bluuebunny/crossref_metadata_2025 huggingface dataset:
VGLL3 expression is associated with macrophage infiltration and predicts poor prognosis in epithelial ovarian cancer
Authors: Haque Razaul , Lee Jaebon , Chung Joon-Yong , Shin Ha-Yeon , Kim Hyosun , Kim Jae-Hoon , Yun Jae Won , Kang Eun-Suk
Published: June 2023

Background/objective

High-grade serous ovarian carcinoma (HGSOC) is the most common histologic type of epithelial ovarian cancer (EOC). Due to its poor survival outcomes, it is essential to identify novel biomarkers and therapeutic targets. The hippo pathway is crucial in various cancers, including gynaecological cancers. Herein, we examined the expression of the key genes of the hippo pathway and their relationship with clinicopathological significance, immune cells infiltration and the prognosis of HGSOC.

Methods

The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) data were curated to analyse the mRNA expression as well as the clinicopathological association and correlation with immune cell infiltration in HGSOC. The protein levels of significant genes in the HGSOC tissue were analysed using Tissue Microarray (TMA)-based immunohistochemistry. Finally, DEGs pathway analysis was performed to find the signalling pathways associated with VGLL3.

Results

VGLL3 mRNA expression was significantly correlated with both advanced tumor stage and poor overall survival (OS) (p=0.046 and p=0.003, respectively). The result of IHC analysis also supported the association of VGLL3 protein with poor OS. Further, VGLL3 expression was significantly associated with tumor infiltrating macrophages. VGLL3 expression and macrophages infiltration were both found to be independent prognostic factors (p=0.003 and p=0.024, respectively) for HGSOC. VGLL3 was associated with four known and three novel cancer-related signalling pathways, thus implying that VGLL3 is involved in the deregulation of many genes and pathways.

Conclusion

Our study revealed that VGLL3 may play a distinct role in clinical outcomes and immune cell infiltration in patients with HGSOC and that it could potentially be a prognostic marker of EOC.
Association of extent of resection on recurrence-free survival and functional outcome in vestibular schwannoma of the elderly
Authors: Wang Sophie Shih-Yüng , Machetanz Kathrin , Ebner Florian , Naros Georgios , Tatagiba Marcos
Published: June 2023

Background

Despite the ongoing debate on the risk–benefit ratio of vestibular schwannoma (VS) treatment options, watchful observation and radiation are usually favored in the elderly (>65 years). If surgery is inevitable, a multimodal approach after deliberate subtotal resection has been described as a valid option. The relationship between the extent of resection (EOR) of surgical and functional outcomes and recurrence-free survival (RFS) remains unclear. This present study aims to evaluate the functional outcome and RFS of the elderly in relation to the EOR.

Methods

This matched cohort study analyzed all consecutive elderly VS patients treated at a tertiary referral center since 2005. A separate cohort (<65 years) served as a matched control group (young). Clinical status was assessed by the Charlson Comorbidity Index (CCI), the Karnofsky Performance (KPS), and the Gardner and Robertson (GR) and House & Brackmann (H&B) scales. RFS was evaluated by Kaplan–Meier analysis using contrast-enhanced magnetic resonance imaging to identify tumor recurrence.

Results

Among 2,191 patients, 296 (14%) patients were classified as elderly, of whom 133 (41%) were treated surgically. The elderly were characterized by a higher preoperative morbidity and worse gait uncertainty. Postoperative mortality (0.8% and 1%), morbidity (13% and 14%), and the functional outcome (G&R, H&B, and KPS) did not differ between the elderly and the young. There was a significant benefit in regard to the preoperative imbalance. Gross total resection (GTR) was accomplished in 74% of all cases. Lower grades of the EOR (subtotal and decompressive surgery) raised the incidence of recurrence significantly. Mean time to recurrence in the surgELDERLY was 67.33 ± 42.02 months and 63.2 ± 70.98 months in the surgCONTROL.

Conclusions

Surgical VS treatment aiming for complete tumor resection is feasible and safe, even in advanced age. A higher EOR is not associated with cranial nerve deterioration in the elderly compared to the young. In contrast, the EOR determines RFS and the incidence of recurrence/progression in both study cohorts. If surgery is indicated in the elderly, GTR can be intended safely, and if only subtotal resection is achieved, further adjuvant therapy, e.g., radiotherapy, should be discussed in the elderly, as the incidence of recurrence is not significantly lower compared to the young.
NLRX1 functions as a tumor suppressor in Pan02 pancreatic cancer cells
Authors: Nagai-Singer Margaret A. , Morrison Holly A. , Woolls Mackenzie K. , Leedy Katerina , Imran Khan Mohammad , Tupik Juselyn D. , Allen Irving C.
Published: June 2023

