bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characterization of a lytic EBP bacteriophage with large size genome against Enterobacter cloacae
Authors: Asif Muhammad , Naseem Hafsa , Alvi Iqbal Ahmad , Basit Abdul , Rehman Shafiq‐ur‐ 
Published: May 2021

Enterobacter cloacae (E. cloacae) is an emerging nosocomial pathogen that had acquired antibiotic resistance against multiple classes of antibiotics. The current study was aimed to isolate and characterize lytic bacteriophage against E. cloacae. The bacteriophage EBP was isolated from a sewage water sample using E. cloacae as a host strain by double‐layer agar technique. EBP was found stabile at a wide range of temperatures (25, 37, 60, and 80°C) and pH (5, 6, 7, 8, and 9) with antibacterial activity up to 24 h of infection. The latent period of EBP was 20 min with a burst size of 252 phages per cell. It showed a narrow host range and infected 12/21 (57%) isolates of E. cloacae tested. It has helical symmetry with a head size of 105 and 120 nm long tail with contractile sheath. The EBP has 179.1 kb long double‐stranded DNA genome with 44.8% GC content. Majority of identified ORFs (187/281) were encoding putative proteins with unknown function. Necessary replication enzymes, structural proteins, and lytic enzymes were detected in the genome of EBP. Phylogenetic analysis revealed that EBP closely resembles with Coronobacter phage vB_CsaM_IeN, vB_CsaM_IeE, vB_CsaM_IeB, and Citrobacter phage Margaery. Based on electron microscopy and molecular characterization, EBP was classified as a Myoviridae phage.
Design and development of a biological implant for long term intravaginal retention in cattle
Authors: Stephen CP , Norman ST 
Published: May 2021

ObjectiveDesign, develop and trial an intravaginal device able to remain within the bovine vagina for up to 6 months, accommodating various technologies, while not adversely affecting the cow, or pregnancy.MethodsDevice scoping required minimal interference with vaginal drainage, no constant pressure on any single point of the vaginal mucosa and minimal footprint on the vaginal floor. A polycarbonate prototype was developed consisting of a central cargo space to house sensors and battery, with a separate retention module. Mathematical modelling informed the required length and flexibility of the arms on the retention module to reduce pressure necrosis and inflammation within the vagina. The prototype was initially trialled, with a loaded cargo pod, for 4 weeks in five non‐pregnant cows. Cows were monitored for signs of systemic infection and inflammation by collecting blood samples for haematology and acute phase inflammatory proteins. Cows were also assessed for general demeanour, signs of discomfort and positioning of the device. Later, the device was inserted into 20 early pregnant cows, with 20 contemporary, untreated controls. Cows were monitored, as in the initial trial, every 4 weeks for the next 5 to 6 months until calving.ResultsIn Trial 1, there was 100% retention with no adverse effects. In Trial 2, device retention was 75% until calving with no adverse effects on cow health or pregnancy.ConclusionsWe describe the longest successful deployment of an intravaginal device in pregnant and non‐pregnant cattle, with long‐term retention, no adverse effects and 28 cm3 of cargo space.
Ethical issues in managing the COVID‐19 pandemic
Authors: Raus Kasper , Mortier Eric , Eeckloo Kristof 
Published: May 2021

AbstractThe COVID‐19 pandemic has had an immense and worldwide impact. In light of future pandemics or subsequent waves of COVID‐19 it is crucial to focus on the ethical issues that were and still are raised in this COVID‐19 crisis. In this paper, we look at issues that are raised in the testing and tracing of patients with COVID‐19. We do this by highlighting and expanding on an approach suggested by Fineberg that could serve as a public health approach. In this way, we highlight several ethical issues. As regards testing, questions are raised such as whether it is ethical to use less reliable tests in order to increase testing capacity or minimize harm for patients. Another issue is how wide testing should be and whether selective testing is in accordance with principles of social justice. Patients who have recovered from COVID‐19 might have some degree of immunity but attributing certain ‘immunopriviliges’ raises ethical questions. The use of various tracing methodologies (mobile apps or databases and trained tracers) raised evident questions of social justice and privacy. We argue why it is key to always uphold a test of proportionality where a fair balance must be sought.
He Jiankui´s gene‐editing experiment and the non‐identity problem
Authors: Alonso Marcos , Savulescu Julian 
Published: May 2021

