bluuebunny/crossref_metadata_2025_split huggingface dataset:
WNV and SLEV coinfection in avian and mosquito hosts: impact on viremia, antibody responses, and vector competence
Authors: Gallichotte Emily N. , Fitzmeyer Emily A. , Williams Landon , Spangler Mark Cole , Bosco-Lauth Angela M. , Ebel Gregory D. 
Published: September 2024

ABSTRACT

West Nile virus (WNV) and St. Louis encephalitis virus (SLEV) are closely related flaviviruses that can cause encephalitis in humans and related diseases in animals. In nature, both are transmitted by
Culex
, with wild birds, including jays, sparrows, and robins, serving as vertebrate hosts. WNV and SLEV circulate in the same environments and have recently caused concurrent disease outbreaks in humans. The extent that coinfection of mosquitoes or birds may alter transmission dynamics, however, is not well characterized. We therefore sought to determine if coinfection alters infection kinetics and virus levels in birds and infection rates in mosquitoes. Accordingly, American robins (
Turdus migratorius
), two species of mosquitoes, and vertebrate and invertebrate cells were infected with WNV and/or SLEV to assess how simultaneous exposure may alter infection outcomes. There was variable impact of coinfection in vertebrate cells, with some evidence that SLEV can suppress WNV replication. However, robins had comparable viremia and antibody responses regardless of coinfection. Conversely, in
Culex
cells and mosquitoes, we saw a minimal impact of simultaneous exposure to both viruses on replication, with comparable infection, dissemination, and transmission rates in singly infected and coinfected mosquitoes. Importantly, while WNV and SLEV levels in coinfected mosquito midguts were positively correlated, we saw no correlation between them in salivary glands and saliva. These results reveal that while coinfection can occur in both avian and mosquito hosts, the viruses minimally impact one another. The potential for coinfection to alter virus population structure or the likelihood of rare genotypes emerging remains unknown.

IMPORTANCE

West Nile virus (WNV) and St. Louis encephalitis virus (SLEV) are closely related viruses that are transmitted by the same mosquitoes and infect the same birds in nature. Both viruses circulate in the same regions and have caused concurrent outbreaks in humans. It is possible that mosquitoes, birds, and/or humans could be infected with both WNV and SLEV simultaneously, as has been observed with Zika, chikungunya, and dengue viruses. To study the impact of coinfection, we experimentally infected vertebrate and invertebrate cells, American robins, and two
Culex
species with WNV and/or SLEV. Robins were efficiently coinfected, with no impact of coinfection on virus levels or immune response. Similarly, in mosquitoes, coinfection did not impact infection rates, and mosquitoes could transmit both WNV and SLEV together. These results reveal that WNV and SLEV coinfection in birds and mosquitoes can occur in nature, which may impact public health and human disease risk.
Innate cells and STAT1-dependent signals orchestrate vaccine-induced protection against invasive
Cryptococcus
infection
Authors: Wang Keyi , Espinosa Vanessa , Wang Yina , Lemenze Alexander , Kumamoto Yosuke , Xue Chaoyang , Rivera Amariliz 
Published: September 2024

ABSTRACT

Fungal pathogens are underappreciated causes of significant morbidity and mortality worldwide. In previous studies, we determined that a heat-killed,
Cryptococcus neoformans
fbp1-deficient strain (HK-fbp1) is a potent vaccine candidate. We determined that vaccination with HK-fbp1 confers protective immunity against lethal Cryptococcosis in an interferon γ (IFNγ)-dependent manner. In this study, we set out to uncover cellular sources and relevant targets of the protective effects of IFNγ in response to the HK-fbp1 vaccine. We found that early IFNγ production peaks at day 3 and that monocytes and neutrophils are important sources of this cytokine after vaccination. Neutralization of IFNγ at day 3 results in impaired CCR2
+
monocyte recruitment and reduced differentiation into monocyte-derived dendritic cells (Mo-DC). In turn, depletion of CCR2
+
cells prior to immunization results in impaired activation of IFNγ-producing CD4 and CD8 T cells. Thus, monocytes are important targets of innate IFNγ and help promote further IFNγ production by lymphocytes. We employed monocyte-fate mapper and conditional STAT1 knockout mice to uncover that STAT1 activation in CD11c
+
cells, including alveolar macrophages, Mo-DCs, and monocyte-derived macrophages (Mo-Mac) is essential for HK-fbp1 vaccine-induced protection. Altogether, our aggregate findings suggest critical roles for innate cells as orchestrators of vaccine-induced protection against
Cryptococcus
infection.

