bluuebunny/crossref_metadata_2025_split huggingface dataset:
New pneumococcal serotype 20C is a WciG O-acetyltransferase deficient variant of canonical serotype 20B
Authors: Yu Jigui , Ravenscroft Neil , Davey Peter , Liyanage Roshan , Lorenz Oliver , Kuttel Michelle M. , Lo Stephanie W. , Ganaie Feroze A. , Nahm Moon H. 
Published: November 2024

ABSTRACT

The polysaccharide (PS) capsule of
Streptococcus pneumoniae
(pneumococcus) is the immunodominant surface structure that shields the bacteria from the host immune system. Since the capsule is the primary target of currently available pneumococcal vaccines, anti-capsular antibodies are highly protective but serotype-specific. Pneumococci may evade host or vaccine-induced immunity as a result of variation in capsule structure mediated via multiple mechanisms, such as the loss or gain of O-acetylation. Previous biochemical studies of serogroup 20 isolates have identified two subtypes—20A and 20B, whose capsule PS differs in the WhaF-mediated glucose side chain. Herein, we characterize a newly discovered capsule type, 20C, that differs from serotype 20B via the inactivation of capsule O-acetyltransferase gene,
wciG
. Structural analysis demonstrated that 20C and 20B share an identical repeat unit [→3)-α-D-Glc
p
NAc-[β-D-Gal
f
-(1→4)][α-D-Glc
p
-(1→6)]-(1→P→6)-α-D-Glc
p
-(1→6)- β-D-Glc
p
-(1→3)-β-D-Gal
f
5,6Ac
2
-(1→3)-β-D-Glc
p
-(1→], except for the absence of WciG-mediated O
-
acetyl group at terminal galactofuranose (β-D-Gal
f
). We confirmed that deletion of the
wciG
gene in a 20B strain resulted in the expression of the 20C capsule. Serotype 20C is serologically indistinguishable from the canonical 20A and 20B using conventional serotyping antibodies, but serogroup 20 subtypes can be distinguished by sequencing of
cps
genes—
whaF
,
wciG
, and
wcjE
. While genetic screening suggests 20C to be globally less prevalent, a new variant was identified which appears to have both
wciG
and
whaF
genes inactive, potentially indicating it to be a new serotype. Consequently, genome-based serotyping/bioinformatic tools must scrutinize all
cps
genes for mutations that might inactivate/modify
cps
-encoded enzymes, ensuring effective tracking of emerging capsule variants in response to ongoing vaccination efforts.

IMPORTANCE

Streptococcus pneumoniae
(pneumococcus) is a significant human pathogen known for producing a wide array of antigenically and structurally diverse capsule types, a fact that poses a serious challenge to the effectiveness of vaccines targeting pneumococcal capsule polysaccharide (PS). Herein, we provide a comprehensive analysis-genetic, antigenic, and biochemical of a newly identified capsule type, 20C, which differs from the canonical serotype 20B due to the inactivation of the capsule O-acetyltransferase gene,
wciG
. Our findings highlight how pneumococci can alter their capsule PS structure and immunological characteristics through minor genetic modifications. Since the appearance of new capsule types can directly affect pneumococcal conjugate vaccine (PCV) implementation, a deeper understanding of capsule PS at the genetic, immunological, and biochemical levels is critical for the development of future diagnostic tools and vaccines.
Modulation of Azithromycin Activity against Single-Species and Binary Biofilms of Staphylococcus aureus and Kytococcus schroeteri by Norepinephrine
Authors: Diuvenji E. V. , Soloviev I. D. , Sukhacheva M. V. , Nevolina E. D. , Ovcharova M. A. , Loginova N. A. , Mosolova A. M. , Mart’yanov S. V. , Plakunov V. K. , Gannesen A. V. 
Published: November 2024

