bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pan-azole- and multi-fungicide-resistant
Aspergillus fumigatus
is widespread in the United States
Authors: Celia-Sanchez B. N. , Mangum B. , Gómez Londoño L. F. , Wang C. , Shuman B. , Brewer M. T. , Momany M. 
Published: April 2024

ABSTRACT

Aspergillus fumigatus
is an important global fungal pathogen of humans. Azole drugs are among the most effective treatments for
A. fumigatus
infection. Azoles are also widely used in agriculture as fungicides against fungal pathogens of crops. Azole-resistant
A. fumigatus
has been increasing in Europe and Asia for two decades where clinical resistance is thought to be driven by agricultural use of azole fungicides. The most prevalent mechanisms of azole resistance in
A. fumigatus
are tandem repeats (TR) in the
cyp51A
promoter coupled with mutations in the coding region which result in resistance to multiple azole drugs (pan-azole resistance). Azole-resistant
A. fumigatus
has been isolated from patients in the United States (U.S.), but little is known about its environmental distribution. To better understand the distribution of azole-resistant
A. fumigatus
in the U.S., we collected isolates from agricultural sites in eight states and tested 202 isolates for sensitivity to azoles. We found azole-resistant
A. fumigatus
in agricultural environments in seven states showing that it is widespread in the U.S. We sequenced environmental isolates representing the range of U.S. sample sites and compared them with publicly available environmental worldwide isolates in phylogenetic, principal component, and ADMIXTURE analyses. We found worldwide isolates fell into three clades, and TR-based pan-azole resistance was largely in a single clade that was strongly associated with resistance to multiple agricultural fungicides. We also found high levels of gene flow indicating recombination between clades highlighting the potential for azole-resistance to continue spreading in the U.S.

IMPORTANCE

Aspergillus fumigatus
is a fungal pathogen of humans that causes over 250,000 invasive infections each year. It is found in soils, plant debris, and compost. Azoles are the first line of defense antifungal drugs against
A. fumigatus
. Azoles are also used as agricultural fungicides to combat other fungi that attack plants. Azole-resistant
A. fumigatus
has been a problem in Europe and Asia for 20 years and has recently been reported in patients in the United States (U.S.). Until this study, we did not know much about azole-resistant
A. fumigatus
in agricultural settings in the U.S. In this study, we isolated azole-resistant
A. fumigatus
from multiple states and compared it to isolates from around the world. We show that
A. fumigatus
which is resistant to azoles and to other strictly agricultural fungicides is widespread in the U.S.
Automated detection of methicillin-resistant
Staphylococcus aureus
with the MRSA CHROM imaging application on BD Kiestra Total Lab Automation System
Authors: McElvania Erin , Mindel Susan , Lemstra Jaap , Brands Karin , Patel Parul , Good Caryn E. , Morel Didier , Orny Cedrick , Volle Jean-Marc , Desjardins Marc , Rhoads Daniel 
Published: April 2024

ABSTRACT

The virulence of methicillin-resistant
Staphylococcus aureus
(MRSA) and its potentially fatal outcome necessitate rapid and accurate detection of patients colonized with MRSA in healthcare settings. Using the BD Kiestra Total Lab Automation (TLA) System in conjunction with the MRSA Application (MRSA App), an imaging application that uses artificial intelligence to interpret colorimetric information (mauve-colored colonies) indicative of MRSA pathogen presence on CHROMagar chromogenic media, anterior nares specimens from three sites were evaluated for the presence of mauve-colored colonies. Results obtained with the MRSA App were compared to manual reading of agar plate images by proficient laboratory technologists. Of 1,593 specimens evaluated, 1,545 (96.98%) were concordant between MRSA App and laboratory technologist reading for the detection of MRSA growth [sensitivity 98.15% (95% CI, 96.03, 99.32) and specificity 96.69% (95% CI, 95.55, 97.60)]. This multi-site study is the first evaluation of the MRSA App in conjunction with the BD Kiestra TLA System. Using the MRSA App, our results showed 98.15% sensitivity and 96.69% specificity for the detection of MRSA from anterior nares specimens. The MRSA App, used in conjunction with laboratory automation, provides an opportunity to improve laboratory efficiency by reducing laboratory technologists’ labor associated with the review and interpretation of cultures.
Making Social Science Actionable for the NWS: The Brief Vulnerability Overview Tool (BVOT)
Authors: Friedman Jack R. , LaDue Daphne S. , Hurst Elizabeth H. , Saunders Michelle E. , Marmo Alex N. 
Published: April 2024

