bluuebunny/crossref_metadata_2025 huggingface dataset:
The efficacy of electroacupuncture in among early diabetic patients with lower limb arteriosclerotic wounds
Authors: Sang Peng , Zhao Jiahui , Yang Hui
Published: December 2023

Diabetic foot ulcers are the prevalent complication of diabetes mellitus, frequently culminating in arteriosclerosis of the lower extremities and consequent development of chronic wounds. The effectiveness of electroacupuncture (EA) as therapeutic intervention for promoting wound healing in this particular group of patients has been comprehensively assessed in this study. A randomized controlled trial involving 380 early diabetic patients with arteriosclerotic lesions of the lower limbs was conducted. Standard wound care plus EA was administered to the treatment group, while standard wound care alone was administered to the control group. The principal outcome assessed was the reduction in lesion size following the 8‐week treatment period. Pain scores, recuperation time, and quality of life (QoL) evaluations constituted secondary outcomes. In comparison to the control group, the treatment group exhibited a significantly greater reduction in wound size (p < 0.05). The treatment group exhibited significantly reduced pain scores and significantly higher QoL scores (p < 0.05). The duration of recovery did not vary substantially among the groups (p > 0.05). Electroacupuncture thus appeared to be an effective adjunctive treatment for early diabetic patients with lower limb arteriosclerotic lesions, promoting pain relief and quality of life. Additional investigation is necessary to validate these results and delve into the underlying mechanisms of action.
Porosity effect on the functional properties and energy harvesting performance of Ba0.85Ca0.15Ti0.90Zr0.10O3 ceramics
Authors: Horchidan Nadejda , Curecheriu Lavinia P. , Lukacs Vlad A. , Stirbu Radu S. , Tufescu Florin M. , Dumitru Ioan , Stoian George , Ciomaga Cristina E.
Published: December 2023

In this study, the effect of porosity on the structural and functional (dielectric, ferroelectric, nonlinear, and piezoelectric) properties in Ba0.85Ca0.15Ti0.90Zr0.10O3 ceramics was investigated. Various levels of microporosity in the range of 3% to 31 vol.% have been produced using poly(methyl methacrylate) microspheres as sacrificial templates. The structural investigation indicates a phase coexistence, as expected for this composition at room temperature. The maximum permittivity decreases with increasing porosity, from around 7000 (ceramic with 3 vol.% porosity) down to 3500 (ceramic with 31 vol.% porosity), and the Curie temperature shifts from 47 to 67°C when increasing porosity, related to the possible porosity‐induced structural and internal stress modifications. An enhanced piezoelectric response was found in the Ba0.85Ca0.15Ti0.90Zr0.10O3 ceramic with intermediate porosity around 18 vol.%, with the highest value of piezoelectric response of 470 pC/N and a figure of merit of 7.3 pm2/N. The optimum piezoelectric properties at the intermediate porosity level are related to the microstructural changes (pore shape and connectivity) and possible field‐induced structural modifications. The piezoelectric energy harvesting measurement results have shown the possibility of using Pb‐free porous ferroelectric materials in devices for energy harvesting applications.
Insights from primary care workers supporting people at risk of suicide in local communities in Japan: A qualitative descriptive study
Authors: Tanaka Koji , Ikeuchi Satomi
Published: December 2023

Aim

To identify insights for supporting people at risk of suicide in the community based on primary healthcare workers' experiences.

Design

Qualitative descriptive design.

Methods

Semi‐structured interviews were conducted with fifteen primary healthcare workers employed by Japanese municipalities between August and October 2019. The data were subjected to qualitative descriptive analysis.

Results

The analysis revealed eleven subthemes, clustered under the following three themes: (1) fostering ‘opportunities for discovery’ for people at risk of suicide by encompassing strategies such as increasing access to services and promoting a holistic understanding of the life cycle; (2) fostering ‘meaningful connections’ by searching for channels to reach the heart and taking approaches from different objectives; and (3) engaging in ‘risk management’, by understanding and coping with real‐life struggles and implementing timely crisis intervention.

Conclusion

Not only direct care targeting suicide prevention but also holistic care that includes atypical perspectives such as ‘approaches from different objectives’ may provide important insights for supporting people with suicide risk.

Implications for Practice

Beyond the limitations of existing suicide risk screening methods, this study highlights the importance of a holistic approach that sees people at risk of suicide in the context of their daily lives and aims to alleviate the difficulties in their lives that have brought them to the point of considering suicide.

Impact

By describing support focused on the difficulties that people at risk of suicide face in their daily lives, this study identified insights for supporting people at risk of suicide in communities where screening and intervention are difficult. These findings will contribute to the relief of people at risk of suicide by stimulating suicide prevention measures in primary healthcare settings.

Reporting Method

This study complied with the COREQ guidelines.

