bluuebunny/crossref_metadata_2025 huggingface dataset:
Magnetic ordering in Ce substituted zirconite-YCrO4 nanostructures: focus on tunable energy bandgap and local-atomic environment
Authors: Dokala R K , Das S , Mishra P K , Thota S
Published: August 2023

This study presents a comprehensive investigation of the structural, magnetic, electronic, and optical spectroscopic properties of tetragonal Zirconite Y1−x
Ce
x
CrO4 polycrystals that were synthesized at various temperature ranges. The YCrO4 phase in its pristine state demonstrates ferromagnetic (FM) ordering, characterized by a Curie temperature, T
C ∼ 9.3 K. Nevertheless, the introduction of magnetic Ce3+ in place of Y3+ ions results in a reduction of the T
C and the appearance of a weak antiferromagnetic (AFM) behaviour, as indicated by the presence of a negative Curie–Weiss temperature (−10 K ≲ θ
CW ≲ −30 K). It is observed that the introduction of moderate levels of Ce substitution leads to a significant increase in thermal irreversibility in the magnetization difference between field-cooled and zero-field-cooled states ΔM (M
FC − M
ZFC). This phenomenon indicates the substantial influence of magneto-crystalline anisotropy that exists within the system. Field-dependent magnetization data exhibits higher saturation magnetization values (M
S ≳ (2.7 to 4.4) × 103 emu mole−1) and higher magneto-crystalline anisotropy (K
1 ∼ 2.18 to 3.41 J m−3) for the dilute dispersion of Ce (x ≤ 0.05). Local atomic environment probed by the electron spin resonance clearly indicates the presence of hyperfine splitting of Cr5+ spectra having a single d-electron (

t

2
g

1

e

g

0

) with orbital configuration bearing the possible doublet:

F
=
1
,

2

I
=

3
2

J
=

1
2

.

On the other hand, the rare-earth Ce3+ spectra show hyperfine-doublets as

7
2

and

9
2

.

Finally, the energy band-gap (E
g = 2.14 to 2.38 eV, for x ∼ 0 to 0.1) determined from the diffuse reflectance spectroscopy reveals the emergence of intermediate localized states upon substitution of Ce3+.
Detection of Ischemic Brain Stroke using Deep Learning
Authors: Sharmila C , Santhiya S , Poongundran M , Sanjeeth S , Pranesh S
Published: August 2023

Stroke is a severe disease that is currently the country’s fourth greatest reason of death. Ischaemic stroke is a medical emergency that necessitates prompt triage, diagnosis, and treatment. A patient’s stroke lesion site must be identified as soon as feasible and properly to assess the risks and give more early and efficient treatment. It is essential to develop automated methods for identifying and segmenting stroke lesions. In this work, MRI is sliced into two-dimensional network groups and used each division set to train sessions and predict individually. Finally, before slicing and splitting to produce a 3D lesion result, two-dimensional slices results of all groups are arranged according to the position order in the MRI.
Self-Supervised Approach to Addressing Zero-Shot Learning Problem
Authors: Okerinde Ademola , Hoggatt Sam , Lakkireddy Divya Vani , Brubaker Nolan , Hsu William , Shamir Lior , Spiesman Brian
Published: August 2023

In recent years, self-supervised learning has had significant success in applications involving computer vision and natural language processing. The type of pretext task is important to this boost in performance. One common pretext task is the measure of similarity and dissimilarity between pairs of images. In this scenario, the two images that make up the negative pair are visibly different to humans. However, in entomology, species are nearly indistinguishable and thus hard to differentiate. In this study, we explored the performance of a Siamese neural network using contrastive loss by learning to push apart embeddings of bumblebee species pair that are dissimilar, and pull together similar embeddings. Our experimental results show a 61% F1-score on zero-shot instances, a performance showing 11% improvement on samples of classes that share intersections with the training set.
Medical Image Segmentation Method Based on Improved Unet
Authors: Ge Shufan , Wang Zhaorui , Li Ruixuan , Shao Tianhao
Published: August 2023

This paper is an attempt to apply 3DUnet system to medical image segmentation. The classifying model is built based on actual medical images from MSD Cardiac dataset. The 3DUnet system, which is developed on Convolutional Neural Networks will be of great significance in medical diagnosis and analysis. The paper analyzes and contains details of the 3DUnet system we built and the algorithms we applied. We applied the method of cutting the input images into patches and K-fold cross validation to obtain better results. The final average value of Dice is over 87%. Codes are available: https://github.com/LRXuanxuan/jubilant-chainsaw.
Breast Cancer Prediction Feature Selection Using ML Algorithms
Authors: Jiang Lin
Published: August 2023

Breast cancer is a disease that breast epithelial cells uncontrolled hyperplasia under the effects of several different carcinogens. The early symptoms of breast cancer are breast lesions, nipple discharge and axillary fossa lymphadenectasis. Breast cancer can directly threat the life of patient by casing various organ lesions and metastasis of cancer cells in the late stage of suffering from this disease. The method of classifying tumors into malignant or benign is the main challenge that needed to be dealt with to treat patient in a correct way. This paper shows the different classification models to predict the kind of breast cancer. All data used to distinguish the type of breast cancer in the research comes from UCI repository. Some simple classifiers are employed in the research, for instance, Decision Tree Classifier, Extreme Gradient Boosting, Naïve Bayes Classifier, Gradient Boosting, Support Vector Machine. The results show that using Support Vector Machine algorithm the prediction accuracy of breast cancer reaches 99.7%.
Multiple Object Tracking Based on YOLOv5 and Optimized DeepSORT Algorithm
Authors: Bai Tianyou
Published: August 2023

