bluuebunny/crossref_metadata_2025 huggingface dataset:
Stigmatizing deferrals disproportionally reduce donor return rates: Evidence from Brazil
Authors: Vieites Yan , Ferreira Claudio M. , Goldszmidt Rafael , Andrade Eduardo B.
Published: March 2024

Background and Objectives

Prior research has shown that temporary deferrals negatively influence donor return rates, but it remains unknown the extent to which these effects vary across reasons for deferral. We investigate whether deferrals differ in their degree of perceived stigmatization and, if so, how being deferred for stigmatizing (vs. non‐stigmatizing) reasons affects subsequent donation behaviour.

Materials and Methods

We examined whether reasons for deferral vary on their perceived level of stigmatization through an online survey (n = 400). Furthermore, we used a dataset encompassing 25 years of donation records from the state‐run blood collection agency (BCA) from Rio de Janeiro, Brazil, to investigate how stigmatizing (vs. non‐stigmatizing) reasons for deferral affected return rates of 82,648 donors over a 60‐month follow‐up period.

Results

Being deferred for sex‐ and drug‐related reasons was perceived as much more stigmatizing than other reasons for deferral (odds ratio = 3.14, 95% confidence interval [CI]: 2.33–4.25). Controlling for multiple observables, prospective donors were less likely to return to the BCA when deferred for stigmatizing (vs. non‐stigmatizing) reasons (adjusted hazard ratio = 0.87, 95% CI: 0.83–0.93).

Conclusion

Donors perceive deferrals motivated by sex‐ and drug‐related reasons as particularly stigmatizing, which is negatively associated with donor return rates. BCAs may want to pay special attention when communicating stigmatizing reasons for deferral to prospective donors.
The infected diabetic foot: Analysis of diabetic and non‐diabetic foot infections
Authors: Lavery Lawrence A. , Suludere Mehmet A. , Ryan Easton , Crisologo Peter A. , Tarricone Arthur , Malone Matthew , Oz Orhan K.
Published: March 2024

The aim of this study was to compare outcomes of moderate and severe foot infections in people with and without diabetes mellitus (DM). We retrospectively evaluated 382 patients (77% with DM and 23% non‐DM). We collected demographic data, co‐morbidities and one‐year outcomes including healing, surgical interventions, number of surgeries, length of stay, re‐infection and re‐hospitalisation. DM patients required more surgeries (2.3 ± 2.2 vs. 1.7 ± 1.3, p = 0.01), but did not have a longer hospital length of stay during the index hospitalisation (DM 10.9 days ±9.2 vs. non‐DM = 8.8 days ±5.8, p = 0.43). After the index hospitalisation, DM patients had increased rates of re‐hospitalisation for any reason (63.3% vs. 35.2%, CI 1.9–5.2, OR 3.2, p < 0.01), re‐infection at the index wound infection site (48% vs. 30.7%, CI 1.3–3.5, OR 2.1, p < 0.01), re‐hospitalisation for a foot pathology (47.3% vs. 29.5%, CI 1.3–3.6, OR 2.1, p < 0.01), and longer times to ulcer healing (151.8 days ±108.8 vs. 108.8 ± 90.6 days, p = 0.04). Patients with DM admitted to hospital with foot infections have worse clinical outcomes during the index hospitalisation and are more likely to have re‐infection and re‐admission to hospital in the next year.
A New Global Gas Dynamics Performance Optimization Method for Refrigeration Centrifugal Compressor Stage Based on the Immune Algorithm
Authors: Liang Lu , Gong Wuqi , Liu Yitong , Wang Fang
Published: March 2024

This study proposes a new global gas dynamics optimization method, which was applied to a multi-objective optimization task of centrifugal compressor performance with the aim of determining the improvement probability for achieving high efficiency across a wide operating range. Initially, the original nondominated neighbor immune algorithm (NNIA) was extended to solve constrained multi-objective optimization problems for the first time, which mainly incorporated a procedure for handling inequality and equality constraints without additional parameters. Subsequently, an adaptive topological back-propagation multilayer feed-forward artificial neural network (BP-MLFANN) was trained using the modified NNIA to quickly evaluate the fitness value of the centrifugal compressor stage performance during the optimization. The feasibility of the method was validated using the first stage of a refrigeration centrifugal compressor. The results indicated a substantial enhancement in the stage efficiency of the optimized impeller at the Near-stall, Design, and Near-choke operating points, with increasement of 1.8%, 1.9%, and 4%, respectively, as compared to the baseline stage. The flow field analysis shows that the impact loss at impeller leading edge and flow separation in the passage reduced greatly, the mixing process between the leakage flow and mainstream in the channel is significantly weakened, thus the flow field becomes more uniform after optimization. The new global gas dynamics optimization method provides a reference for the development of efficient and rapid optimization techniques for centrifugal compressor.
Unaligned Hip Radiograph Assessment Utilizing Convolutional Neural Networks for the Assessment of Developmental Dysplasia of the Hip
Authors: Perry Sheridan , Folkman Matthew , O'Brien Takara , Wilson Lauren A. , Coyle Eric , Liu Raymond W. , Price Charles T. , Huayamave Victor A.
Published: March 2024

