bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acinetobacter calcoaceticus-baumannii
complex prevalence, spatial-temporal distribution, and contamination sources in Canadian aquatic environments
Authors: Benoit Thomas , Sajjad Dania , Cloutier Michel , Lapen David R. , Craiovan Emilia , Sykes Ellen M. E. , Kumar Ayush , Khan Izhar U. H. 
Published: September 2024

ABSTRACT

Acinetobacter calcoaceticus-baumannii
(ACB) complex has been identified as a group of emerging opportunistic pathogens that cause nosocomial infections. The current study investigates the prevalence, distribution, and diversity of pathogenic ACB complex in various aquatic systems with different uses. Of the total 157 agricultural, raw drinking water intake, recreational beach, and wastewater treatment plant (WWTP) effluent samples, acinetobacters were isolated, quantified, and confirmed by genus- and ACB complex-specific PCR assays. Of all agricultural surface water samples,
A. calcoaceticus
(65%) was more frequently detected than
A. pittii
(14%),
A. nosocomialis
(9%), and
A. baumannii
(3%). In WWTP effluent samples,
A. baumannii
was more prevalent in de-chlorinated (60%) samples compared to both
A. pittii
and
A. nosocomialis
(40%). Interestingly
, A. nosocomialis
(43%),
A. calcoaceticus
(29%), and
A. baumannii
(14%) were detected in raw drinking water intake samples, whereas
A. pittii
(50%) and
A. nosocomialis
(25%) were detected in beach samples. Although no sampling location-specific differences were recorded, significant (
P
< 0.05) seasonal differences were observed when agricultural surface water samples collected in spring were compared with the summer and fall. Whereas effluent chlorination significantly impacted the degree of prevalence of
Acinetobacter
in WWTP effluent samples, overall, the prevalence of ACB complex in all sampling locations and seasons indicates that these water sources, containing human-associated ACB complex, may pose potential health risks as community-acquired opportunistic infections.

IMPORTANCE

Acinetobacter calcoaceticus-baumannii
(ACB) complex is a group of organisms known to cause problematic nosocomial opportunistic infections. A member of the species complex,
A. baumannii
, is becoming a global threat to infection treatment as strains are increasingly develop resistance to antibiotics. The prevalence and distribution of potentially pathogenic
Acinetobacter calcoaceticus-baumannii
complex species remain poorly understood, and there is a need to better understand the occurrence of
A. baumannii
in non-nosocomial environments. Our research details the spatial-temporal distribution of ACB complex species in a regional watershed and highlights the presence of ACB complex in wastewater effluent that is discharged into a river. These findings deepen our understanding of this group of species in non-nosocomial environments and encourage the development of monitoring programs for these species in regional waters.
Patient safety culture in home healthcare centres: protocol for a scoping review
Authors: Etebarian Khorasgani Abolfazl , Najafi Ghezeljeh Tahereh , Sharif-Nia Hamid , Ashghali Farahani Mansoureh , Golestan Fateme , Saraipour Ferdos 
Published: September 2024

IntroductionPatient safety culture is a critical factor in improving the quality of home healthcare and preventing adverse events in patients receiving care in home health centres. However, the concept of patient safety culture in home healthcare centres is not clearly defined, and its dimensions and characteristics are still largely unknown. The aim of this scoping review is to provide a comprehensive overview of research on patient safety culture in home healthcare centres, identify related definitions and characteristics, and focus on key factors to fill the existing knowledge gaps.Methods and analysisThis review will follow Arksey and O’Malley’s methodological framework, updated by the Joanna Briggs Institute (JBI), which comprises five stages: identifying the research question, identifying relevant studies, selecting the studies, charting the data, and collating, summarising and reporting the results. The inclusion criteria will be based on the Population, Concept and Context framework. A comprehensive search of PubMed, Embase, Scopus, ProQuest, Web of Science, Cochrane and grey literature sources, with no date restrictions, was conducted with the assistance of a qualified research librarian to include all relevant published study designs and ensure a thorough understanding of the topic. The search will be continuously updated until the study is completed. In addition, we will review the reference lists of the final included studies and their citations to find further relevant studies. Studies that are duplicates and those not written in Persian or English will be excluded. The selection of studies based on the eligibility criteria will carried out by two independent reviewers who will perform a title/abstract screening followed by a full-text screening. Data extraction will be conducted using a standardised form from the JBI. Descriptive and content analyses will be conducted to identify key concepts in the literature reviewed.Ethics and disseminationNo ethical review is required for this study. Results will be submitted for publication in a peer-reviewed journal and presented at conferences.
Implementing a pharmacogenomic-driven algorithm to guide antiplatelet therapy among Caribbean Hispanics: a non-randomised clinical trial
Authors: Nuñez-Medina Hector J , Monero Mariangeli , Torres Lorna M , Leal Enrique , Gonzalez-Sepulveda Lorena , Mayor Ángel M , Renta Jessicca Y , González-García Edgardo R , González Ariel , Melin Kyle , Scott Stuart A , Ruaño Gualberto , Hernandez-Suarez Dagmar F , Duconge Jorge 
Published: September 2024