As a widely discussed issue in academic and industrial fields, multiple object tracking (MOT) has a huge impact on various aspects, such as video surveillance, human-machine interaction, viral reality and autonomous driving. Among all the MOT algorithms, DeepSORT enjoys a high reputation for its speed, accuracy and robustness to frequent occlusion circumstance. With the help of DeepSORT, the main objective of this research work is to propose an algorithm with a better performance on frequent occlusion and long-time occlusion issues. To accomplish such a mission, an improved deep appearance descriptor was constructed and trained off-line. To achieve a higher performance, the object detector YOLOv5, which has been proved to be faster than previous detectors, is employed in this research as a substitution of the original detector Faster R-CNN.
Detector challenges of the strong-field QED experiment LUXE at the
European XFEL
Authors: Santra A.
Published: August 2023

The LUXE experiment aims at studying high-field QED in electron-laser and
photon-laser interactions, with the 16.5 GeV electron beam of the European XFEL
and a laser beam with power of up to 350 TW. This experiment will use one
electron bunch out of 2700 bunches per train from XFEL. The experiment will
measure the multiplicity spectra of electrons, positrons and photons in expected
ranges of 10-3 to 109 particles per 1 Hz
bunch crossing, depending on the laser power and focus. These measurements have
to be performed in the presence of low-energy high radiation-background. To meet
these challenges, for high-rate electron and photon fluxes, the experiment will
use Cherenkov radiation detectors, scintillator screens, sapphire sensors as
well as lead-glass monitors for backscattering off the beam-dump. A four layer
silicon-pixel tracker and a compact electromagnetic tungsten calorimeter with
GaAs sensors will be used to measure the positron spectra. The layout of the
experiment and the expected performance under the harsh radiation conditions
will be presented. Beam tests for the Cherenkov detector and the electromagnetic
calorimeter were performed at DESY recently and results will be presented. The
experiment received a stage 0 critical approvement (CD0) from the DESY
management and is in the process of preparing its technical design report (TDR).
It is expected to start running in 2025/6.
A deep learning-based method for predicting the low-cycle fatigue life of austenitic stainless steel
Authors: Duan Hongyan , Yue Shunqiang , Liu Yang , He Hong , Zhang Zengwang , Zhao Yingjian
Published: August 2023

In modern engineering, predicting the fatigue life of materials is crucial for safety assessment. The relationship between fatigue life and its influencing factors is difficult to predict by traditional methods, and deep learning can achieve great power and flexibility through nested hierarchies of concepts. Taking the low cycle fatigue life of 316 austenitic stainless steel as an example, a method for predicting the low cycle fatigue life of austenitic stainless steel by deep learning is established based on the limited ability of traditional neural network model and genetic algorithm optimization model. The deep neural network model is introduced to predict the fatigue life of the material. The results show that the prediction correlation coefficient R of the deep neural network prediction model with three hidden layers is 0.991, and the deep neural network learning model has better prediction ability.
Structural properties of graded In
x
Ga 1−x
As metamorphic buffer layers for quantum dots emitting in the telecom bands
Authors: Scaparra Bianca , Ajay Akhil , Avdienko Pavel S , Xue Yuyang , Riedl Hubert , Kohl Paul , Jonas Björn , Costa Beatrice , Sirotti Elise , Schmiedeke Paul , Villafañe Viviana , Sharp Ian D , Zallo Eugenio , Koblmüller Gregor , Finley Jonathan J , Müller Kai
Published: August 2023

In recent years, there has been a significant increase in interest in tuning the emission wavelength of InAs quantum dots (QDs) to wavelengths compatible with the already existing silica fiber networks. In this work, we develop and explore compositionally graded In
x
Ga

1
−
x

As metamorphic buffer layers (MBLs), with lattice constant carefully tailored to tune the emission wavelengths of InAs QDs towards the telecom O-band. The designed heterostructure is grown by molecular beam epitaxy (MBE), where a single layer of InAs QDs is grown on top of the MBL and is capped with a layer having a fixed indium (In) content. We investigate the structural properties of the grown MBLs by reciprocal space mapping, as well as transmission electron microscopy, and verify the dependence of the absorption edge of the MBL on the In-content by photothermal deflection spectroscopy measurements. This allows us to identify a growth temperature range for which the MBLs achieve a near-equilibrium strain relaxation for In-content up to ∼30

%

. Furthermore, we explore the emission wavelength tunability of QDs grown on top of a residual strained layer with a low density of dislocations. Specifically, we demonstrate a characteristic red-shift of the QD photoluminescence towards the telecom O-band (1300 nm) at low temperature. This study provides insights into the relaxation profiles and dislocation propagation in compositionally graded MBLs grown via MBE thus paving the way for realizing MBE-grown heterostructures containing InAs QDs for advanced nanophotonic devices emitting in the telecom bands.
Novel “Z” Technique to Overcome Warping of Costal Cartilage
Authors: Zhang Zhe , Wu Junzheng , Yu Zhou , Zhang Yu , Zhang Juan , Song Baoqiang
Published: August 2023

Background

Dorsal augmentation with costal cartilage is generally used for aesthetic rhinoplasty. However, the tendency of costal cartilage to warp may jeopardize the aesthetic outcome.

Objectives

The aim of this study was to describe a new “Z” technique to overcome the warping of costal cartilage after implantation and to evaluate the efficacy of this technique in vitro.

Methods

A total of 31 pairs of porcine costal cartilage grafts (40 mm × 10 mm × 5 mm) were obtained and kept in Dulbecco's Modified Eagle Medium (Sigma-Aldrich, St. Louis, MO) to maintain cell viability. Paired grafts were obtained and randomly allocated for preparation by the accordion technique and the “Z” technique. Standardized photographs (obtained immediately after operation and at 4 weeks) were used for warping analysis. Biomechanical testing was performed to measure the graft's capacity to resist deformation by an external force.

