bluuebunny/crossref_metadata_2025_split huggingface dataset:
The heterogeneous wound microbiome varies with wound care pain, dressing type, and inflammatory gene expression
Authors: Campbell Amy , Bae Jaewon , Hein Maria , Hillis Stephen L. , Rebeck Olivia N. , Rakel Barbara A. , Grice Elizabeth , Gardner Sue E. 
Published: April 2024

AbstractWound dressing changes are essential procedures for wound management. However, ~50% of patients experience severe pain during these procedures despite the availability of analgesic medications, indicating a need for novel therapeutics that address underlying causes of pain. Along with other clinical factors, wound pathogens and inflammatory immune responses have previously been implicated in wound pain. To test whether these factors could contribute to severe pain during wound dressing changes, we conducted an exploratory, cross‐sectional analysis of patient‐reported pain, inflammatory immune responses, and wound microbiome composition in 445 wounds at the time of a study dressing change. We profiled the bacterial composition of 406 wounds using 16S ribosomal RNA amplicon sequencing and quantified gene expression of 13 inflammatory markers in wound fluid using quantitative real‐time polymerase chain reaction (qPCR). Neither inflammatory gene expression nor clinically observed inflammation were associated with severe pain, but Corynebacterium and Streptococcus were of lower relative abundance in wounds of patients reporting severe pain than those reporting little or no pain. Wound microbiome composition differed by wound location, and correlated with six of the inflammatory markers, including complement receptor C5AR1, pro‐inflammatory cytokine interleukin (IL)1β, chemokine IL‐8, matrix metalloproteinase MMP2, and the antimicrobial peptide encoding cathelicidin antimicrobial peptide. Interestingly, we found a relationship between the wound microbiome and vacuum‐assisted wound closure (VAC). These findings identify preliminary, associative relationships between wound microbiota and host factors which motivate future investigation into the directional relationships between wound care pain, wound closure technologies, and the wound microbiome.
Flow Performance Enhancement of a Fluidic Oscillator Through the Integration of Rectangular Ribs on Coanda Surface
Authors: Hussain Liaqat , Khan Muhammad Mahabat , Ahmad Naseem 
Published: April 2024

Abstract
Fluidic oscillators utilize internal flow dynamics to produce oscillatory fluid jets. The Coanda surface in the mixing chamber of a fluidic oscillator plays a critical role by facilitating controlled fluid manipulation through flow attachment and redirection. The mixing chamber pressure drop, jet oscillating frequency, and deflection angles are hence dependent on the geometry of the Coanda surface. In this study, the Coanda surface is modified by using rectangular ribs of different aspect ratios. The effects of ribbed Coanda surface on oscillating jet characteristics are computed numerically through two-dimensional unsteady Favre-averaged Navier–Stokes equations. The aspect ratio (ARribs), the ratio of rib height to rib base, is varied from 0.64 to 1.56 and air is used as a working fluid. An increase in the ARribs increases the jet oscillation frequency. The highest aspect ratio achieves an oscillation frequency of 820 Hz, contrasting with 355 Hz for the smooth case. On the other hand, the jet deflection angles are decreased as the aspect ratio increases. Interestingly the introduction of the ribs on the Coanda surface decreased the pressure drop in the oscillator. A decrease in pressure drop of 22% for an aspect ratio of 1.56 was achieved as compared to the smooth case. These results are attributed to the influence of the ribs on the formation of a separation bubble formed in the mixing chamber. The jet performance parameter, frequency-deflection-pressure ratio, was found to be 43% higher for ARribs of 1.56 as compared to the smooth case.
Genetic basis of clarithromycin resistance in
Bacillus anthracis
Authors: Maxson Tucker , Overholt Will A. , Chivukula Vasanta , Caban-Figueroa Victoria , Kongphet-Tran Thiphasone , Medina Cordoba Luz K. , Cherney Blake , Rishishwar Lavanya , Conley Andrew , Sue David 
Published: April 2024