Pancreatic cancer is a deadly malignancy with limited treatment options. NLRX1 is a unique, understudied member of the Nod-like Receptor (NLR) family of pattern recognition receptors that regulates a variety of biological processes that are highly relevant to pancreatic cancer. The role of NLRX1 in cancer remains highly enigmatic, with some studies defining its roles as a tumor promoter, while others characterize its contributions to tumor suppression. These seemingly contradicting roles appear to be due, at least in part, to cell type and temporal mechanisms. Here, we define roles for NLRX1 in regulating critical hallmarks of pancreatic cancer using both gain-of-function and loss-of-function studies in murine Pan02 cells. Our data reveals that NLRX1 increases susceptibility to cell death, while also suppressing proliferation, migration, and reactive oxygen species production. We also show that NLRX1 protects against upregulated mitochondrial activity and limits energy production in the Pan02 cells. Transcriptomics analysis revealed that the protective phenotypes associated with NLRX1 are correlated with attenuation of NF-κB, MAPK, AKT, and inflammasome signaling. Together, these data demonstrate that NLRX1 diminishes cancer-associated biological functions in pancreatic cancer cells and establishes a role for this unique NLR in tumor suppression.
Pediatric antibiotic stewardship programs in Europe: a pilot survey among delegates of The European Academy of Pediatrics
Authors: Reingold Stephen M. , Grossman Zachi , Hadjipanayis Adamos , Del Torso Stefano , Valiulis Arunas , Dembinski Lukasz , Ashkenazi Shai
Published: June 2023

Background

Antimicrobial resistance (AMR) is one of the leading causes of morbidity and mortality worldwide. Efforts to promote the judicious use of antibiotics and contain AMR are a priority of several medical organizations, including the WHO. One effective way to achieve this goal is the deployment of antibiotic stewardship programs (ASPs). This study aimed to survey the current situation of pediatric ASPs in European countries and establish a baseline for future attempts to harmonize pediatric ASPs and antibiotic use in Europe.

Methods

A web-based survey was conducted among national delegates of the European Academy of Paediatrics (EAP). The survey assessed the presence of pediatric ASPs in the representatives’ countries in the inpatient and outpatient settings, the staff included in the programs, and their detailed activities regarding antibiotic use.

Results

Of the 41 EAP delegates surveyed, 27 (66%) responded. Inpatient pediatric ASPs were reported in 74% (20/27) countries, and outpatient programs in 48% (13/27), with considerable variability in their composition and activities. Guidelines for managing pediatric infectious diseases were available in nearly all countries (96%), with those for neonatal infections (96%), pneumonia (93%), urinary tract (89%), peri-operative (82%), and soft tissue (70%) infections being the most common. Pediatric ASPs were reported at the national (63%), institutional (41%), and regional/local (<15%) levels. Pediatricians with infectious disease training (62%) and microbiologists (58%) were the most common members of the program personnel, followed by physician leaders (46%), infectious disease/infection control physicians (39%), pharmacists (31%), and medical director representatives (15%). Activities of the pediatric ASPs included educational programs (85%), monitoring and reporting of antibiotic use (70%) and resistance (67%), periodic audits with feedback (44%), prior approval (44%), and post-prescription review of selected antibiotic agents (33%).

Conclusion

Although pediatric ASPs exist in most European countries, their composition and activities vary considerably across countries. Initiatives to harmonize comprehensive pediatric ASPs across Europe are needed.
Adaptive noise suppression for low-S/N microseismic data based on ambient-noise-assisted multivariate empirical mode decomposition
Authors: Yu Zhichao , Huang Yingkun , Fang Zisen , Tan Yuyang , He Chuan
Published: June 2023

Microseismic monitoring data may be seriously contaminated by complex and nonstationary interference noises produced by mechanical vibration, which significantly impact the data quality and subsequent data-processing procedure. One challenge in microseismic data processing is separating weak seismic signals from varying noisy data. To address this issue, we proposed an ambient-noise-assisted multivariate empirical mode decomposition (ANA-MEMD) method for adaptively suppressing noise in low signal-to-noise (S/N) microseismic data. In the proposed method, a new multi-channel record is produced by combining the noisy microseismic signal with preceding ambient noises. The multi-channel record is then decomposed using multivariate empirical mode decomposition (MEMD) into multivariate intrinsic mode functions (MIMFs). Then, the MIMFs corresponding to the main ambient noises can be identified by calculating and sorting energy percentage in descending order. Finally, the IMFs associated with strong interference noise, high-frequency and low-frequency noise are filtered out and suppressed by the energy percentage and frequency range. We investigate the feasibility and reliability of the proposed method using both synthetic data and field data. The results demonstrate that the proposed method can mitigate the mode mixing problem and clarify the main noise contributors by adding additional ambient-noise-assisted channels, hence separating the microseismic signal and ambient noise effectively and enhancing the S/Ns of microseismic signals.
Allelic haplotype combinations at the MS-P1 region, including P-class pentatricopeptide repeat family genes, influence wide phenotypic variation in pollen grain number through a cytoplasmic male sterility model in citrus
Authors: Goto Shingo , Fujii Hiroshi , Hamada Hiroko , Ohta Satoshi , Endo Tomoko , Shimizu Tokurou , Nonaka Keisuke , Shimada Takehiko
Published: June 2023