Developmental dysplasia of the hip (DDH) is a condition in which the acetabular socket inadequately contains the femoral head (FH). If left untreated, DDH can result in degenerative changes in the hip joint. Several imaging techniques are used for DDH assessment. In radiographs, the acetabular index (ACIN), center-edge angle, Sharp's angle (SA), and migration percentage (MP) metrics are used to assess DDH. Determining these metrics is time-consuming and repetitive. This study uses a convolutional neural network (CNN) to identify radiographic measurements and improve traditional methods of identifying DDH. The dataset consisted of 60 subject radiographs rotated along the craniocaudal and mediolateral axes 25 times, generating 1500 images. A CNN detection algorithm was used to identify key radiographic metrics for the diagnosis of DDH. The algorithm was able to detect the metrics with reasonable accuracy in comparison to the manually computed metrics. The CNN performed well on images with high contrast margins between bone and soft tissues. In comparison, the CNN was not able to identify some critical points for metric calculation on a few images that had poor definition due to low contrast between bone and soft tissues. This study shows that CNNs can efficiently measure clinical parameters to assess DDH on radiographs with high contrast margins between bone and soft tissues with purposeful rotation away from an ideal image. Results from this study could help inform and broaden the existing bank of information on using CNNs for radiographic measurement and medical condition prediction.
Efficient multipole representation for matter-wave optics
Authors: Teske J. , Walser R.
Published: March 2024

Technical optics with matter waves requires a universal description of three-dimensional traps, lenses, and complex matter-wave fields. In analogy to the two-dimensional Zernike expansion in beam optics, we present a three-dimensional multipole expansion for Bose-condensed matter waves and optical devices. We characterize real magnetic chip traps, optical dipole traps, and the complex matter-wave field in terms of spherical harmonics and radial Stringari polynomials. We illustrate this procedure for typical harmonic model potentials as well as real magnetic and optical dipole traps. Eventually, we use the multipole expansion to characterize the aberrations of a ballistically interacting expanding Bose–Einstein condensate in (3 + 1) dimensions. In particular, we find deviations from the quadratic phase ansatz in the popular scaling approximation. The scheme is data efficient by representing millions of complex amplitudes of a field on a Cartesian grid in terms of a low order multipole expansion without precision loss. This universal multipole description of aberrations can be used to optimize matter-wave optics setups, for example, in matter-wave interferometers.
HAXPES reference spectra of bulk Mo and MoSe2 with Cr Kα excitation
Authors: Deleuze Pierre-Marie , Gauthier Nicolas , Artyushkova Kateryna , Martinez Eugénie , Renault Olivier
Published: March 2024

Monochromatic Cr Kα radiation (5414.8 eV) was used to acquire high-energy photoelectron spectroscopy (HAXPES) data on pure Mo and bulk MoSe2 compound with special attention paid to binding energy scale correction and quantification. The reported spectra include a survey scan and high-resolution Mo 2s, Mo 2p1/2, Mo 2p3/2, Mo 3d, Mo 3p1/2, Mo 3p3/2, Mo 3s, Mo 4s, Mo4p, Se2s, Se 2p1/2, Se 2p3/2, Se 3s, Se 3p1/2, Se 3p3/2, and Se 3d core-levels. The data will be useful as reference core-level spectra for HAXPES studies on molybdenum and its compounds.
Integrated silicon electron source for high vacuum microelectromechanical system devices
Authors: Krysztof Michał , Miera Paweł , Urbański Paweł , Grzebyk Tomasz , Hausladen Matthias , Schreiner Rupert
Published: March 2024

The article presents the process of developing a silicon electron source designed for high-vacuum microelectromechanical system (HV MEMS) devices, i.e., MEMS electron microscope and MEMS x-ray source. Technological constraints and issues of such an electron source are explained. The transition from emitters made of carbon nanotubes to emitters made of pure silicon is described. Overall, the final electron source consists of a silicon tip emitter and a silicon gate electrode integrated on the same glass substrate. The source generates an electron beam without any carbon nanotube coverage. It generates a high and stable electron current and works after the final bonding process of an HV MEMS device.
Lexical effects on talker discrimination in adult cochlear implant users
Authors: Tamati Terrin N. , Jebens Almut , Başkent Deniz
Published: March 2024

The lexical and phonological content of an utterance impacts the processing of talker-specific details in normal-hearing (NH) listeners. Adult cochlear implant (CI) users demonstrate difficulties in talker discrimination, particularly for same-gender talker pairs, which may alter the reliance on lexical information in talker discrimination. The current study examined the effect of lexical content on talker discrimination in 24 adult CI users. In a remote AX talker discrimination task, word pairs–produced either by the same talker (ST) or different talkers with the same (DT-SG) or mixed genders (DT-MG)–were either lexically easy (high frequency, low neighborhood density) or lexically hard (low frequency, high neighborhood density). The task was completed in quiet and multi-talker babble (MTB). Results showed an effect of lexical difficulty on talker discrimination, for same-gender talker pairs in both quiet and MTB. CI users showed greater sensitivity in quiet as well as less response bias in both quiet and MTB for lexically easy words compared to lexically hard words. These results suggest that CI users make use of lexical content in same-gender talker discrimination, providing evidence for the contribution of linguistic information to the processing of degraded talker information by adult CI users.
Dynamics of a two-layer immiscible fluid system exposed to ultrasound
Authors: Hoque S. Z. , Sen A. K.
Published: March 2024