IMPORTANCE

The number of patients susceptible to invasive fungal infections across the world continues to rise at an alarming pace yet current antifungal drugs are often inadequate. Immune-based interventions and novel antifungal vaccines hold the promise of significantly improving patient outcomes. In previous studies, we identified a
Cryptococcus neoformans
mutant strain (Fbp1-deficient) as a potent, heat-inactivated vaccine candidate capable of inducing homologous and heterologous antifungal protection. In this study, we used a combination of methods together with a cohort of conditional knockout mouse strains to interrogate the roles of innate cells in the orchestration of vaccine-induced antifungal protection. We uncovered novel roles for neutrophils and monocytes as coordinators of a STAT1-dependent cascade of responses that mediate vaccine-induced protection against invasive cryptococcosis. This new knowledge will help guide the future development of much-needed antifungal vaccines.
Importance of immunosuppression in haemophagocytic lymphohistiocytosis caused by miliary tuberculosis
Authors: Nielsen Tine , Dimitrijevic Andreja , Dahl Sørensen Mia , Johansen Isik Somuncu , Hansen Dennis Lund 
Published: September 2024

Haemophagocytic lymphohistiocytosis (HLH) is a syndrome with an abnormal activation of the immune system and is associated with a high mortality even with treatment. We present a case of a woman in her mid-50s who developed HLH triggered by miliary tuberculosis (TB) while receiving a tumour necrosis factor alpha inhibitor.The patient was admitted with a high fever and respiratory pain. Her condition deteriorated despite empirical treatment. Diagnosis of HLH was established based on clinical presentation, H-score and HLH-04 criteria. Concurrently, miliary TB was identified as the trigger. She was treated with anti-tuberculous therapy and HLH-directed treatment with dexamethasone, etoposide and anakinra. Initial improvement was observed, leading to the withholding of HLH-orientated treatment. However, several relapses occurred, necessitating prolonged HLH treatment.A literature review corroborated the importance of combined anti-tuberculous and immunosuppressive therapy for managing HLH. This case underscores the necessity of timely and comprehensive management of HLH-oriented treatment.
Impact of the COVID-19 pandemic on psychotropic prescribing: a systematic review
Authors: Mahesarajah Swettha , El Asmar Marie Line , Irwin Ryan , Vallejo-Vaz Antonio J , Mastellos Nikolaos , Dharmayat Kanika I 
Published: September 2024

ObjectivesThe global prevalence of mental health disorders has risen significantly since the beginning of the COVID-19 pandemic. The pandemic has additionally caused disruption to mental health services, leading to a shift from in-person to remote service delivery. Given its long-term impact, it has become critical to evaluate whether changes in health delivery during the pandemic have had an effect on prescribing patterns for commonly prescribed psychotropic drugs. This study aims to assess the impact of the COVID-19 pandemic on changes in psychotropic prescribing patterns in adults, as well as differences in prescribing in different healthcare delivery approaches across various geographical contexts.Design and eligibility requirementsSystematic review of cohort, interrupted time-series and cross-sectional studies examining prescribing trends for at least one commonly prescribed psychotropic drug during and after COVID-19 in accessing care remotely or face to face between 1 January 2020 and 17 June 2022.Data sourcesMEDLINE, EMBASE, CINAHL, HMIC and PsycINFO databases were searched in addition to citation chaining of relevant reviews.Extraction and analysisStudy screening, data extraction and quality assessment were completed by two independent reviewers. The PECO strategy was used to devise the systematic review and findings were synthesised narratively.Results16 studies were eligible for inclusion. Studies documenting changes in psychotropic prescribing trends provided very conflicting findings. There were no stark differences in prescribing outcomes between different healthcare delivery methods (ie, face-to-face consultations vs remote consultations). A noteworthy finding was that the prescribing rate of benzodiazepines was higher in women than men. No particular trends were observed for the prescription rates of hypnotics, antidepressants or antipsychotics.ConclusionsFindings support mixed trends in the prescription of psychotropic medications in a range of settings, hindering conclusive statements on COVID-19’s impact on prescribing. In areas where remote consultations are in use, more comprehensive research is required to assess the safety of prescribing in these settings to inform public health policy and assess if the observed trends in our systematic review persist over time (given the increased consideration of remote and telehealth care in delivering services), particularly the safe and effective deployment of these services.
Disparities in the real-world prescription pattern of oral anticoagulants for US Medicare beneficiaries: a geospatial analysis
Authors: Zou Jingrui , Liang Dong , Zhu Yong 
Published: September 2024