In citrus breeding programs, male sterility is an important trait for developing seedless varieties. Sterility associated with the male sterile cytoplasm of Kishu mandarin (Kishu-cytoplasm) has been proposed to fit the cytoplasmic male sterility (CMS) model. However, it remains undetermined whether CMS in citrus is controlled by interactions between sterile cytoplasm and nuclear restorer-of-fertility (Rf) genes. Accordingly, mechanisms underlying the control of the wide phenotypic variation in pollen number for breeding germplasm should be elucidated. This study aimed to identify complete linkage DNA markers responsible for male sterility at the MS-P1 region based on fine mapping. Two P-class pentatricopeptide repeat (PPR) family genes were identified as candidates for Rf based on predicted mitochondrial localization and higher expression in a male fertile variety/selected strain than in a male sterile variety. Eleven haplotypes (HT1–HT11) at the MS-P1 region were defined based on genotyping of DNA markers. Association analysis of diplotypes at the MS-P1 region and the number of pollen grains per anther (NPG) in breeding germplasms harboring Kishu-cytoplasm revealed that the diplotypes in this region influenced NPG. Among these haplotypes, HT1 is a non-functional restorer-of-fertility (rf) haplotype; HT2, a less-functional Rf; HT3–HT5 are semi-functional Rfs; and HT6 and HT7 are functional Rfs. However, the rare haplotypes HT8–HT11 could not be characterized. Therefore, P-class PPR family genes in the MS-P1 region may constitute the nuclear Rf genes within the CMS model, and a combination of the seven haplotypes could contribute to phenotypic variation in the NPG of breeding germplasms. These findings reveal the genomic mechanisms of CMS in citrus and will contribute to seedless citrus breeding programs by selecting candidate seedless seedlings using the DNA markers at the MS-P1 region.
Basic values as a motivational framework relating individual values with acculturation strategies among Arab immigrants and refugees across different settlement contexts
Authors: Abu-Rayya Hisham M. , Berry John W. , Lepshokova Zarina , Alnunu Momin , Grigoryev Dmitry
Published: June 2023

There is a lack of systematic acculturation research on the motivations underpinning the behavior of migrants, which could explain how they acculturate and adapt to their new country of residence. This paper examines the link between values, using the Schwartz Theory of Basic Human Values, and acculturation strategies among Arab immigrant and refugee groups across different settlement contexts. The results of Study 1 (Arab immigrants; N = 456) showed, as hypothesized, positive links between strategies and values: the integration strategy with conservation, social focus, self-protection, and self-transcendence values; assimilation with openness to change, personal focus, and growth values; and separation with conservation, social focus, and self-protection. These findings were generally repeated in Study 2 (Syrian refugees; N = 415) except that integration was not associated with self-transcendence and that assimilation was positively linked to self-enhancement instead of openness to change. Our analyses indicated that acculturation preferences are mainly related to motivational values, rather than to different settlement contexts in both samples; however, assimilation seems to be more associated to context than values among the refugee sample. Implications of the findings to the acculturation literature are discussed.
Objectification decreases prosociality: the mediating role of relative deprivation
Authors: Zhang Zaixuan , Chen Zhansheng , Poon Kai-Tak , Jiang Tonglin
Published: June 2023

Objectification denies individuals’ personhood and renders them as tools for facilitating others’ goal achievement. With two studies (N = 446), the present investigation aimed to contribute to the literature by testing whether and how objectification impacts prosociality, including prosocial intention and prosocial behavior. Study 1, with a correlational design, aimed to test whether participants with greater experience of objectification would report lower levels of prosociality, and to test whether participants’ relative deprivation could account for the proposed association between objectification and prosociality. To further test these associations and provide causal evidence, in Study 2, we manipulated objectification by asking participants to imagine future objectification experiences. These studies converged in support of the negative relationship between objectification and prosocial intention, as well as the mediating role of relative deprivation. Regarding prosocial behavior, our findings support a mediating mechanism between objectification and prosocial behavior, although the evidence for the effect of objectification on prosocial behavior is not sufficient. These findings enrich our understanding of the consequences of objectification, while highlighting interpersonal processes’ contribution to prosocial intention and behavior. The limitations and potential future directions were discussed.
The health gap and HRQoL inequalities in Greece before and during the economic crisis
Authors: Yfantopoulos John , Chantzaras Athanasios , Yfantopoulos Platon
Published: June 2023

Objective

The aim of this study was twofold: (i) to assess the health gap among young socio-economic groups generated by the economic crisis in Greece and (ii) to investigate HRQoL (Health Related Quality of Life) inequalities using the Theil index.

Methods

The EQ-5D-5L instrument was administered to a sample of 4,177 young individuals in Greece, mean age 22.3 (±SD 4.8) and 53.8% males, and 46.2% females. The Greek version of the EQ-5D-5L instrument was used in a web-based questionnaire to collect data. Subjects were asked to assess their subjective health status during the economic crisis of 2016 using the EQ-5D-5L instrument, and to recall their health before the crisis of 2009. The health gap was assessed on a Visual Analogue Scale (EQ-VAS), the EQ-5D-5L Index, and the five dimensions of the EQ-5D-5L instrument. Regression analysis was employed to measure the effects of the economic crisis on age, sex, education, and income on the EQ-VAS and EQ-5D-5L. Theil index was used to assess HRQoL inequalities.