Abstract
This paper provides an introduction to a new tool that is designed to provide operationally useful vulnerability information to National Weather Service (NWS) Weather Forecasting Offices (WFOs). The Brief Vulnerability Overview Tool (BVOT) is a shapefile containing local known, spatially specific, and weather-hazard-related vulnerabilities in a format that is easily integrated into the existing forecasting, warning, and decision support responsibilities and tasks of NWS WFO meteorologists. The methods for gathering vulnerability data and then building a BVOT for a WFO leverage and strengthen the relationships that NWS WFOs already have with their local emergency managers (EMs) and core partners to work together to identify operationally useful, local vulnerability knowledge. The BVOT is populated with discrete, known vulnerabilities to provide NWS meteorologists spatial situational awareness of those people, places, and things of greatest concern to their core partners. Crucially, the BVOT is a subsample of all potential vulnerabilities; its primary purpose is to make meteorologists aware of those weather-hazard-specific vulnerabilities that, as we posed to them, “keep them awake at night.” Here, we describe the development of the BVOT as a social science–informed operational tool; how the BVOT methods have evolved and how it can be integrated into the culture of the NWS as a tool for building and maintaining relationships with partners; and how the BVOT is designed to be used and its impact on operational decision-making as observed in NOAA’s Hazardous Weather Testbed.
Quantifying the Impacts of Land-Cover Change on the Hydrologic Response to Hurricane Ida in the Lower Mississippi River Basin
Authors: Tran Hoang , Fang Yilin , Tan Zeli , Zhou Tian , Leung L. Ruby 
Published: April 2024

Abstract
The Lower Mississippi River basin (LMRB) has experienced significant changes in land cover and is one of the most vulnerable regions to hurricanes in the United States. Here, we study the impacts of land-cover change on the hydrologic response to Hurricane Ida in LMRB. By using an integrated surface–subsurface hydrologic model, Energy Exascale Earth System Model (E3SM) Land Model coupled with the three-dimensional ParFlow subsurface flow model (ELM-ParFlow), we simulate the effects of land-cover change on the flood volume and peak timing induced by rainfall from Hurricane Ida. The results show that land-cover changes from 1850 to 2015, which resulted in a smoother surface and less vegetation, exacerbated both flood peak time and volume induced by Hurricane Ida. The effects of land-cover changes can be decomposed into two mechanisms: a smoother surface routes more water faster to a watershed outlet and less vegetation allows more water to contribute to surface runoff. By comparing scenarios in which the two mechanisms were isolated, we found that changes in soil moisture due to vegetation cover change have more dominant effects on floods in the southern part and changes in Manning’s coefficient have the largest effect on floods in the northern part of the LMRB. The study provides important insights into the complex relationship between land-use, land-cover, and hydrologic processes in coastal regions.
A Daily Checklist Method Increases Documentation of Code Status in Trauma Patients
Authors: Bontrager Alexandria M. , Ouadah Sarah J. , Anand Malini , Smith Michael C. 
Published: March 2024

Objectives While insufficient code status documentation (CSD) is a longstanding challenge, all patients deserve the opportunity to participate in decision-making regarding code status, especially trauma patients with an unpredictable course. Prior interventions to increase CSD relied on reminder systems. We hypothesize that introducing a daily checklist will increase CSD for patients in the trauma ICU. Methods This quality improvement study examined the efficacy of a twice-daily checklist for improving CSD in trauma patients at a level I trauma center. A pre-intervention (PRE) and post-intervention (POST) daily census characterized the percentage of patients with CSD (primary outcome), time-to-code status (TTCS, secondary outcome) documentation, and information about patients who were discharged with no code status (DNCS, secondary outcome). Results Of 213 PRE and 207 POST, daily census CSD for all patients increased from a median of 50.0% PRE to 64.4% POST ( P < .05). Time-to-code status was halved (PRE: 25.30 h, POST: 12.71 h, P < .05). Code status documentation within 12 h increased from 41.8% PRE to 60.9% POST ( P < .05). Overall, the percentage of patients with CSD during their hospitalization increased 20% (PRE: 63.8%, POST: 83.6%, P < .05). Discharged with no code status patients decreased 20% (PRE: 35.2%, POST: 15.5%, P < .05). Conclusion Including code status in a daily checklist involving key aspects of care for trauma patients is an effective method for improving code status documentation. Capturing code status for more patients in trauma allows us to provide patient-centered, goal-concordant care.
The Impact of Pre-Trauma Steroid Use on Wound Healing and Outcomes
Authors: Derouen Kaleb , Aleman Sarah , Travis Harrison , Hunt John P. , Marr Alan , Greiffenstein Patrick , Stuke Lance , Schoen Jonathan , Smith Alison 
Published: March 2024