Results

Cell viability of the grafts at 4 weeks was comparably good in the accordion group and the Z group (61.88% ± 4.47% vs 67.48% ± 7.03%, P = 0.55). Warping angle was comparable between the 2 groups (P > 0.01). The capacity to resist external force was significantly better in the Z group; the force needed to cause deformation was 3.98 ± 1.04 N in the Z group vs 1.61 ± 0.47 N in the accordion group in lateral view (P < 0.0001), and 1.33 ± 0.41 N vs 0.96 ± 0.24 N, respectively, in frontal view (P = 0.0013).

Conclusions

The “Z” technique appears to be a simple and effective method to minimize the tendency of costal cartilage to warp after implantation.
‘4-Check’ protocol for intraoperative anastomotic assessment during transanal total mesorectal excision: retrospective cohort study
Authors: Tirelli Flavio , Lorenzon Laura , Biondi Alberto , Neri Ilaria , Santoro Gloria , Persiani Roberto
Published: August 2023

Background

Anastomotic leakage is a major complication following rectal cancer surgery. The primary aim of this study was to investigate the efficacy of a protocol based on a quadruple intraoperative anastomotic assessment (4-Check) during transanal total mesorectal excision (TaTME).

Methods

Patients who underwent TaTME for rectal cancer with primary anastomosis were reviewed and divided into two groups: before (pre-4-Check: April 2015 - April 2019) and after the implementation of the 4-Check protocol (May 2019 - May 2022). This protocol consisted of a multimodal anastomotic integrity assessment, including indocyanine green-evaluation of colonic stump and intraluminal anastomosis perfusion, a reverse air leak test and anastomotic doughnuts assessment. The primary outcome was incidence of clinical and/or radiological anastomotic leakage. The secondary outcome included intraoperative anastomosis defects and repairs and 30-day complication rate. Propensity score matching and multivariable analyses were performed.

Results

Of 186 patients, 160 were selected: 86 patients in the pre-4-Check and 74 in the 4-Check group. After propensity score matching, there was no difference in postoperative anastomotic leakage (pre-4-Check versus 4-Check: 11.1 per cent versus 7.4 per cent; P = 0.50). However, in the 4-Check group, the intraoperative detection of defects and repairs was significantly increased (P = 0.03), and the number of complications was reduced (pre-4-Check versus 4-Check: 33.3 per cent versus 9.3 per cent, P = 0.004). Multivariable analyses confirmed that the use of the 4-Check protocol, the detection of anastomotic defects and increased albumin levels were associated with a reduced number of complications.

Conclusion

The 4-Check protocol allowed the intraoperative detection and repair of anastomotic defects. Anastomotic leakage rates were not reduced; however, 30-day complication rates were lower after implementation of this protocol.
Prevalence of Comorbid Factors in Patients With Recurrent Clostridioides difficile Infection in ECOSPOR III, a Randomized Trial of an Oral Microbiota–Based Therapeutic
Authors: Berenson Charles S , Lashner Bret , Korman Louis Y , Hohmann Elizabeth , Deshpande Abhishek , Louie Thomas J , Sims Matthew , Pardi Darrell , Kraft Colleen S , Wang Elaine E L , Cohen Stuart H , Feuerstadt Paul , Oneto Caterina , Misra Bharat , Pullman John , De Ananya , Memisoglu Asli , Lombardi David A , Hasson Brooke R , McGovern Barbara H , von Moltke Lisa , Lee Christine H
Published: August 2023

Background

Although comorbidities are risk factors for recurrent Clostridioides difficile infection (rCDI), many clinical trials exclude patients with medical conditions such as malignancy or immunosuppression. In a phase 3, double-blind, placebo-controlled, randomized trial (ECOSPOR III), fecal microbiota spores, live (VOWST, Seres Therapeutics; hereafter “VOS,” formerly SER-109), an oral microbiota therapeutic, significantly reduced the risk of rCDI at week 8. We evaluated the efficacy of VOS compared with placebo in patients with comorbidities and other risk factors for rCDI.

Methods

Adults with rCDI were randomized to receive VOS or placebo (4 capsules daily for 3 days) following standard-of-care antibiotics. In this post hoc analysis, the rate of rCDI through week 8 was assessed in VOS-treated participants compared with placebo for subgroups including (i) Charlson comorbidity index (CCI) score category (0, 1–2, 3–4, ≥5); (ii) baseline creatinine clearance (<30, 30–50, >50 to 80, or >80 mL/minute); (iii) number of CDI episodes, inclusive of the qualifying episode (3 and ≥4); (iv) exposure to non-CDI-targeted antibiotics after dosing; and (v) acid-suppressing medication use at baseline.

Results

Of 281 participants screened, 182 were randomized (59.9% female; mean age, 65.5 years). Comorbidities were common with a mean overall baseline age-adjusted CCI score of 4.1 (4.1 in the VOS arm and 4.2 in the placebo arm). Across all subgroups analyzed, VOS-treated participants had a lower relative risk of recurrence compared with placebo.

Conclusions

In this post hoc analysis, VOS reduced the risk of rCDI compared with placebo, regardless of baseline characteristics, concomitant medications, or comorbidities.
Powassan Virus Encephalitis: A Tertiary Center Experience
Authors: Mendoza Maria Alejandra , Hass Reece M , Vaillant James , Johnson Derek R , Theel Elitza S , Toledano Michel , Abu Saleh Omar
Published: August 2023

Background

Powassan virus (POWV) is an emerging arthropod-borne flavivirus, transmitted by Ixodes spp. ticks, which has been associated with neuroinvasive disease and poor outcomes.

Methods

A retrospective study was conducted at Mayo Clinic from 2013 to 2022. We included clinical and epidemiologic data of probable and confirmed neuroinvasive POWV cases.