Results

The economic crisis brought a significant deterioration in the HRQoL of young Greeks. The EQ-VAS was reduced during the crisis by −10.05% (p < 0.001) and the EQ-5D-5L index declined by −19.61% (p < 0.001). The prevalence of the health gap in each dimension of the EQ-5D-5L was also significant in terms of deterioration of Mobility [change by 66.8% (p < 0.001)], Self-care [change by 61.0% (p < 0.001)], Usual activities [change by 97.1% (p < 0.001)], Pain/discomfort [change by 65.0% (p < 0.001)], and Anxiety/depression [change by 70.5% (p < 0.001)]. Significant reductions in EQ-5D-5L indices were also associated with greater inequalities in the distribution of health among age, gender, income, and educational groups. The EQ-5D-5L health gap among the poor was much greater (0.198), in comparison to richer (0.128) classes. Similar gaps were also found in terms of educational inequalities. The EQ-5D-5L health gap among those with primary education was 0.211, whereas for those with tertiary education it was 0.16. The Theil index indicated an increase in income-related HRQoL inequalities by 222.3% for the EQ-5D-5L index and by 124.2% for the EQ-VAS. The effects of demographic and socioeconomic variables on the EQ-VAS were found statistically significant: sex (p < 0.05), age (p < 0.001), education (p < 0.001), and income (p < 0.001).

Conclusion

The EQ-5D-5L instrument appears to be a powerful tool in assessing the health gap and the HRQoL inequalities among young people in Greece. The findings indicate the importance of developing effective health policies to combat inequalities and mitigate the impact of austerity measures on the quality of life of the young.
Tooth loss, denture use, and all-cause and cause-specific mortality in older adults: a community cohort study
Authors: Dai Miao , Song Quhong , Lin Taiping , Huang Xiaohong , Xie Yufang , Wang Xiang , Zheng Liwei , Yue Jirong
Published: June 2023

Objectives

The available evidence on the connections between tooth loss, denture use, and mortality from all causes or specific causes among older adults is inconclusive. Therefore, we aimed to investigate the association between tooth loss, denture use, and all-cause and cause-specific mortality in older adults.

Methods

A cohort of 5,403 participants aged 65 and older were recruited in the 2014 Chinese Longitudinal Healthy Longevity Survey wave and followed up in the 2018 wave. Cox proportional hazard models were used to examine the association between the number of natural teeth, denture use, and all-cause and cause-specific mortality.

Results

During a mean (SD) follow-up of 3.1  years (1.3), 2,126 deaths (39.3%) occurred. Individuals with 0 and 1–9 teeth had higher mortality due to all-cause, cardiovascular disease (CVD), cancer, and other causes (all p-trend <0.05) than those with 20+ teeth. At the same time, no association was found with respiratory disease mortality. Participants who used dentures had lower mortality due to all causes [hazard ratios (HR) 0.79, 95% confidence intervals (CI) 0.71–0.88], CVD (HR 0.80, 95% CI 0.64–1.00), respiratory disease (HR 0.66, 95% CI 0.48–0.92), and other causes (HR 0.77, 95% CI 0.68–0.88) than those without dentures. Joint analysis revealed that older adults with fewer natural teeth and no dentures had higher mortality. Additionally, interaction analyses showed that the effects of the number of natural teeth on all-cause mortality were more pronounced in older adults aged <80  years (p-value for interaction = 0.03).

Conclusion

Having fewer natural teeth, particularly less than 10 teeth, is linked to an increased risk of mortality from all causes, including CVD, cancer, and other causes, but not respiratory disease. The use of dentures would mitigate the adverse impact of tooth loss on all-cause and some cause-specific mortality.
Exploration of high-pressure processing (HPP) for preservation of the Swedish grown brown macroalgae Saccharina latissima
Authors: Jönsson Madeleine , Allahgholi Leila , Rayner Marilyn , Nordberg Karlsson Eva
Published: June 2023

Introducing seaweed to new food markets entails new challenges concerning efficient preservation. Hence, this study explores high-pressure processing (HPP) as an alternative technique to conventional methods by evaluating its effects on the composition, quality, and microbial safety of the Swedish grown macroalgae Saccharina latissima. The results from the physicochemical analysis showed that after high-pressure treatment the color was retained, while the algal texture was altered by up to an 87.7% reduction in hardness and a 60.0% reduction in compression. Biochemical analysis demonstrated some variations in the algal samples, but the nutritional content was overall retained after treatment. The microbial analysis showed a low microbial load of untreated fresh material, which was confirmed by a lack of amplification in polymerase chain reaction attempts and low growth during attempts on spontaneous proliferation using fresh and frozen algae. Additionally, shelf-life studies showed inconsistent growth, but overall, a low increase in unspecific bacteria, an increasing load of Enterobacteriaceae, no growth of Lactobacilli, and low fouling by mold and yeast. The results from this study can be useful in the continued attempts of introducing seaweed to new markets, with different prerequisites for post-harvest treatment.
Evaluation of COVID-19 vaccine implementation in a large safety net health system
Authors: Chen Jennifer C. , Gutierrez Griselda , Kamran Rachel , Terry Jill , Telliyan Armenui , Zaks Camilo , Carson Savanna L. , Brown Arleen , Kim Karen
Published: June 2023

Objectives

To evaluate rapid COVID-19 vaccine clinic implementation from January-April 2021 in the Los Angeles County Department of Health Services (LACDHS), the second-largest US safety net health system. During initial vaccine clinic implementation, LACDHS vaccinated 59,898 outpatients, 69% of whom were Latinx (exceeding the LA County Latinx population of 46%). LACDHS is a unique safety net setting to evaluate rapid vaccine implementation due to system size, geographic breadth, language/racial/ethnic diversity, limited health staffing resources, and socioeconomic complexity of patients.