Abstract
The effect of norepinephrine as a compound modulating the activity of the antibiotic azithromycin on single-species and binary biofilms of members of the human microbiota, Staphylococcus aureus and Kytococcus schroeteri, was studied in various model systems. At the concentration of 3.55 µM, the hormone was shown to be able, depending on the cultivation system and incubation time, of both enhancing and weakening the effects of azithromycin at subinhibitory concentrations (0.001 and 4 µg/mL). In the case of rapidly formed biofilms, norepinephrine weakened the inhibitory effect of the antibiotic, while in the presence of the full stage of adhesion the hormone, on the contrary, enhanced the inhibitory effect. Interaction between two microorganisms in the community was no less important, since the presence of K. schroeteri in the community changed the effect of azithromycin (4 μg/mL) in combination with norepinephrine on S. aureus. It was shown that azithromycin and norepinephrine, as well as their combinations, were able to change the expression of the genes coding resistance not only to macrolides (increased expression of the mrx gene by a combination of 4 μg/mL azithromycin and 3.55 μM norepinephrine), but also to fluoroquinolones (decreased expression of the arlR gene and increased one of mdtK).
Herpetic encephalitis with autoimmune recurrence following cerebral aneurysm clipping
Authors: Moniz Dionísio Joana , Santos Mariana , Seromenho-Santos Alexandra , Reizinho Carla 
Published: November 2024

A man in his late 60s with well-controlled HIV underwent an uneventful surgical clipping of an unruptured intracranial aneurism. Postoperatively, he developed fever, seizures and an altered mental status. Cerebrospinal fluid (CSF) showed lymphocytic pleocytosis, high protein count and a positive herpes simplex virus (HSV)-2 PCR. Acyclovir was started. Brain MRI showed right hemisphere T2/FLAIR-weighted anterior temporal cortical and subcortical hyperintensities. After 2 months, he developed psychosis, an upper limb tremor and pyramidal tract dysfunction. A new brain MRI revealed a new right frontal white matter lesion, extending to the corpus callosum. Anti-N-methyl-D-aspartate receptor (NMDAR) antibodies were positive in CSF, while there was no evidence of active HSV infection. Methylprednisolone and IVIg were started, and a significant clinical improvement was achieved.If an unknown inflammatory process occurs after surgery, herpetic encephalitis should be considered, and treatment should be initiated precociously. Since herpetic encephalitis can trigger an anti-NMDAR encephalitis, this autoimmune complication must be considered.
The effects of literacy on health in Gypsies, Roma and Travellers (GRT): a systematic review and narrative synthesis
Authors: Dunn Montgomery , Turner-Moss Eleanor J C , Carpenter Beverley , Speed Ewen , Dixon Kathryn Charlotte , Blumenfeld Tanya 
Published: November 2024

IntroductionGypsies, Roma and Travellers (GRT) frequently experience poorer health outcomes than the general population and represent the most socially and economically disadvantaged individuals in many countries. In general, GRT in OECD (Organisation for Economic Co-operation and Development) countries have lower rates of literacy than the general population. Although ‘health literacy’ has been examined before, the link between low functional literacy and its effects on health has not yet been explored.MethodsSearches were conducted on five large English-language databases for research papers since 2008. Grey literature was included as the number of eligible papers was small. This was complimented by citation ‘chaining’. Study findings of qualitative papers were extracted, codes were devised and then analysed thematically. A narrative synthesis was reported, supplemented by the quantitative findings.Results15 studies (and two substudies) were analysed. Four strongly overlapping themes were developed: (1) The context of culturally inadequate healthcare systems, (2) psychological impact and disempowerment, (3) intersectional, contextual factors and the unique needs of GRT and (4) considerations for health information resources for GRT patients with low literacy.ConclusionAlthough low literacy in GRT groups is a well-recognised issue, this is the first systematic review to analyse the link between low literacy and its effects on health outcomes for GRT. The wide range of socioeconomic and cultural factors present in GRT communities, combined with low literacy, act synergistically to worsen the physical and mental health of GRT groups in different ways than that seen in members of the general population with similar low literacy levels. National intervention is required to improve the literacy of GRT children and adults. There is a clear need to develop policies and processes that facilitate a better understanding of literacy levels and how they interact with other social determinants of GRT health among healthcare professionals.Registration numberCRD42023468449.
Understanding the demographic and socioeconomic determinants of morbidity in Eastern Uganda: a retrospective analysis of the Iganga-Mayuge health and demographic surveillance data
Authors: Cygu Steve Bicko , Nabukeera Betty , English Lindsey , Babirye Shakira , Gyezaho Collins , Ng'etich Maureen , Ochola Michael , Amadi David , Odero Henry Owoko , Banturaki Grace , Kadengye Damazo Twebaze , Kiragga Agnes , Kajungu Dan 
Published: November 2024