AbstractGenetic engineering has been a topic of discussion for over 50 years, but it is only recently that gene editing has become a reality. CRISPR biotechnologies have made gene editing much safer, precise and feasible. We have witnessed the first cases of human germline genetic modification resulting in live births, conducted by He Jiankui. In this paper, we will analyse He Jiankui’s case in relation to one of the most difficult problems in procreative ethics (or the ethics of future generations): the non‐identity problem. We believe that this analysis will help us to understand the ethics involved in gene editing and hopefully allow for a better, more philosophically grounded legislation on CRISPR and other gene‐editing technologies.
Health care system barriers and facilitators to early prenatal care among diverse women in Florida
Authors: Reid Chinyere N. , Fryer Kimberly , Cabral Naciely , Marshall Jennifer 
Published: May 2021

AbstractBackgroundWorldwide, women continue to experience barriers to accessing early prenatal care. Given the unique nature of the United States health care system, this study aimed to identify barriers and facilitators to early prenatal care reported by women in Florida.MethodsA mixed‐methods study of postpartum women with entry to care after 14 weeks’ gestation was conducted at a tertiary care hospital in Florida. First, eligible women completed a survey including demographic characteristics and open‐ended questions on prenatal care barriers. Second, a semi‐structured interview was conducted to contextualize the conditions of access. The qualitative analysis was based on the combined theoretical frameworks of Phillippi and Khan.ResultsThe majority of the 55 participants self‐identified as Hispanic (n = 28, 51%), non‐Hispanic White (n = 12, 22%), or non‐Hispanic Black (n = 9, 16%). Quantitative analysis identified frequent barriers, including the following: “couldn't get an appointment when wanted one” (n = 24, 47%); “didn't have insurance” (n = 21, 41%); and “not aware of pregnancy” (n = 21, 41%). From the combined quantitative and qualitative analyses, three major themes emerged that help to explain barriers faced by birthing people in Florida: personal factors (mental health, awareness of pregnancy, considering abortion, tumultuous life), community conditions (transportation, stigma/fear, social support), and health care system (language barriers, delay at clinic level, cost of care).DiscussionBarriers to early prenatal care are multifaceted and operate at personal, societal, and health care systems levels. Prenatal care practitioners have multiple potential targets for interventions at the clinic level to help mitigate barriers to early prenatal care. Strategies should include health care policy reforms to Medicaid access and interventions at the clinic level aimed at fast‐tracking access to care.
Uncovering opportunities for effective species conservation banking requires navigating technical and practical complexities
Authors: White Thomas B. , Bull Joseph W. , Toombs Theodore P. , Knight Andrew T. 
Published: May 2021

AbstractIn the USA, Species Conservation Banking is a prominent example of compensatory biodiversity impact mitigation, with an annual market value estimated at US$354.2 million. Species Conservation Banking represents a useful case study of a well‐established program that can provide empirical insights into the practicalities of implementing quantitative compensatory biodiversity mitigation on‐the‐ground. Using semi‐structured key‐informant interviews structured around well‐established technical challenges to compensatory mitigation, this study aimed to understand (i) how and why these challenges are or are not addressed in practice; and (ii) how these challenges relate to practical challenges faced by conservation banking stakeholders on‐the‐ground. Challenges identified included: (i) defining trading currencies and equivalence, (ii) regulatory and political uncertainty, (iii) regulatory agency capacity, will and knowledge, (iv) lack of policies, standards, and competition with other mitigation mechanisms, (v) long‐term uncertainty/longevity, and (vi) lack of species knowledge and data transparency. These challenges are numerous, diverse, interlinked and transdisciplinary, and collectively inhibit the ability of practitioners to resolve underlying technical challenges—a finding likely applicable to related biodiversity offset programs. To help address challenges and navigate this complexity, we formulate several recommendations for conservation banking stakeholders to improve the chances of beneficial biodiversity outcomes being achieved.
Patients with geographic barriers to health care access are prescribed a higher proportion of drugs with pharmacogenetic testing guidelines
Authors: Dalton Rachel , Brown Joshua D. , Duarte Julio D. 
Published: May 2021