Methods

Implementation factors were assessed through semi-structured interviews of staff from all twelve LACDHS vaccine clinics from August-November 2021 using the Consolidated Framework for Implementation Research (CFIR) and themes analyzed using rapid qualitative analysis.

Results

Of 40 potential participants, 25 health professionals completed an interview (27% clinical providers/medical directors, 23% pharmacist, 15% nursing staff, and 35% other). Qualitative analysis of participant interviews yielded ten narrative themes. Implementation facilitators included bidirectional communication between system leadership and clinics, multidisciplinary leadership and operations teams, expanded use of standing orders, teamwork culture, use of active and passive communication structures, and development of patient-centered engagement strategies. Barriers to implementation included vaccine scarcity, underestimation of resources needed for patient outreach, and numerous process challenges encountered.

Conclusion

Previous studies focused on robust advance planning as a facilitator and understaffing and high staff turnover as barriers to implementation in safety net health systems. This study found facilitators that can mitigate lack of advance planning and staffing challenges present during public health emergencies such as the COVID-19 pandemic. The ten identified themes may inform future implementations in safety net health systems.
Advancing adaptation of evidence-based interventions through implementation science: progress and opportunities
Authors: Chambers David A.
Published: June 2023

While the recognition of the need to adapt interventions to improve their fit with populations and service systems has been well established within the scientific community, limited consideration of the role of adaptation within implementation science has impeded progress toward optimal uptake of evidence-based care. This article reflects on the traditional paths through which adapted interventions were studies, progress made in recent years toward better integration of the science of adaptation within implementation studies with reference to a special publication series, and next steps for the field to continue to build a robust knowledge base on adaptation.
Examining how internet use and non-farm employment affect rural households’ income gap? Evidence from China
Authors: Zhang Aopeng , Chandio Abbas Ali , Yang Tingwei , Ding Zhao , Liu Yan
Published: June 2023

The objective of this study is to assess the effect of Internet use on the income disparity between rural households and to determine how Internet usage can be used to reduce this income gap. We use the Recentered Influence Function Regression (RIF) and data from the China Family Panel Studies (CFPS) conducted by the China Social Science Survey (CSSS) center at Peking University to make the results of regression estimation more reliable. The results reveal that Internet use can make rural households’ income gap shrink considerably, and that the degree of non-farm employment among rural families has a mediating effect between Internet use and the income disparity of farm households. In addition, the Eastern region experiences a stronger mitigating effect from Internet use, whereas ethnic minorities find out no such mitigating effect. This study expands the scope of income disparity theory, provides new ideas for the construction of digital villages, and identifies new empirical evidence and decision-making grounds for improving the livelihoods of rural households and narrowing the income gap between rural households.
Multiple uses of dexmedetomidine in small animals: a mini review
Authors: Di Franco Chiara , Evangelista Flavia , Briganti Angela
Published: June 2023

Dexmedetomidine is an alpha-2 adrenergic agonist, which use had an exponential increase in human and veterinary medicine in the last 10 years. The aim of this mini review is to summarize the various uses of dexmedetomidine underlining its new applications and capabilities in the small animals’ clinical activity. While this drug was born as sedative in veterinary medicine, some studies demonstrated to be effective as an analgesic both in single administration and in continuous infusion. Recent studies have also shown the role of dexmedetomidine as an adjuvant during locoregional anesthesia, increasing the duration of the sensitive block and consequently decreasing the demand for systemic analgesics. The various analgesic properties make dexmedetomidine an interesting drug for opioid-free analgesia. Some studies highlighted a potential neuroprotective, cardioprotective and vasculoprotective role of dexmedetomidine, thus conferring it a place in critical care medicine, such as trauma and septic patients. Dexmedetomidine has demonstrated to be a multitasking molecule and it is ready to face new challenges.
Attitudes towards Urban Air Mobility for E-Commerce Deliveries: An Exploratory Survey Comparing European Regions
Authors: Silva André Teixeira , Duarte Sérgio Pedro , Melo Sandra , Witkowska-Konieczny Adriana , Giannuzzi Michele , Lobo António
Published: June 2023

This study explores attitudes towards urban air mobility (UAM) for e-commerce deliveries. UAM, which utilizes drones, has the potential to revolutionize transport services and logistics, leading to economic benefits and reductions in congestion and pollution. However, public acceptance is crucial for a successful implementation; thus, understanding the people’s perspective is key. Descriptive statistics were employed to evaluate survey results from three different European regions, followed by a cluster analysis to define potential user profiles. This study revealed slightly different perceptions towards UAM between the analyzed regions, but also a generally positive attitude. The most important expected identified benefits from UAM were a decrease in congestion and pollution in city centers. High-acceptance segments are gender-balanced and correspond mostly to active population and frequent online shoppers that perceive value in drone deliveries, especially related to an increased convenience and speed. They support public investment in UAM and are willing to pay more for these services and to have their home flown over. Opposite attitudes were expressed by low-acceptance segments, which are female-dominated and include mostly non-frequent online shoppers. The identified user profiles in this study can support the development of public policy and marketing strategies to increase acceptance and adoption.
Validating Automatic Speech Recognition and Understanding for Pre-Filling Radar Labels—Increasing Safety While Reducing Air Traffic Controllers’ Workload
Authors: Ahrenhold Nils , Helmke Hartmut , Mühlhausen Thorsten , Ohneiser Oliver , Kleinert Matthias , Ehr Heiko , Klamert Lucas , Zuluaga-Gómez Juan
Published: June 2023