Patient or Public Contribution

No patient or public contribution.
Untangling hairy cell leukaemia (HCL) variant and other HCL‐like disorders: Diagnosis and treatment
Authors: Troussard Xavier , Maitre Elsa
Published: December 2023

The variant form of hairy cell leukaemia (HCL‐V) is a rare disease very different from hairy cell leukaemia (HCL), which is a very well‐defined entity. The 5th WHO edition (Leukemia, 36, 2022 and 1720) classification (WHO‐HAEM5) introduced splenic lymphomas/leukaemias including four different entities: (1) HCL, (2) splenic marginal zone lymphoma (SMZL) with circulating villous cells in the peripheral blood, (3) splenic lymphoma with prominent nucleolus (SLPN), which replaced HCL‐V and CD5 negative B‐prolymphocytic leukaemia (B‐PLL), and (4) splenic diffuse red pulp lymphoma (SDRPL). All these entities have to be distinguished because of a different clinical course and the need for a different treatment. The diagnosis can be challenging because of complex cases and overlap and/or grey zones between all the entities and needs integrating clinical, histologic, immunophenotypic, cytogenetic and molecular data. We review the diagnostic criteria including clinical, immunophenotypic and molecular characteristics of patients with HCL‐V and other HCL‐like disorders including HCL, SDRPL, SMZL, B‐PLL and the Japanese form of HCL. We also discuss the different criteria allowing us to separate these different entities and we will update the recent therapeutic options that have emerged, in particular the advances with chemoimmunotherapy and/or targeted therapies.
Clinical and histopathological features in horses with neuroaxonal degeneration: 100 cases (2017‐2021)
Authors: Brown Kara A. , Bender Susan J. , Johnson Amy L.
Published: December 2023

Background

Adult horses with proprioceptive ataxia and behavior changes that have histologic lesions consistent with neurodegenerative disease have been increasingly recognized.

Hypothesis/Objectives

Describe the history, clinical findings and histopathologic features of horses presented to a referral institution with neuroaxonal degeneration.

Animals

One hundred horses with a necropsy diagnosis of neuroaxonal degeneration compatible with neuroaxonal dystrophy/degenerative myeloencephalopathy (eNAD/EDM).

Methods

Retrospective study of horses presented to the University of Pennsylvania, New Bolton Center, between 2017 and 2021 with a necropsy diagnosis of eNAD/EDM.

Results

Affected horses had a median age of 8 years (range, 1‐22), and the majority were Warmbloods (72). Sixty‐eight horses had behavioral changes, and all 100 had proprioceptive ataxia (median grade, 2/5). Fifty‐seven horses had abnormal findings on cervical vertebral radiographs, and 14 had myelographic findings consistent with compressive myelopathy. No antemortem diagnostic test results were consistently associated with necropsy diagnosis of neurodegenerative disease. All 100 horses had degenerative lesions characteristic of eNAD in the brainstem gray matter, and 24 had concurrent degenerative features of EDM in the spinal cord white matter.

Conclusions and Clinical Importance

Clinical and histopathologic findings in this large group of horses with neurodegenerative disease were most consistent with eNAD/EDM, but with a different signalment and clinical presentation from earlier descriptions. The increasing occurrence of neurodegenerative disease in horses and the safety risk posed emphasize the importance of focused research in affected horses.
Adolescents' perspectives on the barriers to reading for pleasure
Authors: Webber Charlotte , Wilkinson Katherine , Duncan Lynne G. , McGeown Sarah
Published: December 2023

Adolescence is often positioned as a particularly vulnerable period for reading motivation and engagement, both for academic reading and reading for pleasure. However, closer scrutiny of the literature reveals a much more nuanced pattern of changing interest, attitude, and motivation for reading during adolescence. Despite this, there is a distinct lack of research that explores the barriers adolescents' face to reading for pleasure from the perspectives of adolescents themselves. Working with a Young People's Advisory Panel, peer‐ and adult‐led interviews were carried out with 46 adolescents (13–15 years old) from six high schools. Six themes were identified from the thematic analysis, reflecting adolescents' perceptions of the barriers to their reading for pleasure: (1) access; (2) mismatch between provision and needs; (3) social factors; (4) reading experiences in school; (5) reading affect; and (6) time and competing activities. This article makes a novel and significant contribution to the limited literature on reading for pleasure during adolescence and provides important qualitative insights for researchers and educational practitioners interested in supporting adolescents' reading motivation.
First foods in a packaged world: Results from the COMMIT consortium to protect young child diets in Southeast Asia
Authors: Blankenship Jessica L. , White Jessica M. , Pries Alissa , Badham Jane , Betigeri Arvind , Cade Janet , Cashin Jennifer , Cosenza Lucy , Drummond Elizabeth , Mulder Anzélle , Nasser Nadine , Nguyen Tuan , Singhkumarwong Anusara , Sweet Lara , Threpleton Diane , Vu Duong , Zehner Elizabeth , Kupka Roland
Published: December 2023

Although commercially produced complementary foods (CPCFs) are increasingly sold throughout Southeast Asia, concerns have been raised about CPCFs nutritional quality, labelling practices and the strength and scope of national CPCF regulations. The Consortium for Improving Complementary Foods in Southeast Asia (COMMIT), composed of UN agencies and civil society organizations, was formed to assess the nutrient gap in the diets of young children and the consumer, product and policy landscapes for CPCFs in seven Southeast Asian countries. Results from a nutrient gap assessment indicate that the diets of children aged 6–23 months are suboptimal and deficient in micronutrients. A consumer survey revealed that caretakers commonly use CPCFs, are conscious of the importance of nutrition and are influenced by label claims. Results from a CPCF benchmarking showed that many products sold in Southeast Asia contained added sugar or sweeteners, had a high total sugar and/or high sodium content and that no CPCF product adhered to all recommended labelling practices. Further, a legal review of national binding legal measures relevant to CPCFs showed minimal alignment with available global guidance. Urgent actions are necessary to strengthen national regulations related to CPCF nutrient composition and labelling practices. To speed progress, COMMIT developed a compendium of existing standards and global guidance to help countries align their national regulations with CPCF composition, labelling and production recommendations. Advocacy to garner public support for new or improved CPCF regulations, as well as strong government monitoring and enforcement of regulations, is crucial to support efforts to safeguard and improve the diets of older infants and young children in Southeast Asia.
A COMPASS histone H3K4 trimethyltransferase pentamer transactivates drought tolerance and growth/biomass production in Populus trichocarpa
Authors: Zhang Baofeng , Wang Zhuwen , Dai Xiufang , Gao Jinghui , Zhao Jinfeng , Ma Rong , Chen Yanjie , Sun Yi , Ma Hongyan , Li Shuang , Zhou Chenguang , Wang Jack P. , Li Wei
Published: December 2023

