bluuebunny/crossref_metadata_2025_split huggingface dataset:
Meningococcal Detoxified Outer Membrane Vesicle Vaccines Enhance Gonococcal Clearance in a Murine Infection Model
Authors: Matthias Kathryn A , Connolly Kristie L , Begum Afrin A , Jerse Ann E , Macintyre Andrew N , Sempowski Gregory D , Bash Margaret C 
Published: September 2021

Abstract

Background
Despite decades of research efforts, development of a gonorrhea vaccine has remained elusive. Epidemiological studies suggest that detoxified outer membrane vesicle (dOMV) vaccines from Neisseria meningitidis (Nm) may protect against infection with Neisseria gonorrhoeae (Ng). We recently reported that Nm dOMVs lacking the major outer membrane proteins (OMPs) PorA, PorB, and RmpM induced greater antibody cross-reactivity against heterologous Nm strains than wild-type (WT) dOMVs and may represent an improved vaccine against gonorrhea.

Methods
We prepared dOMV vaccines from meningococcal strains that were sufficient or deleted for PorA, PorB, and RmpM. Vaccines were tested in a murine genital tract infection model and antisera were used to identify vaccine targets.

Results
Immunization with Nm dOMVs significantly and reproducibly enhanced gonococcal clearance for mice immunized with OMP-deficient dOMVs; significant clearance for WT dOMV-immunized mice was observed in one of two experiments. Clearance was associated with serum and vaginal anti-Nm dOMV immunoglobulin G (IgG) antibodies that cross-reacted with Ng. Serum IgG was used to identify putative Ng vaccine targets, including PilQ, MtrE, NlpD, and GuaB.

Conclusions
Meningococcal dOMVs elicited a protective effect against experimental gonococcal infection. Recognition and identification of Ng vaccine targets by Nm dOMV-induced antibodies supports the development of a cross-protective Neisseria vaccine.
Equity in telemedicine for older adults during the COVID-19 pandemic
Authors: Kuang Weihong , Zeng Guojun , Nie Yunbo , Cai Yan , Li Jin , Wan Yang , Qiu Peiyuan 
Published: September 2021

Abstract
The coronavirus disease 2019 (COVID-19) pandemic has spurred an unprecedented paradigm shift to telemedicine across healthcare fields in order to limit exposure to the virus. At the West China Hospital of Sichuan University, telemedicine has been used to perform COVID-19-related tele-education to health professionals and the general population, as well as tele-diagnosis, online treatment and internet-based drug prescription and delivery. However, many older adults could not make appointments with doctors due to difficulty using the internet-based platform. Careful attention needs to be paid by future researchers and policymakers in order to mitigate barriers older adults face when using telemedicine.
Peripheral nerve stimulation and immunity: the expanding opportunities for providing mechanistic insight and therapeutic intervention
Authors: Falvey Aidan , Metz Christine N , Tracey Kevin J , Pavlov Valentin A 
Published: September 2021

Abstract
Pre-clinical research advances our understanding of the vagus nerve-mediated regulation of immunity and clinical trials successfully utilize electrical vagus nerve stimulation in the treatment of patients with inflammatory disorders. This symbiotic relationship between pre-clinical and clinical research exploring the vagus nerve-based ‘inflammatory reflex’ has substantially contributed to establishing the field of bioelectronic medicine. Recent studies identify a crosstalk between the vagus nerve and other neural circuitries in controlling inflammation and delineate new neural immunoregulatory pathways. Here we outline current mechanistic insights into the role of vagal and non-vagal neural pathways in neuro-immune communication and inflammatory regulation. We also provide a timely overview of expanding opportunities for bioelectronic neuromodulation in the treatment of various inflammatory disorders.
Predictors of job satisfaction and intention to stay in the job among health-care providers in Uganda and Zambia
Authors: kim min kyung , arsenault catherine , Atuyambe Lynn m , Kruk Margaret e 
Published: September 2021

Abstract

Background
A shortage of competent health-care providers is a major contributor to poor quality health care in sub-Saharan Africa. To increase the retention of skilled health-care providers, we need to understand which factors make them feel satisfied with their work and want to stay in their job. This study investigates the relative contribution of provider, facility and contextual factors to job satisfaction and intention to stay on the job among health-care providers who performed obstetric care in Uganda and Zambia.