This study presents data on pre-trauma steroid use, a topic underrepresented in the trauma literature. Long-term steroid use has been linked to impaired wound healing, compromised immune responses, and hindrance of bone healing, alongside the potential for adrenal insufficiency during traumatic events. The aim of this study was to conduct a retrospective analysis of clinical outcomes for trauma patients with chronic steroid use. Examining adult trauma cases with pre-trauma steroid use at a level 1 trauma center (January 2016-September 2023), we identified 18 patients (58.6 ± 19.4 years, 55.6% males). All were on prednisone prior to trauma activation and 66.7% had autoimmune disease. Complications included orthopedic fractures (72.2%), ICU admissions (16.7%), and low mortality (5.6%). Future larger, multi-center studies are needed to determine the impact of immunosuppression and pre-trauma steroids on clinical outcomes.
Size of Splenic Subcapsular Hematoma Is Associated With Varying Outcomes of Nonoperative Management
Authors: Dhillon Navpreet K. , Harfouche Melike N. , DuBose Joseph J. , Kozar Rosemary A. , Scalea Thomas M. 
Published: March 2024

The presence of a splenic subcapsular hematoma (SCH) has been associated with higher rates of failure of nonoperative management (FNOM) in patients with blunt splenic injury (BSI), with rates up to 80%. We hypothesized that contemporary rates are lower. A retrospective review was conducted of patients admitted with BSI to a level I trauma center (2016-2021). Patients with SCH who had FNOM were compared to those who did not. There were 661 BSI patients, of which 102 (15.4%) had SCH. Among the SCH patients, 8 (7.8%) had FNOM. Failure of nonoperative management was higher in patients who had a SCH measuring 15 mm or greater. To the best of our knowledge, this is the largest study to date examining the relationship between SCH and FNOM. The presence of a SCH alone is not associated with a high risk for FNOM contrary to previous literature. However, SCH thickness was larger in those who failed.
What resources do people with persistent pain use to help them better understand their pain? A cross-sectional survey
Authors: Xie Tenglong , Chalmers K Jane , Moseley G Lorimer , Wallwork Sarah B 
Published: March 2024

Objectives: Pain education has been shown to reduce pain and disability in people with persistent pain by increasing their understanding of ‘how pain works’. There are many resources that people can engage with to help them learn about pain. The primary aim of this study was to investigate the resources with which people with persistent pain engage, to learn about pain. Secondary aims included investigating the helpfulness of those resources, whether people assess the quality of the resources with which they engage and whether the resources sought differed according to whether or not they had a diagnosis for their pain. Design: Cross-sectional descriptive study. Setting: Online and paper-based surveys. Methods: People with persistent pain were recruited through advertising on social media and through local university health clinics. Participants completed a survey providing details about their pain condition, the resources with which they engaged to learn about pain, how useful they found these resources and whether they assessed the quality of the resources used. Results: Data were collected from 127 online surveys (80% female; age [± SD] was 41 [±16] years). Healthcare professionals were the most common resource with which participants engaged (85.0%), followed by the Internet (68.5%) and scientific articles (52.8%). Books and scientific articles had the highest helpfulness rating; healthcare professionals and pamphlets had the lowest. Most respondents (85.3%) reported assessing the quality of the resources they engaged with. Conclusion: Despite being the most common resource participants engaged with, healthcare professionals were awarded some of the lowest helpfulness ratings. Care needs to be taken to ensure that people with persistent pain are directed towards learning resources that can provide helpful, relevant and evidence-based information.
Preparation and intrinsical flame resistance of reed-based polyurethane foam modified by 9,10-dihydro-9-oxa-10 phosphaphenanthrene 10-oxide
Authors: Jiao Xiaofei , Zhang Wenjing , Wu Ruiying , Ma Haiyun , Jiao Yunhong , Huo Li 
Published: April 2024