Histone H3 lysine‐4 trimethylation (H3K4me3) activating drought‐responsive genes in plants for drought adaptation has long been established, but the underlying regulatory mechanisms are unknown.

Here, using yeast two‐hybrid, bimolecular fluorescence complementation, biochemical analyses, transient and CRISPR‐mediated transgenesis in Populus trichocarpa, we unveiled in this adaptation a regulatory interplay between chromatin regulation and gene transactivation mediated by an epigenetic determinant, a PtrSDG2‐1–PtrCOMPASS (complex proteins associated with Set1)‐like H3K4me3 complex, PtrSDG2‐1–PtrWDR5a‐1–PtrRbBP5‐1–PtrAsh2‐2 (PtrSWRA).

Under drought conditions, a transcription factor PtrAREB1‐2 interacts with PtrSWRA, forming a PtrSWRA–PtrAREB1‐2 pentamer, to recruit PtrSWRA to specific promoter elements of drought‐tolerant genes, such as PtrHox2, PtrHox46, and PtrHox52, for depositing H3K4me3 to promote and maintain activated state of such genes for tolerance. CRISPR‐edited defects in the pentamer impaired drought tolerance and elevated expression of PtrHox2, PtrHox46, or PtrHox52 improved the tolerance as well as growth in P. trichocarpa.

Our findings revealed the identity of the underlying H3K4 trimethyltransferase and its interactive arrangement with the COMPASS for catalysis specificity and efficiency. Furthermore, our study uncovered how the H3K4 trimethyltransferase–COMPASS complex is recruited to the effector genes for elevating H3K4me3 marks for improved drought tolerance and growth/biomass production in plants.
Parents' preferences for respite care of children with medical complexity
Authors: Yamamoto Yoshiko , Aoki Ai , Fuji Hiroshi , Chen Gang , Bolt Timothy , Suto Maiko , Mori Rintaro , Uchida Katsuyasu , Takehara Kenji , Gai Ruoyan
Published: December 2023

Background

The number of children with medical complexity (CMC) is increasing worldwide. For these children and their families, various forms of support are legislated; among them, short‐stay respite care has a great unmet need. We examined such children's parents' preferences for respite care and their willingness to pay.

Methods

We used discrete choice experiments (DCEs) to estimate the parents' preferences and willingness to pay. Parents whose children used overnight short‐stay respite services answered a questionnaire to compare two hypothetical facilities of respite care having seven attributes and three levels. The DCE data was analyzed using the conditional logit model. The willingness to pay was calculated based on DCE estimates.

Results

A total of 70 parents participated in this study and mean age of their children was 7.8 years (standard deviation [SD] 4.3). Among those children, 67 (96%) had the severest certification of disability, and 27 (38%) used a ventilator at home. We found that the parents' highest preferences was the best level of medical care level that can manage ventilators (coefficient 1.61, 95% confidence interval [CI]: 1.32–1.90). The better and best level of medical care, daily care, education/nursing, and emergency care were preferred over basic quality services. Willingness to pay for the best level of medical care was approximately 75,367 JPY per night.

Conclusion

This study shows a need for respite care that can deliver high‐level medical care, especially for the management of ventilators, to CMC. This finding can serve as a basis for promoting respite care services.
Association between perinatal and early life exposures and lung function in Australian Indigenous young adults: The Aboriginal Birth Cohort study
Authors: Navaratnam Vidya , Forrester Douglas L. , Chang Anne B. , Dharmage Shyamali C. , Singh Gurmeet R.
Published: December 2023

Background and Objective

Despite the high burden of respiratory disease amongst Indigenous populations, prevalence data on spirometric deficits and its determinants are limited. We estimated the prevalence of abnormal spirometry in young Indigenous adults and determined its relationship with perinatal and early life factors.

Methods

We used prospectively collected data from the Australian Aboriginal Birth Cohort, a birth cohort of 686 Indigenous Australian singletons. We calculated the proportion with abnormal spirometry (z‐score <−1.64) and FEV1 below the population mean (FEV1% predicted 0 to −2SD) measured in young adulthood. We evaluated the association between perinatal and early life exposures with spirometry indices using linear regression.

Results

Fifty‐nine people (39.9%, 95%CI 31.9, 48.2) had abnormal spirometry; 72 (49.3%, 95%CI 40.9, 57.7) had a FEV1 below the population mean. Pre‐school hospitalisations for respiratory infections, younger maternal age, being overweight in early childhood and being born remotely were associated with reduced FEV1 and FVC (absolute, %predicted and z‐score). The association between maternal age and FEV1 and FVC were stronger in women, as was hospitalization for respiratory infections before age 5. Being born remotely had a stronger association with reduced FEV1 and FVC in men. Participants born in a remote community were over 6 times more likely to have a FEV1 below the population mean (odds ratio [OR] 6.30, 95%CI 1.93, 20.59).