Methods
This study was a secondary analysis of data from a maternal and newborn health program implementation evaluation in Uganda and Zambia. Using a Likert scale, providers rated their job satisfaction and intention to stay in their job. Predictors included gender, cadre, satisfaction with various facility resources and country. We used the Shapley and Owen decomposition of R2 method to estimate the variance explained by individual factors and groups of factors, adjusting for covariates at the facility and provider levels.

Results
Of the 1134 providers included in the study, 68.3% were female, 32.4% were nurses and 77.1% worked in the public sector. Slightly more than half (52.3%) of providers were strongly satisfied with their job and 42.8% strongly agreed that they would continue to work at their facility for some time. A group of variables related to facility management explained most of the variance in both job satisfaction (37.6%) and intention to stay (43.1%). Among these, the most important individual variables were satisfaction with pay (20.57%) for job satisfaction and opinions being respected in the workplace (17.52%) for intention to stay. Doctors reported lower intention to stay than nurses. Provider demographics and facility level and ownership (public/private) were not associated with either outcome. There were also differences in job satisfaction and intention to stay between Ugandan and Zambian health-care providers.

Conclusion
Our study suggests that managers play a crucial role in retaining a sufficient number of satisfied health-care providers providing obstetric care in two sub-Saharan African countries, Uganda and Zambia. Prioritizing and investing in health management systems and health managers are essential foundations for high-quality health systems.
Nationality versus Gender? The Administrative Politics of Gender Parity in the United Nations and the Implementation of SCR1325
Authors: Davies Hannah 
Published: September 2021

AbstractThis article will shed light on an under-researched aspect of the implementation of gender policies in the UN Secretariat—the administrative and budgetary committees that establish the staff regulations for civilian personnel. The article will explore how the politics of UN recruitment invokes two primary identities—nationality and gender—and how these conflict with each other. Using demographic analysis of UN civilian staff in peace operations and a micro-case study of an ongoing attempt by the Secretary-General to change the staff rules and regulations to introduce a form of affirmative action to reach gender parity, this article finds that efforts to achieve the representative provisions of UN Security Council Resolution 1325, including through gender parity of civilians in peace operations, are hampered by the primacy of national identity in international organizations as well as by the highly politicized and nation state-driven process of administrative and budgetary decision-making. By focusing on the inner dynamics of decision-making in the United Nations, the article contributes to the literature on international organizations and gender by demonstrating how normative goals can be undermined by competition among member states over internal administrative processes arising from complex principal–agent relationships.
Eating Identity: Theorizing the Everyday Foreign Policy Assemblage
Authors: Gaufman Elizaveta 
Published: September 2021

Abstract
While everyday high-level practices have become an important area of study in foreign policy research, the every day of every (wo)man has been overlooked both in theoretical and empirical conceptualizations. Building on feminist, sociological, and ethnographic research, this article argues that everyday foreign policy is an assemblage—a combination of physical and cultural practices that inhabit digital and bodily spaces. Following the feminist call to liberate international relations from the straitjacket of high politics, this article aims to contextualize foreign policy within daily practices of regular citizens, who enact foreign policy at home, at the supermarket, and online. In effect, everyday foreign policy is not just about discussing identity, it is also about embodying and literally eating it. This article focuses on the grassroots of foreign policy sanctions in Russia in the aftermath of the annexation of Crimea.
Priming Effect of Colour on Aiding the Attentional Reorientation in Sequential Presentations of Temporal Data Visualization: Evidence From Eye-Tracking
Authors: Peng Ningyue , Xue Chengqi , Wang Haiyan , Niu Yafeng , Wu Lei 
Published: September 2021