The relocation dynamics of a two-layer immiscible fluid system exposed to bulk acoustic waves using simulations and experiments are reported. A theoretical formulation of the acoustic radiation pressure (ARP) acting on the interface reveals that ARP is a nonlinear function of the impedance contrast. It has been shown that the force acting on the interface is the simple sum of the ARP and the interfacial tension, which is dependent on the angle of the interface. It was discovered that although the acoustic radiation force is directed from high-impedance fluid (HIF) to low-impedance fluid (LIF), the final steady-state configuration depends on the wall-fluid contact angle (CA). Our study reveals that the HIF and LIF would relocate to the channel center for CA>110°, and CA<70°, respectively, while complete flipping of the fluids is observed for intermediate angles. The forces relocate the fluids in the channel, generally, by a clockwise or anticlockwise rotation. Here, it is demonstrated that the direction of this twist can be determined by the relative densities and wettabilities of the two fluids.
Prediction of regional infrasound produced by supersonic sources using a ray-based Mach cone source
Authors: Blom Philip , Gammans Christine , Delbridge Brent , Carmichael Joshua D.
Published: March 2024

The geometry of the Mach cone produced by a supersonic source is analyzed and mapped into initial conditions used in acoustic ray tracing. The resulting source model is combined with spherical geometry ray tracing methods to enable propagation simulations for infrasonic signals produced by bolides, space debris, rockets, aircraft, and other fast-than-sound sources out to typical infrasonic observation distances of hundreds or thousands of kilometers. Idealized linear and parabolic trajectories typical of bolides and rockets, respectively, are used to demonstrate the calculation of regional infrasonic signals produced by such sources and characteristics of the radiated infrasonic waves are found to vary strongly with the geometry of the trajectory and atmospheric structure. Predicted regional infrasonic signals are compared with those observed from a November 2020 bolide that passed over Scandinavia using a combination of institutionally maintained infrasound stations and “citizen scientist” data from the Raspberry Shake data repository.
A weak subducting slab at intermediate depths below northeast Japan
Authors: Delbridge Brent G. , Houston Heidi , Bürgmann Roland , Kita Saeko , Asano Youichi
Published: March 2024

Knowledge of the state of stress in subducting slabs is essential for understanding their mechanical behavior and the physical processes that generate earthquakes. Here, we develop a framework which uses a high-resolution focal mechanism catalog to determine the change in the position of the neutral plane before and after the M9 Tohoku-oki earthquake to determine that the deviatoric stress within the slab at intermediate depths must be very low (∼1 MPa). We show that by combining the static stress calculated from coseismic slip distributions with the stress orientations before and after the mainshock, we can determine the full deviatoric stress tensor within the subducting slab at intermediate depths. These results preclude earthquake source mechanisms that require large background driving stresses, favoring a mechanically weak subducting slab, thus providing quantitative constraints on the physical processes that generate intermediate-depth earthquakes.
BRG1 establishes the neuroectodermal chromatin landscape to restrict dorsal cell fates
Authors: Hoffman Jackson A. , Muse Ginger W. , Langer Lee F. , Patterson A. Isabella , Gandara Isabella , Ward James M. , Archer Trevor K.
Published: March 2024

Cell fate decisions are achieved with gene expression changes driven by lineage-specific transcription factors (TFs). These TFs depend on chromatin remodelers including the Brahma-related gene 1 (BRG1)-associated factor (BAF) complex to activate target genes. BAF complex subunits are essential for development and frequently mutated in cancer. Thus, interrogating how BAF complexes contribute to cell fate decisions is critical for human health. We examined the requirement for the catalytic BAF subunit BRG1 in neural progenitor cell (NPC) specification from human embryonic stem cells. During the earliest stages of differentiation, BRG1 was required to establish chromatin accessibility at neuroectoderm-specific enhancers. Depletion of BRG1 dorsalized NPCs and promoted precocious neural crest specification and enhanced neuronal differentiation. These findings demonstrate that BRG1 mediates NPC specification by ensuring proper expression of lineage-specific TFs and appropriate activation of their transcriptional programs.
How the COVID-19 pandemic signaled the demise of Antarctic exceptionalism
Authors: Liggett Daniela , Frame Bob , Convey Peter , Hughes Kevin A.
Published: March 2024

This paper explores how the COVID-19 pandemic affected science and tourism activities and their governance in the Antarctic and Southern Ocean. The pandemic reduced the ability of Antarctic Treaty Parties to make decisions on policy issues and placed a considerable burden on researchers. Tourism was effectively suspended during the 2020–2021 Antarctic season and heavily reduced in 2021–2022 but rebounded to record levels in 2022–2023. The pandemic stimulated reflection on practices to facilitate dialog, especially through online events. Opportunities arose to integrate innovations developed during the pandemic more permanently into Antarctic practices, in relation to open science, reducing operational greenhouse gas footprints and barriers of access to Antarctic research and facilitating data sharing. However, as well as the long-term impacts arising directly from the pandemic, an assemblage of major geopolitical drivers are also in play and, combined, these signal a considerable weakening of Antarctic exceptionalism in the early Anthropocene.
Recurrent infections drive persistent bladder dysfunction and pain via sensory nerve sprouting and mast cell activity
Authors: Hayes Byron W. , Choi Hae Woong , Rathore Abhay P.S. , Bao Chunjing , Shi Jianling , Huh Yul , Kim Michael W. , Mencarelli Andrea , Bist Pradeep , Ng Lai Guan , Shi Changming , Nho Joo Hwan , Kim Aram , Yoon Hana , Lim Donghoon , Hannan Johanna L. , Purves J. Todd , Hughes Francis M. , Ji Ru-Rong , Abraham Soman N.
Published: March 2024