Conclusion

Young Indigenous adults have a high prevalence of impaired lung function associated with several perinatal and early life factors, some of which are modifiable with feasible interventions.
Granitic‐melt and carbonic‐fluid inclusions in diopside megacrysts from ankaramitic basalt dikes at Kamisano, Yamanashi prefecture, northeastern Japan
Authors: Amagai Takashi , Kurosawa Masanori
Published: December 2023

Large phenocrysts, known as megacrysts, are focal points for research due to their ability to encapsulate large inclusions suitable for precise chemical analyses. Ankaramite, a distinctive type of undifferentiated volcanic rock, stands out due to its high MgO and CaO contents and the presence of abundant Ca‐rich clinopyroxene (diopside) and less common Mg‐rich olivine phenocrysts. In this study, granitic melt inclusions together with carbonic fluid inclusions were identified within diopside megacrysts of ankaramitic basalt dikes in the Kamisano region, Yamanashi Prefecture, Japan. The identified melt inclusions are completely crystallized and primarily composed of quartz, alkali feldspar, and plagioclase, with smaller amounts of pargasite, augite, apatite, and sulfides. Small amounts of residual glass were also occasionally observed in the inclusions. The average chemical composition of these granitic melts within the inclusions corresponds to that of calc‐alkaline granodiorite and the melts are characterized by low water content (0.38 wt%) and high concentrations of sulfur (7000 ppm), copper, and iron. The findings suggested that the composition of granitic melt inclusions may provide insights into the characteristics of near‐surface hydrothermal metal ore deposits. The diopside megacrysts also contain CO2H2O fluid inclusions, which are completely crystallized and mainly comprised of calcite and chlorite, along with small amounts of quartz. The crystals are interpreted to have formed by the reaction of original CO2H2O fluids and host diopside. The diopside megacrysts are estimated to have started crystallization from tholeiitic basalt at a depth of ~30 km in the lower crust, and trapped fluids and granitic melts as inclusions at a shallower depth when the tholeiitic magma ascended.
Brief video training for suicide prevention in veterans: A randomized controlled trial of VA S.A.V.E.
Authors: Teo Alan R. , Hooker Elizabeth R. , Call Aaron A. , Dobscha Steven K. , Gamble Stephanie , Cross Wendi F. , Rodgers Carie
Published: December 2023

Introduction

VA S.A.V.E. (Signs; Ask; Validate; Encourage/Expedite) is a gatekeeper training developed by the Department of Veterans Affairs (VA) that teaches individuals to identify and assist veterans at risk for suicide. Although VA S.A.V.E. has been widely disseminated, rigorous evaluation is lacking.

Methods

In a pilot randomized controlled trial of a brief, video‐based version of VA S.A.V.E., individuals were recruited through Facebook, randomized to VA S.A.V.E. versus an attention control condition, and completed 6‐month follow‐up. A subgroup (n = 15) completed interviews. We used a mixed methods framework to integrate quantitative and qualitative findings.

Results

Among 214 participants, 61% were spouses/partners of veterans and 77% had prior suicide exposure. Sixty‐seven percent (n = 68) of VA S.A.V.E. participants watched the entire video, and satisfaction and usability were highly rated. At 6‐month follow‐up, compared to the control group, the VA S.A.V.E. group had a higher proportion of participants use each gatekeeper behavior (66.7%–84.9% vs. 44.4%–77.1%), and used significantly more total gatekeeper behaviors (2.3 ± 0.9 vs. 1.8 ± 1.0; p = 0.01). Interviews supported positive reactions, learning, and behavior change from VA S.A.V.E.

Conclusion

VA S.A.V.E. merits further investigation into its effectiveness as a brief, scalable gatekeeper training for suicide prevention in veterans.
A Case Study Analysis of the Coach–Athlete Dyad in Different Age Grade Nonelite Rugby Union Teams
Authors: Smith Kevin , Burns Con , O’Neill Cian , Quinn Noreen , Duggan John D. , Winkelman Nick , Wilkie Matthew , Coughlan Edward K.
Published: December 2023

The coach–athlete dyad is complex where both parties can often have contrasting perceptions of each other. The purpose of this research was to examine coaching behaviors and perceptions of the coach–athlete relationship across different age grades of rugby football union. Coaches (n = 5) and athletes (n = 78) from three separate rugby union teams (Child, Adolescent, and Adult) had their training sessions (n = 3) analyzed using the Coach Analysis and Intervention System. Athlete perceptions of their coaches’ behaviors were measured via the Coaching Behavior Scale for Sport, while coach perceptions of their relationship with their athletes were measured using the Coach–Athlete Relationship Questionnaire. Prescriptive coaching styles were observed in all coaches as Coach Analysis and Intervention System results showed high levels of explicit behaviors: “instruction,” “direct management,” and “feedback.” All coaches utilized similar time proportions within sessions for Coach Analysis and Intervention System “Practice,” “Playing,” and “Management” states, respectively. Questionnaire results revealed positive perceptions between coaches and athletes for all teams. Despite positive bidirectional relationships, the prescriptive coaching style displayed by all coaches may not align to best coaching practice. Development of a coach’s behaviors, training content, and perceptions through coach education has the potential to enhance their athletes’ sporting experience, athletic development, and sport-specific competencies.
Dinosaur extinction researcher guilty of research misconduct
Authors: Price Michael
Published: December 2023