Abstract
In the present study, we focus on the priming effect of colour on mitigating the attentional reorientation cost, which is led by re-constructing the frame of reference for attention shift and visual search in sequential presentations of temporal data visualization. The study involves two experiments using complementary recordings of behavioural performance and eye-tracking events. Two aspects of colour primes are highlighted: the prime validity and the colour perceptual accessibility. A task paradigm integrating the feature search and keeping-track task was adopted in our experiments. In Experiment 1 (with a group of 16 participants), we confirmed the colour priming effect by comparing the priming condition to the neutral baseline. Furthermore, global colours that are with high perceptual accessibility generated more evident priming effects than local colours. However, more interferences in misguiding the attention to task-irrelevant regions were found when the global primes were invalid. In Experiment 2 (with another group of 15 participants), we verify the finding in Experiment 1 that global colours produced more pronounced priming effects in alleviating the attentional reorientation cost by comparing two groups of real-world visualizations with either global or local colours as the prime. Large saccades were initiated much earlier, and the search efficiency got improved when provided with global colours. We conjecture that the facilitatory effect from global colours may stem from its benefit on the pre-attentive processing of the search field. The research findings provide evidence for utilizing colours as the primes in mitigating the attentional reorientation cost and accelerating visual search in sequential presentations.
Comparison of in vitro activities of plazomicin and other aminoglycosides against clinical isolates of Klebsiella pneumoniae and Escherichia coli
Authors: İnce Gizem , Mirza Hasan Cenk , Üsküdar Güçlü Aylin , Gümüş Hale , Erol Çiğdem , Başustaoğlu Ahmet 
Published: September 2021

Abstract

Objectives
To compare the in vitro activity of plazomicin and two older aminoglycosides (gentamicin and amikacin) against 180 isolates of Escherichia coli and Klebsiella pneumoniae, including subsets of 60 non-ESBL-producing, 60 ESBL-producing and 60 carbapenem-resistant (46 carrying blaOXA-48, 11 carrying blaNDM and 3 carrying blaOXA-48 and blaNDM) strains.

Methods
MICs of plazomicin, gentamicin and amikacin were determined by a gradient diffusion method. Gentamicin and amikacin MICs were interpreted according to CLSI criteria and EUCAST breakpoint tables. Plazomicin MICs were interpreted using FDA-defined breakpoints.

Results
All non-ESBL-producing and ESBL-producing isolates were susceptible to plazomicin. The plazomicin susceptibility rate (71.7%) in carbapenem-resistant isolates was significantly higher than those observed for gentamicin (45%) and amikacin (56.7% and 51.7% according to CLSI and EUCAST breakpoints, respectively). Gentamicin, amikacin and plazomicin susceptibility rates (35.6% for gentamicin; 44.4% and 37.8% for amikacin according to CLSI and EUCAST breakpoints, respectively; 64.4% for plazomicin) in carbapenem-resistant K. pneumoniae were significantly lower than those observed for carbapenem-resistant E. coli isolates (73.3% for gentamicin; 93.3% for amikacin and plazomicin). Gentamicin, amikacin and plazomicin susceptibility rates for blaNDM-positive isolates were lower than those observed for blaOXA-48-positive isolates, but differences were not statistically significant. Among the isolates that were non-susceptible to both gentamicin and amikacin, the plazomicin susceptibility rate was less than 30%.

Conclusions
Although plazomicin showed excellent in vitro activity against carbapenem-susceptible isolates, the plazomicin resistance rate increased to 35.6% among carbapenem-resistant K. pneumoniae and further increased to 45.5% among blaNDM-positive isolates.
Double deletion of cpxR and tolC significantly increases the susceptibility of Salmonella enterica serovar Typhimurium to colistin
Authors: Zhang Meng-Ke , Zhang Meng-Yao , Liu Shuo-Bo , Yang Ying-Ying , Zhai Ya-Jun , He Dan-Dan , Wu Hua , Pan Yu-Shan , Liu Jian-Hua , Yuan Li , Hu Gong-Zheng 
Published: September 2021

Abstract

Background
The increasing use of colistin causes a serious breach in our last line of defence against MDR Gram-negative pathogens. Our previous study showed that CpxR overexpression increases the susceptibility of acrB and cpxR double-deleted Salmonella enterica serovar Typhimurium to colistin.

Objectives
To identify the mechanism of CpxAR and efflux pumps that synergistically enhance the susceptibility of S. Typhimurium to colistin.

Methods
A series of cpxR- and tolC-deleted mutants and a cpxR-complemented strain from a multidrug-susceptible standard strain of S. Typhimurium (JS) were generated in our previous study. Herein, we investigated the susceptibility of these strains to colistin through the broth microdilution method, time–kill curves and survival assays. Growth curves were measured by OD600 in LB broth, tryptone-soy broth (TSB) and M9-glucose (0.2%) minimal media. Finally, molecular mechanisms underlying the mode of action were elucidated by transcriptomic analysis.