Urinary tract infections (UTIs) account for almost 25% of infections in women. Many are recurrent (rUTI), with patients frequently experiencing chronic pelvic pain and urinary frequency despite clearance of bacteriuria after antibiotics. To elucidate the basis for these bacteria-independent bladder symptoms, we examined the bladders of patients with rUTI. We noticed a notable increase in neuropeptide content in the lamina propria and indications of enhanced nociceptive activity. In mice subjected to rUTI, we observed sensory nerve sprouting that was associated with nerve growth factor (NGF) produced by recruited monocytes and tissue-resident mast cells. Treatment of rUTI mice with an NGF-neutralizing antibody prevented sprouting and alleviated pelvic sensitivity, whereas instillation of native NGF into naïve mice bladders mimicked nerve sprouting and pain behavior. Nerve activation, pain, and urinary frequency were each linked to the presence of proximal mast cells, because mast cell deficiency or treatment with antagonists against receptors of several direct or indirect mast cell products was each effective therapeutically. Thus, our findings suggest that NGF-driven sensory sprouting in the bladder coupled with chronic mast cell activation represents an underlying mechanism driving bacteria-independent pain and voiding defects experienced by patients with rUTI.
Physiological characterization of single-gene lysis proteins
Authors: Antillon S. Francesca , Bernhardt Thomas G. , Chamakura Karthik , Young Ry
Published: March 2024

Single-strand RNA (ssRNA) and single-strand DNA phages elicit host lysis using a single gene, in each case designated as
sgl
. Of the 11 identified Sgls, three have been shown to be specific inhibitors of different steps in the pathway that supplies lipid II to the peptidoglycan (PG) biosynthesis machinery. These Sgls have been called “protein antibiotics” because the lytic event is a septal catastrophe indistinguishable from that caused by cell wall antibiotics. Here, we designate these as type I Sgls. In this formalism, the other eight Sgls are assigned to type II, the best-studied of which is protein L of the paradigm F-specific ssRNA phage MS2. Comparisons have suggested that type II Sgls have four sequence elements distinguished by hydrophobic and polar character. Environmental metatranscriptomics has revealed thousands of new ssRNA phage genomes, each of which presumably has an Sgl. Here, we describe methods to distinguish type I and type II Sgls. Using phase contrast microscopy, we show that both classes of Sgls cause the formation of blebs prior to lysis, but the location of the blebs differs significantly. In addition, we show that L and other type II Sgls do not inhibit the net synthesis of PG, as measured by radio-labeling of PG. Finally, we provide direct evidence that the Sgl from
Pseudomonas
phage PP7 is a type I Sgl, in support of a recent report based on a genetic selection. This shows that the putative four-element sequence structure suggested for L is not a reliable discriminator for the operational characterization of Sgls.

IMPORTANCE

The ssRNA phage world has recently undergone a metagenomic expansion upward of a thousandfold. Each genome likely carries at least one single-gene lysis (
sgl
) cistron encoding a protein that single-handedly induces host autolysis. Here, we initiate an approach to segregate the Sgls into operational types based on physiological analysis, as a first step toward the alluring goal of finding many new ways to induce bacterial death and the attendant expectations for new antibiotic development.
Stoichiometry for entry and binding properties of the Env protein of R5 T cell-tropic HIV-1 and its evolutionary variant of macrophage-tropic HIV-1
Authors: Bonner Xavier , Sondgeroth Amy , McCue Amelia , Nicely Nathan , Tripathy Ashutosh , Spielvogel Ean , Moeser Matthew , Ke Ruian , Leiderman Karin , Joseph Sarah B. , Swanstrom Ronald
Published: March 2024

Human immunodeficiency virus type 1 typically requires a high density of CD4 for efficient entry as a mechanism to target CD4+ T cells (T-tropic), with CCR5 being used most often as the coreceptor. When target T cells are limiting, the virus can evolve to infect cells with a low density of CD4 such as macrophages (M-tropic). The entry phenotype is known to be encoded in the viral Env protein on the surface of the virus particle. Using data showing a dose response for infectivity based on CD4 surface density, we built a model consistent with T-tropic viruses requiring multiple CD4 molecules to mediate infection, whereas M-tropic viruses can infect cells using a single CD4 receptor molecule interaction. We also found that T-tropic viruses bound to the surface of cells with a low density of CD4 are released more slowly than M-tropic viruses which we modeled to be due to multiple interactions of the T-tropic virus with multiple CD4 molecules to allow the initial stable binding. Finally, we found that some M-tropic Env proteins, as the gp120 subunit, possess an enhanced affinity for CD4 compared with their T-tropic pair, indicating that the evolution of macrophage tropism can be reflected both in the closed Env trimer conformation on the virion surface and, in some cases, also in the open confirmation of gp120 Env. Collectively, these studies reveal differences in the stoichiometry of interaction of T-tropic and M-tropic viruses with CD4 and start to identify the basis of binding differences at the biochemical level.