Results

Sixteen patients with neuroinvasive POWV were identified; their median age was 63.2 years, and 62.5% were male. Six patients presented with rhombencephalitis, 4 with isolated meningitis, 3 with meningoencephalitis, 2 with meningoencephalomyelitis, and 1 with opsoclonus myoclonus syndrome. A median time of 18 days was observed between symptom onset and diagnosis. Cerebrospinal fluid analysis showed lymphocytic pleocytosis with elevated protein and normal glucose in the majority of patients. Death occurred within 90 days in 3 patients (18.8%), and residual neurologic deficits were seen in 8 survivors (72.7%).

Conclusions

To our knowledge, this is the largest case series of patients with neuroinvasive POWV infection. We highlight the importance of a high clinical suspicion among patients who live in or travel to high-risk areas during the spring to fall months. Our data show high morbidity and mortality rates among patients with neuroinvasive disease.
Kinesiophobia and associated variables in patients with heart failure
Authors: Sentandreu-Mañó Trinidad , Deka Pallav , Almenar Luis , Tomás José M , Ferrer-Sargues Francisco-José , López-Vilella Raquel , Klompstra Leonie , Marques-Sule Elena
Published: August 2023

Aims

Patients with heart failure (HF) can exhibit kinesiophobia, an excessive, debilitating, and irrational fear of movement. This study aimed to enhance the understanding of kinesiophobia in patients with HF by analysing associations with the following variables: musculoskeletal pain, quality of life, quality of sleep, functional capacity, disability, frailty, sex, and age.

Methods and results

In this cross-sectional study, 107 participants were included, with ages ranging from 28 to 97 years (57% men, mean age 73.18 ± 12.68 years). Multiple regression analyses were performed with all variables, including polynomial regressions for variables with a non-linear relationship. Kinesiophobia was significantly correlated (P < 0.01) with musculoskeletal pain, quality of life, quality of sleep, functional capacity, disability, and being at risk of frailty, while age and sex were not statistically significant. Frailty disability and musculoskeletal pain intensity were variables linearly associated with kinesiophobia, while quality of sleep and disability had a non-linear relationship with kinesiophobia.

Conclusion

Kinesiophobia needs to be evaluated and better understood in patients with HF to improve physical activity and exercise adherence. This study found that musculoskeletal pain intensity, quality of sleep, disability, and frailty risk have a significant association with kinesiophobia in patients with HF. Our results suggest multi-dimensional associations of kinesiophobia in patients with HF, which require further examination and understanding.
Time trends in income-related disparity in incidence of acute coronary syndrome
Authors: Simoni Amalie H , Kragholm Kriatian H , Bøggild Henrik , Jensen Svend E , Valentin Jan B , Johnsen Søren P
Published: August 2023

Background

Higher incidence of acute coronary syndrome (ACS), among those with lower income, has been recognized in the most recent decades. Still, there is a paucity of data on temporal changes. This study aims to investigate 20-year time trends in income-related disparity in the incidence of ACS in Denmark.

Methods

This Population-based repeated cross-sectional study included all patients with first-time ACS, aged ≥20 years, registered in the Danish National Patient Registry 1998–2017. Aggregated sociodemographic data for the Danish population was accessed from Statistics Denmark. Yearly incidence rates (IR) and incidence rate ratios (IRR), with the highest-income quartile as a reference, were standardized using cell-specific personal equivalent income according to year, sex and age group with 95% confidence intervals. Interaction analysis was executed for differences in IR of ACS between the lowest- and highest-income quartile over time.

Results

A total of 220 070 patients hospitalized with ACS from 1998 to 2017 were identified. The yearly standardized ACS IRs decreased in all income quartiles. However, the IR remained higher in the lowest-income quartile compared to the highest for both men [1998: IRR 1.45 (95% confidence interval, CI 1.39–1.52) and 2017: 1.47 (1.40–1.54)] and women [1998: IRR 1.73 (1.64–1.82) and 2017: 1.76 (1.65–1.88)]. Interaction analysis showed that over the period the difference in IR between the lower- and the highest-income quartile decreased with 1–5 ACS cases per 100 000 person-year.

Conclusion

Income-related disparity in the incidence of ACS was present in Denmark between 1998 and 2017. Despite a marked overall decrease in the yearly ACS incidence, the extent of income-related disparity remained unchanged.
Illuminating the oral microbiome: cellular microbiology
Authors: Lamont Richard J , Miller Daniel P , Bagaitkar Juhi
Published: August 2023

Epithelial cells line mucosal surfaces such as in the gingival crevice and provide a barrier to the ingress of colonizing microorganisms. However, epithelial cells are more than a passive barrier to microbial intrusion, and rather constitute an interactive interface with colonizing organisms which senses the composition of the microbiome and communicates this information to the underlying cells of the innate immune system. Microorganisms, for their part, have devised means to manipulate host cell signal transduction pathways to favor their colonization and survival. Study of this field, which has become known as cellular microbiology, has revealed much about epithelial cell physiology, bacterial colonization and pathogenic strategies, and innate host responses.
The 95 per cent confidence interval for the mean sea-level change rate derived from tide gauge data
Authors: Wang Guoquan
Published: August 2023

