bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bacterial-fungal crosstalk is defined by a fungal lactone mycotoxin and its degradation by a bacterial lactonase
Authors: Dor Shlomit , Nudel Keren , Eagan Justin L. , Cohen Rami , Hull Christina M. , Keller Nancy P. , Prusky Dov , Afriat-Jurnou Livnat 
Published: May 2024

ABSTRACT

Bacteria, fungi, and mammals contain lactonases that can degrade the Gram-negative bacterial quorum sensing (QS) molecules N-acyl homoserine lactones (AHLs). AHLs are critical for bacteria to coordinate gene expression and pathogenicity with population density. However, AHL-degrading lactonases present variable substrate ranges, including degradation of the
Pencillium expansum
lactone mycotoxin patulin. We selected
Erwinia
spp. as our model bacteria to further investigate this interaction. We find both native apple microbiome
Erwinia
spp. and the fruit tree pathogen
Erwinia amylovora
to be inhibited by patulin. At patulin concentrations that inhibited
E. amylovora
growth, expression of
E. amylovora
lactonase encoded by
EaaiiA
was increased. EaAiiA demonstrated the ability to degrade patulin
in vitro,
as well, as
in vivo
where it reduced apple disease and patulin production by
P. expansum
. Fungal-bacterial co-cultures revealed that the
E. amylovora
Δ
eaaiia
strain failed to protect apples from
P. expansum
infections, which contained significant amounts of patulin. Our results suggest that bacterial lactonase production can modulate the pathogenicity of
P. expansum
in response to the secretion of toxic patulin.

IMPORTANCE

Chemical signaling in the microbial world facilitates the regulation of gene expression as a function of cell population density. This is especially true for the Gram-negative bacterial signal N-acyl homoserine lactone (AHL). Lactonases that deactivate AHLs have attracted a lot of attention because of their antibacterial potential. However, the involvement of these enzymes in inhibiting fungal pathogens and the potential role of these enzymes in bacterial-fungal interactions are unknown. Here, we find that a bacterial enzyme involved in the degradation of AHLs is also induced by and degrades the fungal lactone mycotoxin, patulin. This work supports the potential use of bacterial enzymes and/or the producing bacteria in controlling the post-harvest fruit disease caused by the patulin-producing fungus
Penicillium expansum
.
Host obesity impacts genetic variation in influenza A viral populations
Authors: Knoll Marissa , Honce Rebekah , Meliopoulos Victoria , Segredo-Otero Ernesto Alejandro , Johnson Katherine E.E. , Schultz-Cherry Stacey , Ghedin Elodie , Gresham David 
Published: May 2024

ABSTRACT

Obesity is well established as a risk factor for many noncommunicable diseases; however, its consequences for infectious disease are poorly understood. Here, we investigated the impact of host obesity on influenza A virus (IAV) genetic variation using a diet-induced obesity ferret model and the A/Hong Kong/1073/1999 (H9N2) strain. Using a co-caging study design, we investigated the maintenance, generation, and transmission of intrahost IAV genetic variation by sequencing viral genomic RNA obtained from nasal wash samples over multiple days of infection. We found evidence for an enhanced role of positive selection acting on
de novo
mutations in obese hosts that led to nonsynonymous changes that rose to high frequency. In addition, we identified numerous cases of mutations throughout the genome that were specific to obese hosts and that were preserved during transmission between hosts. Despite detection of obese-specific variants, the overall viral genetic diversity did not differ significantly between obese and lean hosts. This is likely due to the high supply rate of
de novo
variation and common evolutionary adaptations to the ferret host regardless of obesity status, which we show are mediated by variation in the hemagglutinin and polymerase genes (PB2 and PB1). We also identified defective viral genomes (DVGs) that were found uniquely in either obese or lean hosts, but the overall DVG diversity and dynamics did not differ between the two groups. Our study suggests that obesity may result in a unique selective environment impacting intrahost IAV evolution, highlighting the need for additional genetic and functional studies to confirm these effects.