IMPORTANCE

Human immunodeficiency virus type 1 normally targets CD4+ T cells for viral replication. When T cells are limiting, the virus can evolve to infect myeloid cells. The evolutionary step involves a change from requiring a high surface density of CD4 for entry to being able to infect cells with a low density of CD4, as is found on myeloid lineage cells such as macrophage and microglia. Viruses able to infect macrophages efficiently are most often found in the CNS late in the disease course, and such viruses may contribute to neurocognitive impairment. Here, we examine the CD4 binding properties of the viral Env protein to explore these two different entry phenotypes.
L-arginine supplementation abrogates hypoxia-induced virulence of
Staphylococcus aureus
in a murine diabetic pressure wound model
Authors: Baker Carol L. , Seo Keun Seok , Park Nogi , Rutter Jaime K. , Thornton Justin A. , Pruett Stephen B. , Park Joo Youn
Published: March 2024

Diabetic foot ulcers (DFUs) are the most common complications of diabetes resulting from hyperglycemia leading to ischemic hypoxic tissue and nerve damage.
Staphylococcus aureus
is the most frequently isolated bacteria from DFUs and causes severe necrotic infections leading to amputations with a poor 5-year survival rate. However, very little is known about the mechanisms by which
S. aureus
dominantly colonizes and causes severe disease in DFUs. Herein, we utilized a pressure wound model in diabetic TALLYHO/JngJ mice to reproduce ischemic hypoxic tissue damage seen in DFUs and demonstrated that anaerobic fermentative growth of
S. aureus
significantly increased the virulence and the severity of disease by activating two-component regulatory systems leading to expression of virulence factors. Our
in vitro
studies showed that supplementation of nitrate as a terminal electron acceptor promotes anaerobic respiration and suppresses the expression of
S. aureus
virulence factors through inactivation of two-component regulatory systems, suggesting potential therapeutic benefits by promoting anaerobic nitrate respiration. Our
in vivo
studies revealed that dietary supplementation of L-arginine (L-Arg) significantly attenuated the severity of disease caused by
S. aureus
in the pressure wound model by providing nitrate. Collectively, these findings highlight the importance of anaerobic fermentative growth in
S. aureus
pathogenesis and the potential of dietary L-Arg supplementation as a therapeutic to prevent severe
S. aureus
infection in DFUs.

IMPORTANCE

S. aureus
is the most common cause of infection in DFUs, often resulting in lower-extremity amputation with a distressingly poor 5-year survival rate. Treatment for
S. aureus
infections has largely remained unchanged for decades and involves tissue debridement with antibiotic therapy. With high levels of conservative treatment failure, recurrence of ulcers, and antibiotic resistance, a new approach is necessary to prevent lower-extremity amputations. Nutritional aspects of DFU treatment have largely been overlooked as there has been contradictory clinical trial evidence, but very few
in vitro
and
in vivo
modelings of nutritional treatment studies have been performed. Here we demonstrate that dietary supplementation of L-Arg in a diabetic mouse model significantly reduced duration and severity of disease caused by
S. aureus
. These findings suggest that L-Arg supplementation could be useful as a potential preventive measure against severe
S. aureus
infections in DFUs.
Bisphenol A exposure affects specific gut taxa and drives microbiota dynamics in childhood obesity
Authors: Lopez-Moreno Ana , Cerk Klara , Rodrigo Lourdes , Suarez Antonio , Aguilera Margarita , Ruiz-Rodriguez Alicia
Published: March 2024

Cumulative xenobiotic exposure has an environmental and human health impact which is currently assessed under the One Health approach. Bisphenol A (BPA) exposure and its potential link with childhood obesity that has parallelly increased during the last decades deserve special attention. It stands during prenatal or early life and could trigger comorbidities and non-communicable diseases along life. Accumulation in the nature of synthetic chemicals supports the “environmental obesogen” hypothesis, such as BPA. This estrogen-mimicking xenobiotic has shown endocrine disruptive and obesogenic effects accompanied by gut microbiota misbalance that is not yet well elucidated. This study aimed to investigate specific microbiota taxa isolated and selected by direct BPA exposure and reveal its role on the overall children microbiota community and dynamics, driving toward specific obesity dysbiosis. A total of 333 BPA-resistant isolated species obtained through culturing after several exposure conditions were evaluated for their role and interplay with the global microbial community. The selected BPA-cultured taxa biomarkers showed a significant impact on alpha diversity. Specifically,
Clostridium
and
Romboutsia
were positively associated promoting the richness of microbiota communities, while
Intestinibacter
,
Escherichia-Shigella
,
Bifidobacterium
, and
Lactobacillus
were negatively associated. Microbial community dynamics and networks analyses showed differences according to the study groups. The normal-weight children group exhibited a more enriched, structured, and connected taxa network compared to overweight and obese groups, which could represent a more resilient community to xenobiotic substances. In this sense, subnetwork analysis generated with the BPA-cultured genera showed a correlation between taxa connectivity and more diverse potential enzymatic BPA degradation capacities.

IMPORTANCE

Our findings indicate how gut microbiota taxa with the capacity to grow in BPA were differentially represented within differential body mass index children study groups and how these taxa affected the overall dynamics toward patterns of diversity generally recognized in dysbiosis. Community network and subnetwork analyses corroborated the better connectedness and stability profiles for normal-weight group compared to the overweight and obese groups.
Noninvasive serum markers for predicting significant liver histopathology in HBeAg-negative chronic HBV-infected patients with normal alanine aminotransferase
Authors: Gao Yuhua , Wang Mingyang , Liu Xia’nan
Published: March 2024

