bluuebunny/crossref_metadata_2025_split huggingface dataset:
SARS-CoV-2 pandemic non-pharmacologic interventions temporally associated with reduced pediatric infections due to
Mycoplasma pneumoniae
and co-infecting respiratory viruses in Arkansas
Authors: Boyanton Bobby L. , Frenner Rachel A. , Ingold Ashton , Ambroggio Lilliam , Kennedy Joshua L. 
Published: March 2024

ABSTRACT

Non-pharmacologic interventions (NPIs), such as universal masking, implemented during the SARS-CoV-2 pandemic have reduced respiratory infections among children. This study evaluated the impact of NPIs on
Mycoplasma pneumoniae
infections in children, analyzing data from two hospitals in Arkansas and examining age-related differences and co-infections with other respiratory viruses. The study was approved by the Institutional Review Board and included patients (≤18 years) with upper respiratory tract symptoms. Data generated from the FilmArray Respiratory Panel were divided into pre-NPI, NPI, and post-NPI periods for analysis. Overall test positivity rate and positivity rate interval changes were evaluated. Statistical differences were determined by Chi-square (χ
2
independence) analysis. A total of 100,077 tests were performed, with a statistical increase in testing volume during the NPI and post-NPI periods. The number of positive
M. pneumoniae
tests decreased by 77% (77 to 18) during the NPI period, then increased by 50% (18 to 27) during the post-NPI period. Preschool and elementary school age groups had the highest number of positive tests during the study at 59 (48%) and 40 (33%), respectively. Reduced
M. pneumoniae
infections were consistent across age groups. Co-infections with other respiratory viruses, particularly human rhinovirus/enterovirus, were observed at much lower levels. Pediatric
M. pneumoniae
infections in Arkansas were temporally associated with implementation and discontinuation of NPIs. Specific viral co-infections still occurred, albeit at lower levels during the SARS-CoV-2 pandemic. Because of the slower growth of this bacterium, we expect
M. pneumoniae
infections to return to pre-pandemic levels within approximately 2 years.

IMPORTANCE

Non-pharmacologic interventions (NPIs) effectively curtailed the spread of SARS-CoV-2 and, fortuitously, many other aerosol-transmitted respiratory pathogens. This study included the largest data set of symptomatic, pediatric patients from within the United States spanning a period from November 2017 through December 2023, and encompassed individuals residing in both rural and urban settings. We observed a strong correlation between the implementation and cessation of NPIs with the rate of respiratory infections due to
Mycoplasma pneumoniae
and viral co-infections. These infections are returning to baseline levels approximately 2 years following NPI cessation. This observation was not unexpected since the replication time for viruses is exponentially faster than that of bacteria. The resurgence of
M. pneumoniae
and likely other atypical bacterial pathogens is currently in process. Healthcare providers should strongly consider these pathogens in individuals presenting with respiratory tract illnesses.
Targeting intracellular nontuberculous mycobacteria and
M. tuberculosis
with a bactericidal enzymatic cocktail
Authors: Bartlett Helen P. , Dawson Clinton C. , Glickman Cody M. , Osborn David W. , Evans Christopher R. , Garcia Benjamin J. , Frost Lauren C. , Cummings Jason E. , Whittel Nicholas , Slayden Richard A. , Holder Jason W. 
Published: March 2024

ABSTRACT

To address intracellular mycobacterial infections, we developed a cocktail of four enzymes that catalytically attack three layers of the mycobacterial envelope. This cocktail is delivered to macrophages, through a targeted liposome presented here as ENTX_001. Endolytix Cocktail 1 (EC1) leverages mycobacteriophage lysin enzymes LysA and LysB, while also including α-amylase and isoamylase for degradation of the mycobacterial envelope from outside of the cell. The LysA family of proteins from mycobacteriophages has been shown to cleave the peptidoglycan layer, whereas LysB is an esterase that hydrolyzes the linkage between arabinogalactan and mycolic acids of the mycomembrane. The challenge of gaining access to the substrates of LysA and LysB provided exogenously was addressed by adding amylase enzymes that degrade the extracellular capsule shown to be present in
Mycobacterium tuberculosis
. This enzybiotic approach avoids antimicrobial resistance, specific receptor-mediated binding, and intracellular DNA surveillance pathways that limit many bacteriophage applications. We show this cocktail of enzymes is bactericidal
in vitro
against both rapid- and slow-growing nontuberculous mycobacteria (NTM) as well as
M. tuberculosis
strains. The EC1 cocktail shows superior killing activity when compared to previously characterized LysB alone. EC1 is also powerfully synergistic with standard-of-care antibiotics. In addition to
in vitro
killing of NTM, ENTX_001 demonstrates the rescue of infected macrophages from necrotic death by
Mycobacteroides abscessus
and
Mycobacterium avium
. Here, we demonstrate shredding of mycobacterial cells by EC1 into cellular debris as a mechanism of bactericide.