ABSTRACT

The high-consequence pathogen
Bacillus anthracis
causes human anthrax and often results in lethal infections without the rapid administration of effective antimicrobial treatment. Antimicrobial resistance profiling is therefore critical to inform post-exposure prophylaxis and treatment decisions, especially during emergencies such as outbreaks or where intentional release is suspected. Whole-genome sequencing using a rapid long-read sequencer can uncover antimicrobial resistance patterns if genetic markers of resistance are known. To identify genomic markers associated with antimicrobial resistance, we isolated
B. anthracis
derived from the avirulent Sterne strain with elevated minimal inhibitory concentrations to clarithromycin. Mutants were characterized both phenotypically through broth microdilution susceptibility testing and observations during culturing, as well as genotypically with whole-genome sequencing. We identified two different in-frame insertions in the L22 ribosomal protein-encoding gene
rplV
, which were subsequently confirmed to be involved in clarithromycin resistance through the reversion of the mutant gene to the parent (drug-susceptible) sequence. Detection of the
rplV
insertions was possible with rapid long-read sequencing, with a time-to-answer within 3 h. The mutations associated with clarithromycin resistance described here will be used in conjunction with known genetic markers of resistance for other antimicrobials to strengthen the prediction of antimicrobial resistance in
B. anthracis
.

IMPORTANCE

The disease anthrax, caused by the pathogen
Bacillus anthracis
, is extremely deadly if not treated quickly and appropriately. Clarithromycin is an antibiotic recommended for the treatment and post-exposure prophylaxis of anthrax by the Centers for Disease Control and Prevention; however, little is known about the ability of
B. anthracis
to develop resistance to clarithromycin or the mechanism of that resistance. The characterization of clarithromycin-resistant isolates presented here provides valuable information for researchers and clinicians in the event of a release of the resistant strain. Additionally, knowledge of the genetic basis of resistance provides a foundation for susceptibility prediction through rapid genome sequencing to inform timely treatment decisions.
Big slow-movers, debris slides and flows, and mega-boulders of the Blue Ridge Escarpment, western North Carolina, USA
Authors: Hill§ Jesse , Wooten§ Richard , Cattanach§ Bart , Bauer§ Jennifer , Bozdog§ Nick , Douglas§ Tommy , Isard§ Sierra , Khashchevskaya§ Daria , Korte§ David , Kuhne§ Jody , Owen§ Lewis , Prince§ Philip , Scheip§ Corey , Waters-Tormey§ Cheryl , Wegmann§ and Karl 
Published: April 2024

ABSTRACTThis one-day field trip will explore the geomorphology, landslide mapping, geochronology, tectonics, meteorology, and geoengineering related to the Blue Ridge Escarpment (BRE), North Carolina, USA. Our aim is to show why it has persisted in the landscape and how it influences landslide frequency and the lives of the western North Carolina people. Some of the work we highlight has been published and some we present for the first time. Landslides pose a frequent geologic hazard to the people of western North Carolina, and they cause losses of road access, property, or, in the worst scenarios, human lives. We will also discuss landslide disaster response and mitigation efforts that required the collaboration of state and local emergency managers with other local, state, and federal agencies and the public.As we traverse the rugged terrain along the BRE in Polk and Rutherford counties, we will examine rockfalls, rockslides, debris flows, and debris slides occurring in late Proterozoic to early Paleozoic metasedimentary and meta-igneous rocks southeast of the Brevard fault zone. Our focus will be steep-walled, topographic reentrants where streams exploit brittle, post-orogenic bedrock structures, incise into the BRE, and produce landforms prone to debris flows and other types of mass wasting, often triggered by extreme rainfall events. The research we present on these extreme historical storms will help illustrate the scope and magnitude of the BRE’s influence on meteorological and hydrological events that lead to landslides and flooding.In addition to ongoing countywide landslide hazard mapping, a complementary research objective is to better understand the influence brittle cross-structures and earlier ductile bedrock structures have on rock slope failures and debris flows in the North Pacolet River valley and Hickory Nut Gorge, two major structurally controlled topographic lineaments.
Bacterial magnetofossil evidence for enhanced Pacific Ocean respired carbon storage during buildup of Antarctic glaciation
Authors: Wang Dunfan , Chen Yihui , Liu Yan , Roberts Andrew P. , Rohling Eelco J. , Zhao Xiangyu , Zhang Xu , Li Jinhua , Yao Weiqi , Qu Xuejiao , Tan Xianfeng , Liu Qingsong 
Published: April 2024