AbstractPharmacogenetic (PGx) testing may be particularly beneficial in medically underserved populations by reducing the number of appointments required to optimize drug therapy and increasing the effectiveness of less expensive off‐patent drugs. The objective of this study was to identify patient populations with poor health care access and assess prescribing trends for drugs with published PGx testing guidelines. We used electronic health record data from 67,753 University of Florida Health patients, geographic access scores calculated via the 2‐step floating catchment area method, and a composite measure of socioeconomic status. Comparing the poorest (Q4) and greatest (Q1) access score quartiles, poor geographic access was significantly associated with fewer prescriber encounters (incidence rate ratio [IRR] 0.88, 95% confidence interval [CI] 0.86–0.91), fewer total unique drugs (IRR 0.92, 95% CI 0.9–0.95), and fewer PGx guideline drugs (IRR 0.94, 95% CI 0.9–0.99). After correcting for number of unique drugs, patients in low‐access areas were prescribed a greater proportion of PGx guideline drugs (IRR 1.08, 95% CI 1.04–1.13). We detected significant interactions between Black race and access score. Compared to Q1, Black patients with Q4 access scores were disproportionately affected and had fewer encounters (IRR 0.76, 95% CI 0.7–0.82) and a higher proportion of PGx drugs (IRR 1.26, 95% CI 1.13–1.41), creating further disparity. Overall, these results suggest that improved geographic access to PGx testing may allow prescribers to make more efficient use of limited opportunities to optimize therapy for drugs with PGx testing guidelines.
Treatment outcomes of a lesbian, gay, bisexual, transgender and queer alcohol and other drug counselling service in Australia: A retrospective analysis of client records
Authors: Lea Toby , Brener Loren , Lambert Sarah , Whitlam Genevieve , Holt Martin 
Published: May 2021

AbstractIntroductionSubstance use disorders are more prevalent among lesbian, gay, bisexual, transgender and queer (LGBTQ) people than among their heterosexual and cisgender peers. There has been limited alcohol and other drug (AOD) treatment research with LGBTQ people outside of North America. This study aimed to examine the treatment outcomes of clients attending a LGBTQ‐specific AOD counselling service in Australia (ACON's Substance Support Service) and compare their client profile and treatment outcomes with LGBTQ and non‐LGBTQ clients of similar mainstream services.MethodsThis study was a retrospective analysis of the health records of 284 ACON clients and 1011 clients of five mainstream services in 2016–2018. Clients completed clinical interviews at treatment entry and periodically throughout treatment and completed measures of substance use, severity of dependence, psychological distress and quality of life.ResultsMost ACON clients were seeking treatment for methamphetamine (58%) and alcohol use (26%). Among ACON clients, there were reductions in past month days of substance use and severity of dependence between treatment entry and counselling sessions 4, 8 and 12 (all P < 0.001). There were statistically significant reductions in psychological distress and improved quality of life among ACON clients. Despite ACON and the mainstream services having similar treatment approaches, their client profiles were markedly different in terms of sociodemographic characteristics, substance use and source of referral, which precluded comparison of treatment outcomes.Discussion and ConclusionsACON's clients showed reduced substance use and improved psychosocial wellbeing during treatment. The findings support the provision of LGBTQ‐specific AOD services.
From the (skin) doctor’s office to the lecture hall: An innovative, practice‐oriented, media‐supported teaching project with supra‐regional interdisciplinary usage options
Authors: Wittbecker Linda Marlen , von Spreckelsen Regina , Bandholz Thyra Caroline , Lehmhaus Friedrich‐Wilhelm , Schwarz Thomas , Gläser Regine 
Published: May 2021