IMPORTANCE
Obesity is a chronic health condition characterized by excess adiposity leading to a systemic increase in inflammation and dysregulation of metabolic hormones and immune cell populations. Influenza A virus (IAV) is a highly infectious pathogen responsible for seasonal and pandemic influenza. Host risk factors, including compromised immunity and pre-existing health conditions, can contribute to increased infection susceptibility and disease severity. During viral replication in a host, the negative-sense single-stranded RNA genome of IAV accumulates genetic diversity that may have important consequences for viral evolution and transmission. Our study provides the first insight into the consequences of host obesity on viral genetic diversity and adaptation, suggesting that host factors associated with obesity alter the selective environment experienced by a viral population, thereby impacting the spectrum of genetic variation.
Relationship between oscillatory volume and oscillatory pressure in neonatal high-frequency oscillatory ventilators: an in vitro study
Authors: Zannin Emanuela , Rigotti Camilla , Dellacà Raffaele L , Ventura Maria Luisa 
Published: May 2024

ObjectiveWe analysed the relationship between oscillatory volume (VOSC) and pressure amplitude (ΔP) in six neonatal high-frequency oscillatory (HFO) ventilators and related it to (1) the accuracy of VOSCand ΔP measurements and (2) the maximal delivered ΔP.DesignIn vitro study.SettingNeonatal intensive care unit.InterventionsVentilators tested were VN800 (Dräger), Servo-n (Maquet Getinge), SensorMedics 3100A (Vyaire Medical), Fabian HFOi (Vyaire Medical), SLE6000 (SLE UK) and Humming Vue (Metran). We changed various settings and mechanical characteristics of the test lung to mimic preterm and term conditions.Main outcome measuresFor each condition, we measured VOSCand ΔP. We assessed the accuracy of the VOSCand ΔP measurements versus a reference measurement system using linear regression and Bland-Altman analysis. We evaluated the maximum delivered ΔP at different oscillatory frequencies.ResultsWe observed large variability between machines in the ΔP displayed at any target VOSC. Most ventilators over-read ΔP with errors up to 30 cmH2O or 60%. The error in the measurement of VOSCwas up to ±2 mL or ±30%. We observed high variability in the accuracy of ΔP and VOSCmeasurements; the SLE6000 committed the lowest errors in ΔP measurements and the Fabian HFOi in VOSC. The maximum delivered ΔP varied depending on the ventilator, being maximal for the Humming Vue, followed by the SLE6000 and SensorMedics 3100A.ConclusionsThe variability in the relationship between VOSCand ΔP among HFO ventilators is largely explained by the variable accuracy in ΔP and VOSCmeasurement. Different ventilators also exhibit important differences in the maximal generated ΔP.
Resolving unsolved whole-genome sequencing data in paediatric neurological disorders: a cohort study
Authors: Chi Ching-Shiang , Tsai Chi-Ren , Lee Hsiu-Fen 
Published: May 2024

ObjectiveTo resolve unsolved whole-genome sequencing (WGS) data in individuals with paediatric neurological disorders.DesignA cohort study method using updated bioinformatic tools, new analysis targets, clinical information and literature databases was employed to reanalyse existing unsolved genome data.ParticipantsFrom January 2016 to September 2023, a total of 615 individuals who aged under 18 years old, exhibited neurological disorders and received singleton WGS were recruited. 364 cases were unsolved during initial WGS analysis, in which 102 consented to reanalyse existing singleton WGS data.ResultsMedian duration for reanalysis after initial negative WGS results was 2 years and 4 months. The diagnostic yield was 29 of 102 individuals (28.4%) through reanalysis. New disease gene discovery and new target acquisitions contributed to 13 of 29 solved cases (44.8%). The reasons of non-detected causative variants during initial WGS analysis were variant reclassification in 9 individuals (31%), analytical issue in 9 (31%), new emerging disease–gene association in 8 (27.6%) and clinical update in 3 (10.3%). The 29 new diagnoses increased the cumulative diagnostic yield of clinical WGS in the entire study cohort to 45.5% after reanalysis.ConclusionsUnsolved paediatric WGS individuals with neurological disorders could obtain molecular diagnoses through reanalysis within a timeframe of 2–2.5 years. New disease gene, structural variations and deep intronic splice variants make a significant contribution to diagnostic yield. This approach can provide precise genetic counselling to positive reanalysis results and end a diagnostic odyssey.
Foveal atrophy in patients with active central serous chorioretinopathy at first presentation: characteristics and treatment outcomes
Authors: Son Ki Young , Lim Seul Gi , Hwang Sungsoon , Choi Jaehwan , Kim Sang Jin , Kang Se Woong 
Published: May 2024

Background/aims
This study aimed to investigate the clinical characteristics and treatment outcomes of patients with active central serous chorioretinopathy (CSC) and foveal atrophy.

Methods
Patients diagnosed with active idiopathic CSC using multimodal imaging and followed up for at least 6 months were included. They were divided into two groups (foveal atrophy group vs foveal non-atrophy group) according to a cut-off central foveal thickness of 120 µm on baseline optical coherence tomography (OCT). Baseline characteristics, angiographic and tomographic features and treatment outcomes were compared between the two groups.