ObjectivesThis study was conducted to examine urban–rural differences in the real-world prescribing pattern of oral anticoagulants and geographic variations in the prescribing pattern among clinicians serving Medicare beneficiaries in the USA.DesignA cross-sectional study.SettingA real-world setting.Participants232 665 clinicians who prescribed oral anticoagulants for Medicare beneficiaries from the 2020 Medicare Provider Utilisation and Payment Data were classified as warfarin only, direct oral anticoagulants (DOACs) only or warfarin+DOAC prescribers.Main outcome measuresUrban–rural differences in the prescribing patterns were examined using multivariate multinominal logistic regression analysis. A geospatial analysis was conducted to estimate standardised prescriber ratios (SPR) for DOAC only or warfarin only prescribers versus warfarin+DOAC prescribers to illustrate hot and cold spots for DOAC adoption in the USA.Results92% of clinicians who prescribed oral anticoagulants prescribed DOAC in 2020. Clinicians from rural regions were more likely to prescribe warfarin only (adjusted OR=1.335, 95% CI=(1.281 to 1.391)) and DOAC only (adjusted OR=2.052, 95% CI=(1.999 to 2.106)), compared with clinicians from urban regions. Hot spots for SPR of DOAC only versus warfarin+DOAC prescribers were mostly found in California, southern and southeastern states; cold spots were mostly found in Minnesota and Iowa. Hot spots for SPR of warfarin only versus warfarin+DOAC prescribers were mostly found in several metropolitan areas on the west coast and in Midwest; cold spots were mostly found on the east coast.ConclusionsUrban–rural status of clinicians was associated with their prescribing patterns of oral anticoagulants. The study identifies geographical heterogeneity in DOAC adoption and highlights gaps that may need to be addressed for increased accessibility of DOAC for patients in need.
Professional identity formation of medical students in relation to older persons’ healthcare: exploring the views of older persons living in the Netherlands – a qualitative study
Authors: Moll-Jongerius Annemarie , Langeveld Kirsten , Gussekloo Jacobijn , Kramer Anneke , Achterberg Wilco P 
Published: September 2024

ObjectivesGiven the growing population of older persons, medical students need to develop an appropriate professional identity to comply with older persons’ healthcare needs. In this study, we explored the needs and expectations of older persons regarding their doctor to gain more insight into the characteristics of this professional identity.DesignA qualitative study based on a constructivist research paradigm was conducted, based on individual semistructured, in-depth interviews using a letter as a prompt, and focus groups. Thematic analysis was applied to structure and interpret the data.Setting and participantsOur study population consisted of older persons, aged 65 years and above, living at home in the South-West of the Netherlands, with no apparent cognitive or hearing problems and sufficient understanding of the Dutch language to participate in writing, talking and reflecting. The in-depth interviews took place at the participant’s home or the Leiden University Medical Center (LUMC), and the focus groups were held at the LUMC.ResultsThe older persons shared and reflected on what they need and expect from the doctor who takes care of them. Four major themes were identified: (1) personal attention, (2) equality, (3) clarity and (4) reasons why.ConclusionIncreasing complexity, dependency and vulnerability that arise at an older age, make it essential that a doctor is familiar with the older person’s social context, interacts respectfully and on the basis of equality, provides continuity of care and gives clarity and perspective. To this end, the doctor has to be caring, involved, patient, honest and self-aware. Participation in a community of practice that provides the context of older persons’ healthcare may help medical students develop a professional identity that is appropriate for this care.
Atrial fibrillation after cardiac surgery: identifying candidate predictors through a Delphi process
Authors: Bedford Jonathan , Fields Kara G , Collins Gary Stephen , Lip Gregory Y H , Clifton David A , O’Brien Benjamin , Muehlschlegel Jochen D , Watkinson Peter J , Redfern Oliver C 
Published: September 2024

