bluuebunny/crossref_metadata_2025_split huggingface dataset:
Basis of the persistence of capsule-negative Streptococcus suis in porcine endocarditis inferred from comparative genomics
Authors: Tohya Mari , Dozaki Shinichi , Ishida-Kuroki Kasumi , Watanabe Takayasu , Sekizaki Tsutomu 
Published: July 2021

Abstract
The capsule (cap) of Streptococcus suis is an anti-phagocytic element and is one of the major virulence factors. However, we have found cap-positive and cap-negative isolates in porcine endocarditis. Here, we compared genome sequences of multiple cap-negative isolates with those of a cap-positive isolate from a single endocarditis. Cap-positive and cap-negative isolates from the same pig were phylogenetically closest compared with those from other pigs. Some of cap-negative isolates from the same pig showed different mutations in capsular polysaccharide synthesis (cps) genes, suggesting that these isolates arisen in pigs after infection. Different mutations in whole-genomes were also found among isolates with identical mutations in cps genes, indicating that mutations in cps genes and the whole-genome occurred independently. Since cap-negative isolates are rarely found in lesions of other diseases, these results suggest that endocarditis lesions may simply favored cap-negative mutants to survive the niches, leading to their persistence in the lesions.
NAD+-targeting by bacteria: an emerging weapon in pathogenesis
Authors: Roussin Morgane , Salcedo Suzana P 
Published: July 2021

ABSTRACT
Nicotinamide adenine dinucleotide (NAD+) is a major cofactor in redox reactions in all life-forms. A stable level of NAD+ is vital to ensure cellular homeostasis. Some pathogens can modulate NAD+ metabolism to their advantage and even utilize or cleave NAD+ from the host using specialized effectors known as ADP-ribosyltransferase toxins and NADases, leading to energy store depletion, immune evasion or even cell death. This review explores recent advances in the field of bacterial NAD+-targeting toxins, highlighting the relevance of NAD+ modulation as an emerging pathogenesis strategy. In addition, we discuss the role of specific NAD+-targeting toxins in niche colonization and bacterial lifestyle as components of toxin/antitoxin systems and key players in interbacterial competition. Understanding the mechanisms of toxicity, regulation and secretion of these toxins will provide interesting leads in the search for new antimicrobial treatments in the fight against infectious diseases.
Worker Empowerment, Collective Labour Rights and Article 11 of the European Convention on Human Rights
Authors: Arabadjieva Kalina 
Published: July 2021

Abstract
This article proposes a normative, moral justification for the protection of collective labour rights as aspects of the right to freedom of association under Article 11 European Convention on Human Rights. A justification of this kind has so far been largely absent from the reasoning of the European Court of Human Rights , which has referred more frequently to international labour rights instruments in respect of some of the developments in its case-law on collective labour rights. The article argues that Article 11 should be interpreted also by reference to a particular theoretical account of the right to freedom of association as a moral right, which emphasises the role of freedom of association in enabling individuals to meet on more equal terms the power of those whose decisions affect them, and thus to participate in determining the circumstances of their life. According to this account, certain collective labour rights necessarily derive from the right to freedom of association.
Trade-offs and uncertainties in Northeast Pacific herring fisheries: ecosystem modelling and management strategy evaluation
Authors: Surma Szymon , Pitcher Tony J , Pakhomov Evgeny A 
Published: July 2021

AbstractPacific herring (Clupea pallasii) plays an important and multifaceted role in the Northeast Pacific as a forage fish in coastal ecosystems, target species for commercial fisheries, and culturally significant subsistence resource for coastal communities. This study comparatively evaluated herring fisheries management strategy performance relative to ecological and socioeconomic objectives. Management strategy evaluation employed a mass-balanced ecosystem operating model and accounted for parameter uncertainty, stock assessment error, and strategy implementation error through Monte Carlo resampling. Results revealed a notable trade-off between stable herring catches and high biomasses of herring and several predators. Herring biomass control point values influenced this trade-off more than harvest control rule form. All British Columbia and Alaska strategies yielded similar ecological and socioeconomic impacts relative to the unfished herring baseline. Precautionary strategies recommended for forage fish combined high ecosystem benefits and socioeconomic costs. Reducing fishing mortality fourfold within an existing strategy suggested a possible compromise solution to this trade-off. However, ecological impacts of all strategies were sensitive to operating model parameter uncertainty, stock assessment error, and strategy implementation error, with the potential for undesirable ecosystem states across all strategies. This study suggests trade-offs among management objectives should be considered in pursuing ecosystem-based fisheries management for forage fish.
Shifting baselines of cetacean conservation in Europe
Authors: Bearzi Giovanni , Reeves Randall R 
Published: July 2021