Automatic speech recognition and understanding (ASRU) for air traffic control (ATC) has been investigated in different ATC environments and applications. The objective of this study was to quantify the effect of ASRU support for air traffic controllers (ATCos) radar label maintenance in terms of safety and human performance. Therefore, an implemented ASRU system was validated within a human-in-the-loop environment by ATCos in different traffic-density scenarios. In the baseline condition, ATCos performed radar label maintenance by entering verbally instructed ATC commands with a mouse and keyboard. In the proposed solution, ATCos were supported by ASRU, which achieved a command recognition rate of 92.5% with a command error rate of 2.4%. ASRU support reduced the number of wrong or missing inputs from ATCos into the radar label by a factor of two, which contemporaneously improved their situational awareness. Furthermore, ATCos where able to perform more successful secondary tasks when using ASRU support, indicating a greater capacity to handle unexpected events. The results from NASA TLX showed that the perceived workload decreased with a statistical significance of 4.3% across all scenarios. In conclusion, this study provides evidence that using ASRU for radar label maintenance can significantly reduce workload and improve flight safety.
Effect of Climatic Conditions on Wheat Starch Granule Size Distribution, Gelatinization and Flour Pasting Properties
Authors: Rakita Slađana , Torbica Aleksandra , Pezo Lato , Nikolić Ivana
Published: June 2023

The aim of this study was to determine the effects of different varieties, year and location of growing, and their interactions, on wheat starch and flour properties, and to analyze the relationship between these attributes. The set of 92 wheat samples chosen to cover wide ranges in the parameters commonly used for the assessment of wheat flour and starch properties was reduced to a representative set of 27 samples. The obtained results showed that wheat variety and year significantly affected maximum viscosity (MV), alpha–amylase activity (AA), amylose content (AM), volume proportion of A-, B- and C-starch granules, as well as gelatinization temperatures, while the year and location by year interaction had a significant effect on the falling number (FN). In this work, a number of significant correlations were observed among analyzed starch and flour properties. AA was mostly influenced by the changes in packing of starch granules and granule size distribution, while gelatinization temperatures were affected by particle size distribution. Additionally, when testing the suitability of the parameters for the estimation of alpha–amylase activity, it was determined that Amylograph was more reliable in predicting alpha–amylase than FN because it provided a better description of the state of flour starch complex.
Safety and Efficacy of a Single Procedure of Extraction and Reimplantation of Infected Cardiovascular Implantable Electronic Device (CIED) in Comparison with Deferral Timing: An Observational Retrospective Multicentric Study
Authors: Tascini Carlo , Giuliano Simone , Attanasio Vittorio , Segreti Luca , Ripoli Andrea , Sbrana Francesco , Severino Sergio , Sordelli Chiara , Weisz Sara Hana , Zanus-Fortes Agnese , Leanza Gabriele Maria , Carannante Novella , Di Cori Andrea , Bongiorni Maria Grazia , Zucchelli Giulio , De Vivo Stefano
Published: June 2023

(1) Background: Infections are among the most frequent and life-threatening complications of cardiovascular implantable electronic device (CIED) implantation. The aim of this study is to compare the outcome and safety of a single-procedure device extraction and contralateral implantation versus the standard-of-care (SoC) two-stage replacement for infected CIEDs. (2) Methods: We retrospectively included 66 patients with CIED infections who were treated at two Italian hospitals. Of the 66 patients enrolled in the study, 27 underwent a single procedure, whereas 39 received SoC treatment. All patients were followed up for 12 months after the procedure. (3) Results: Considering those lost to follow-up, there were no differences in the mortality rates between the two cohorts, with survival rates of 81.5% in the single-procedure group and 84.6% in the SoC group (p = 0.075). (4) Conclusions: Single-procedure reimplantation associated with an active antibiofilm therapy may be a feasible and effective therapeutic option in CIED-dependent and frail patients. Further studies are warranted to define the best treatment regimen and strategies to select patients suitable for the single-procedure reimplantation.
Deficiencies of Rule-Based Technology-Generated Antibiograms for Specialized Care Units
Authors: Hill David M. , Todor Lorraine A.
Published: June 2023

The objective of this study was to compare the pathogens and susceptibilities of the current automated, rule-based technology (RBT) antibiogram with one manually collected through chart review with additional rules applied. This study was a two-year, retrospective cohort study and included all bacterial cultures within the first 30 days from patients admitted to a single Burn Center. The current RBT antibiogram served as the control, and new antibiogram versions were created using additional rules and compared to the control. Six-hundred fifty-seven patients were admitted (61% excluded for lack of cultures). 59% had at least one hospital-acquired risk factor, with over one-third having recent illicit drug use and one-third having a recent hospitalization. Of the 410 cultures included, 57% were Gram-negative, and half were from wound infections. Sensitivities were significantly different when comparing the manual and the RBT version after including factors such as days since admission, presence of hospital-acquired risk factors, or previous antibiotic courses. Recommended empiric Gram-negative antibiotics changed from double coverage to a single β-lactam with >90% susceptibility. The susceptibilities between the first and subsequent courses were dramatically different. Before developing an antibiogram or interpreting the output, it is important to consider which automated criteria are utilized, especially for units with extended lengths of stay.
Optimization of Empirical Antimicrobial Therapy in Enterobacterales Bloodstream Infection Using the Extended-Spectrum Beta-Lactamase Prediction Score
Authors: Haimerl Brian J. , Encinas Rodrigo , Justo Julie Ann , Kohn Joseph , Bookstaver P. Brandon , Winders Hana Rac , Al-Hasan Majdi N.
Published: June 2023