ObjectivesTo assess whether genotype-guided selection of oral antiplatelet drugs using a clinical decision support (CDS) algorithm reduces the rate of major adverse cardiovascular and cerebrovascular events (MACCEs) among Caribbean Hispanic patients, after 6 months.DesignAn open-label, multicentre, non-randomised clinical trial.SettingEight secondary and tertiary care hospitals (public and private) in Puerto Rico.Participants300 Caribbean Hispanic patients on clopidogrel, both genders, underwent percutaneous coronary intervention (PCI) for acute coronary syndromes, stable ischaemic heart disease and documented extracardiac vascular diseases.InterventionsPatients were separated into standard-of-care (SoC) and genotype-guided (pharmacogenetic (PGx)-CDS) groups (150 each) and stratified by risk scores. Risk scores were calculated based on a previously developed CDS risk prediction algorithm designed to make actionable treatment recommendations for each patient. Individual platelet function, genotypes, clinical and demographic data were included. Ticagrelor was recommended for patients with a high-risk score ≥2 in the PGx-CDS group only, the rest were kept or de-escalated to clopidogrel. The intervention took place within 3–5 days after PCI. Adherence medication score was also measured.Primary and secondary outcomesThe occurrence rate of MACCEs (primary) and bleeding episodes (secondary). Statistical associations between patient time free of events and predictor variables (ie, treatment groups, risk scores) were tested using Kaplan-Meier survival analyses and Cox proportional-hazards regression models.ResultsThe genotype-guided group had a clinically lower but not significantly different risk of MACCEs compared with the SoC group (8.7% vs 10.7%, p=0.56; HR=0.56). Among high-risk score patients, genotype-driven guidance of antiplatelet therapy showed superiority over SoC in reducing MACCE incidence 6 months postcoronary stenting (adjusted HR=0.104; p< 0.0001).ConclusionsThe potential benefit of implementing our PGx-CDS algorithm to significantly reduce the incidence rate of MACCEs in post-PCI Caribbean Hispanic patients on clopidogrel was observed exclusively among high-risk patients, with apparently no evident effect in other patient groups.Trial registration numberNCT03419325.
Qualitative study of UK health and care professionals to determine resources and processes that can support actions to improve quality of data used to address and monitor health inequalities
Authors: Moorthie Sowmiya , Oguzman Emre , Evans Sian , Brayne Carol , LaFortune Louise 
Published: September 2024

IntroductionHealth inequalities in the UK are investigated and addressed by analysing data across socioeconomic factors, geography and specific characteristics, including those protected under law. It is acknowledged that the quality of data underpinning these analyses can be improved. The objective of this work was to gain insights from professionals working across the health and care sector in England into the type(s) of resource(s) that can be instrumental in implementing mechanisms to improve data quality into practice.DesignQualitative study based on semistructured interviews involving health and care professionals.SettingEngland.ParticipantsA total of 16 professionals, mainly from the East of England.ResultsAwareness of mechanisms that could be put in place to improve quality of data related to health inequalities was high among interviewees. However, logistical (eg, workforce time, capacity and funding) as well as data usage (eg, differences in data granularity, information governance structures) barriers impacted on implementation of many mechanisms. Participants also acknowledged that concepts and priorities around health inequalities can vary across the system. While there are resources already available that can aid in improving data quality, finding them and ensuring they are suited to needs was time-consuming. Our analysis indicates that resources to support the creation of a shared understanding of what health inequalities are and share knowledge of specific initiatives to improve data quality between systems, organisations and individuals are useful.ConclusionsDifferent resources are needed to support actions to improve quality of data used to investigate heath inequalities. These include those aimed at raising awareness about mechanisms to improve data quality as well as those addressing system-level issues that impact on implementation. The findings of this work provide insights into actionable steps local health and care services can take to improve the quality of data used to address health inequalities.
Identifying combinations of long-term conditions associated with sarcopenia: a cross-sectional decision tree analysis in the UK Biobank study
Authors: Hillman Susan J , Dodds Richard M , Granic Antoneta , Witham Miles D , Sayer Avan A , Cooper Rachel 
Published: September 2024