Abstract
Within just one human lifetime, the underlying motivation to conserve whales, dolphins and porpoises has shifted from being purely practical and anthropogenic to something much broader, reflecting a desire to protect populations as well as individual animals. In European waters, cetacean conservation currently tends to focus on direct and obvious threats, whereas those originating from widespread human encroachment and consumption patterns tend to be overlooked, even when they are pervasive enough to seriously affect cetacean populations. Cetacean habitat and prey rarely benefit from actual protection (including within Marine Protected Areas), while only moderate and often nominal protection is granted to the cetaceans, without clear conservation baselines and quantitative recovery targets. Meanwhile, historical baselines of cetacean diversity, abundance and distribution appear to be shifting, and the memory of past culling campaigns is fading. Here, we argue that cetacean conservation should go beyond just avoiding further population decline or warding off the extinction of single species. Allowing only the most opportunistic and resilient species to persist, often by merely attempting to mitigate direct mortality (e.g. bycatch in fishing gear), should not pass for actual cetacean conservation. We should strive instead for the full recovery of multiple species throughout their historical ranges.
High Prevalence of Plasmodium falciparum K13 Mutations in Rwanda Is Associated With Slow Parasite Clearance After Treatment With Artemether-Lumefantrine
Authors: Straimer Judith , Gandhi Preetam , Renner Katalin Csermak , Schmitt Esther K 
Published: July 2021

Abstract
In Southeast Asia, mutations in the Plasmodium falciparum K13 gene have led to delayed parasite clearance and treatment failures in patients with malaria receiving artemisinin combination therapies. Until recently, relevant K13 mutations had been mostly absent from Africa. Between 2018 and 2019, a phase 2 clinical study with 186 patients was conducted in Mali, Gabon, Ghana, Uganda, and Rwanda. Patients with malaria were randomized and treated with artemether-lumefantrine or cipargamin. Here we report an allele frequency of 22% for R561H in Rwanda and associated delayed parasite clearance. Notwithstanding, efficacy of artemether-lumefantrine remained high in Rwanda, with a 94.4% polymerase chain reaction–corrected cure rate.
Patient coaching in secondary care: healthcare professionals’ views on target group, intervention and coach profile
Authors: Alders Irène M R , Van Dulmen Sandra , Smits Carolien H M , Marcus-Varwijk Anne Esther , Groen-Van de Ven Leontine , Brand Paul L P 
Published: July 2021

Abstract

Background
Not all patients are able to communicate effectively during consultations with medical specialists. Patient coaching has shown to be effective for enhancing communication.

Objective
We aimed to get healthcare professionals’ views on target groups for patient coaching, on supportive elements in patient coaching and on the necessary qualifications and profile of a patient coach, to further our knowledge on the concept of patient coaching as supportive intervention for patients in consultations with medical specialists.

Methods
We chose a qualitative research design and interviewed 18 healthcare professionals (six medical specialists, four family physicians, four community nurses and four nurse specialists/physician assistants) and analysed the verbatim transcripts using Qualitative Analysis Guide of Leuven. After a short introduction of the global concept of patient coaching and presentation of patients’ perceived barriers, two interviewers structured the interview around three research questions: which patients could benefit from a patient coach, what should such a coach do and who could act like such a coach?

Results
Participants describe patients who could benefit from patient coaching as generally vulnerable (e.g. older age, insufficiently accompanied, lower socioeconomic status, co-morbidity and cognitive problems) but also patients who are situationally vulnerable (e.g. elicited by bad news). Patient coaching should comprise emotional and instrumental support, aiming at reducing stress and improving the processing of medical information. Patient coaching should start from the patient’s home and include preparing questions, navigating to and in the hospital, recording information during the consultation, checking understanding and recalling information. Patient coaches should have at least basic medical knowledge and a higher education.