Abstract
Global cooling with the onset of Antarctic glaciation ca. 34 Ma across the Eocene-Oligocene transition (EOT) terminated the early Cenozoic greenhouse climate state and marked the beginning of icehouse conditions. Although a pCO2 decline is considered to have been a major cause of this climate shift, the associated carbon-sequestration mechanism remains unclear. Here, we assessed ocean production and circulation changes across the EOT using numerical simulations combined with a novel proxy, namely, bacterial magnetofossils, the abundance and morphology of which are sensitive to sedimentary organic matter accumulation and oxygenation. We detected production and oxygenation declines in the equatorial Pacific Ocean coeval with increased biological production in the Southern Ocean after the EOT. Corroborated by simulation results and evidence from the Subantarctic region, we interpret this counterintuitive combination as a result of enhanced bottom-water formation and biological pump efficiency in the Southern Ocean due to Antarctic glacial buildup across the EOT. These results provide key evidence for deep Pacific Ocean deoxygenation and increased respired carbon concentrations, which amplified CO2 decline across the EOT.
Missing link: a qualitative analysis of community-based organisations’ contributions to partnered collaborative care to treat late-life depression
Authors: Gosdin Melissa M , Hoeft Theresa , Henderson Stuart , Wagner Jenny , Hinton Ladson 
Published: April 2024

ObjectiveExtending collaborative care, a model integrating mental health services into primary care, to include community-based organisations (CBOs) may improve older patient health outcomes by increasing access to care and addressing patients’ social needs; however, little is known about how CBOs contribute to such partnered depression care. We explored how six primary care clinic and CBO partnerships came together to provide late-life depression care through the Care Partners funded in 2014.Design43 key informant interviews and 15 focus groups were conducted with care managers, administrators and primary care providers partnering to provide late-life depression care. Data were coded and analysed iteratively using qualitative thematic analysis.SettingSix primary care clinic–CBO sites across California.ParticipantsCare managers, administrators and primary care providers participated in this study.ResultsThree unique contributions of CBOs to depression care in these clinic–CBO partnerships were identified: (1) CBOs added new services that focus on social needs and enhanced depression care; (2) CBOs strengthened core aspects of collaborative care for depression; (3) CBOs provided new avenues for building connections and trust with underserved patients.ConclusionsCBOs, when partnered with clinics, enhanced both medical and social aspects of depression treatment for older adults. CBOs are well positioned to assist primary care clinics in treating the complex health needs of older adults by providing new and strengthening existing aspects of partnered depression care while building patient trust among culturally diverse populations.
Intersectional stigma and the non-communicable disease syndemic in the context of HIV: protocol for a multisite, observational study in the USA
Authors: Friedman M Reuel , Badri Sheila , Bowleg Lisa , Haberlen Sabina A , Jones Deborah L , Kempf Mirjam-Colette , Konkle-Parker Deborah , Kwait Jenn , Martinson Jeremy , Mimiaga Matthew J , Plankey Michael W , Stosor Valentina , Tsai Alexander C , Turan Janet M , Ware Deanna , Wu Katherine 
Published: April 2024

IntroductionThe increasing burden of non-communicable diseases, such as hypertension, diabetes and dyslipidaemia, presents key challenges to achieving optimal HIV care outcomes among ageing people living with HIV. These diseases are often comorbid and are exacerbated by psychosocial and structural inequities. This interaction among multiple health conditions and social factors is referred to as a syndemic. In the USA, there are substantial disparities by social position (ie, racial, ethnic and socioeconomic status) in the prevalence and/or control of non-communicable diseases and HIV. Intersecting stigmas, such as racism, classism and homophobia, may drive these health disparities by contributing to healthcare avoidance and by contributing to a psychosocial syndemic (stress, depression, violence victimisation and substance use), reducing success along the HIV and non-communicable disease continua of care. Our hypothesis is that marginalised populations experience disparities in non-communicable disease incidence, prevalence and control, mediated by intersectional stigma and the psychosocial syndemic.Methods and analysisCollecting data over a 4 year period, we will recruit sexual minority men (planned n=1800) enrolled in the MACS/WIHS Combined Cohort Study, a long-standing mixed-serostatus observational cohort in the USA, to investigate the following specific aims: (1) assess relationships between social position, intersectional stigma and the psychosocial syndemic among middle-aged and ageing sexual minority men, (2) assess relationships between social position and non-communicable disease incidence and prevalence and (3) assess relationships between social position and HIV and non-communicable disease continua of care outcomes, mediated by intersectional stigma and the psychosocial syndemic. Analyses will be conducted using generalised structural equation models using a cross-lagged panel model design.Ethics and disseminationThis protocol is approved as a single-IRB study (Advarra Institutional Review Board: Protocol 00068335). We will disseminate results via peer-reviewed academic journals, scientific conferences, a dedicated website, site community advisory boards and forums hosted at participating sites.
Swissped-RECOVERY: masked independent adjudication for the interpretation of non-randomised treatment in a two-arm open-label randomised controlled trial (methylprednisolone vs immunoglobulins) in Paediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS) involving 10 secondary and tertiary paediatric hospitals in Switzerland
Authors: Schöbi Nina , Sanchez Carlos , Welzel Tatjana , Bamford Alasdair , Webb Kate , Rojo Pablo , Tremoulet Adriana , Atkinson Andrew , Schlapbach Luregn J , Bielicki Julia Anna 
Published: April 2024