SummaryBackgroundThe transfer of practical knowledge and skills is the focus of modern medical teaching (master plan medical studies 2020). The aim of the teaching project is to provide medical students with important dermatological learning goals and contents by using innovative methods.MethodsAs part of a teaching project funded by the Federal Ministry of Education and Research (BMBF) at the Department of Dermatology, University Hospital Schleswig‐Holstein in Kiel, various new, partly media‐supported teaching modules were developed in addition to curricular teaching and optimized by regular acceptance evaluations during the development process.Results(1.) Professionally created instructional movies present essential techniques for diagnosis and therapy: standardized dermatological whole‐body examination, wound smear sampling, performing of biopsies, curettages and excisions as well as skin suturing techniques on exercise material and on patients. (2.) Tutor‐based courses offer students the ability to practice these techniques independently. (3.) Seminar lectures show different clinical pictures in university medicine and doctor’s offices as well as the important interaction between clinic and doctor’s practice in patient care. (4.) One‐day internships in a teaching practice convey the activity in this setting. (5.) Seminars on psychodermatology provide insight into the stress caused by the skin disease using the “bio‐psychosocial disease model”. So far, 282 students have participated in the modules. In 88–100 % of the evaluations, there was a desire for further expansion of the new courses and integration into curricular teaching.ConclusionsOur innovative teaching modules resulted in great acceptance by the students. The freely available instructional films were successfully used by other university locations due to networking in the Academic Teaching Forum. One perspective is the supra‐regional and sustainable use of our teaching modules and the transfer of the concept to other departments and faculties.
Ocular syphilis – a case series of four patients
Authors: Jahnke Stephanie , Sunderkötter Cord , Lange Danica , Wienrich Ricarda , Kreft Burkhard 
Published: May 2021

SummaryOcular manifestations of syphilis with visual impairment symptoms may occur already at the stage of secondary syphilis. They may also be the only manifestation of syphilis and mimic other diseases of the eye. Therefore, in all patients with uveitis, optic neuritis, optic atrophy, acute ocular muscle paresis, or loss of visual acuity, syphilis infection should be ruled out, even if the medical history does not initially raise suspicion.Ocular involvement should be treated as neurosyphilis. Delayed diagnosis and inadequate therapy are often associated with irreversible consequences for the affected patient. As with any syphilis infection, HIV infection should be considered and excluded, especially in the case of ocular manifestations.
Technology in the management of type 2 diabetes: Present status and future prospects
Authors: Daly Aideen , Hovorka Roman 
Published: May 2021

AbstractThe growing incidence of type 2 diabetes (T2D) is a significant health concern, representing 90% of diabetes cases worldwide. As the disease progresses, resultant insulin deficiency and hyperglycaemia necessitates insulin therapy in many cases. It has been recognized that a significant number of people who have a clinical requirement for insulin therapy, as well as their healthcare professionals, are reluctant to intensify treatment with insulin due to fear of hypoglycaemia, poor understanding of treatment regimens or lack of engagement, and are therefore at higher risk of developing complications from poor glycaemic control. Over the past decade, the rise of diabetes technologies, including dosing advisors, continuous glucose monitoring systems, insulin pumps and automated insulin delivery systems, has led to great improvements in the therapies available, particularly to those requiring insulin. Although the focus has largely been on delivering these therapies to the type 1 diabetes population, it is becoming increasingly recognized that people with T2D face similar challenges to achieve recommended glycaemic standards and also have the potential to benefit from these advances. In this review, we discuss diabetes technologies that are currently available for people with T2D and the evidence supporting their use, as well as future prospects. We conclude that there is a clinical need to extend the use of these technologies to the T2D population to curb the consequences of suboptimal disease management in this group.
Flower diet enhances Adalia bipunctata larval development significantly when prey is limited
Authors: Holm Liv Linea , He Xueqing , Sigsgaard Lene 
Published: May 2021