Results
Of the 463 patients, 92 eyes of 92 patients (19.9%) were in the foveal atrophy group and 371 eyes of 371 patients (80.1%) were in the foveal non-atrophy group. The baseline subretinal fluid (SRF) height was 111.3±76.8 µm in the foveal atrophy group and 205.0±104.4 µm in the foveal non-atrophy group on OCT images (p<0.001). Complete resolution of SRF after treatment was noted in 60.4% and 93.5% of patients in the foveal atrophy and foveal non-atrophy groups at the final visit, respectively (p<0.001). The foveal atrophy group showed worse visual acuity at baseline (logarithm of the minimum angle of resolution, 0.43±0.33 vs 0.13±0.18, p<0.001) and final visit (0.41±0.32 vs 0.05±0.15, p=0.035).

Conclusions
CSC with foveal atrophy was associated with a shallow SRF height, low treatment efficacy and poor vision before and after treatment. We suggest that early active treatment should be considered for eyes with CSC accompanied by a persistent shallow SRF and foveal atrophy.
Unveiling the clinical incapabilities: a benchmarking study of GPT-4V(ision) for ophthalmic multimodal image analysis
Authors: Xu Pusheng , Chen Xiaolan , Zhao Ziwei , Shi Danli 
Published: May 2024

PurposeTo evaluate the capabilities and incapabilities of a GPT-4V(ision)-based chatbot in interpreting ocular multimodal images.MethodsWe developed a digital ophthalmologist app using GPT-4V and evaluated its performance with a dataset (60 images, 60 ophthalmic conditions, 6 modalities) that included slit-lamp, scanning laser ophthalmoscopy, fundus photography of the posterior pole (FPP), optical coherence tomography, fundus fluorescein angiography and ocular ultrasound images. The chatbot was tested with ten open-ended questions per image, covering examination identification, lesion detection, diagnosis and decision support. The responses were manually assessed for accuracy, usability, safety and diagnosis repeatability. Auto-evaluation was performed using sentence similarity and GPT-4-based auto-evaluation.ResultsOut of 600 responses, 30.6% were accurate, 21.5% were highly usable and 55.6% were deemed as no harm. GPT-4V performed best with slit-lamp images, with 42.0%, 38.5% and 68.5% of the responses being accurate, highly usable and no harm, respectively. However, its performance was weaker in FPP images, with only 13.7%, 3.7% and 38.5% in the same categories. GPT-4V correctly identified 95.6% of the imaging modalities and showed varying accuracies in lesion identification (25.6%), diagnosis (16.1%) and decision support (24.0%). The overall repeatability of GPT-4V in diagnosing ocular images was 63.3% (38/60). The overall sentence similarity between responses generated by GPT-4V and human answers is 55.5%, with Spearman correlations of 0.569 for accuracy and 0.576 for usability.ConclusionGPT-4V currently is not yet suitable for clinical decision-making in ophthalmology. Our study serves as a benchmark for enhancing ophthalmic multimodal models.
Two-year outcomes of Xen 45 gel stent implantation in patients with open-angle glaucoma: real-world data from the Fight Glaucoma Blindness registry
Authors: Arnould Louis , Balsat Elise , Hashimoto Yohei , White Andrew , Kong George , Dunn Hamish , Fan Leo , Gabrielle Pierre-Henry , Bron Alain M , Creuzot-Garcher Catherine P , Lawlor Mitchell 
Published: May 2024