ObjectivesIn trials of acute severe infections or inflammations frequent administration of non-randomised treatment (ie, intercurrent event) in response to clinical events is expected. These events may affect the interpretation of trial findings. Swissped-RECOVERY was set up as one of the first randomised controlled trials worldwide, investigating the comparative effectiveness of anti-inflammatory treatment with intravenous methylprednisolone or intravenous immunoglobulins in children and adolescents with Paediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS). We present one approach towards improving the interpretation of non-randomised treatment in a randomised controlled trial.DesignThis is a pre-planned ancillary analysis of the Swissped-RECOVERY trial, a randomised multicentre open-label two-arm trial.Setting10 Swiss paediatric hospitals (secondary and tertiary care) participated.ParticipantsPaediatric patients hospitalised with PIMS-TS.InterventionsAll patient-first intercurrent events, if applicable, were presented to an independent adjudication committee consisting of four international paediatric COVID-19 experts to provide independent clinical adjudication to a set of standardised questions relating to whether additional non-randomised treatments were clinically indicated and disease classification at the time of the intercurrent event.ResultsOf 41 treatments in 75 participants (24/41 (59%) and 17/41 (41%) in the intravenous methylprednisolone and immunoglobulin arms of the trial, respectively), two-thirds were considered indicated. The most common treatment (oral glucocorticoids, 14/41, 35%) was mostly considered not indicated (11/14, 79%), although in line with local guidelines. Intercurrent events among patients with Shock-like PIMS-TS at baseline were mostly considered indicated. A significant proportion of patients with undifferentiated PIMS-TS at baseline were not attributed to the same group at the time of the intercurrent event (6/12 unchanged, 4/12 Kawasaki disease-like, 2/12 Shock-like).ConclusionThe masked adjudication of intercurrent events contributes to the interpretation of results in open-label trials and should be incorporated in the future.Trial registration numbersSNCTP000004720 and NCT 04826588.
Social care data and its fitness for integrated health and social care service governance: an exploratory qualitative analysis in the Dutch context
Authors: Bos Véronique LLC , Klazinga Niek S , Kringos Dionne S 
Published: April 2024

IntroductionTo date, little is known on how social care data could be used to inform performance-based governance to accelerate progress towards integrated health and social care.Objectives and designThis study aims to perform a descriptive evaluation of available social care data in the Netherlands and its fitness for integrated health and social care service governance. An exploratory mixed-method qualitative study was undertaken based on desktop research (41 included indicators), semi-structured expert interviews (13 interviews including 18 experts) and a reflection session (10 experts).SettingThe Netherlands; social care is care provided in accordance with the Social Support Act, the Participation Law and the Law for Municipal debt-counselling.ResultsThis study found six current uses for social care data: (a) communication and accountability, (b) monitoring social care policy, (c) early warning systems, (d) controls and fraud detection, (e) outreaching efforts and (f) prioritisation. Further optimisation should be sought through: standardisation, management of data exchange across domains, awareness of the link between registration and financing, strengthening the overall trust in data sharing. The study found five ways the enhanced social care data could be used to improve the governance of integrated health and social care services: (a) cross-domain learning and cooperation (eg, through benchmarks), (b) preventative measures and early warning systems, (c) give insight regarding the quality and effectivity of social care in a broader perspective, (d) clearer accountability of social care towards contracting parties and policy, (e) enable cross-sector data-driven governance model.ConclusionAlthough there are several innovative initiatives for the optimisation of the use of social care data in the Netherlands, the current social care data landscape and management is not yet fit to support the new policy initiatives to strengthen integrated health and social care service governance. Directions for addressing the shortcomings are provided.
Value-based comparison of ambulatory children with respiratory diseases in an emergency department and a walk-in clinic: a retrospective cohort study in Québec, Canada
Authors: Marx Tania , Moore Lynne , Talbot Denis , Guertin Jason Robert , Lachapelle Philippe , Blais Sébastien , Singbo Narcisse , Simonyan David , Lavallée Jeanne , Zada Nawid , Shahrigharahkoshan Shaghayegh , Huard Benoit , Olivier Pascale , Mallet Myriam , Létourneau Mélanie , Lafrenière Michel , Archambault Patrick , Berthelot Simon 
Published: April 2024