Clinical tools for the prediction of antimicrobial resistance have been derived and validated without examination of their implementation in clinical practice. This study examined the impact of utilization of the extended-spectrum beta-lactamase (ESBL) prediction score on the time to initiation of appropriate antimicrobial therapy for bloodstream infection (BSI). The quasi-experimental cohort study included hospitalized adults with BSI due to ceftriaxone-resistant (CRO-R) Enterobacterales at three community hospitals in Columbia, South Carolina, USA before (January 2010 to December 2013) and after (January 2014 to December 2019) implementation of an antimicrobial stewardship intervention. In total, 45 and 101 patients with BSI due to CRO-R Enterobacterales were included before and after the intervention, respectively. Overall, the median age was 66 years, 85 (58%) were men, and 86 (59%) had a urinary source of infection. The mean time to appropriate antimicrobial therapy was 78 h before and 46 h after implementation of the antimicrobial stewardship intervention (p = 0.04). Application of the ESBL prediction score as part of an antimicrobial stewardship intervention was associated with a significant reduction in time to appropriate antimicrobial therapy in patients with BSI due to CRO-R Enterobacterales. Utilization of advanced rapid diagnostics may be necessary for a further reduction in time to appropriate antimicrobial therapy in this population.
Conditions Necessary for the Transfer of Antimicrobial Resistance in Poultry Litter
Authors: Oxendine Aaron , Walsh Allison A. , Young Tamesha , Dixon Brandan , Hoke Alexa , Rogers Eda Erdogan , Lee Margie D. , Maurer John J.
Published: June 2023

Animal manures contain a large and diverse reservoir of antimicrobial resistance (AMR) genes that could potentially spillover into the general population through transfer of AMR to antibiotic-susceptible pathogens. The ability of poultry litter microbiota to transmit AMR was examined in this study. Abundance of phenotypic AMR was assessed for litter microbiota to the antibiotics: ampicillin (Ap; 25 μg/mL), chloramphenicol (Cm; 25 μg/mL), streptomycin (Sm; 100 μg/mL), and tetracycline (Tc; 25 μg/mL). qPCR was used to estimate gene load of streptomycin-resistance and sulfonamide-resistance genes aadA1 and sul1, respectively, in the poultry litter community. AMR gene load was determined relative to total bacterial abundance using 16S rRNA qPCR. Poultry litter contained 108 CFU/g, with Gram-negative enterics representing a minor population (<104 CFU/g). There was high abundance of resistance to Sm (106 to 107 CFU/g) and Tc (106 to 107 CFU/g) and a sizeable antimicrobial-resistance gene load in regards to gene copies per bacterial genome (aadA1: 0.0001–0.0060 and sul1: 0.0355–0.2455). While plasmid transfer was observed from Escherichia coli R100, as an F-plasmid donor control, to the Salmonella recipient in vitro, no AMR Salmonella were detected in a poultry litter microcosm with the inclusion of E. coli R100. Confirmatory experiments showed that isolated poultry litter bacteria were not interfering with plasmid transfer in filter matings. As no R100 transfer was observed at 25 °C, conjugative plasmid pRSA was chosen for its high plasmid transfer frequency (10−4 to 10−5) at 25 °C. While E. coli strain background influenced the persistence of pRSA in poultry litter, no plasmid transfer to Salmonella was ever observed. Although poultry litter microbiota contains a significant AMR gene load, potential to transmit resistance is low under conditions commonly used to assess plasmid conjugation.
Extended-Spectrum β-Lactamase-Producing Escherichia coli Isolated from Food-Producing Animals in Tamaulipas, Mexico
Authors: Mandujano Antonio , Cortés-Espinosa Diana Verónica , Vásquez-Villanueva José , Guel Paulina , Rivera Gildardo , Juárez-Rendón Karina , Cruz-Pulido Wendy Lizeth , Aguilera-Arreola Guadalupe , Guerrero Abraham , Bocanegra-García Virgilio , Martínez-Vázquez Ana Verónica
Published: June 2023

Extended-spectrum β-lactamase (ESBL)-producing E. coli has become an important global problem for the public health sector. This study aims to investigate the E. coli antimicrobial resistance profile among living food-producing animals in Tamaulipas, Mexico. A total of 200 fecal samples were collected from bovines, pigs, chickens and sheep. A total of 5.0% of the strains were phenotypically confirmed as ESBL producers. A high percentage of phenotypic antimicrobial resistance was observed against gentamicin (93.3%), tetracycline (86.6%) and streptomycin (83.3%). The gentamicin-resistant strains showed MDR, distributed among 27 resistance patterns to different antimicrobials. The antimicrobial resistance gene tet(A) was detected in 73.3% of isolates, aadA1 in 60.0% and sul2 in 43.3% of strains. The blaCTX-M gene was found in 23.3% of strains. The virulence gene hlyA was detected in 43.3% of isolates; stx1 and stx2 were not detected in any strain. The phylotyping indicated that the isolates belonged to groups A (33.3%), B1 (16.6%), B2 (40.0%) and D (10.0%). These results show that food-producing animals might be a reservoir of ESBL-producing bacteria and may play a role in their spread.
Bacteriophages in Infectious Diseases and Beyond—A Narrative Review
Authors: Ioannou Petros , Baliou Stella , Samonis George
Published: June 2023