ObjectivesThis study aims to determine whether machine learning can identify specific combinations of long-term conditions (LTC) associated with increased sarcopenia risk and hence address an important evidence gap—people with multiple LTC (MLTC) have increased risk of sarcopenia but it has not yet been established whether this is driven by specific combinations of LTC.DesignDecision trees were used to identify combinations of LTC associated with increased sarcopenia risk. Participants were classified as being at risk of sarcopenia based on maximum grip strength of <32 kg for men and <19 kg for women. The combinations identified were triangulated with logistic regression.SettingUK Biobank.ParticipantsUK Biobank participants with MLTC (two or more LTC) at baseline.ResultsOf 140 001 participants with MLTC (55.3% women, median age 61 years), 21.0% were at risk of sarcopenia. Decision trees identified several LTC combinations associated with an increased risk of sarcopenia. These included drug/alcohol misuse and osteoarthritis, and connective tissue disease and osteoporosis in men, which showed the relative excess risk of interaction of 3.91 (95% CI 1.71 to 7.51) and 2.27 (95% CI 0.02 to 5.91), respectively, in age-adjusted models.ConclusionKnowledge of LTC combinations associated with increased sarcopenia risk could aid the identification of individuals for targeted interventions, recruitment of participants to sarcopenia studies and contribute to the understanding of the aetiology of sarcopenia.
Effectiveness of acceptance commitment therapy for head and neck cancer patients with body image distress in China: a study protocol for randomised controlled trial
Authors: Xu Wenjie , Xiang Lina , Wang Shuman , Zhu Yu , Zheng Mimi , Wan Hongwei 
Published: September 2024

IntroductionThe head and neck comprise vital organs and are apparent human body parts. Tumours here impair physical and sensory functions as well as appearance and social interactions, leading to body image distress (BID) and threatening mental health and quality of life. Acceptance and commitment therapy has shown effectiveness in improving BID in groups such as breast cancer patients. This study aims to apply this therapy to intervene in head and neck cancer (HNC) patients, aiming to improve BID and promote better psychological well-being.Methods and analysisThis study is a prospective, parallel-group, randomised controlled trial. A total of 64 HNC patients will be allocated to either an intervention group or a control group. The intervention group will engage in a 3 week, six-session group-based acceptance and commitment therapy programme, while the control group will receive standard treatment. The primary outcome is cancer-related BID, and secondary outcomes are HNC-related BID, psychological flexibility, coping style and psychological distress. These indicators will be measured at baseline, postintervention and 1 month following the intervention’s completion.Ethics and disseminationThe trial has received approval from the Institutional Review Board of Shanghai Proton and Heavy Ion Hospital (2308-67-02). The study results will be shared through peer-reviewed journals and conferences.Trial registration numberChiCTR2300077863.
Unveiling the prevalence of anaemia and its predictors among adults on highly active antiretroviral therapy in the dolutegravir era: a retrospective cross-sectional study
Authors: Sisay Zewdu Woretaw , Molla Zeleke Mulugeta , Ferede Yared Andargie , Kassie Achenef Bogale , Singh Pradeep , Alemu Muluken Adela , Desta Getaye Tessema 
Published: September 2024

