Wahid Amar , Edwards Martin Oliver
Published: December 2023

Introduction

Incidence of inflammatory bowel disease (IBD) is increasing in childhood and treatment increasingly targets mucosal healing. Monitoring bowel inflammation requires endoscopy or MRI enterography which are invasive, expensive and have long waiting lists.

We aim to examine the feasibility of a non-invasive monitoring tool—bowel ultrasound (BUS)—in children with IBD and explore correlations with inflammatory markers and disease activity measures. Some BUS criteria have been found to correlate with these markers; however, this has not been validated in children.

We aim to examine the feasibility of BUS for monitoring inflammation in this population; highlighting useful parameters for this purpose. We aim to inform a larger scale randomised controlled trial using BUS.

Methods and analysis

This prospective observational feasibility study will be carried out over 24 months at the Noah’s Ark Children’s Hospital for Wales, Cardiff; with the endpoint recruitment of 50 participants. Children aged 2–18 years with a modified Porto criteria diagnosis of IBD will be included.

Patients without IBD or who have previously undergone IBD-related surgery will be excluded; as will families unable to give informed consent.

Ultrasound scan images and reports will be collected, as well as laboratory results and clinical outcomes.

The primary aim will assess the feasibility of targeted BUS for disease monitoring; including recruitment statistics. The secondary aims will involve data collection and correlation analysis for targeted ultrasound parameters, biomarkers, disease activity scores and prediction of changes in treatment. The statistical methods will include: feasibility metrics, descriptive statistics, cross-tabulation and χ2analysis, correlation analysis, regression analysis.

Ethics and dissemination

Ethical approval is granted by NHS Research Ethics Committee. The sponsor is Cardiff and Vale University Health Board. We will publish the results in a peer-reviewed medical journal.

Trial registration number

NCT05673278.
Impact of pelvic radiation therapy in patients with early neuroendocrine cervical carcinoma and no residual disease in the radical hysterectomy specimen: a NeCTuR study
Authors: Khurana Nilsha , Frumovitz Michael , Flores Legarreta Alejandra , Ramalingam Preetha , Jhingran Anuja , Bhosale Priya , Saab Reem , Gonzales Naomi R R , Chisholm Gary B , Salvo Gloria
Published: December 2023

Objective

The impact of adjuvant pelvic radiation therapy on the rate and location of recurrences was evaluated in patients with early-stage (IA1–IB2) neuroendocrine cervical carcinoma who underwent prior conization or polypectomy with no residual disease and negative nodes in the subsequent upfront radical hysterectomy specimen. As a secondary objective, disease-free and overall survival were analyzed.

Methods

We searched the Neuroendocrine Cervical Tumor Registry (NeCTuR) to identify patients with clinical early-stage neuroendocrine cervical carcinoma with no residual disease in the specimen from upfront radical surgery and negative nodes. Patients who received pelvic radiation therapy were compared with those who did not, regardless of whether they received adjuvant chemotherapy.

Results

Twenty-seven patients met the inclusion criteria, representing 17% of all patients with clinical early-stage disease who underwent upfront radical hysterectomy included in the NeCTuR registry. The median age was 36.0 years (range 26.0–51.0). Six (22%) patients had stage IA, 20 (74%) had stage IB1, and one (4%) had stage IB2 disease. Seven (26%) patients received adjuvant radiation therapy and 20 (74%) did not. All seven patients in the radiation group and 14 (70%) in the no-radiation group received adjuvant chemotherapy (p=0.16). Fifteen percent (4/27) of patients had a recurrence, 14% (1/7) in the radiation group and 15% (3/20) in the no-radiation group (p=0.99). In the radiation group the recurrence was outside the pelvis, and in the no-radiation group, 67% (2/3) recurred outside the pelvis and 33% (1/3) recurred both inside and outside the pelvis (p=0.99). In the radiation group the 5-year disease-free and overall survival rates were 100% while, in the no-radiation group, the 5-year disease-free and overall survival rates were 81% (95% CI 61% to 100%) (p=0.99) and 80% (95% CI 58% to 100%) (p=0.95), respectively.

Conclusions

For patients with no residual disease and negative nodes in the upfront radical hysterectomy specimen, our study did not find that pelvic radiation therapy improves survival.
Effect of aerobic exercise training on pulse wave velocity in adults with and without long-term conditions: a systematic review and meta-analysis
Authors: Bakali Majda , Ward Thomas CJ , Daynes Enya , Jones Amy V , Hawthorne Grace M , Latimer Lorna , Divall Pip , Graham-Brown Matt , McCann Gerry P , Yates Thomas , Steiner Michael C , Evans Rachael Andrea
Published: December 2023

Rationale

There is conflicting evidence whether aerobic exercise training (AET) reduces pulse wave velocity (PWV) in adults with and without long-term conditions (LTCs).

Objective

To explore whether PWV improves with AET in adults with and without LTC, to quantify the magnitude of any effect and understand the influence of the exercise prescription.

Data sources

CENTRAL, MEDLINE and EMBASE were among the databases searched.

Eligibility criteria

We included studies with a PWV measurement before and after supervised AET of at least 3 weeks duration. Exclusion criteria included resistance exercise and alternative measures of arterial stiffness.

Design

Controlled trials were included in a random effects meta-analysis to explore the effect of AET on PWV. Uncontrolled studies were included in a secondary meta-analysis and meta-regression exploring the effect of patient and programme factors on change in PWV. The relevant risk of bias tool was used for each study design.

Results

79 studies (n=3729) were included: 35 controlled studies (21 randomised control trials (RCT) (n=1240) and 12 non-RCT (n=463)) and 44 uncontrolled (n=2026). In the controlled meta- analysis, PWV was significantly reduced following AET (mean (SD) 11 (7) weeks) in adults with and without LTC (mean difference −0.63; 95% CI −0.82 to −0.44; p<0.0001). PWV was similarly reduced between adults with and without LTC (p<0.001). Age, but not specific programme factors, was inversely associated with a reduction in PWV −0.010 (−0.020 to −0.010) m/s, p<0.001.

Discussion

Short-term AET similarly reduces PWV in adults with and without LTC. Whether this effect is sustained and the clinical implications require further investigation.