Tide gauge (TG) data are crucial for assessing global sea-level and climate changes, coastal subsidence and inundation. Mean sea-level (MSL) time-series derived from TG data are autocorrelated. The conventional ordinary least-squares regression method provides reasonable estimates of relative sea-level (RSL) change rates (linear trends) but underestimates their uncertainties. In order to cope with the autocorrelation issue, we propose an approach that uses an ‘effective sample size’ (${N}_{\mathrm{ eff}}$) to estimate the uncertainties (±95 per cent confidence interval, or 95 per cent CI for short). The method involves decomposing the monthly MSL time-series into three components: a linear trend, a periodic component and a noise time-series. The ${N}_{\mathrm{ eff}}$ is calculated according to the autocorrelation function (ACF) of the noise time-series. We present an empirical model that fits an inverse power-law relationship between 95 per cent CI and time span (T) based on 1160 TG data sets globally distributed, where $95\ \mathrm{ per}\ \mathrm{ cent}\,\mathrm{ CI} = 179.8{T}^{ - 1.29}$. This model provides a valuable tool for projecting the optimal observational time span needed for the desired uncertainty in sea-level rise rate or coastal subsidence rate from TG data. It suggests that a 20-yr TG time-series may result in a 3–5 mm yr−1 uncertainty (95 per cent CI) for the RSL change rate, while a 30-yr data set may achieve about 2 mm yr−1 uncertainty. To achieve a submillimetre per year (< 1 mm yr−1) uncertainty, approximately 60 yr of TG observations are needed. We also present a Python module (TG_Rate_95CI.py) for implementing the methodology. The Python module and the empirical model have broad applications in global sea-level rise and climate change studies, and coastal environmental and infrastructure planning, as well as Earth science education.
Prevalence of Disease-Related Malnutrition and Micronutrients Deficit in Patients with Inflammatory Bowel Disease: A Multicentric Cross-Sectional Study by the GSMII (Inflammatory Bowel Disease Study Group)
Authors: Viganò Chiara , Palermo Andrea , Mulinacci Giacomo , Pirola Lorena , Losco Alessandra , Meucci Gianmichele , Saibeni Simone , Pastorelli Luca , Amato Arnaldo , Gatti Mario , Cortelezzi Claudio , Di Sabatino Antonio , Morganti Daniela , Boni Francesca , Grasso Gianalberto , Casella Giovanni , Casini Valentina , Caprioli Flavio Andrea , Vecchi Maurizio , Bezzio Cristina , Bergna Irene , Radaelli Franco , Mengoli Caterina , Massironi Sara
Published: August 2023

Background and Aims

Inflammatory bowel disease (IBD) patients might experience disease-related malnutrition (DRM), but prevalence and risk factors are not well defined. The primary aim of the study was to define the prevalence of DRM and micronutrient deficiency in IBD patients; the secondary aim was to assess variables related to DRM.

Materials and methods

A multicenter, cross-sectional study was performed including consecutive adult IBD patients during a period of 2 weeks. Nutritional status was assessed with the body mass index (BMI) and the Malnutrition Universal Screening Tool. DRM was defined according to European Society for Clinical Nutrition and Metabolism guidelines.

Results

Among the 295 enrolled patients, the prevalence of DRM was 23%, with no statistical difference between Crohn’s disease and ulcerative colitis. Compared with well-nourished patients, patients with DRM showed higher rate of hospitalization in the previous month, were more often receiving systemic steroids, and had lower hemoglobin, albumin, and prealbumin levels and higher median C-reactive protein levels. At univariate logistic regression, current hospitalization, hospitalization in the previous month, low serum albumin, low BMI, high C-reactive protein, high Crohn’s Disease Activity Index, and female sex were variables related to DRM. At the multivariate logistic regression, low BMI, current hospitalization and hospitalization in the previous month were significantly associated with DRM. In 23% of IBD patients, a deficiency of at least 1 micronutrient was observed, with no difference between ulcerative colitis and Crohn’s disease.

Conclusions

DRM and microelements malnutrition are frequent conditions in the IBD population. DRM seems to be associated with disease activity and hospitalization.
Exploring Colitis through Dynamic T Cell Adoptive Transfer Models
Authors: Yang Wenjing , Cong Yingzi
Published: August 2023

Numerous animal models of colitis have provided important insights into the pathogenesis of inflammatory bowel disease (IBD), contributing to a better understanding of the underlying mechanisms for IBD. As aberrant CD4+ T cell responses play a critical role in the pathogenesis and development of IBD, T cell adoptive transfer models of colitis have become a valuable tool in investigating the immunopathogenesis of intestinal inflammation. While the adoptive transfer of CD4+ CD45RBhi T cells into immunedeficient recipient mice was the first discovered and is currently the most widely used model, several variations of the T cell transfer model have also been developed with distinct features. Here, we describe the history, principle, and characteristics of adoptive transfer colitis models and discuss their strengths, limitations, and applications.
Neuronal and Glial Metabolite Abnormalities in Participants With Persistent Neuropsychiatric Symptoms After COVID-19: A Brain Proton Magnetic Resonance Spectroscopy Study
Authors: Ernst Thomas , Ryan Meghann C , Liang Hua-Jun , Wang Justin P , Cunningham Eric , Saleh Muhammad G , Kottilil Shyamasundaran , Chang Linda
Published: August 2023

Background

The aim of this study was to determine whether neurometabolite abnormalities indicating neuroinflammation and neuronal injury are detectable in individuals post–coronavirus disease 2019 (COVID-19) with persistent neuropsychiatric symptoms.

Methods

All participants were studied with proton magnetic resonance spectroscopy at 3 T to assess neurometabolite concentrations (point-resolved spectroscopy, relaxation time/echo time = 3000/30 ms) in frontal white matter (FWM) and anterior cingulate cortex–gray matter (ACC-GM). Participants also completed the National Institutes of Health Toolbox cognition and motor batteries and selected modules from the Patient-Reported Outcomes Measurement Information System.