The discovery of antibiotics has revolutionized medicine and has changed medical practice, enabling successful fighting of infection. However, quickly after the start of the antibiotic era, therapeutics for infectious diseases started having limitations due to the development of antimicrobial resistance. Since the antibiotic pipeline has largely slowed down, with few new compounds being produced in the last decades and with most of them belonging to already-existing classes, the discovery of new ways to treat pathogens that are resistant to antibiotics is becoming an urgent need. To that end, bacteriophages (phages), which are already used in some countries in agriculture, aquaculture, food safety, and wastewater plant treatments, could be also used in clinical practice against bacterial pathogens. Their discovery one century ago was followed by some clinical studies that showed optimistic results that were limited, however, by some notable obstacles. However, the rise of antibiotics during the next decades left phage research in an inactive status. In the last decades, new studies on phages have shown encouraging results in animals. Hence, further studies in humans are needed to confirm their potential for effective and safe treatment in cases where there are few or no other viable therapeutic options. This study reviews the biology and applications of phages for medical and non-medical uses in a narrative manner.
High Heme and Low Heme Oxygenase-1 Are Associated with Mast Cell Activation/Degranulation in HIV-Induced Chronic Widespread Pain
Authors: Chatterjee Tanima , Arora Itika , Underwood Lilly , Gryshyna Anastasiia , Lewis Terry L. , Masjoan Juncos Juan Xavier , Goodin Burel R. , Heath Sonya , Aggarwal Saurabh
Published: June 2023

An overwhelming number of people with HIV (PWH) experience chronic widespread pain (CWP) throughout their lifetimes. Previously, we demonstrated that PWH with CWP have increased hemolysis and attenuated heme oxygenase 1 (HO-1) levels. HO-1 degrades reactive, cell-free heme into antioxidants like biliverdin and carbon monoxide (CO). We found that high heme or low HO-1 caused hyperalgesia in animals, likely through multiple mechanisms. In this study, we hypothesized that high heme or low HO-1 caused mast cell activation/degranulation, resulting in the release of pain mediators like histamine and bradykinin. PWH who self-report CWP were recruited from the University of Alabama at Birmingham HIV clinic. Animal models included HO-1−/− mice and hemolytic mice, where C57BL/6 mice were injected intraperitoneally with phenylhydrazine hydrochloride (PHZ). Results demonstrated that plasma histamine and bradykinin were elevated in PWH with CWP. These pain mediators were also high in HO-1−/− mice and in hemolytic mice. Both in vivo and in vitro (RBL-2H3 mast cells), heme-induced mast cell degranulation was inhibited by treatment with CORM-A1, a CO donor. CORM-A1 also attenuated mechanical and thermal (cold) allodynia in hemolytic mice. Together, the data suggest that mast cell activation secondary to high heme or low HO-1 seen in cells and animals correlates with elevated plasma levels of heme, histamine, and bradykinin in PWH with CWP.
Oxidative Stress in a Mother Consuming Alcohol during Pregnancy and in Her Newborn: A Case Report
Authors: Derme Martina , Piccioni Maria Grazia , Brunelli Roberto , Crognale Alba , Denotti Marika , Ciolli Paola , Scomparin Debora , Tarani Luigi , Paparella Roberto , Terrin Gianluca , Di Chiara Maria , Mattia Alessandro , Nicotera Simona , Salomone Alberto , Ceccanti Mauro , Messina Marisa Patrizia , Maida Nunzia La , Ferraguti Giampiero , Petrella Carla , Fiore Marco
Published: June 2023

Fetal alcohol spectrum disorder (FASD) is a set of conditions resulting from prenatal alcohol exposure (PAE). FASD is estimated to affect between 2% and 5% of people in the United States and Western Europe. The exact teratogenic mechanism of alcohol on fetal development is still unclear. Ethanol (EtOH) contributes to the malfunctioning of the neurological system in children exposed in utero by decreasing glutathione peroxidase action, with an increase in the production of reactive oxygen species (ROS), which causes oxidative stress. We report a case of a mother with declared alcohol abuse and cigarette smoking during pregnancy. By analyzing the ethyl glucuronide (EtG, a metabolite of alcohol) and the nicotine/cotinine in the mother’s hair and meconium, we confirmed the alcohol and smoking abuse magnitude. We also found that the mother during pregnancy was a cocaine abuser. As a result, her newborn was diagnosed with fetal alcohol syndrome (FAS). At the time of the delivery, the mother, but not the newborn, had an elevation in oxidative stress. However, the infant, a few days later, displayed marked potentiation in oxidative stress. The clinical complexity of the events involving the infant was presented and discussed, underlining also the importance that for cases of FASD, it is crucial to have more intensive hospital monitoring and controls during the initial days.