But Robert DePalma did not commit fraud in paper claiming asteroid hit in springtime, university report finds
Sulbactam-durlobactam susceptibility test method development and quality control ranges for MIC and disk diffusion tests
Authors: McLeod Sarah M. , Carter Nicole M. , Huband Michael D. , Traczewski Maria M. , Bradford Patricia A. , Miller Alita A.
Published: December 2023

Sulbactam-durlobactam is a β-lactam/β-lactamase inhibitor combination developed to treat hospital-acquired and ventilator-associated bacterial pneumonia caused by
Acinetobacter baumannii-calcoaceticus
complex (ABC). Durlobactam is a diazabicyclooctane β-lactamase inhibitor with potent activity against Ambler classes A, C, and D serine β-lactamases and restores sulbactam activity against multidrug-resistant ABC. Studies were conducted to establish sulbactam-durlobactam antimicrobial susceptibility testing methods for both broth microdilution minimal inhibitory concentration (MIC) and disk diffusion tests as well as quality control (QC) ranges. To establish the MIC test method, combinations of sulbactam and durlobactam were evaluated using a panel of genetically characterized
A. baumannii
isolates which were categorized as predicted to be susceptible or resistant based on the spectrum of β-lactamase inhibition by durlobactam. MIC testing with doubling dilutions of sulbactam with a fixed concentration of 4 µg/mL of durlobactam resulted in the greatest discrimination of the pre-defined susceptible and resistant strains. Similarly, the sulbactam/durlobactam 10/10 µg disk concentration showed the best discrimination as well as correlation with the MIC test.
A. baumannii
NCTC 13304 was selected for QC purposes because it assesses the activity of both sulbactam and durlobactam with clear endpoints. Multi-laboratory QC studies were conducted according to CLSI M23 Tier 2 criteria. A sulbactam-durlobactam broth MIC QC range of 0.5/4–2/4 µg/mL and a zone diameter QC range of 24–30 mm were determined for
A. baumannii
NCTC 13304 and have been approved by CLSI. These studies will enable clinical laboratories to perform susceptibility tests with accurate and reproducible methods.
Compared with pure forest, mixed forest alters microbial diversity and increases the complexity of interdomain networks in arid areas
Authors: Guo Qian , Gong Lu
Published: December 2023

Soil microbial communities are key to material cycling and energy exchange in forest soils. As the Tianshan Mountains in Xinjiang are rich in tree species, it is important to understand the impact of tree species composition on soil microbial community structure and co-occurrence networks in arid mountain habitats. In this study, soil microbial community structure of five typical vegetation types in the Tianshan Mountains of Xinjiang, China, was investigated using bacterial 16S rRNA and fungal ITS sequences. The results showed that the relationship between the fungal community and tree species was strong, while the bacterial community was mainly affected by soil carbon. The dominant bacterial composition was Ascomycota, which had the highest relative abundance in herbaceous soils (27%–41%); the dominant fungal phylum was Ascomycota (50.22%–63.95% of the total sequences), followed by Stramonium (8.99%–28.09%). The fungal community structure of mixed coniferous and broadleaf forests was similar to that of conifers, while the bacterial community structure was similar to that of pure broadleaf forests. Mixed forests (mean connectivity: 812.50, clustering coefficient: 8.89) showed a more complex co-occurrence network and a significant increase in microbial structure related to soil carbon and nitrogen than pure forests (broad: mean connectivity: 710.69, clustering coefficient: 6.94; coniferous: mean connectivity: 730.79, clustering coefficient: 7.76). The results contribute to the understanding of the interactions between soil microorganisms and soil factors in different forest ecosystems and provide new insights into the interactions among forest microorganisms in arid zones.

IMPORTANCE

The results provide a comparative study of the response of soil microbial ecology to the afforestation of different tree species and deepen the understanding of the factors controlling soil microbial community structure.
Comparative analysis of a rapid diagnostic test and scoring tools for ESBL detection in
Enterobacterales
bloodstream infections for optimizing antimicrobial therapy
Authors: Andrews Sam R. , Timbrook Tristan T. , Fisher Mark A. , Tritle Brandon J.
Published: December 2023

Extended-spectrum beta-lactamase (ESBL)-producing
Enterobacterales
bloodstream infections (BSI) are associated with increased cost, morbidity, and mortality compared with BSI by non-ESBL-producing bacteria. Phenotypic susceptibility data from blood cultures can take up to 72 hours to result, leading to delays in appropriate antimicrobial administration and unnecessary carbapenem usage. We sought to evaluate the performance of a rapid diagnostic test (RDT) and two published diagnostic scoring tools for predicting ceftriaxone resistance in BSI by
Enterobacterales
. This was a retrospective observational cohort study evaluating adult patients with BSI by select
Enterobacterales
species (
Escherichia coli
,
Klebsiella oxytoca
,
Klebsiella pneumoniae
group,
Proteus mirabilis
, and
Salmonella
spp.). We compared the performance of a multiplex-PCR panel by BioFire (BCID2) with two diagnostic scoring tools for predicting ceftriaxone resistance. Among 356 patients, ceftriaxone resistance was observed in 41 of 356 (11.5%) isolates. BCID2 accurately predicted ceftriaxone susceptibility in 99.2% of isolates (92.7% sensitivity and 100% specificity), compared with <90% for the two scoring tools (
P
< 0.05 for both). In ceftriaxone-resistant isolates (
n
= 41), BCID2 led to fewer instances of undertreatment with ceftriaxone compared with scoring tools (7.3% vs 68.3% and 92.7%). In ceftriaxone-susceptible isolates (
n
= 315), BCID2 led to no instances of overtreatment with carbapenems compared with 3.8% and 5.7% with the scoring tools. The BCID2 panel outperformed both ESBL scoring tools in our population. Local evaluation of RDT and scoring tools should be performed in conjunction with institutional implementation.