Conclusion
Healthcare professionals believe that patient coaching by a trained professional with medical knowledge could be beneficial to patients who are stressed when visiting a medical specialist. Future research should involve the views of patients on patient coaching, focus on investigating to what extent patient coaching is able to reduce stress and support a patient in processing medical information and the preferred patient coach’s profile.
Impact of changing reimbursement criteria on the use of fluoroquinolones in Belgium
Authors: Vermeulen Helene , Coenen Samuel , Hens Niel , Bruyndonckx Robin 
Published: July 2021

Abstract

Objectives
The criteria for the reimbursement of fluoroquinolones changed in Belgium on 1 May 2018. This study aims to quantify the difference in fluoroquinolone use after this change, and to assess the timing and persistence of this effect, both in terms of total reimbursed fluoroquinolone use and its relative proportion.

Methods
Longitudinal reimbursement data on fluoroquinolone use in the Belgian community from January 2017 to November 2018 were analysed to identify a change in reimbursed fluoroquinolone use expressed in DDD per 1000 inhabitants per day (DID), using a set of non-linear mixed models including change-points. In addition, longitudinal data on the relative proportion of prescribed fluoroquinolones from January 2017 to December 2018 were analysed to identify a change in the relative proportion of prescribed fluoroquinolones using generalized estimation equations including change-points.

Results
Fluoroquinolone use dropped significantly immediately after the change in reimbursement criteria, from 2.21 DID (95% CI: 2.03–2.38) to 0.52 DID (95% CI: 0.48–0.56) and from 9.14% (95% CI: 8.75%–9.56%) to 6.52% (95% CI: 6.04%–7.04%). The observed decrease in fluoroquinolone use persisted over time.

Conclusions
While fluoroquinolone use was still above the target of 5% after the change in reimbursement criteria, its implementation helped to lower fluoroquinolone use in Belgium.
Gamma Glutamyl Transferase Activity Has Limited Utility in Assessment of Alkaline Phosphatase Elevations
Authors: Geno K Aaron , Poore Brad , Cervinski Mark A , Nerenz Robert D 
Published: July 2021

Abstract

Introduction
As part of an ongoing effort to improve healthcare value for patients, laboratories increasingly implement test utilization review. Alkaline phosphatase (ALP) isoenzymes (hereafter: isoenzymes) testing distinguishes the various ALP isoforms to explain elevations in total serum ALP. Gamma glutamyl transferase activity (GGT) has served as a proxy for total ALP elevations attributable to the hepatic isoform given that both are membrane-bound proteins with a shared mechanism of release. We assessed the utility of GGT in evaluating isoenzymes requests.

Methods
We obtained 8 years of isoenzymes results and identified same-patient GGT measurements obtained within 7 days. We assessed the ability of GGT to predict elevations in hepatic, bone, intestinal, and nonhepatic ALP isoforms overall. We generated ROC curves and calculated sensitivity and specificity using our in-house reference limits for GGT.

Results
GGT as a predictor of hepatic isoform elevation had an area under the ROC curve (AUC) of 0.68, and GGT activity above the upper reference limit was 46.6% sensitive and 85.0% specific for hepatic ALP elevation. GGT activity as a predictor of nonhepatic isoform elevation had an AUC of 0.52, and GGT within reference limits was 59.8% sensitive and 46.4% specific for elevation in a nonhepatic ALP isoform. In 133 individuals with hepatic isoform elevations, 93 had a concurrent elevation in a nonhepatic ALP isoform.

Conclusion
GGT was reasonably specific but insensitive for hepatic ALP isoform elevation and was a poor predictor of ALP isoform elevation overall, suggesting that its usefulness in evaluating isoenzymes orders is limited.
Shared clinical decision-making on vaccines: out of sight, out of mind
Authors: Shen Angela K , Michel Jeremey J , Langford Aisha T , Sobczyk Elizabeth A 
Published: July 2021