IntroductionUnderstanding the determinants of disease burden is imperative in enhancing population health outcomes. This study uses data from the Iganga-Mayuge Health and Demographic Surveillance Site, to understand demographic and socioeconomic factors influencing morbidity.MethodsWe analysed secondary data from 2018 to 2023. We employed graphs and tables to present morbidity patterns across different sociodemographic factors and applied mixed-effects multinomial multivariate logistic regression model to understand the correlates of morbidity.ResultsThe findings reveal a predominant prevalence of malaria, lower respiratory tract infections, coryza, gastric acid-related and urinary tract infections, collectively constituting 83% of diagnosed diseases. Noteworthy demographic variations, particularly gender and age, significantly impact disease distribution, revealing higher diagnosis rates among females. Additionally, socioeconomic factors, including education and wealth status, contribute to discernible differences in disease burden.ConclusionThis research provides crucial insights into the implications of demographic and socioeconomic factors on disease burden in Uganda. The results contribute to evidence-based policy-making, highlighting the necessity for targeted interventions addressing specific health challenges encountered by diverse populations. The study advocates for continuous assessment of the epidemiological landscape to inform more tailored and effective health strategies, ultimately enhancing resilience in disease control efforts.
Association of child weight and adverse outcomes following antibiotic prescriptions in children: a national data study in Wales, UK
Authors: Opatola Ayodele Vincent , Seaborne Mike J , Kennedy Jonathan , Hughes Dyfrig , Laing Hamish , Owen Rhiannon K , Tuthill David , Bracchi Robert , Brophy Sinead 
Published: November 2024

ObjectiveTo examine if the weight of a child determines adverse events following oral antibiotics prescription.DesignPopulation respective cohort using linked general practice (GP), hospital data and linkage with the Welsh Demographic Service for demographic information. Data linkage was performed using Wales health data, extracted from the SAIL (Secure Anonymised Information Linkage) databank.InclusionChildren (0–12 years) prescribed oral antibiotics by their GP in Wales.ExposureAntibiotic prescription (penicillins, cephalosporins, macrolides, dihydropyrimidines, nitroimidazoles, nitrofurans, lincosamides).OutcomeAdverse event as defined by; patients’ death within 5 days, records of emergency admission within 5 days and GP records of adverse drug reactions or prescription of another antibiotic within 14 days.AnalysisLogistic regression of adverse events versus no adverse events at follow-up time.ResultsThere were 139 571 prescriptions of the selected antibiotics and 71 541 children (51.39% male) included with follow-up data of which there were 25 445 (18.23% of all prescriptions) children experienced adverse outcomes. There was higher odds of adverse events for lower weight children and those who were younger, female, of Asian origin or deprived.ConclusionThe findings support the hypothesis that smaller children for their age (eg, low weight, female, Asian) are more likely to experience adverse events following antibiotics prescription. This work suggests child weight, in addition to age, should be used when prescribing antibiotics to children in primary care.
Large-scale observational study of AI-based patient and surgical material verification system in ophthalmology: real-world evaluation in 37 529 cases
Authors: Tabuchi Hitoshi , Ishitobi Naofumi , Deguchi Hodaka , Nakaniida Yuta , Tanaka Hayato , Akada Masahiro , Tanabe Mao 
Published: November 2024