This study is to explore the proportion of significant liver histopathology in hepatitis B e antigen (HBeAg)-negative chronic hepatitis B virus (HBV)-infected patients with normal alanine aminotransferase (ALT) and investigate noninvasive indicators for predicting significant liver histopathology. A total of 201 HBeAg-negative chronic HBV-infected patients with normal ALT who underwent liver biopsy were involved in this study. Significant liver histological changes were defined as necroinflammation grade ≥2 (G ≥ 2) and/or fibrosis stage ≥2 (S ≥ 2). The results showed that 42.3% (85/201) and 45.8% (92/201) of the HBeAg-negative patients with normal ALT have significant liver necroinflammation (G ≥ 2) and fibrosis (S ≥ 2), respectively. High normal ALT (>22 U/L), high level of serum HBV DNA (>3.42 log IU/mL), and low level of prealbumin (PA) (<170 mg/L) were independent predictors for significant liver necroinflammation, and the predictive value of the combined indicators was 0.750 (
P
< 0.001), while high normal ALT (>24 U/L) and high level of FIB-4 (>1.53) were independent predictors for significant liver fibrosis, and the predictive value of the combined indicators was 0.740 (
P
< 0.001). In conclusion, more than 40% of HBeAg-negative patients with normal ALT have significant liver histopathology and require immediate antiviral treatment. ALT, PA, HBV DNA, and FIB-4 can independently predict significant liver inflammation and fibrosis for HBeAg-negative patients with normal ALT. Lowering the treatment threshold of ALT may benefit the HBeAg-negative chronic HBV-infected patients.

IMPORTANCE

Hepatitis B e antigen (HBeAg)-negative chronic hepatitis B virus (HBV)-infected patients with normal alanine aminotransferase (ALT) were supposed to have a low risk of progression to cirrhosis or hepatocellular carcinoma, and it was recommended to regularly follow up or undergo liver biopsy to assess liver histopathology according to the major international guidelines. However, this study indicates that a considerable number of HBeAg-negative chronic HBV-infected patients with normal ALT have significant liver histopathology and require immediate antiviral treatment. Besides, several clinical commonly used noninvasive indicators were found that can be used to predict significant liver histopathology; thereby liver biopsy might be avoided for HBeAg-negative chronic HBV-infected patients with normal ALT.
The timing of bacterial mesophyll infection shapes the leaf chemical landscape
Authors: Roman-Reyna Veronica , Heiden Nathaniel , Butchacas Jules , Toth Hannah , Cooperstone Jessica L. , Jacobs Jonathan M.
Published: March 2024

Chemistry in eukaryotic intercellular spaces is shaped by both hosts and symbiotic microorganisms such as bacteria. Pathogenic microorganisms like barley-associated
Xanthomonas translucens
(Xt) swiftly overtake the inner leaf tissue becoming the dominant microbial community member during disease development. The dynamic metabolic changes due to Xt pathogenesis in the mesophyll spaces remain unknown. Genomic group I of Xt consists of two barley-infecting lineages: pathovar translucens (Xtt) and pathovar undulosa (Xtu). Xtu and Xtt, although genomically distinct, cause similar water-soaked lesions. To define the metabolic signals associated with inner leaf colonization, we used untargeted metabolomics to characterize Xtu and Xtt metabolism signatures associated with mesophyll growth. We found that mesophyll apoplast fluid from infected tissue yielded a distinct metabolic profile and shift from catabolic to anabolic processes over time compared to water-infiltrated control. The pathways with the most differentially expressed metabolites by time were glycolysis, tricarboxylic acid cycle, sucrose metabolism, pentose interconversion, amino acids, galactose, and purine metabolism. Hierarchical clustering and principal component analysis showed that metabolic changes were more affected by the time point rather than the individual colonization of the inner leaves by Xtt compared to Xtu. Overall, in this study, we identified metabolic pathways that explain carbon and nitrogen usage during host–bacterial interactions over time for mesophyll tissue colonization. This foundational research provides initial insights into shared metabolic strategies of inner leaf colonization niche occupation by related but phylogenetically distinct phyllosphere bacteria.

IMPORTANCE

The phyllosphere is a habitat for microorganisms including pathogenic bacteria. Metabolic shifts in the inner leaf spaces for most plant–microbe interactions are unknown, especially for
Xanthomonas
species in understudied plants like barley (
Hordeum vulgare
).
Xanthomonas translucens
pv. translucens (Xtt) and
Xanthomonas translucens
pv. undulosa (Xtu) are phylogenomically distinct, but both colonize barley leaves for pathogenesis. In this study, we used untargeted metabolomics to shed light on Xtu and Xtt metabolic signatures. Our findings revealed a dynamic metabolic landscape that changes over time, rather than exhibiting a pattern associated with individual pathovars. These results provide initial insights into the metabolic mechanisms of
X. translucens
inner leaf pathogenesis.
Magnetite-apatite ores record widespread involvement of molten salts
Authors: Xu Xinyue , Bain Wyatt M. , Tornos Fernando , Hanchar John M. , Lamadrid Hector M. , Lehmann Bernd , Xu Xiaochun , Steadman Jeffrey A. , Bottrill Ralph S. , Soleymani Majid , Rajabi Abdorrahman , Li Peng , Tan Xuehai , Xu Shihong , Locock Andrew J. , Steele-MacInnis Matthew
Published: March 2024