Abstract
Clinical decision support systems, which provide automated reminders in electronic health systems, are designed to provide physicians and other health professionals support in clinical decision-making. New clinical guidance from the Advisory Committee on Immunization Practices on a new category of recommendations referred to as “shared clinical decision-making” have left providers struggling to interpret how to best implement recommendations for adult vaccines. The issue at hand is how to ensure that a conversation between the patient and provider occurs. While traditional clinical decision support systems have driven immunization for years, these systems support a binary default opt-in process. The goal for shared decision-making is the discussion rather than the vaccination. The recommended provider–patient conversations need to be supported with both provider guidance as well as tools to ensure vaccines are not omitted from the conversations, particularly as future vaccine candidates progress through the vaccine development pipeline.
Nexobrid Treatment for Burn Injuries in Patients With Chronic Obstructive Pulmonary Disease and Home Oxygen Therapy
Authors: Daniels Marc , Stromps Jan Philipp , Heitzmann Wolfram , Schiefer Jennifer , Fuchs Paul Christian , Seyhan Harun 
Published: July 2021

Abstract
There is an increased risk for burn injuries associated with home oxygen therapy of patients with chronic obstructive pulmonary disease (COPD) since 10% to 50% of these patients continue to smoke. Enzymatic eschar removal of facial burns is gaining popularity but intubation of this specific patient group often leads to prolonged weaning and can require tracheostomy. This study dealt with the question if enzymatic debridement in these patients can also be performed in analgosedation. A selective review of the literature regarding burn trauma associated with home oxygen use in patients with COPD was performed, as well as a retrospective analysis of all patients with burn injuries associated with home oxygen use and COPD that were admitted to the study clinic. In the literature, 1746 patients with burns associated with home oxygen use are described, but none of them received enzymatic debridement. In this study, 17 patients were included. All three patients in this study with facial full-thickness burn injuries received enzymatic debridement. The mortality rate in this cohort was 17.6% (3/17). Up to date, there is limited experience performing regional anesthesia debridement in patients with COPD. This is the first manuscript describing the use of enzymatic debridement in patients with COPD and home oxygen therapy. We could confirm other studies that intubation of these patients leads to prolonged ventilation hours and increases the probability for poor prognosis. Therefore, we described the treatment of enzymatic debridement in analgosedation without intubation.
Subgroup analysis of the AFTER I-O study: a retrospective study on the efficacy and safety of subsequent molecular targeted therapy after immune-oncology therapy in Japanese patients with metastatic renal cell carcinoma
Authors: Tomita Yoshihiko , Kimura Go , Fukasawa Satoshi , Numakura Kazuyuki , Sugiyama Yutaka , Yamana Kazutoshi , Naito Sei , Kaneko Hirokazu , Tajima Yohei , Oya Mototsugu 
Published: July 2021

Abstract

Background
We performed subgroup analyses of the AFTER I-O study to clarify the association of time-to-treatment failure (TTF) and discontinuation reason of prior immune-oncology (I-O) therapy, and molecular targeted therapy (TT) regimen with the outcomes of TT after I-O.

Methods
The data of Japanese metastatic renal cell carcinoma patients treated with TT after nivolumab (NIVO) (CheckMate 025) or NIVO + ipilimumab (IPI) (CheckMate 214) were retrospectively analyzed. The objective response rates (ORRs), progression-free survival (PFS) and overall survival (OS) of TT after I-O were analyzed by subgroups: TTF (&lt;6 or ≥6 months) and discontinuation reason of prior I-O (progression or adverse events), and TT regimen (sunitinib or axitinib). We also analyzed PFS2 of prior I-O and OS from first-line therapy.

Results
The ORR and median PFS of TT after NIVO and NIVO+IPI among the subgroups was 17–36% and 20–44%, and 7.1–11.6 months and 16.3-not reached (NR), respectively. The median OS of TT after NIVO was longer in patients with longer TTF of NIVO and treated with axitinib. Conversely, median OS of TT after NIVO+IPI was similar among subgroups. The median PFS2 of NIVO and NIVO+IPI was 36.7 and 32.0 months, respectively. The median OS from first-line therapy was 70.5 months for patients treated with NIVO and NR with NIVO+IPI. The safety profile of each TT after each I-O was similar to previous reports.