IMPORTANCE

Our study addresses a significant issue in the medical and scientific community—the delayed administration of appropriate antimicrobial treatments due to the time-consuming process of phenotypic susceptibility data collection in gram-negative bloodstream infections. Our research indicates that a multiplex PCR rapid diagnostic test (RDT) significantly outperformed two clinical scoring tools in predicting ceftriaxone susceptibility. Multiplex PCR also led to reduced instances of undertreatment with ceftriaxone and minimized overtreatment with carbapenems. Furthermore, multiplex PCR demonstrated high sensitivity and specificity in predicting ceftriaxone susceptibility. The results of our study underscore the potential RDTs to reduce the time to appropriate antimicrobial therapy, leading to improved patient outcomes and reduced healthcare costs.
Middle Devonian, late Carboniferous, and Triassic magmatic flare-ups in eastern Armorica (Sakarya Zone, Turkey) as revealed by detrital zircon U-Pb-Hf isotopic data
Authors: Topuz Gültekin , Candan Osman , Laurent Oscar , Mohammadi Ali , Okuyucu Cengiz , Çelik Ömer Faruk , Wang Jia-Min
Published: December 2023

The Sakarya Zone of northern Turkey contains a well-preserved Early–Middle Jurassic and Late Cretaceous submarine magmatic arc constructed over pre-Jurassic bedrocks that are considered to be the eastward extension of the Armorican Terrane Assemblage in Europe. In this study, we present U-Pb-Hf isotopic data from the detrital zircons of middle Permian and Lower Jurassic sandstones to reveal episodes of Paleozoic–early Mesozoic magmatic flare-ups. Detrital zircon ages, together with data from the literature, define three major age groups at 400–380 Ma, 326–310 Ma, and 250–230 Ma, which indicates three distinct magmatic flare-ups. In addition, there are minor age clusters at 460–430 Ma and 215–195 Ma. Initial εHf values of the detrital zircons indicate significant juvenile input during the Triassic flare-up, the involvement of significantly reworked crustal material during the late Carboniferous magmatic flare-up, and both juvenile and reworked crustal material during the Middle Devonian magmatic flare-up. Within the pre-Jurassic continental basement rocks of the Sakarya Zone, the late Carboniferous igneous rocks are well documented and most voluminous, and the Middle Devonian rocks are known locally, while the Triassic igneous rocks—apart from those in Triassic accretionary complexes—are hardly known. Because the Sakarya Zone is a Gondwana-derived continental block that was later involved in the Variscan and Alpine orogenies, these magmatic flare-ups cannot be explained by subduction-related processes along a single subduction zone. We propose that the Sakarya Zone rifted from the northern margin of Gondwana during the Late Ordovician–Silurian, the Devonian magmatic flare-up (400–380 Ma) was related to the southward subduction of the Rheic Ocean beneath the Sakarya Zone during its northward drift, the late Carboniferous magmatic flare-up (326–310 Ma) occurred following the collision of the Sakarya Zone with Laurussia, and the Triassic flare-up (250–230 Ma) resulted from northward subduction of the Tethys Ocean beneath the Sakarya Zone. Comparison with data from the literature shows that the Triassic and late Carboniferous magmatic flare-ups are also characteristic features of neighboring Armorican domains, such as the Balkans and the Caucasus; however, the Middle Devonian flare-up appears to be restricted to the Sakarya Zone. Along with the late Carboniferous flare-up, the Late Ordovician–Silurian flare-up, which is locally recorded in the Sakarya Zone, is typical of the Armorican Terrane Assemblage as a whole.
Reconciling complex stratigraphic frameworks reveals temporally and geographically variable depositional patterns of the Campanian Ignimbrite
Authors: Gallo Rose I. , Ort Michael H. , Iacovino Kayla , Silleni Aurora , Smith Victoria C. , Giordano Guido , Isaia Roberto , Boro Joseph
Published: December 2023

The 39.8-ka Campanian Ignimbrite was emplaced during a large caldera-forming eruption of Campi Flegrei near Naples, Italy. The ignimbrite is found up to 80 km from the caldera, and co-ignimbrite ash-fall deposits occur 3200 km away. The proximal and distal stratigraphy of the Campanian Ignimbrite has not been definitively correlated due to the dissimilar appearance of the proximal and distal deposits, a lack of medial exposures, and the inconsistency and heterogeneity of the proximal stratigraphy. Here, we document the major-element glass-shard chemistry, matrix componentry, and lithic componentry of the proximal and distal stratigraphic sequences of the ignimbrite to attempt to correlate the units. The results of these disparate observations taken together suggest that the established stratigraphic units cannot be directly and uniquely correlated between the proximal and distal regions and that neither the proximal nor distal stratigraphy provides a record of the entire eruptive sequence. However, the characteristics studied can be used to demarcate eruptive phases that are connected to some of the defined units in the proximal and distal stratigraphy.
Predictive biomarkers and specific immune responses of COVID-19 mRNA vaccine in patients with cancer: prospective results from the CACOV-VAC trial
Authors: Spehner Laurie , Orillard Emeline , Falcoz Antoine , Lepiller Quentin , Bouard Adeline , Almotlak Hamadi , Kim Stefano , Curtit Elsa , Meynard Guillaume , Jary Marine , Nardin Charlee , Asgarov Kamal , Abdeljaoued Syrine , Chartral Ugo , Mougey Virginie , Ben Khelil Myriam , Lopez Morgane , Loyon Romain , Vernerey Dewi , Adotevi Olivier , Borg Christophe , Mansi Laura , Kroemer Marie
Published: December 2023