The origins of magnetite-apatite deposits are controversial, and the crux of the debate is what types of fluids form these rocks. We present evidence from 20 magnetite-apatite deposits worldwide showing ubiquitous involvement of molten salts. The studied deposits are distributed globally, from various tectonic settings, and from Precambrian to Quaternary in age. In every case, water-poor polycrystalline melt inclusions in ore-stage minerals are dominated by sulfate, chloride, and carbonate components plus variable proportions of calc-silicates, phosphates, and iron ± titanium oxides that re-melt between 285 °C and 1100 °C. These fluids are very different from what is generally expected in most geologic settings, but their ubiquitous presence in magnetite-apatite rocks indicates that molten salts are widespread and essential to the formation of these deposits.
Strong seismic anisotropy due to upwelling flow at the root of the Yellowstone mantle plume
Authors: Wolf Jonathan , Li Mingming , Haws Anne A. , Long Maureen D.
Published: March 2024

The Yellowstone region (western United States) is a commonly cited example of intraplate volcanism whose origin has been a topic of debate for several decades. Recent work has suggested that a deep mantle plume, rooted beneath southern California, is the source of Yellowstone volcanism. Seismic anisotropy, which typically results from deformation, can be used to identify and characterize mantle flow. Here, we show that the proposed plume root location at the base of the mantle is strongly seismically anisotropic. This finding is complemented by geodynamic modeling results showing upwelling flow and high strains in the lowermost mantle beneath the Yellowstone region. Our results support the idea that the Yellowstone volcanism is caused by a plume rooted in the deepest mantle beneath southern California, connecting dynamics in the deepest mantle with phenomena at Earth's surface.
Conversational AI facilitates mental health assessments and is associated with improved recovery rates
Authors: Rollwage Max , Habicht Johanna , Juchems Keno , Carrington Ben , Hauser Tobias U , Harper Ross
Published: March 2024

Mental health services across the globe are overburdened due to increased patient need for psychological therapies and a shortage of qualified mental health practitioners. This is unlikely to change in the short-to-medium term. Digital support is urgently needed to facilitate access to mental healthcare while creating efficiencies in service delivery. In this paper, we evaluate the use of a conversational artificial intelligence (AI) solution (Limbic Access) to assist both patients and mental health practitioners with referral, triage, and clinical assessment of mild-to-moderate adult mental illness. Assessing this solution in the context of England’s National Health Service (NHS) Talking Therapies services, we demonstrate in a cohort study design that deploying such an AI solution is associated with improved recovery rates. We find that those NHS Talking Therapies services that introduced the conversational AI solution improved their recovery rates, while comparable NHS Talking Therapies services across the country reported deteriorating recovery rates during the same time period. Further, we provide an economic analysis indicating that the usage of this AI solution can be highly cost-effective relative to other methods of improving recovery rates. Together, these results highlight the potential of AI solutions to support mental health services in the delivery of quality care in the context of worsening workforce supply and system overburdening. For transparency, the authors of this paper declare our conflict of interest as employees and shareholders of Limbic Access, the AI solution referred to in this paper.
Prognostic implications of T stage in different pathological types of colorectal cancer: an observational study using SEER population-based data
Authors: Yao Nan , Li Wenqiang , Wang Jiwei , Chu Hongyuan , Duan Ning , Niu Xinyu , Yu Guoyong , Qu Jun
Published: March 2024

Objectives

Colorectal cancer (CRC) encompasses a spectrum of pathological types, each exhibiting distinct biological behaviours that challenge the conventional T-staging system’s predictive efficiency. Thus, this study aims to explore the prognostic significance of the T stage across various CRC pathological types, seeking to unravel insights that could enhance prognostic assessment in this complex disease.

Study design

We performed a retrospective analysis using the Surveillance, Epidemiology, and End Results (SEER) database for primary CRC cases from 2010 to 2017.

Setting

The SEER database, comprising data from various US regional and state cancer registries, identified 39 321 patients with CRC. Our analysis focused on the three most common CRC pathological types: adenocarcinoma (AC), mucinous adenocarcinoma (MC) and signet ring cell carcinoma (SR).

Primary outcome measures

The study used Cox regression models to evaluate how different pathological characteristics impact mortality risk in patients with CRC. Time-dependent receiver operating characteristic curves were also applied to assess the prognostic accuracy of various tumour node metastasis (TNM)/non-mucinous (NM) stages.

Results

We observed significant associations between T stage and mortality risk for patients with AC and MC. Notably, in comparison to those at T1 stage, patients with AC in the T4 stage demonstrated a 2.01-fold increase in mortality risk (HR=2.01, 95% CI: 1.89 to 2.15), while patients with MC at T4 stage showed a 1.42-fold increase (HR=1.42, 95% CI: 1.03 to 1.97). However, within the SR group, T stages did not independently impact survival, showing no significant distinction (HR=1.07, 95% CI: 0.59 to 1.95). Intriguingly, the traditional TNM staging systems demonstrated limited discriminatory power in predicting prognosis for patients with SR when compared with the more innovative NM staging systems.

Conclusions

This study uncovers important insights about the prognostic significance of the T stage in different types of CRC, highlighting the need for personalised assessments based on specific histological subtypes.
Prospective study examining the impact of cerebral angiography on quantitative pupillometer values in the interventional radiology suite
Authors: Nguyen Brian , Marshall Jade L , Rana Chahat , Atem Folefac D , Stutzman Sonja E , Olson DaiWai M , Aiyagari Venkatesh , Ray Bappaditya
Published: March 2024

Objectives

The purpose of this pilot study was to obtain baseline quantitative pupillometry (QP) measurements before and after catheter-directed cerebral angiography (DCA) to explore the hypothesis that cerebral angiography is an independent predictor of change in pupillary light reflex (PLR) metrics.