The production of polyurethane foam (PUF) from green and sustainable agricultural waste reeds could replace traditional petroleum-based PUF. In this paper, reed naturally contains nano-SiO2.was liquefied to reed-based polyol (R-P) using Castor oil and PEG-400 as a compound solvent and H2SO4 as a catalyst, The liquefaction efficiency is as high as 97.16%; Reed-based polyurethane foam (R-PUF) was prepared with R-P, water, and isocyanate by one-pot and free rise method. Moreover, DOPO with a rigid ring and Phosphorus was introduced into the cross-linked structure of rigid PUF as a reactive-type flame retardant. The mechanical properties, microstructure, thermal stability, and flame retardance of the R-PUFs were investigated, The results showed that the density of R-PUF was 33.03 kg/m3, the thermal conductivity was 0.0350 W/(m·K), and the limiting oxygen index (LOI) was 20.5%, which was higher than petroleum-based polyurethane; the 6%-DOPO PUF has better flame retardant and thermal stability. The mechanism of R-PUF added DOPO is intrinsic flame retardant and the result of the presence of the gas phase inhibiting the combustion chain reaction and the coalescence phase blocking the transfer of oxygen and heat to the interior of the foam.
A retrospective study of the effects of uterine manipulators on prognosis in patients with cervical cancer
Authors: Guo Xinmeng , Zhao Enfeng , Guan Zheng , Li Weiping , Zhang Jinning , Tian Shuang , Yao Yuanqing 
Published: March 2024

Objective This retrospective study investigated the effects of uterine manipulator use during minimally invasive radical hysterectomy on prognosis in patients with cervical cancer. Methods We collected clinical data on 762 patients with stage IA2 to IIB cervical cancer who underwent radical hysterectomy and pelvic lymphadenectomy in Chinese PLA General Hospital from 2009 to 2019. Kaplan–Meier analysis and log-rank tests were used to compare the 5-year overall survival rates between patients treated with and without a uterine manipulator. Results Patient demographics did not differ between the two groups. In addition, the incidence of lymphovascular space invasion, tumor size, pathologic types, the International Federation of Gynecology and Obstetrics stage, the histologic grade, and the rate of lymphatic metastases did not differ between the groups. Meanwhile, perioperative clinical indicators were similar in the groups. Furthermore, no significant differences in 5-year survival rates and survival curves were recorded between the groups among both all patients (84.5% vs. 85.6%) and early-stage patients (89.1% vs. 89.2%). Conclusions The use of uterine manipulators during minimally invasive radical hysterectomy for cervical cancer did not affect clinicopathological markers or increase the risk of death.
Effect of digital storytelling-case studies patient privacy: A randomized controlled study
Authors: Eyuboglu Gulcan , Gocmen Baykara Zehra 
Published: March 2024

Background It is essential to develop future nurses’ privacy consciousness and attitudes toward patient privacy to recognise threats to patient privacy and take the necessary precautions. Objectives To determine the effect of digital storytelling and case studies teaching methods on nursing students’ privacy consciousness and attitudes toward patient privacy. Research design Pretest-posttest, factorial group randomised controlled study. Participants and research context Eligible 113 nursing students were randomised to the intervention I ( n = 38), intervention II ( n = 38), and control group ( n = 37) by stratified block randomisation method. The education program consisted of two theoretical sessions and three practical sessions. Data were collected using questionnaires pre-, post-, 4 weeks, and 16 weeks after the intervention between November 2020 and May 2021 in Türkiye. Ethical considerations Written approval was obtained from the university’s Ethics Board. Informed written and verbal consent were obtained from the participants. Findings The results showed a significant time effect on nursing students’ privacy consciousness and attitudes toward patient privacy ( p < .05), no significant difference between the groups ( p > .05), and a significant, positive, and strong relationship between the privacy consciousness and the attitudes toward patient privacy. Students stated that digital storytelling was beneficial in focusing on the subject, memorability, interest, curiosity, and attention. Conclusions Besides the ethics course, the privacy education program with digital storytelling and case studies develops nursing students’ privacy consciousness and attitudes toward patient privacy. It is recommended to integrate privacy education into ethics courses and popularise digital storytelling and ethical case studies in ethics education.
In Silico Prediction of NOS2, NOS3 and Arginase 1 Genes Targeting by Micro RNAs Upregulated in Systemic Sclerosis
Authors: Singh Neha , Rai Mohit Kumar , Agarwal Vishwesh , Agarwal Vikas 
Published: March 2024