Objective

Vaccinated patients with cancer in follow-up studies showed a high seropositivity rate but impaired antibody titres and T cell responses following mRNA vaccine against COVID-19. Besides clinical characteristics and the type of anticancer treatment before vaccination, the identification of patients susceptible to non-response following vaccination using immunological markers is worth to be investigated.

Methods and analysis

All patients (n=138, solid cancers) were included in the CACOV-VAC Study comprising three cohorts ((neo)-adjuvant, metastatic and surveillance). Immune responses were assessed using, respectively, anti-receptor-binding domain (RBD) SARS-CoV-S-IgG assay and interferon-γ ELISpot assay 3 months following the prime vaccination dose. Immunophenotyping of T cells and immunosuppressive cells from peripheral blood was performed before the prime dose. The serological threshold 3563 AU/mL was used to discriminate non-responders or suboptimal responders versus responders.

Results

Most patients achieved seroconversion after receiving the two doses of vaccine (97.6%). The median serological level of anti-RBD SARS-CoV-S-IgG was equal to 3029 for patients at the metastatic stage. The patient’s age was the main demographic characteristic that influenced vaccine efficacy. Among the immunological parameters measured at baseline, lower TIGIT (T cell immunoreceptor with Ig and ITIM domains) expression on CD8 T cells was associated with a better vaccine immunogenicity both in terms of humoral and cellular immune responses.

Conclusion

Despite a high seroconversion rate, median serological levels of patients with cancer, particularly elderly patients, were below the threshold equal to 3563 AU/mL considered as a humoral correlate of protection against SARS-CoV-2. Our findings suggest that the inhibitory receptor TIGIT might be an interesting predictive biomarker of COVID-19 vaccine immunogenicity and beyond in an anticancer vaccine context.

Trial registration number

ClinicalTrials.gov Registry (NCT04836793).
‘When there is love between a father and mother, the child will also be loved’: a qualitative exploration of the links between couples’ relationships, parenting and early childhood development in Mwanza, Tanzania
Authors: McCann Juliet K , Alsager Alya , Bhojani Alina , Joachim Damas , Joseph Julieth , Kabati Mary , Jeong Joshua
Published: December 2023

Introduction

The relationship between parents is a key component of the family system that is associated with various child outcomes. However, less is known about how caregivers and community members make meaning of the influence of couples’ relationships on child outcomes and to what extent family caregiving processes underlie these links in low-income and middle-income countries. We therefore aimed to qualitatively investigate the pathways through which positive and negative couples’ relationship dynamics influence early child development.

Methods

In June 2022, we conducted 60 in-depth interviews (29 fathers and 23 mothers and 8 community stakeholders) and 9 focus group discussions (3 with fathers only, 2 with mothers only and 4 mixed parent groups) from across four purposively sampled communities in Mwanza, Tanzania. We analysed data using elements of thematic content analysis and a grounded theory methodology.

Results

We identified five main mechanisms through which couples’ relationships influenced early child outcomes, including child emotional well-being, health, nutrition and development: (1) parents’ nurturing care practices, (2) parental violence against children, (3) parent–child bonding, (4) parental mental health and (5) child indirect exposures through witnessing interparental relationships. Many of these pathways were interconnected and shaped by gender norms.

Conclusions

Our results highlight the importance of engaging couples and targeting marital relationship dynamics as part of caregiving interventions that aim to improve early child outcomes. Strengthening family caregiving relationships between mothers, fathers, and each with their children is crucial for promoting early childhood development.
Documenting capacity and existing gaps in reporting adverse events following immunisation in Northern Ghana: a quantitative cross-sectional survey of healthcare workers
Authors: Ansah Nana Akosua , Weibel Daniel , Oladokun Samuel Tomilola , Duah Enyonam , Ansah Patrick , Oduro Abraham , Sturkenboom Miriam
Published: December 2023

Background

Immunisation remains an indispensable tool in preventing infectious diseases. A robust pharmacovigilance system assures the public of vaccine safety, particularly in countries like Ghana where there is relatively low reporting of adverse events following immunisation (AEFIs). We explored the experiences of health workers in Ghana to ascertain the existing capacity for data collection and information reporting flows for health events associated with vaccination in the country.

Methods

We conducted a cross-sectional quantitative survey among healthcare workers (HCWs) in Ghana between December 2020 and April 2021. We documented their experiences with regard to knowledge, perceptions and practice of reporting AEFIs to the national pharmacovigilance centre (Ghana Food and Drugs Authority).