ObjectiveTo evaluate efficacy and safety outcomes of the Xen 45 gel stent implant over 24 months of follow-up.MethodsA retrospective analysis of prospectively collected data from the Fight Glaucoma Blindness observational registry. Complete success (CS) was defined as intraocular pressure (IOP) reduction ≥20% from preoperative and an IOP ≤18 mm Hg and ≥6 mm Hg with no secondary procedure at 2 years and without IOP-lowering medications. Qualified success (QS) was defined similarly, allowing the use of IOP-lowering medications.ResultsThe Xen 45 gel stent implant was implanted in 646 eyes of 515 patients. Preoperative IOP was 21.4±7.6 (mean±SD) mm Hg on 2.7±1.3 IOP-lowering medication and mean deviation was −10.2±8.4 dB. After 24-month follow-up, IOP was 16.8±7.3 mm Hg (mean reduction of 21.7%) on 1.2±1.4 IOP-lowering medications. CS and QS rates at 24 months were 26% and 48%, respectively. CS and QS were higher in the Xen stand-alone group (33% and 52%, respectively) than in the Xen+cataract group (16% and 42%, respectively). Bleb needling was performed in 28.4% of cases, and 18% underwent a secondary procedure.ConclusionsThe Xen 45 gel stent implant offers acceptable long-term efficacy for the treatment of open-angle glaucoma. However, there is a significant rate of reoperation and needling, and outcomes are less effective if combined with cataract surgery.
Long acting progestogens versus combined oral contraceptive pill for
preventing recurrence of endometriosis related pain: the PRE-EMPT pragmatic,
parallel group, open label, randomised controlled trial
Authors: Cooper Kevin G , Bhattacharya Siladitya , Daniels Jane P , Horne Andrew W , Clark T Justin , Saridogan Ertan , Cheed Versha , Pirie Danielle , Melyda Melyda , Monahan Mark , Roberts Tracy E , Cox Emma , Stubbs Clive , Middleton Lee J 
Published: May 2024

Abstract

Objectives
To evaluate the clinical effectiveness of long acting progestogens
compared with the combined oral contraceptive pill in preventing
recurrence of endometriosis related pain.

Design
The PRE-EMPT (preventing recurrence of endometriosis) pragmatic,
parallel group, open label, randomised controlled trial.

Setting
34 UK hospitals.

Participants
405 women of reproductive age undergoing conservative surgery for
endometriosis.

Interventions
Participants were randomised in a 1:1 ratio using a secure internet
facility to a long acting progestogen (depot medroxyprogesterone acetate
or levonorgestrel releasing intrauterine system) or the combined oral
contraceptive pill.

Main outcome measures
The primary outcome was pain measured three years after
randomisation using the pain domain of the Endometriosis Health Profile
30 (EHP-30) questionnaire. Secondary outcomes (evaluated at six months,
one, two, and three years) included the four core and six modular
domains of the EHP-30, and treatment failure (further therapeutic
surgery or second line medical treatment).

Results
405 women were randomised to receive a long acting progestogen
(n=205) or combined oral contraceptive pill (n=200). At three years,
there was no difference in pain scores between the groups (adjusted mean
difference −0.8, 95% confidence interval −5.7 to 4.2, P=0.76), which had
improved by around 40% in both groups compared with preoperative values
(an average of 24 and 23 points for long acting progestogen and combined
oral contraceptive pill groups, respectively). Most of the other domains
of the EHP-30 also showed improvement at all time points compared with
preoperative scores, without evidence of any differences between groups.
Women randomised to a long acting progestogen underwent fewer surgical
procedures or second line treatments compared with those randomised to
the combined oral contraceptive pill group
(73v97; hazard ratio 0.67, 95% confidence
interval 0.44 to 1.00).

Conclusions
Postoperative prescription of a long acting progestogen or the
combined oral contraceptive pill results in similar levels of
improvement in endometriosis related pain at three years, with both
groups showing around a 40% improvement compared with preoperative
levels. While women can be reassured that both options are effective,
the reduced risk of repeat surgery for endometriosis and hysterectomy
might make long acting reversible progestogens preferable for
some.

Trial registration
ISRCTN registryISRCTN97865475.
Examining the application of the IDEAL framework in the reporting and evaluation of innovative invasive procedures: secondary qualitative analysis of a systematic review
Authors: Richards Hollie Sarah , Cousins Sian , Scroggie Darren L , Elliott Daisy , Macefield Rhiannon , Hudson Elizabeth , Mutanga Ian Rodney , Shah Maximilian , Alford Natasha , Blencowe Natalie S , Blazeby Jane 
Published: May 2024