Introduction: Systemic sclerosis (SSc) is a chronic disorder, characterised by endothelial dysfunction and fibrosis of skin and internal organs. Endothelium dysfunction leads to a decrease in nitric oxide levels, consequent to reduced Nitric Oxide synthase 3 (NOS3) activity due to decreased NOS3 gene function. Besides endothelium, macrophages too play an important role in the pathogenesis of SSc; classically activated M1 macrophages (express NOS2) and alternatively activated M2 macrophages (express Arginase1) are differentially altered in favour of M2 macrophages. Micro-RNAs (miRNAs) regulate expression of various genes and may favour disease phenotype. Aim: Our aim was to identify differentially expressed micro-RNAs in SSc, which target NOS2, NOS3 and Arginase1 genes by in-silico approach. Methods: Data on miRNAs upregulation reported in various studies was collected and their sequence ID from miRBase was identified in FASTA format from NCBI. Binding strength of these miRNAs against NOS2, NOS3 and Arginase1 genes was evaluated by RNA22. Results: After scanning 39 publications reporting miRNA expression in SSc, a total of 13 miRNAs were found to be up-regulated for NOS2 (Gibbs free energy ≤18.0Kj/mol) and 15 miRNAs up-regulated for NOS3 (Gibbs free energy ≤18.0Kj/mol) whereas for Arginase1 only 2 miRNAs were up-regulated. Conclusion: There is differential upregulation of miRNAs in SSc. Micro RNAs targeting NOS2 and NOS3 genes are highly up-regulated in comparison to Arginase 1. Role of epigenetic regulation of genes by miRNAs may play a key role in pathogenesis of SSc.
Clinical and Serological Associations of Subclinical Atherosclerosis in Systemic Sclerosis
Authors: Gangadharan Harikrishnan , Rai Mohit Kumar , Jain Neeraj , Mohindra Namita , Kumar Sudeep , Agarwal Vikas , Misra Durga Prasanna 
Published: March 2024

Background: While patients with systemic sclerosis (SSc) are predisposed to cardiovascular events, data regarding this from India is sparse. We analysed correlates of subclinical atherosclerosis in Indian patients with SSc. Methods: Patients with SSc fulfilling the 2013 classification criteria ( n = 61) were recruited after obtaining written informed consent. Clinical risk factors for cardiovascular disease (CVD) were assessed. A carotid ultrasound was performed to assess the mean carotid intima-media thickness (CIMT). Total and endothelial microparticles (EMP, positive for CD31 and CD146) were estimated from plasma. Serum cytokines known to play a role in atherosclerosis (interleukin-1β [IL-1β], tumour necrosis factor-alpha, IL-6 and IL-17) were assessed. Forty-one age- and sex-similar healthy controls were recruited for comparison. Clinical and serological risk factors for CVD were compared between SSc with and without carotid plaque. Linear regression analyses were conducted to identify predictors of CIMT and carotid plaque in SSc. Results: Patients with SSc had lower body-mass index than healthy controls, however, had higher CIMT, higher serum IL-1β, IL-6, total microparticles and EMP than control subjects. SSc with carotid plaque ( n = 13) were older, and more likely to be male, but demonstrated no differences in serological markers of CVD. On multivariable-adjusted regression analyses, age was the only significant predictor of CIMT in SSc and male sex was the only significant predictor of carotid plaque in SSc. Conclusions: Carotid plaques were present in one-fifth of young patients with SSc. Older age and male sex predicted a higher risk of subclinical atherosclerosis in SSc.