Results

Fifty-four participants were evaluated: 29 post–COVID-19 (mean ± SD age, 42.4 ± 12.3 years; approximately 8 months from COVID-19 diagnosis; 19 women) and 25 controls (age, 44.1 ± 12.3 years; 14 women). When compared with controls, the post–COVID-19 group had lower total N-acetyl compounds (tNAA; ACC-GM: −5.0%, P = .015; FWM: –4.4%, P = .13), FWM glutamate + glutamine (–9.5%, P = .001), and ACC-GM myo-inositol (−6.2%, P = .024). Additionally, only hospitalized patients post–COVID-19 showed age-related increases in myo-inositol, choline compounds, and total creatine (interaction P = .029 to <.001). Across all participants, lower FWM tNAA and higher ACC-GM myo-inositol predicted poorer performance on several cognitive measures (P = .001–.009), while lower ACC-GM tNAA predicted lower endurance on the 2-minute walk (P = .005).

Conclusions

In participants post–COVID-19 with persistent neuropsychiatric symptoms, the lower-than-normal tNAA and glutamate + glutamine indicate neuronal injury, while the lower-than-normal myo-inositol reflects glial dysfunction, possibly related to mitochondrial dysfunction and oxidative stress in Post-COVID participants with persistent neuropsychiatric symptoms.
Significant increase of CTX-M-15-ST131 and emergence of CTX-M-27-ST131 Escherichia coli high-risk clones causing healthcare-associated bacteraemia of urinary origin in Spain (ITUBRAS-2 project)
Authors: Becerra-Aparicio Federico , Gómez-Zorrilla Silvia , Hernández-García Marta , Gijón Desiré , Siverio Ana , Berbel Dàmaris , Sánchez-Carrillo Carlos , Cercenado Emilia , Rivera Alba , de Malet Ana , Xercavins Mariona , Ruiz de Gopegui Enrique , Canoura-Fernández Luis , Martínez José Antonio , Seral Cristina , Del Pozo José Luis , Cotarelo Manuel , Díaz-Regañón Jazmín , Cantón Rafael , Oliver Antonio , Horcajada Juan Pablo , Ruiz-Garbajosa Patricia
Published: August 2023

Objectives

To assess the microbiological characteristics of Escherichia coli causing healthcare-associated bacteraemia of urinary origin (HCA-BUO) in Spain (ITUBRAS-2 project), with particular focus on ESBL producers and isolates belonging to ST131 high-risk clone (HiRC). Clinical characteristics and outcomes associated with ST131 infection were investigated.

Methods

A total of 222 E. coli blood isolates were prospectively collected from patients with HCA-BUO from 12 tertiary-care hospitals in Spain (2017–19). Antimicrobial susceptibility and ESBL/carbapenemase production were determined. ST131 subtyping was performed. A subset of 115 isolates were selected for WGS to determine population structure, resistome and virulome. Clinical charts were reviewed.

Results

ESBL-producing E. coli prevalence was 30.6% (68/222). ST131 represented 29.7% (66/222) of E. coli isolates and accounted for the majority of ESBL producers (46/68, 67.6%). The C2/H30-Rx subclone accounted for most ST131 isolates (44/66) and was associated with CTX-M-15 (37/44) and OXA-1 enzymes (27/44). Cluster C1-M27 was identified in 4/10 isolates belonging to subclade C1/H30-R1 and associated with CTX-M-27. Additionally, ST131 isolates showed a high content of other acquired resistance genes, and clade C/ST131 isolates carried characteristic QRDR mutations. They were categorized as uropathogenic E. coli and had higher aggregate virulence scores. ST131 infection was associated with more complex patients, prior use of cephalosporins and inadequate empirical treatment but was not associated with worse clinical outcomes.

Conclusions

ST131 HiRC is the main driver of ESBL-producing E. coli causing HCA-BUO in Spain, mainly associated with the expansion of subclade CTX-M-15-C2/H30-Rx and the emergence of CTX-M-27-C1/H30-R1 (Cluster C1-M27).
Blood telomere length gain in people living with HIV switching to dolutegravir plus lamivudine versus continuing triple regimen: a longitudinal, prospective, matched, controlled study
Authors: Lombardi Francesca , Sanfilippo Alessia , Fabbiani Massimiliano , Borghetti Alberto , Ciccullo Arturo , Tamburrini Enrica , Di Giambenedetto Simona
Published: August 2023

Background

Blood telomere length (BTL) is a validated biomarker of aging. ART reduces immunosenescence and has benefits in terms of BTL in people living with HIV (PLWH). However, it has also been observed that ART containing NRTIs, such as tenofovir or abacavir, which are potent inhibitors of human telomerase activity in vitro, might negatively affect BTL. Here we investigated the effects on BTL 1 year after switching to a dual therapy (DT) with dolutegravir + lamivudine versus maintaining a standard triple therapy (TT) with a two-NRTI backbone and an anchor drug.

Methods

This was a longitudinal, prospective, matched, controlled study that included virologically suppressed adults on stable three-drug ART who either switched at baseline (BL) to DT or maintained TT. The DT and TT groups were 1:1 matched for age, sex, years since HIV diagnosis, years on ART and anchor drug. BTL was assessed by a monochrome multiplex qPCR at BL and after 48 weeks (W48).

Results

We enrolled 120 PLWH, i.e. 60 participants in each group. At BL, the BTL means were comparable between the two groups (P = 0.973). At W48, viro-immunological status was stable and an overall increase in the mean BTL was observed, i.e., +0.161 (95%CI, 0.054–0.268) (P = 0.004). However, the within-group analysis showed a significant mean BTL gain in the DT group (P = 0.003) but not in the TT group (P = 0.656).