ObjectiveTo compare health outcomes and costs given in the emergency department (ED) and walk-in clinics for ambulatory children presenting with acute respiratory diseases.DesignA retrospective cohort study.SettingThis study was conducted from April 2016 to March 2017 in one ED and one walk-in clinic. The ED is a paediatric tertiary care centre, and the clinic has access to lab tests and X-rays.ParticipantsInclusion criteria were children: (1) aged from 2 to 17 years old and (2) discharged home with a diagnosis of upper respiratory tract infection (URTI), pneumonia or acute asthma.Main outcome measuresThe primary outcome measure was the proportion of patients returning to any ED or clinic within 3 and 7 days of the index visit. The secondary outcome measures were the mean cost of care estimated using time-driven activity-based costing and the incidence of antibiotic prescription for URTI patients.ResultsWe included 532 children seen in the ED and 201 seen in the walk-in clinic. The incidence of return visits at 3 and 7 days was 20.7% and 27.3% in the ED vs 6.5% and 11.4% in the clinic (adjusted relative risk at 3 days (aRR) (95% CI) 3.17 (1.77 to 5.66) and aRR at 7 days 2.24 (1.46 to 3.44)). The mean cost (95% CI) of care (CAD) at the index visit was $C96.68 (92.62 to 100.74) in the ED vs $C48.82 (45.47 to 52.16) in the clinic (mean difference (95% CI): 46.15 (41.29 to 51.02)). Antibiotic prescription for URTI was less common in the ED than in the clinic (1.5% vs 16.4%; aRR 0.10 (95% CI 0.03 to 0.32)).ConclusionsThe incidence of return visits and cost of care were significantly higher in the ED, while antibiotic use for URTI was more frequent in the walk-in clinic. These data may help determine which setting offers the highest value to ambulatory children with acute respiratory conditions.
Physical activity and mental health in individuals with multimorbidity during COVID-19: an explanatory sequential mixed-method study
Authors: Ambrosio Leire , Faulkner James , Morris Jacqui H , Stuart Beth , Lambrick Danielle , Compton Eric , Portillo Mari Carmen 
Published: April 2024

ObjectiveTo understand the physical activity and mental health of individuals living with long-term conditions during the COVID-19 pandemic.DesignA sequential explanatory mixed-methods study with two phases: phase 1: quantitative survey and phase 2: qualitative follow-up interviews.SettingFor the quantitative phase, an online survey was launched in March 2021, using Microsoft Forms. For the qualitative phase, in-depth semistructured interviews were conducted via online.Participants368 adults over 18 years old living in the UK with at least one long-term condition completed the survey. Interviews were conducted in a subsample of participants from the previous quantitative phase, with 26 people. Data were analysed using thematic analysis.ResultsResponses from the survey showed that people with one long-term condition were significantly more physically active and spent less time sitting, than those with two or more conditions, presenting with significantly higher well-being (p<0.0001), and lower levels of anxiety (p<0.01), and depression (p<0.0001). Interviews found that people developed a range of strategies to cope with the impact of changeability and the consequences of their long-term condition on their physical activity.ConclusionsThe number of long-term conditions influenced physical activity and how people coped with their condition during COVID-19. Findings will inform policy developments in preparation for future pandemics to support and remain people to remain physically active and mental health.