ObjectivesThe development of new surgical procedures is fundamental to advancing patient care. The Idea, Developments, Exploration, Assessment and Long-term (IDEAL) framework describes study designs for stages of innovation. It can be difficult to apply due to challenges in defining and identifying innovative procedures. This study examined how the IDEAL framework is operationalised in real-world settings; specifically, the types of innovations evaluated using the framework and how authors justify their choice of IDEAL study design.DesignSecondary qualitative analysis of a systematic review.Data sourcesCitation searches (Web of Science and Scopus) identified studies following the IDEAL framework and citing any of the ten key IDEAL/IDEAL_D papers.Eligibility criteriaStudies of invasive procedures/devices of any design citing any of the ten key IDEAL/IDEAL_D papers.Data extraction and synthesisAll relevant text was extracted. Three frameworks were developed, namely: (1) type of innovation under evaluation; (2) terminology used to describe stage of innovation and (3) reported rationale for IDEAL stage.Results48 articles were included. 19/48 described entirely new procedures, including those used for the first time in a different clinical context (n=15/48), reported as IDEAL stage 2a (n=8, 53%). Terminology describing stage of innovation was varied, inconsistent and ambiguous and was not defined. Authors justified their choice of IDEAL study design based on limitations in published evidence (n=36) and unknown feasibility and safety (n=32) outcomes.ConclusionIdentifying stage of innovation is crucial to inform appropriate study design and governance decisions. Authors’ rationale for choice of IDEAL stage related to the existing evidence base or lack of sufficient outcome data for procedures. Stage of innovation was poorly defined with inconsistent descriptions. Further work is needed to develop methods to identify innovation to inform practical application of the IDEAL framework. Defining the concept of innovation in terms of uncertainty, risk and degree of evidence may help to inform decision-making.
Trust and COVID-19 vaccine hesitancy in the Dominican Republic: a national cross-sectional household survey, June–October 2021
Authors: Garnier Salomé , Then Cecilia , de St Aubin Michael , Cadavid Restrepo Angela , Mayfield Helen J , Dumas Devan , Duke William , Peña Farah , Kucharski Adam J , Skewes Ronald , Zielinski Gutiérrez Emily , Coyoli Julia , Etienne Marie Caroline , Lau Colleen L , Vázquez Marietta , Nilles Eric 
Published: May 2024

ObjectiveThis study investigates the role of trust in shaping COVID-19 vaccine acceptance in the Dominican Republic (DR) during the COVID-19 pandemic.DesignCross-sectional household survey.SettingRandomly selected households across 134 clusters in the DR, from 30 June 2021 to 12 October 2021.Participants5999 participants ≥16 years of age were enrolled.Outcome measuresCOVID-19 vaccine hesitancy (CVH) data were collected from participants ≥16 years of age and analysed as both an ordinal and binary variable.ResultsOverall, CVH was low (5.2% (95% CI 4.6% to 5.8%)), but more common among younger individuals, women and individuals of Mestizo ethnicity. Higher trust in local government, national government, scientists and local doctors (considered official sources) was associated with lower odds of CVH (OR 0.89 (95% CI 0.72 to 0.88), 0.89 (95% CI 0.81 to 0.98), 0.87 (95% CI 0.80 to 0.94) and 0.70 (95% CI 0.62 to 0.80), respectively). Higher trust in religious leaders, social media and traditional media (considered unofficial sources) was associated with higher odds of CVH, with respective ORs of 1.32 (95% CI 1.18 to 1.47), 1.30 (95% CI 1.19 to 1.41) and 1.08 (95% CI 0.97 to 1.22).ConclusionWe report findings on CVH from a national household survey in the DR and identify overall low rates of CVH but marked heterogeneity by age, gender and ethnicity. Trust in unofficial versus official sources of information is associated with increased CVH. These findings highlight and quantify the importance of trust as a key parameter when considering public health communication strategies.
Exploring registered nurses’ perspectives as mentors for newly qualified nurses: a qualitative interview study
Authors: Kallerhult Hermansson Stina , Kasén Anne , Hilli Yvonne , Norström Fredrik , Vaag Jonas Rennemo , Bölenius Karin 
Published: May 2024

ObjectiveExisting research has focused mostly on mentees’ experiences of mentoring rather than mentors’ experiences. Therefore, this study describes registered nurses’ experiences of being a mentor for newly qualified nurses.DesignA qualitative interview study based on semistructured individual interviews. Interviews were analysed using qualitative content analysis.Participants and settingA purposive sample of experienced registered nurses (n=21) from healthcare units in northern Sweden and northern Norway. Inclusion criteria were to have been a mentor to at least one newly qualified nurse, hold permanent employment of 75%–100% as a registered nurse and to be able to communicate in Swedish or Norwegian.ResultsOur study’s findings suggest that being a mentor plays a crucial role in establishing safety in complex work environments. The main theme consists of three themes: feeling motivated in being a mentor; continuously developing the learning environment; and navigating obstacles and cultivating support.ConclusionBeing a mentor is a complicated role for registered nurses. The mentoring role is beneficial—ie, positive and rewarding—if facilitated sufficiently in the context of a structured organisation. This study brings a more profound understanding of and provides new insights into registered nurses’ perspectives and needs regarding being a mentor and the study’s findings make an important contribution to the field of nursing regarding the facilitation of mentoring.