ObjectiveThis study examined the prevalence, severity and risk factors of anaemia among adult people living with HIV attending an antiretroviral therapy centre in Woreta Primary Hospital, Woreta town, Ethiopia.DesignHospital-based retrospective cross-sectional study.SettingPublic health facility that provides HIV care in Woreta town.ParticipantsA total of 289 medical records of adults living with HIV/AIDS on highly active antiretroviral therapy from February 2019 to September 2023 at government hospital were reviewed using a systematic sampling method. The data were entered using Epi-info V.7 and exported to SPSS V.23 for data analysis. The data were analysed using bivariate and then multivariate logistic regression models in order to identify variables associated with anaemia. At the 95% CI level, variables having a p value of <0.05 were deemed to be statistically significant predictors.Primary outcomePrevalence and severity of anaemia and its predictors among adult patients living with HIV on antiretroviral therapy in Woreta Primary Hospital.ResultsThe total prevalence of anaemia was 31.5% (95% CI 28.9 to 33.8). The prevalence of mild, moderate and severe anaemia was 20.42%, 10.38% and 0.70%, respectively. Predictors independently linked with anaemia were female sex (adjusted OR (AOR) 1.08), age ≥40 years (AOR 1.21), lived with HIV >10 years (AOR 2.31), CD4 counts <200 cells/µL (AOR 3.81), non-suppressed viral load (AOR 1.28), history of opportunistic infections (AOR 1.54), WHO clinical stages III and IV (AOR 1.37 and 2.23, respectively) and history of parasitic infestation (AOR 2.81).ConclusionsA sizeable proportion of participants were found anaemic. Female sex, older age, longer periods lived with the virus, lower CD4 count, non-suppressed viral load, history of opportunistic infections, WHO clinical stages III and IV and history of parasitic infestation were the contributing factors. Therefore, to improve the anaemic status and living circumstances of patients living with HIV, immediate action on the linked factors is needed, such as monitoring for maintenance of CD4 counts >200 cells/μL and avoiding progression of HIV to the advanced WHO clinical stages, suppressed viral load, preventing opportunistic infections and parasitic infestation.
Effects of a hospital-based food security programme for children with complex diseases in an upper-middle-income country: a before-and-after study
Authors: Gómez-Casas Ángela María , Gempeler Andrés , Montoya Diana , González Luisa Fernanda , Prada Sergio I , Escobar Luis Alberto , Madriñán Jorge Mario , Granados Marcela 
Published: September 2024

BackgroundTo reduce health inequities in paediatric patients with complex diseases, our hospital developed a food security programme in 2022. The programme aims to mitigate food insecurity (FI) in paediatric patients with oncological, transplantation and congenital cardiovascular diagnoses, by providing a monthly nutritious food supply that covers up to 50% of the patient’s family food intake, accompanied by social and nutritional follow-up. In this study, we aimed to assess the effect of the programme on FI and nutritional status and describe its implementation.MethodWe conducted a before-and-after study of patients who entered the programme in a 14-month period. We used the Escala Latinoamericana y Caribeña de Seguridad Alimentaria (ELCSA) scale score, FI level and nutritional status measures to assess the effect of the programme. We used the Wilcoxon and McNemar tests to assess changes in scores and proportions of patients with moderate and severe FI, respectively, 31.5%–14.4% (p=0.0008) and of moderate FI from 68.5% to 36.9%.Results111 patients were included. They had a baseline median (IQR) ELCSA score=8 (7–11) that changed to 6 (4–9) (p<0.0001). Severe FI according to ELCSA changed from 31.5% to 14.4% (p<0.001) and moderate from 68.5% to 36.9% (p<0.001). We found no differences in nutritional status regarding height for age (49.5% vs 51.3%, p=0.76), weight for height (42.5% vs 59.1%, p=0.75) or body mass index for age (38% vs 46%, p=0.42)ConclusionThe programme reduced FI in families by improving its level to mild or moderate. Children who entered the programme maintained an appropriate nutritional status despite the considerable risk of malnutrition described for oncological paediatric patients and paediatric solid organ transplantation receptors.
Health, burnout and well-being of UK cardiology trainees: insights from the British Junior Cardiologists’ Association Survey
Authors: Jenner William John , Brown Oliver Ian , Moore Abigail , Gilpin Thomas , Morgan Holly , Bowater Sarah , Braganza Denise , Camm C Fielder 
Published: September 2024