Conclusions
The efficacy of TT after NIVO or NIVO+IPI was favorable regardless of the TTF and discontinuation reason of prior I-O, and TT regimen.
Quasi circular orbits around prolate bodies
Authors: Ribeiro T , Winter O C , Mourão D , Boldrin L A G , Carvalho J P S 
Published: July 2021

ABSTRACT
Recent observations of stellar occultations have revealed rings of particles around non-planetary bodies of the Solar system. These bodies are irregular and can be modelled by ellipsoids. In the context of numerical integrations for the study of studying the region close to these ellipsoidal bodies, it is known that the use of geometric initial conditions is necessary when the central object is significantly oblatened. In this paper, we show that for elongated bodies there is also a need for the adaptation of the initial velocity ($\nu _{C_{22}}$) so that equatorial periodic orbits of the first kind around this body have smaller radial variations since the circular Keplerian velocity produces a high oscillating eccentricity and radial variation. We describe an empirical method to obtain the velocity $\nu _{C_{22}}$ of a set of simulations where we vary the physical parameters of the central body. With the obtained data, developed empirical equations that allow the calculation of the orbital eccentricity, the initial velocity and an adapted Kepler’s Third Law as a function of the ellipticity coefficient and the semimajor axis. In addition, we identify an important change in the location of the primary body in relation to the elliptical orbit. In the cases of the orbits with minimal radial variation found in our study, the body starts to occupy the centre of the elliptical orbit. Finally, we include the rotation of the central body in the studied systems and analyse its implications for the dynamics of these orbits of low radial variation.
Determining our peculiar velocity from the aberration in the cosmic microwave background
Authors: Aurich R , Reinhardt D 
Published: July 2021

ABSTRACT
The motion of our Solar system relative to the cosmic microwave background (CMB) rest frame leads to subtle distortions in the observed CMB sky map due to the aberration effect. Usually the corresponding peculiar velocity is determined from the CMB dipole but neglecting intrinsic dipole contributions. Here, it is investigated whether certain invariant scalar measures, which are derived from first and second order covariant derivatives on the sphere, can detect the distortions caused by the aberration effect at high multipoles. This would in principle allow to disentangle the Doppler from intrinsic dipole contributions providing an independent method for the determination of our peculiar velocity. It is found that the eigenvalues of the Hessian matrix of the temperature field are well suited for that task.
Flavors and Implied Reduced-Risk Descriptors in Cigar Ads at Stores Near Schools
Authors: Sterling Kymberle L , Vishwakarma Monika , Ababseh Kimberly , Henriksen Lisa 
Published: July 2021

Abstract

Introduction
Although the FDA prohibits using inaccurate, reduced-risk descriptors on tobacco product advertising, descriptors that imply reduced risk or an enhanced user experience may be present on cigar product advertising in retail outlets near schools. Therefore, to inform the development of federal labeling and advertising requirements that reduce youth appeal of cigars, we conducted a content analysis of cigar ads in retailers near schools to document the presence of implied health claims and other selling propositions that may convey enhanced smoking experience.

Aims and Methods
Up to four interior and exterior little cigar and cigarillo advertisements were photographed in a random sample of licensed tobacco retailers (n = 530) near California middle and high schools. Unique ads (n = 234) were coded for brand, flavor, and presence of implicit health claims, premium branding descriptors, and sensory descriptors. Logistic regressions assessed the association among flavored ads and presence of implicit health claims, premium branding, or sensory descriptors.

Results
Seventeen cigar brands were advertised near schools; Black & Mild (20.1%) and Swisher Sweets (20.1%) were most common. Flavor was featured in 64.5% of ads, with explicit flavor names (eg, grape) being more prevalent than ambiguous names (eg, Jazz) (49.6% vs. 34.2%). Compared to ads without flavors, ads with ambiguous flavors were more likely to feature implicit health claims (OR = 1.83, 95% CI = 1.06% to 3.19%) and sensory descriptors (OR = 2.64, 95% CI = 1.39% to 5.04%); ads with explicit flavors were more likely to feature premium branding (OR = 2.84, 95% CI = 1.53% to 5.41%).

Conclusions
Cigar ads that featured implicit health claims and premium branding, and sensory selling propositions are present at retailer stores near schools.

Implications
We document the presence of implied health claims, premium branding, and sensory descriptors on cigar ads found in retail settings near schools. This study adds to the body of evidence that supports the development of federal labeling and advertising requirements for cigar products to reduce their appeal among vulnerable groups.