AbstractPredaceous coccinellids can feed on non‐prey food, but the ecological value of this feeding to maintain a coccinellid population is not well understood. Prey density can vary greatly in the field, whereas non‐prey food sources such as pollen and nectar are more predictable. In the present study, Adalia bipunctata L. (Coleoptera: Coccinellidae) larval performance on pure and mixed diets of a high‐quality non‐prey food with varying amounts of prey was investigated. Rosy apple aphid, Dysaphis plantaginea Passerini (Hemiptera: Aphididae), served as prey in the experiment and was given to A. bipunctata larvae either ad libitum as a surplus diet or as a limited diet, the amount of which was selected so that it would limit larval development, according to a pilot study. Flowers of buckwheat, Fagopyrum esculentum L. (Polygonaceae), a high‐value floral diet, served as the non‐prey food. Newly hatched A. bipunctata larvae were reared on each of five diets: (1) flowers only, (2) limited prey only, (3) limited prey plus flowers, (4) surplus prey only, (5) surplus prey plus flowers. Larval survival, developmental time, and adult dry weight were measured. The addition of floral diet had a significant positive impact on A. bipunctata larval survival and development when prey diet was limited, survival ratio was 6× higher and developmental time was 25% shorter. In conclusion, A. bipunctata immature development can benefit from a floral diet supplemented to a prey diet, which indicates that the use of flowers in cropping systems can help to enhance biocontrol services by A. bipunctata.
The molecular and phenotypic spectrum of CLCN4‐related epilepsy
Authors: He Hailan , Guzman Raul E. , Cao Dezhi , Sierra‐Marquez Juan , Yin Fei , Fahlke Christoph , Peng Jing , Stauber Tobias 
Published: May 2021

AbstractObjectiveThis study was undertaken to expand the phenotypic and genetic spectrum of CLCN4‐related epilepsy and to investigate genotype–phenotype correlations.MethodsWe systematically reviewed the phenotypic and genetic spectrum of newly diagnosed and previously reported patients with CLCN4‐related epilepsy. Three novel variants identified in four patients reported in this study were evaluated through in silico prediction and functional analysis by Western blot, immunofluorescence, and electrophysiological measurements.ResultsEpilepsy was diagnosed in 54.55% (24/44) of individuals with CLCN4‐related disorders and was drug‐resistant in most cases. Of 24 patients, 15 had epileptic encephalopathy and four died at an early age; 69.57% of patients had seizure onset within the first year of life. Myoclonic seizures are the most common seizure type, and 56.25% of patients presented multiple seizure types. Notably, seizure outcome was favorable in individuals with only one seizure type. All patients showed intellectual disability, which was severe in 65.22% of patients. Additional common features included language delay, behavioral disorders, and dysmorphic features. Five patients benefitted from treatment with lamotrigine. Most variants, which were mainly missense (79.17%), were inherited (70.83%). Whereas frameshift, intragenic deletion, or inherited variants were associated with milder phenotypes, missense or de novo variants led to more severe phenotypes. All evaluated CLCN4 variants resulted in loss of function with reduced ClC‐4 currents. Nonetheless, genotype–phenotype relationships for CLCN4‐related epilepsy are not straightforward, as phenotypic variability was observed in recurrent variants and within single families.SignificancePathogenic CLCN4 variants contribute significantly to the genetic etiology of epilepsy. The phenotypic spectrum of CLCN4‐related epilepsy includes drug‐resistant seizures, cognitive and language impairment, behavioral disorders, and congenital anomalies. Notably, the mutation type and the number of seizure types correlate with the severity of the phenotype, suggesting its use for clinical prognosis. Lamotrigine can be considered a therapeutic option.