Results

Out of 851 participants, 49.2% said their institutions had processes for AEFI reporting. Additionally, 25% of participants had encountered an AEFI within the past year. Out of this number, 55% reported the AEFI. Only 31.2% of community health nurses (vaccinators) considered AEFI reporting part of their job description. Most HCWs (59.34%) had fair to poor knowledge of AEFIs. The main factors affecting AEFI reporting were heavy workload and lack of time (54.1%) and unavailability of reporting forms (57.5%). Only 2% of participants were aware AEFIs could be reported online. Logistic regression analysis revealed female gender as a negative factor influencing AEFI reporting. Training (p<0.0001) and profession (p=0.006) significantly influenced knowledge level of AEFIs. Results of the multiple binary logistic regression indicate that the age and profession of HCWs are the main factors influencing knowledge of reporting AEFIs.

Conclusion

The vaccine pharmacovigilance system in Ghana can be strengthened with targeted regular training on AEFI reporting, guidelines for reporting in all health facilities and prompt feedback from the national pharmacovigilance centre to health workers.
Hydrogen sulfide regulates arsenic-induced cell death in yeast cells by modulating the antioxidative system
Authors: Wu Lihua , Yao Xia , Li Haiyan , Chen Yanfei
Published: December 2023

Arsenic (As) is a metal with potentially toxic effects on different organisms. Hydrogen sulfide (H2S) plays a vital role in mitigating heavy metal toxicity by reducing oxidative stress in plants and animals. However, the role of H2S in alleviating arsenic toxicity in yeast cells remains unclear. In this study, the role of NaHS (exogenous physiological H2S) in alleviating As-induced yeast cell death was investigated. Yeast cells in the logarithmic phase were pretreated with 0.05 mmol/L NaHS for 6 h, and then incubated in the YPD medium with or without 1 mmol/L As. After 12 h of treatment, relative survival rate, H2S content, oxidative stress biomarkers, and antioxidant machinery were measured. Our results showed that sodium arsenite-induced yeast cell death and pretreatment with 0.05 mmol/L NaHS significantly alleviated sodium arsenite-induced cell death. Under sodium arsenite conditions, the levels of intracellular reactive oxygen species (ROS) and malondialdehyde (MDA) increased, accompanied by the inhibition of the catalase (CAT) activity and the downregulation of CTT1 expression. However, the activities of the superoxide dismutase (SOD) and glutathion peroxidase (GPX) increased, and the expression of SOD1 and GPX2 was markedly upregulated in the group treated with sodium arsenite. When yeast cells were pretreated with NaHS, the intracellular ROS and MDA levels decreased significantly, and the activities of SOD, CAT, and GPX increased significantly. This was associated with a significant increase in relative survival rate and H2S content compared to the arsenic treatment alone. Our findings indicate that NaHS alleviates sodium arsenite-induced yeast cell death, mainly by enhancing the antioxidant defense system.
Effects of co-overexpression of ALDH1, CYP71AV1, and iaaM on the density, length, and width of glandular secretory trichomes and the contents of artemisinin in Artemisia annua
Authors: Zhao Yan , Xiao Nan , Long Yanxing , Luo Jie , Liu Xiaozhu , Zhang Xuewen
Published: December 2023

Sesquiterpene lactone artemisinin is one of the main agents used to treat malaria. Artemisinin is produced in the glandular secretory trichomes (GSTs) of Artemisia annua. The plant hormones and metabolic pathways regulate the artemisinin content of A. annua. It was possible to examine the functions of auxin, an important plant hormone, in the development of GSTs in A. annua by enhancing the expression of iaaM, which encodes a tryptophan monooxygenase involved in the biosynthesis of auxin. Additionally, the effects of co-overexpression of aldehyde dehydrogenase 1 ( ALDH1), P450 monooxygenase ( CYP71AV1), and iaaM on the density, length, and width of GSTs and the contents of artemisinin were further investigated. Results indicated that overexpression of iaaM might increase the density, length, and width of GSTs by enhancing auxin biosynthesis. This study also proved the key regulatory role of ALDH1 in the biosynthesis of artemisinin. Moreover, co-overexpression of ALDH1, CYP71AV1, and iaaM successfully increased the density, length, and width of GSTs and improved the artemisinin content in A. annua. Therefore, we established a theoretical basis for modifying artemisinin accumulation in this study by regulating the expression of auxin and artemisinin synthesis-related genes using a metabolic engineering method.
Global comparison between experimentally measured isomeric yield ratios and nuclear model calculations
Authors: Cannarozzo Simone , Pomp Stephan , Solders Andreas , Al-Adili Ali , Göök Alf , Koning Arjan
Published: December 2023

The level density steers transition probabilities between different states in the decay and de-excitation of excited nuclei. Reliable level density modelling is, therefore, key in describing, e.g., de-excitation of fission fragments, with implications on neutron and gamma-rays multiplicities, and also manifested in the population of isomeric states. We test six currently used level density models and the spin distribution in the level density by comparing calculations with measured isomeric yield ratios. The model calculations are performed with the TALYS code and experimental data for nuclear reactions populating spin isomers are retrieved from the EXFOR database. On average, calculations are in agreement with measured data. However, we find that the population of the high-spin state in an isomeric pair is clearly favoured in all of the six studied level density models. Further studies are then performed on the three used phenomenological level density models, to investigate the significance of their effect. We find that a significant reduction of the spin width distribution improves the agreement between calculated and experimentally observed isomeric yield ratios. This result is independent of the incident particle in the nuclear reaction. The needed reduction of the spin width distribution to comply with empirical data has, e.g., implications for studies in angular momentum generation in fission using isomeric yield rations, calculations of anti-neutrino spectra from nuclear reactors, as well as neutron and gamma-ray multiplicities in nuclear reactor calculations.