Conclusions

In this setting of virologically suppressed PLWH, simplifying to dolutegravir + lamivudine was associated with a higher gain in BTL than maintaining triple therapy after the 1 year follow-up. These findings suggest that as a simplification strategy dolutegravir + lamivudine might have a positive effect on BTL.
The epidemiology and microbiological characteristics of infections caused by Gram-negative bacteria in Qatar: national surveillance from the Study for Monitoring of Antimicrobial Resistance Trends (SMART): 2017 to 2019
Authors: Sid Ahmed Mazen A , Petkar Hawabibee Mahir , Saleh Thoraya M , Albirair Mohamed , Arisgado Lolita A , Eltayeb Faiha K , Mahmoud Hamed Manal , Al-Maslamani Muna A , Al Khal Abdul Latif , Alsoub Hussam , Ibrahim Emad Bashir , Abdel Hadi Hamad
Published: August 2023

Background

The global Study of Monitoring Antimicrobial Resistance Trends (SMART) is a surveillance program for evaluation of antimicrobial resistance (AMR) in Gram-negative bacteria (GNB) from different regions including Gulf countries.

Objectives

To evaluate AMR in GNB from various clinical specimens including microbiological and genetic characteristics for existing and novel antimicrobials.

Methods

A prospective study was conducted on clinical specimens from Hamad Medical Corporation, Qatar, between 2017 and 2019 according to the SMART protocol. Consecutive GNB from different sites were evaluated including lower respiratory, urinary tract, intrabdominal and bloodstream infections.

Results

Over the 3 years study period, 748 isolates were evaluated from the specified sites comprising 37 different GNB outlining four key pathogens: Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Stenotrophomonas maltophilia.

For the two major pathogens E. coli and K. pneumoniae, phenotypic ESBL was identified in 55.77% (116/208) compared to 39% (73/187), while meropenem resistance was 3.8% compared to 12.8% and imipenem/relebactam resistance was 2.97% compared to 11.76%, respectively. The overall ceftolozane/tazobactam resistance for E. coli was 9.6% (20/208) compared to 14.97% (28/187) for K. pneumoniae while resistance for ceftazidime/avibactam was 3.65% (5/137) and 5.98% (10/117), respectively. Genomic characteristics of 70 Enterobacterales including 48 carbapenem-resistant, revealed prevalence of β-lactamases from all classes, predominated by blaCXM-15 while carbapenem resistance revealed paucity of blaKPC and dominance of blaOXA-48 and blaNDM resistance genes.

Conclusions

Surveillance of GNB from Qatar showed prevalence of key pathogens similar to other regions but demonstrated significant resistance patterns to existing and novel antimicrobials with different underlying resistance mechanisms.
WHO/INRUD prescribing indicators among tertiary regional referral hospitals in Dar es Salaam, Tanzania: a call to strengthen antibiotic stewardship programmes
Authors: Costantine Judith K , Bwire George M , Myemba David T , Sambayi Godfrey , Njiro Belinda J , Kilipamwambu Amosi , Ching’oro Novatus , Shungu Rehema S , Mganga Mathew , Majigo Mtebe V
Published: August 2023

Background

Antibiotic prescribing should be guided by national essential medicines lists (NEMLs) and treatment guidelines; however, there are inadequate data on antibiotic utilization patterns in tertiary hospitals in Tanzania. This study aimed to determine antibiotic prescribing patterns in tertiary hospitals in Dar es Salaam, Tanzania.

Methods

A retrospective cross-sectional study was conducted in three regional referral hospitals. About 200 prescription records from 2020 to 2022 were analysed at each hospital for prescribing patterns using WHO/ International Network of Rational Use of Drugs (INRUD) indicators (1993) and the AWaRe 2021 classification. Factors associated with receiving an antibiotic prescription were assessed using a logistic regression model. Facilities were ranked on prescribing practices using the index of rational drug prescribing (IRDP).

Results

A total of 2239 drugs were prescribed, of which 920 (41.1%) were antibiotics. An average of 3.7 ± 1.5 (optimal: 1.6–1.8) total medicines and 1.53 ± 0.78 antibiotics were prescribed per patient. About 88.0% (528) of the prescriptions contained antibiotics (optimal: 20.0%–26.8%), while 78.2% (413) of all antibiotic prescriptions contained injections (optimal: 13.4%–24.1%). Furthermore, 87.5% (462) of the antibiotics were prescribed in generic names (optimal: 100%), while 98.7% (521) conformed to the NEML (optimal: 100%). Metronidazole was the most frequently prescribed antibiotic (39.2%; n = 134), followed by ceftriaxone (37.1%, n = 127) and amoxicillin/clavulanic acid (8.5%, n = 29).

Conclusions

We found substantial empirical prescribing and overuse of antibiotics exceeding WHO recommendations. Antibiotic overuse varied across the hospitals. Being male, having underlying conditions such as diabetes mellitus, and/or being treated at Temeke hospital were associated with receiving an antibiotic prescription. We recommend strengthening antibiotic stewardship programmes in the studied facilities.
The CKD-EPI 2021 Equation and Other Creatinine-Based Race-Independent eGFR Equations in Chronic Kidney Disease Diagnosis and Staging
Authors: Lu Song , Robyak Kimberly , Zhu Yusheng
Published: August 2023

Background

Recent debate on the race correction factor in creatinine-based estimated glomerular filtration rate (eGFR) has led to the development of a new race-independent equation (Chronic Kidney Disease Epidemiology Collaboration, CKD-EPI_2021). Previously, some institutions have already modified the early version of the CKD-EPI or Modification of Diet in Renal Disease (MDRD) equations by removing the race factors (CKD-EPI_2009_non-Black (NB), MDRD_NB) for Black populations although this approach remains controversial.

Methods

In this study, the CKD-EPI_2009_NB, MDRD_NB, and European Kidney Function Consortium (EKFC) equations were compared directly with the CKD-EPI_2021 equation in eGFR calculation, chronic kidney disease (CKD) diagnosis, and staging in a local population.