Results
We found that in contrast to JS (0.8 mg/L), the MIC of colistin for JSΔtolC::kan showed a 16-fold decrease (0.05 mg/L). Notably, JSΔcpxRΔtolC and JSΔcpxRΔtolC/pcpxR were associated with a 256-fold decrease (0.0031 mg/L) compared with JS. Growth curves identified that JSΔcpxRΔtolC and JSΔcpxRΔtolC/pcpxR displayed a markedly lower growth rate and poorer adaptability. In addition, time–kill curves and survival assays showed that JSΔcpxRΔtolC and JSΔcpxRΔtolC/pcpxR were more susceptible to colistin. Lastly, double deletion of cpxR and tolC enhanced oxidative damage through promoting oxidative phosphorylation, the tricarboxylic acid (TCA) cycle and trimethylamine N-oxide (TMAO) respiration.

Conclusions
Our findings revealed that double deletion of cpxR and tolC significantly increases the susceptibility of S. Typhimurium to colistin.
Efficacy of doxycycline versus azithromycin for the treatment of rectal chlamydia: a systematic review and meta-analysis
Authors: Chen Liang-Fu , Wang Ting-Cheng , Chen Fu-Lun , Hsu Shih-Chang , Hsu Chin-Wang , Bai Chyi-Huey , Hsu Yuan-Pin 
Published: September 2021

AbstractBackgroundChlamydia trachomatis infection is the most common sexually transmitted infectious disease and carries a risk of complications. However, the optimal treatment for rectal chlamydial infection remains unclear.ObjectivesTo compare the efficacy of doxycycline and azithromycin for the treatment of rectal chlamydia by undertaking a systematic review and meta-analysis of published data.MethodsWe searched PubMed, EMBASE, Cochrane Library, Web of Science and clinicaltrials.gov databases from inception to 7 July 2021 for randomized controlled trials (RCTs) and observational studies that compared the efficacy of doxycycline and single-dose azithromycin on rectal chlamydia cure rates. Data were synthesized using a random-effects model, and subgroup analysis was conducted.ResultsAll included studies were conducted in developed countries. Two RCTs and nine observational studies, with a total of 2457 patients, were analysed. Doxycycline had a higher microbiological cure rate than azithromycin (risk ratio = 1.21; 95% CI = 1.15–1.28; P &lt; 0.05). Pooled results from two RCTs also revealed a higher microbiological cure rate for doxycycline than azithromycin (risk ratio = 1.27; 95% CI = 1.20–1.35; P &lt; 0.05). The results remained consistent in subgroups of different study designs, countries and sexes.ConclusionsOn the basis of our findings, we recommend doxycycline rather than azithromycin as a first-line treatment for rectal chlamydia in developed countries. More RCTs from developing countries are warranted.
Selection and characterization of mutational resistance to aztreonam/avibactam in β-lactamase-producing Enterobacterales
Authors: Mushtaq Shazad , Vickers Anna , Ellaby Nicholas , Woodford Neil , Livermore David M 
Published: September 2021

Abstract

Background
Aztreonam/avibactam is being developed for its broad activity against carbapenemase-producing Enterobacterales, including those with metallo-β-lactamases (MBLs). Its potential to select resistance in target pathogens was explored. Findings are compared with previous data for ceftazidime/avibactam and ceftaroline/avibactam.

Methods
Single-step mutants were sought from 52 Enterobacterales with AmpC, ESBL, KPC, MBL and OXA-48-like enzymes. Mutation frequencies were calculated. MICs were determined by CLSI agar dilution. Genomes were sequenced using Illumina methodology.

Results
Irrespective of β-lactamase type and of whether avibactam was used at 1 or 4 mg/L, mutants could rarely be obtained at &gt;4× the starting MIC, and most MIC rises were correspondingly small. Putative resistance (MIC &gt;8 + 4 mg/L) associated with changes to β-lactamases was seen only for mutants of AmpC, where it was associated with Asn346Tyr and Tyr150Cys substitutions. Asn346Tyr led to broad resistance to avibactam combinations; Tyr150Cys significantly affected only aztreonam/avibactam. MIC rises up to 4 + 4 mg/L were seen for producers of mutant KPC-2 or -3 enzymes, and were associated with Trp105Arg, Ser106Pro and Ser109Pro substitutions, which all reduced the MICs of other β-lactams. For producers of other β-lactamase types, we largely found mutants with lesions in baeRS or envZ, putatively affecting drug accumulation. Single mutants had lesions in ampD, affecting AmpC expression or ftsI, encoding PBP3.