ObjectivesThis study was undertaken to identify potential predictors of atrial fibrillation after cardiac surgery (AFACS) through a modified Delphi process and expert consensus. These will supplement predictors identified through a systematic review and cohort study to inform the development of two AFACS prediction models as part of the PARADISE project (NCT05255224). Atrial fibrillation is a common complication after cardiac surgery. It is associated with worse postoperative outcomes. Reliable prediction of AFACS would enable risk stratification and targeted prevention. Systematic identification of candidate predictors is important to improve validity of AFACS prediction tools.DesignThis study is a Delphi consensus exercise.SettingThis study was undertaken through remote participation.ParticipantsThe participants are an international multidisciplinary panel of experts selected through national research networks.InterventionsThis is a two-stage consensus exercise consisting of generating a long list of variables, followed by refinement by voting and retaining variables selected by at least 40% of panel members.ResultsThe panel comprised 15 experts who participated in both stages, comprising cardiac intensive care physicians (n=3), cardiac anaesthetists (n=2), cardiac surgeons (n=1), cardiologists (n=4), cardiac pharmacists (n=1), critical care nurses (n=1), cardiac nurses (n=1) and patient representatives (n=2). Our Delphi process highlighted candidate AFACS predictors, including both patient factors and those related to the surgical intervention. We generated a final list of 72 candidate predictors. The final list comprised 3 demographic, 29 comorbidity, 4 vital sign, 13 intraoperative, 10 postoperative investigation and 13 postoperative intervention predictors.ConclusionsA Delphi consensus exercise has the potential to highlight predictors beyond the scope of existing literature. This method proved effective in identifying a range of candidate AFACS predictors. Our findings will inform the development of future AFACS prediction tools as part of the larger PARADISE project.Trial registration numberNCT05255224.
Communicating COVID-19 vaccine information to Chinese communities in the UK: a qualitative study of their knowledge, information sources and trust
Authors: Gong Qian Sarah , Gao Zhenghan , Somerville Ian , Steele Circle , Wang Dian , Zhou Huiyu 
Published: September 2024

IntroductionIn late 2020, the COVID-19 vaccine acceptance rates of Chinese people living in the UK were estimated between 52% and 57%, significantly lower than that of the general population (76%). This disparity formed a primary motivation for this study which explored Chinese communities’ overall understanding of and attitude towards the COVID-19 vaccines, the sources of information about the vaccines and levels of (dis)trust in these sources.Methods29 focus groups with 154 participants from UK-based Chinese communities of varied sociodemographic backgrounds were conducted between March and November 2021. Focus group data were coded with NVivo and analysed using thematic analysis.ResultsParticipants generally had a good understanding of the health benefits of the vaccines, however, many still had concerns about vaccine safety and efficacy. They accessed COVID-19 vaccine information from a multitude of sources and had diverse information needs which to a large extent shaped their knowledge of and attitude towards the vaccines. Participants generally had good digital access and some have developed good digital literacy enabling discernment of mis/disinformation. The ways in which they accessed and engaged with various types of information sources were differentiated by diversities in country/regions of origin, years of residence and main language/dialects spoken. They also demonstrated varying degrees of trust about the communication around vaccines depending on the perceived expertise of the authority, their character and the perceived accuracy and transparency of the information.ConclusionThe UK government and health authorities need to understand Chinese communities’ diverse information needs and cultural practices to form culturally and linguistically appropriate COVID-19 vaccine communication strategies to develop trust, targeting not the entire community but subgroups within the community via credible media sources and community networks.
Comparing modalities of opioid education in patients undergoing total knee arthroplasty: a randomized pilot trial
Authors: Sheetz Miriam , Puglisi Angela , Trentalange Mark , Reichel Julia , Chalmers Brian , Gonzalez Della Valle Alejandro , Sideris Alexandra , Lee Bradley H 
Published: September 2024