Results

These 3 previous methods underestimated eGFR compared to CKD-EPI_2021 for eGFR < 90 mL/min/1.73 m2 but overestimated eGFR at the high end (>120 mL/min/1.73 m2). Around the CKD diagnosis cutoff (60 mL/min/1.73 m2), both MDRD_NB and EFKC equations resulted in an increase in CKD cases compared to CKD-EPI_2021. CKD-EPI_2009_NB demonstrated a similar trend although the difference was not statistically significant. In a population with low eGFR (<60 mL/min/1.73 m2), the EKFC equation showed a CKD staging pattern significantly different from that by CKD-EPI_2021, but all 3 previous methods resulted in a similar number of end-stage renal failure cases. In general, the EKFC equation demonstrated a weaker agreement in eGFR calculation and concordance in classification with the CKD-EPI_2021 equation than MDRD_NB and CKD-EPI_2009_NB.

Conclusions

Our study provides a direct visual comparison to demonstrate the potential clinical impact between 3 previously used race-independent methods and the CKD-EPI_2021 equation and aids the communication with healthcare providers during the implementation of this new equation.
Assembly and co-occurrence patterns of rhizosphere bacterial communities are closely linked to soil fertility during continuous cropping of cut chrysanthemum (Chrysanthemum morifolium Ramat)
Authors: Li Jun , Meng Feng , Jiang Maibo , Zhang Hanjie , Chu Guixin , Tao Rui
Published: August 2023

Aims

Continuous cropping is known to have profound effects on the soil microbial community in different planting systems. However, we lack an understanding of how different years of continuous cropping affects rhizosphere soil bacterial community co-occurrence pattern and assembly processes in the cut chrysanthemum (Chrysanthemum morifolium Ramat.) field.

Methods and results

We collected the soils from cut chrysanthemum rhizospheres with planting for 1 year (PY1) and continuous cropping for 6 years (CY6) and 12 years (CY12). Real-time quantitative PCR and flow cytometry (FCM) techniques were used to test the 16S rRNA gene copy number and bacterial cell count, respectively. The bacterial community structure was analysed by using high-throughput sequencing technology. The CY12 had a significantly decreased soil fertility index and rhizosphere bacterial living cell counts and gene copy numbers compared to CY6 and PY1 (P < 0.05). The rhizosphere bacterial community dissimilarity increased as the continuous cropping years increased. Three main ecological clusters (modules #1, #2, and #3) were observed in the bacterial co-occurrence network across all samples, and only the relative abundance of module #1 (enriched in the CY12) was significantly correlated with soil fertility (P < 0.05). Moreover, the rhizosphere bacterial community assembly was primarily governed by the deterministic process under 12 years of continuous cropping.

Conclusions

Soil fertility decline correlates with ecological network modularization and the deterministic assembly process of the rhizosphere bacterial community of cut chrysanthemum during continuous cropping.
Automated search methods for identifying wrong patient order entry—a scoping review
Authors: Garrod Mathew , Fox Andy , Rutter Paul
Published: August 2023

Objective

To investigate: (1) what automated search methods are used to identify wrong-patient order entry (WPOE), (2) what data are being captured and how they are being used, (3) the causes of WPOE, and (4) how providers identify their own errors.

Materials and Methods

A systematic scoping review of the empirical literature was performed using the databases CINAHL, Embase, and MEDLINE, covering the period from database inception until 2021. Search terms were related to the use of automated searches for WPOE when using an electronic prescribing system. Data were extracted and thematic analysis was performed to identify patterns or themes within the data.

Results

Fifteen papers were included in the review. Several automated search methods were identified, with the retract-and-reorder (RAR) method and the Void Alert Tool (VAT) the most prevalent. Included studies used automated search methods to identify background error rates in isolation, or in the context of an intervention. Risk factors for WPOE were identified, with technological factors and interruptions deemed the biggest risks. Minimal data on how providers identify their own errors were identified.

Discussion

RAR is the most widely used method to identify WPOE, with a good positive predictive value (PPV) of 76.2%. However, it will not currently identify other error types. The VAT is nonspecific for WPOE, with a mean PPV of 78%–93.1%, but the voiding reason accuracy varies considerably.

Conclusion

Automated search methods are powerful tools to identify WPOE that would otherwise go unnoticed. Further research is required around self-identification of errors.
Anatomical segmentectomy versus wedge resection for small (≤2 cm) peripheral non-small cell lung cancer in 80 or more aged elderly patients: a randomized phase III study (JCOG2109, AWESOME)
Authors: Mimae Takahiro , Wakabayashi Masashi , Sano Yusuke , Sekino Yuta , Aokage Keiju , Okada Morihito , Watanabe Shun-ichi , Saji Hisashi ,   the Lung Cancer Surgical Study Group/Japan Clinical Oncology Group
Published: August 2023

The standard treatment for small-sized and peripherally located early-stage non-small cell lung cancer is segmentectomy with secured margins. However, in 80 or more aged elderly patients, whether wedge resection will provide a better prognosis than segmentectomy is controversial. The aim of this trial is to confirm the non-inferiority of wedge resection to anatomical segmentectomy in terms of overall survival in these patients, who can tolerate lobectomy, with small-sized (≤2 cm), radiological solid dominant (consolidation-to-tumour ratio >0.5) and peripherally located early-stage non-small cell lung cancer in a randomized phase III trial. The primary endpoint is overall survival. If the non-inferiority of overall survival and the minimal invasiveness of wedge resection are proven, it can be a new standard treatment for such patients. A planned total of 400 patients will be enrolled from 53 institutions in 5 years. This trial has been registered in the Japan Registry of Clinical Trials with code jRCT1030220482 (https://jrct.niph.go.jp/latest-detail/jRCT1030220482).