Design

This was a prospective, observational pilot study of PLR assessments obtained using QP 30 min before and after DCA. All patients had QP measurements performed with the NPi-300 (Neuroptics) pupillometer.

Setting

Recruitment was done at a single-centre, tertiary-care academic hospital and comprehensive stroke centre in Dallas, Texas.

Participants

Fifty participants were recruited undergoing elective or emergent angiography. Inclusion criteria were a physician-ordered interventional neuroradiological procedure, at least 18 years of age, no contraindications to PLR assessment with QP, and nursing transport to and from DCA. Patients with a history of eye surgery were excluded.

Main outcome measures

Difference in PLR metric obtained from QP 30 min before and after DCA.

Results

Statistically significant difference was noted in the pre and post left eye readings for the minimum pupil size (a.k.a., pupil diameter on maximum constriction). The mean maximum constriction diameter prior to angiogram of 3.2 (1.1) mm was statistically larger than after angiogram (2.9 (1.0) mm; p<0.05); however, this was not considered clinically significant. Comparisons for all other PLR metrics pre and post angiogram demonstrated no significant difference. Using change in NPi pre and post angiogram (Δpre=0.05 (0.77) vs Δpost=0.08 (0.67); p=0.62), we calculated the effect size as 0.042. Hence, detecting a statistically significant difference in NPi, if a difference exists, would require a sample size of ~6000 patients.

Conclusions

Our study provides supportive data that in an uncomplicated angiogram, even with intervention, there is no effect on the PLR.
Using feedback on patient health outcomes to improve orthopaedic physical therapist practice: a quality improvement study
Authors: van der Wees Philip J , Balog Emily J , Irrgang James J , Zeleznik Hallie , McDonald Paige L , Harwood Kenneth J
Published: March 2024

Objective

Measuring health outcomes plays an important role in patient-centred healthcare. When aggregated across patients, outcomes can provide data for quality improvement (QI). However, most physical therapists are not familiar with QI methods based on patient outcomes. This mixed-methods study aimed to develop and evaluate a QI programme in outpatient physical therapy care based on routinely collected health outcomes of patients with low-back pain and neck pain.

Methods

The QI programme was conducted by three teams of 5–6 physical therapists from outpatient settings. Plan-do-study-act cycles were used based on team-selected goals. Monthly feedback reports of process and outcomes of care, including pre–post treatment changes in Oswestry Disability Index (ODI) and Neck Disability Index (NDI), guided the QI efforts. Primary outcomes were pre-QI and post-QI changes in knowledge and attitudes towards outcome measures through a survey, and administered and self-reported compliance with using the ODI and NDI. Semistructured interviews and a focus group were conducted to evaluate the perceived value of the programme.

Results

Post-QI, the survey showed improvements in two items related to the role of patients and implementation of outcome measures. Registered pre-QI and post-QI completion rates were high at intake (ODI:91% pre, 88% post; NDI:75% pre, 84% post), while completion rates at discharge improved post-QI (ODI:14% pre, 66% post; NDI: 32% pre, 50% post). Perceived benefits of the QI programme included clinician and institutional accountability to processes and strategies aimed at continuous improvement in patient care. An important facilitator for programme participation was autonomy in project selection and development, while a main barrier was the time required to set up the QI project.

Conclusion

A QI programme based on the feedback of routinely collected health outcomes of patients with low back pain and neck pain was feasible and well accepted by three pilot teams of physical therapists.
AMU patient list generation: from junior scribe to junior doctor
Authors: Ravat Zahra , Sinha Amil , Jellinek Alistair , Page Nigel
Published: March 2024

This quality improvement project (QIP) aimed to assess the impact of automating patient list generation on the acute medical unit (AMU) at Sandwell and West Birmingham Hospitals NHS Trust. The AMU patient list categorises patients requiring ‘clerking’, ‘post-take’ (PTWR) and ‘post-post-take’ (PPTWR) for the morning ward round. During weekdays, this list need only include the patients in AMU. For weekends, this list must include ‘outliers’, that is, patients transferred to different wards (which may lack resident medical teams over the weekends) but still requiring PTWR/PPTWR. The list is created by the junior doctor on their night shift, a daily necessity due to the high AMU patient turnover.

A pilot study, followed by three complete ‘plan-do-study-act’ (PDSA) cycles, was conducted over 2021/2022. Cycle 1 (pre-intervention) and cycle 2 (post-intervention) assessed the impact of the generator on weekdays. This was adapted for the weekend over cycles 2 and 3. The process measure assessed was the time taken for list generation. The outcome measure was the total number of patients clerked per night. The balancing measure was doctors’ attitudes.

The intervention reduced the time taken for list generation by an average of 44.3 min (66.3%) during weekdays and 37.8 min (42%) during weekends. Run charts demonstrated significance for the reduction in weekday list generation time. Both weekdays (63.5% decrease, p<0.00001) and weekends (50.5% decrease, p=0.0007) had significant reductions in total negative attitudes. Both weekdays and weekends had ‘time-consuming’ as the most frequently selected attitude pre-intervention, whereas ‘easy to make’ was most frequently selected post-intervention. Some junior doctors reported the generator enabled clerking of extra patients, supported by non-significant increases in the averages for this outcome.

This QIP demonstrates how the automation of labour-intensive administrative tasks results in notable time-saving outcomes. Thereby improving doctor attitudes and well-being, and facilitating the delivery of quality patient care.