BackgroundPatients undergoing total knee arthroplasty (TKA) experience significant postoperative pain and routinely require opioids, yet they often lack knowledge regarding appropriate use and handling of these medications. Evidence suggests that educational interventions in various formats may help reinforce proper usage and improve postoperative pain control. The aim of this study is to compare the institution standard of care (webinar) with two novel educational interventions—one in-person and the other a video recording—that focus specifically on the use of opioids and pain control.MethodsThis prospective, randomized pilot study included 42 patients undergoing TKA. Patients were randomized into one of three groups: (1) webinar: 50 min virtual session standard of care at Hospital for Special Surgery (HSS), (2) in-person education, or (3) video education. The primary outcomes of this study were the number of opioid refill requests through postoperative day (POD) 30 and POD 60. The secondary outcomes evaluated Numerical Rating Scale (NRS) pain scores, opioid consumption in oral morphine equivalents (OME), surveys on medication usage and opioid knowledge, reported medication storage and disposal. We hypothesize that the novel educational interventions, presented either in-person or by video, will lead to a decrease in opioid refills within 60 days compared with current education delivered through virtual webinar.ResultsNo significant differences were found among groups in the number of opioid refill requests, average NRS pain score, or OME consumption at any time point. Opioid refill requests ranged from 0% to 16.7% at POD 30 (Fisher’s exact test, p=0.625) and from 0% to 8.3% at POD 60 (p=1.000). The median opioid refill request was zero requests per group from POD 21 to 60 (webinar 0 (0.0, 0.0), in-person 0 (0.0, 0.0), video 0 (0.0, 0.0), Kruskal-Wallis test, p=0.381). Average NRS pain scores were 5 or below for all groups on POD 1, 7 and 14. By POD 7, all groups had an average daily intake OME of 14 or below.ConclusionsOverall, patients in each group did well with postoperative pain management after TKA and had minimal opioid refill requests. There were no statistically significant differences in outcomes of NRS pain scores or opioid usage among groups suggesting that educational interventions were similarly effective. As a pilot trial, study demonstrated successful recruitment and retention of participants, and important feedback was elicited from patients regarding education, as well. Of note, this was a pilot study and was likely underpowered to detect a difference.Trial registration numberNCT05593341.
Laboratory evaluation of asphalt mixtures reinforced with aramid fibres coated with bituminous oils
Authors: Almutairi Haya , Qabur Ali , Baaj Hassan 
Published: September 2024

Adding additives such as fibres to asphalt mixtures is believed to improve the overall performance of hot mix asphalt (HMA). Unlike previous studies, this research investigates the performance of HMA modified with oil-coated aramid fibers, exploring its potential to enhance rutting resistance, fatigue behavior, and low-temperature cracking. The fibers were utilized at various dosages (110, 138, and 164 g/tonne) and lengths (13, 20, and 25 mm). Comprehensive evaluations were conducted using the Hamburg wheel tracking device, four-point bending fatigue test, and thermal stress restrained specimen test to assess the impact of these modifications on HMA properties. The results found that 25 mm long aramid fibres, at all dosages, improved the rutting resistance by up to 65% compared to the control mixture. However, the fatigue behaviour and low-temperature cracking resistance were not as good as the rutting performance. Therefore, and based on this study, it was concluded that the addition of the newly developed bituminous oil-coated aramid fibres has no positive impact as a reinforcement of the asphalt mixture.