BackgroundSurgical errors in ophthalmology can have devastating consequences. We developed an artificial intelligence (AI)-based surgical safety system to prevent errors in patient identification, surgical laterality and intraocular lens (IOL) selection. This study aimed to evaluate its effectiveness in real-world ophthalmic surgical settings.MethodsIn this retrospective observational before-and-after implementation study, we analysed 37 529 ophthalmic surgeries (18 767 pre-implementation, 18 762 post implementation) performed at Tsukazaki Hospital, Japan, between 1 March 2019 and 31 March 2024. The AI system, integrated with the WHO surgical safety checklist, was implemented for patient identification, surgical laterality verification and IOL authentication.ResultsPost implementation, five medical errors (0.027%) occurred, with four in non-authenticated cases (where the AI system was not fully implemented or properly used), compared with one (0.0053%) pre-implementation (p=0.125). Of the four non-authenticated errors, two were laterality errors during the initial implementation period and two were IOL implantation errors involving unlearned IOLs (7.3% of cases) due to delayed AI updates. The AI system identified 30 near misses (0.16%) post implementation, vs 9 (0.048%) pre-implementation (p=0.00067), surgical laterality errors/near misses occurred at 0.039% (7/18 762) and IOL recognition at 0.29% (28/9713). The system achieved>99% implementation after 3 months. Authentication performance metrics showed high efficiency: facial recognition (1.13 attempts, 11.8 s), surgical laterality (1.05 attempts, 3.10 s) and IOL recognition (1.15 attempts, 8.57 s). Cost–benefit analysis revealed potential benefits ranging from US$181 946.94 to US$2 769 129.12 in conservative and intermediate scenarios, respectively.ConclusionsThe AI-based surgical safety system significantly increased near miss detection and showed potential economic benefits. However, errors in non-authenticated cases underscore the importance of consistent system use and integration with existing safety protocols. These findings emphasise that while AI can enhance surgical safety, its effectiveness depends on proper implementation and continuous refinement.
Bendamustine–rituximab elicits dual tumoricidal and immunomodulatory responses via cGAS–STING activation in diffuse large B-cell lymphoma
Authors: Xiao Ruipei , Zhao Wenli , Lin Wei , Xiao Yudian , Ren Jie , Zhou Yang , Meng Wei , Bi Enguang , Jiang Ling 
Published: November 2024

Background
Bendamustine–rituximab (BR) therapy stands out as a promising alternative for elderly patients with diffuse large B-cell lymphoma (DLBCL), demonstrating notable efficacy when conventional regimens pose challenges. Despite its clinical success, the intricate mechanisms underlying BR therapy have remained elusive.

Methods
DLBCL cell lines were used to investigate the mechanism of BR therapy in vitro. RNA-seq and Western blot were used to explore the target pathways of BR therapy. STING was knocked out using Crispr-cas9 and inhibited using H-151 to investigate its role in BR therapy. Bulk RNA-seq and single-cell RNA-seq data from patients were analyzed to investigate the association between STING and pyroptosis pathways, validated using STING downregulated cells. Flow cytometry, transwell experiments and co-culture experiments were performed to investigate the inflammatory phenotype of DLBCL cells after BR treatment and its effect on T-cell recruitment and activation.

Results
This study elucidates that BR elicits direct tumoricidal effects by promoting apoptosis and inducing cell cycle arrest. The synergistic impact with rituximab is further potentiated by complement addition, demonstrating the pivotal role of in vivo antibody-dependent cellular cytotoxicity. Moreover, our investigation reveals that, through a cGAS–STING-dependent pathway, prolonged exposure to BR induces pyroptosis in DLBCL cells. Activation of the cGAS–STING pathway by BR therapy triggers the release of inflammatory factors and upregulates major histocompatibility complex molecules, shaping an immunologically hot tumor microenvironment.

Conclusions
This unique dual influence not only directly targets DLBCL cells but also engages the patient’s immune system, paving the way for innovative combination therapies. The study provides comprehensive insights into the multifaceted actions of BR in DLBCL, offering a foundation for refined and personalized treatment strategies in elderly patients.
Endovascular therapy versus medical management in isolated anterior cerebral artery acute ischemic stroke: a multinational multicenter propensity score-weighted study
Authors: Salim Hamza Adel , Pulli Benjamin , Yedavalli Vivek , Milhem Fathi , Musmar Basel , Adeeb Nimer , Lakhani Dhairya A , Essibayi Muhammed Amir , Heit Jeremy Josef , Faizy Tobias D , El Naamani Kareem , Henninger Nils , Sundararajan Sri Hari , Kuhn Anna Luisa , Khalife Jane , Ghozy Sherief , Scarcia Luca , Yeo Leonard LL , Tan Benjamin YQ , Regenhardt Robert W , Cancelliere Nicole M , Rouchaud Aymeric , Fiehler Jens , Sheth Sunil A , Puri Ajit S , Dyzmann Christian , Colasurdo Marco , Renieri Leonardo , Filipe João Pedro , Harker Pablo , Radu Răzvan Alexandru , Abdalkader Mohamad , Klein Piers , Marotta Thomas R , Spears Julian , Ota Takahiro , Mowla Ashkan , Jabbour Pascal , Biswas Arundhati , Clarençon Frédéric , Siegler James E , Nguyen Thanh N , Varela Ricardo , Baker Amanda , Altschul David , Gonzalez Nestor , Möhlenbruch Markus A , Costalat Vincent , Gory Benjamin , Stracke Paul , Hecker Constantin , Marnat Gaultier , Shaikh Hamza , Griessenauer Christoph J , Liebeskind David S , Pedicelli Alessandro , Alexandre Andrea Maria , Tancredi Illario , Kalsoum Erwah , Lubicz Boris , Patel Aman B , Mendes Pereira Vitor , Wintermark Max , Guenego Adrien , Dmytriw Adam A 
Published: November 2024