Conclusions
The risk of mutational resistance to aztreonam/avibactam appears smaller than for ceftazidime/avibactam, where Asp179Tyr arises readily in KPC enzymes, conferring frank resistance. Asn346 substitutions in AmpC enzymes may remain a risk, having been repeatedly selected with multiple avibactam combinations in vitro.
Myositis Antibodies and Interstitial Lung Disease
Authors: Basuita Manpreet , Fidler Lee M 
Published: September 2021

Abstract

Background
Interstitial lung disease (ILD) comprises a heterogeneous group of inflammatory and fibrotic conditions, often resulting in progressive lung function decline and increased mortality. Connective tissue disease (CTD) should be considered in all patients with ILD, as distinguishing between CTD-ILD and other forms of fibrotic lung disease has important therapeutic and prognostic implications. The idiopathic inflammatory myopathies (IIM) represent a CTD subtype of growing interest to ILD experts. The expansion and availability of myositis-specific and myositis-associated antibody testing has allowed for improved disease detection and characterization.

Content
In this review, we highlight the relationship between myositis antibodies and ILD. Select forms of IIM, such as the antisynthetase syndrome and clinically amyopathic dermatomyositis can present with rapidly progressive ILD, warranting timely disease diagnosis and management. Disease phenotypes, prevalence, laboratory testing, prognosis, and management strategies are described according to select myositis antibodies.

Summary
Myositis antibodies provide valuable information for clinicians managing patients with ILD. This review aims to increase awareness of their role in disease detection, pathophysiology, and possibly therapeutics.
Cast suppression in radiographs by generative adversarial networks
Authors: Hržić Franko , Žužić Ivana , Tschauner Sebastian , Štajduhar Ivan 
Published: September 2021

Abstract
Injured extremities commonly need to be immobilized by casts to allow proper healing. We propose a method to suppress cast superimpositions in pediatric wrist radiographs based on the cycle generative adversarial network (CycleGAN) model. We retrospectively reviewed unpaired pediatric wrist radiographs (n = 9672) and sampled them into 2 equal groups, with and without cast. The test subset consisted of 718 radiographs with cast. We evaluated different quadratic input sizes (256, 512, and 1024 pixels) for U-Net and ResNet-based CycleGAN architectures in cast suppression, quantitatively and qualitatively. The mean age was 11 ± 3 years in images containing cast (n = 4836), and 11 ± 4 years in castless samples (n = 4836). A total of 5956 X-rays had been done in males and 3716 in females. A U-Net 512 CycleGAN performed best (P ≤ .001). CycleGAN models successfully suppressed casts in pediatric wrist radiographs, allowing the development of a related software tool for radiology image viewers.
Documentation and review of social determinants of health data in the EHR: measures and associated insights
Authors: Wang Michael , Pantell Matthew S , Gottlieb Laura M , Adler-Milstein Julia 
Published: September 2021

Abstract

Objective
Electronic Health Records (EHRs) increasingly include designated fields to capture social determinants of health (SDOH). We developed measures to characterize their use, and use of other SDOH data types, to optimize SDOH data integration.

Materials and Methods
We developed 3 measures that accommodate different EHR data types on an encounter or patient-year basis. We implemented these measures—documented during encounter (DDE) captures documentation occurring during the encounter; documented by discharge (DBD) includes DDE plus documentation occurring any time prior to admission; and reviewed during encounter (RDE) captures whether anyone reviewed documented data—for the newly available structured SDOH fields and 4 other comparator SDOH data types (problem list, inpatient nursing question, social history free text, and social work notes) on a hospital encounter basis (with patient-year metrics in the Supplementary Appendix). Our sample included all patients (n = 27 127) with at least one hospitalization at UCSF Health (a large, urban, tertiary medical center) over a 1-year period.

Results
We observed substantial variation in the use of different SDOH EHR data types. Notably, social history question fields (newly added at study period start) were rarely used (DDE: 0.03% of encounters, DBD: 0.26%, RDE: 0.03%). Free-text patient social history fields had higher use (DDE: 12.1%, DBD: 49.0%, RDE: 14.4%).

Discussion
Our measures of real-world SDOH data use can guide current efforts to capture and leverage these data. For our institution, measures revealed substantial variation across data types, suggesting the need to engage in efforts such as EHR-user education and targeted workflow integration.

Conclusion
Measures revealed opportunities to optimize SDOH data documentation and review.