BackgroundCardiology training is demanding and associated with high workloads. Poor lifestyle and health among clinicians may stretch workforces and impact patient care. It has not been established what impact training in cardiology has on the doctors undertaking it. We aimed to establish the prevalence of physical and mental illness, burnout and the ability to maintain a healthy lifestyle among cardiology trainees in the United Kingdom (UK).MethodsThe 2023 British Junior Cardiologists’ Association training survey included questions on ill health, burnout, healthy living and invited responders to complete screening questionnaires for depression (Patient Health Questionnaire 9; PHQ-9) and anxiety (Generalised Anxiety Disorder 7; GAD-7). Significant anxiety and depression were defined as scoring within the moderate or severe range (PHQ-9≥10; GAD-7≥10). Burnout was a self-reported outcome. Poisson regression was used to determine prevalence ratios (PR) between univariate predictors of anxiety, depression and burnout.ResultsOf 398 responders, 212 consented to answer health and well-being questions. Prior physical and mental health conditions were reported by 9% and 7% of trainees, respectively. Significant depression and anxiety symptoms were reported by 25% and 18% of trainees, respectively. Burnout was reported by 76% of trainees. Less than full-time trainees reported greater anxiety (PR 2.92, 95% CI 1.39 to 6.16, p<0.01) and depression (PR 3.66, 95% CI 2.24 to 5.98, p<0.01), while trainees with dependents reported less burnout (PR 0.77, 95% CI 0.65 to 0.92, p<0.01). Exercise, good sleep quality and maintaining a healthy diet were associated with less burnout and depressive symptoms (p<0.05). Half of trainees reported training having a negative impact on well-being, driven by the amount of service provision, curriculum requirements and lack of training opportunities.ConclusionsThe prevalence of anxiety, depression and burnout is high among UK cardiology trainees. Further work should establish the impact of cardiology trainee health on the quality of patient care. Training bodies should consider how occupational factors may contribute to health.
Immune isolation-enabled nanoencapsulation of donor T cells: a promising strategy for mitigating GVHD and treating AML in preclinical models
Authors: Mei Dan , Xue Ziyang , Zhang Tianjing , Yang Yining , Jin Lin , Yu Qianqian , Hong Jian , Zhang Xianzheng , Ge Jinru , Xu Li , Wang Han , Zhang Ziwei , Zhao Yuchen , Zhai Yuanfang , Tao Qianshan , Zhai Zhimin , Li Qingsheng , Li Hongxia , Zhang Lingling 
Published: September 2024

BackgroundIn allogeneic-hematopoietic stem cell transplantation for acute myeloid leukemia (AML), donor T cells combat leukemia through the graft-versus-leukemia (GVL) effect, while they also pose a risk of triggering life-threatening graft-versus-host disease (GVHD) by interacting with recipient cells. The onset of GVHD hinges on the interplay between donor T cells and recipient antigen-presenting cells (APCs), sparking T-cell activation. However, effective methods to balance GVHD and GVL are lacking.MethodsIn our study, we crafted nanocapsules by layering polycationic aminated gelatin and polyanionic alginate onto the surface of T cells, examining potential alterations in their fundamental physiological functions. Subsequently, we established an AML mouse model and treated it with transplantation of bone marrow cells (BMCs) combined with encapsulated T cells to investigate the GVL and anti-GVHD effects of encapsulated T cells. In vitro co-culture was employed to probe the effects of encapsulation on immune synapses, co-stimulatory molecules, and tumor-killing pathways.ResultsTransplantation of BMCs combined with donor T cells selectively encapsulated onto AML mice significantly alleviates GVHD symptoms while preserving essential GVL effects. Encapsulated T cells exerted their immunomodulatory effects by impeding the formation of immune synapses with recipient APCs, thereby downregulating co-stimulatory signals such as CD28-CD80, ICOS-ICOSL, and CD40L-CD40. Recipient mice receiving encapsulated T-cell transplantation exhibited a marked increase in donor Ly-5.1-BMC cell numbers, accompanied by unaltered in vivo expression levels of perforin and granzyme B. While transient inhibition of donor T-cell cytotoxicity in the tumor microenvironment was observed in vitro following single-cell nanoencapsulation, subsequent restoration to normal antitumor activity ensued, attributed to selective permeability of encapsulated vesicle shells and material degradation. Moreover, the expression of apoptotic proteins and FAS-FAS ligand pathway at normal levels was still observed in leukemia tumor cells.ConclusionsEncapsulated donor T cells effectively mitigate GVHD while preserving the GVL effect by minimizing co-stimulatory signaling with APCs through early immune isolation. Subsequent degradation of nanocapsules restores T-cell cytotoxic efficacy against AML cells, mediated by cytotoxic pathways. Using transplant-encapsulated T cells offers a promising strategy to suppress GVHD while preserving the GVL effect.