BackgroundIsolated anterior cerebral artery occlusions (ACAo) in patients with acute ischemic stroke present significant challenges due to their rarity. The efficacy and safety of endovascular therapy (EVT) in comparison with best medical therapy (BMT) for ACAo remains unclear. This study aimed to assess the outcomes of these treatments.MethodsThis multinational, multicenter study analyzed data from the MAD-MT registry. Data were collected retrospectively from 37 sites across North America, Asia, and Europe. Inverse probability of treatment weighting (IPTW) was applied to balance confounding variables. The primary outcome was functional independence (modified Rankin Scale (mRS) scores of 0–2) at 90 days. Secondary outcomes included excellent outcomes (mRS 0–1), mortality at 90 days, and NIH Stroke Scale (NIHSS) score on day 1 post treatment.ResultsOf the 108 patients, 36 received BMT and 72 underwent EVT. The median age was 75 years, and 56% were male. At 90 days, 40% of patients achieved mRS 0–2, with no significant difference between EVT and BMT (38% vs 45%, p=0.46). Procedural success (mTICI 2b-3) was 91% in the EVT group, with a sICH rate of 2.9%. IPTW-adjusted analysis showed no significant difference between EVT and BMT for functional independence (OR 1.17, 95% CI 0.23 to 6.02, p=0.85), mortality (25% vs 21%, p=0.71) or day 1 NIHSS scores (Beta 2.2, 95% CI −0.51 to 4.8, p=0.11).ConclusionsEVT showed high procedural success but did not significantly improve functional outcomes or mortality compared with BMT in patients with ACAo. Further randomized trials are needed to clarify EVT’s role in ACAo.
Non-Kerr constraints using binary black hole inspirals considering phase modifications up to 4 PN order
Authors: Das Debtroy , Shashank Swarnim , Bambi Cosimo 
Published: November 2024

AbstractThe gravitational field around an astrophysical black hole (BH) is thought to be described by the Kerr spacetime, which is a solution of the Einstein equation. Signatures of binary black hole (BBH) coalescence in gravitational waves (GW) follow the Kerr spacetime as the theoretical foundation. Hence, any possible deviations from the Kerr spacetime around BHs serve as a test of the nature of gravity in the strong-field regime and of the predictions of General Relativity. In our study, we perform a theory-agnostic test of the Kerr hypothesis using BBH inspirals from the third Gravitational-wave Transient Catalog (GWTC-3). Considering the Johannsen metric, we compute the leading-order deviation to the emitted GW in the frequency domain. Our results provide constraints on two deformation parameters ($$\alpha _{13}$$

α
13

and $$\epsilon _3$$

ϵ
3

) and demonstrate the degeneracy between these two non-Kerr parameters.
Discriminative deep learning based hybrid spectro-temporal features for synthetic voice spoofing detection
Authors: Palsapure Pranita Niraj , Rajeswari Rajeswari , Kempegowda Sandeep Kumar , Ravikumar Kumbhar Trupti 
Published: November 2024

<span lang="EN-US">Voice-based systems like speaker identification systems (SIS) and automatic speaker verification systems (ASV) are proliferating across industries such as finance and healthcare due to their utility in identity verification through unique speech pattern analysis. Despite their advancements, ASVs are susceptible to various spoofing attacks, including logical and replay attacks, posing challenges due to the sophisticated acoustic distinctions between authentic and spoofed voices. To counteract, this study proposes a robust yet computationally efficient countermeasure system, utilizing a systematic data processing pipeline coupled with a hybrid spectral-temporal learning approach. The aim is to identify effective features that optimize the model's detection accuracy and computational efficiency. The model achieved superior performance with an accuracy of 99.44% and an equal error rate (EER) of 0.014 in the logical access scenario of the ASVspoof 2019 challenge, demonstrating its enhanced accuracy and reliability in detecting spoofing attacks with minimized error margin. </span>