IMPORTANCE

The world needs entirely new forms of antibiotics as resistance to chemical antibiotics is a critical problem facing society. We addressed this need by developing a targeted enzyme therapy for a broad range of species and strains within mycobacteria and highly related genera including nontuberculous mycobacteria such as
Mycobacteroides abscessus
,
Mycobacterium avium
,
Mycobacterium intracellulare,
as well as
Mycobacterium tuberculosis
. One advantage of this approach is the ability to drive our lytic enzymes through encapsulation into macrophage-targeted liposomes resulting in attack of mycobacteria in the cells that harbor them where they hide from the adaptive immune system and grow. Furthermore, this approach shreds mycobacteria independent of cell physiology as the drug targets the mycobacterial envelope while sidestepping the host range limitations observed with phage therapy and resistance to chemical antibiotics.
Hygienic complementary feeding practice and its associated factors among mothers having children aged 6–23 months in Antsokia Gemza district, Ethiopia: a cross-sectional survey
Authors: Tadegew Getachew , Chane Tefera , Bogale Eyob Ketema 
Published: March 2024

ObjectiveTo assess the magnitude of parental hygienic complementary feeding practices (PHCFPs) and their associated factors among mothers with children aged 6–23 months in Antsokia Gemza district, Ethiopia, in 2022.MethodologyA community-based cross-sectional study was conducted in Antsokia Gemza district, North Shoa, Ethiopia, from 25 June to 22 July 2022. A systematic random sampling technique was applied to select study participants. A total of 391 respondents participated in the study. All mothers (biological mothers, grandmothers, sisters and others) taking responsibility for caring for a child of age 6–23 months were included in the study. Data were collected by using interviewer-administrated questionnaires. Data were entered into Epi-Data V.3.1 and exported to SPSS V.25 for data cleaning and further analysis. Bivariable and multivariable binary logistic regression were employed to identify predictor variables of hygienic practice in complementary feeding with a p value <0.25 entered into the multivariable logistic regression model. Independent variables with a 95% CI and p values <0.05 in multivariable logistic regression were considered statistically significant.ResultThe magnitude of good parental hygienic practice during complementary feeding of their children aged 6–23 months was 45.3%, with a 95% CI (40.2%–50%). Maternal age of 34–41 years (adjusted odd ratio (AOR): 2.75, 95% CI (1.16–6.53)), secondary school educated mothers (AOR: 8.2, 95% CI (3.26–20.97)), daily laborer mothers (AOR: 0.22, 95% CI (0.06–0.83)), access to pipe water (AOR: 7.1, 95% CI (3.98–12.66)), access to media (AOR: 2.8, 95% CI (1.4–5.7)), and having a positive attitude (AOR: 8.6, 95% CI (2.43–31.0)) were significant predictors of maternal hygienic complementary feeding practice .ConclusionsThe magnitude of good maternal hygienic complementary feeding practice was low. Hence, the district health office, education office, communication office and water and energy office should work hard jointly on maternal education, pipe water supply, awareness creation and information dissemination.
Subjective social status and trajectories of frailty: findings from the English Longitudinal Study of Ageing
Authors: Maharani Asri , Richards Lindsay , Präg Patrick 
Published: March 2024

ObjectivesSubjective social status is a known antecedent for many health outcomes, but little research has examined the association between subjective status and frailty among older people. Using longitudinal data, the goal of this study was, first, to identify latent trajectories of frailty over time, and second, to investigate the relationship between subjective social status and frailty trajectory.MethodsData were drawn from the 2002–2019 surveys of the English Longitudinal Study of Ageing, involving 9484 individuals aged 50+ years at baseline. Group-based trajectory models were used to identify frailty trajectories over the 18-year period, and multinomial regression models were used to investigate the relationship between subjective social status and frailty trajectory membership. Controls were included for confounding factors, including a range of socioeconomic indicators and health behaviours.ResultsFour trajectories of the frailty index were retained: low frailty (53% of participants), progressive mild frailty (25%), progressive moderate frailty (15%) and high frailty (6%). Higher subjective social status is associated with higher probabilities of being in the low-frailty group and lower probabilities of being in one of the progressive or high-frailty groups.ConclusionsSubjective social status is significantly associated with being in a milder frailty trajectory after controlling for age, health behaviours and a wide range of objective socioeconomic status markers.
Prevalence and comorbidity of anxiety disorder in school-attending children and adolescents aged 6–16 years in China
Authors: Wang Fang , Yang Hanxue , Li Fenghua , Zheng Yi , Xu Hui , Wang Rui , Li Ying , Cui Yonghua 
Published: March 2024

BackgroundThe reported prevalence rate of anxiety disorder in the paediatric population varies widely between different counties. Currently, there is no national epidemiological surveyof childhoodanxiety disorder in China. This study aims to investigate the national prevalence of anxiety disorder, the distribution profiles of different subtypes and its comorbidity rates among school students.MethodsA nationwide epidemiological survey of mental disorders in school students aged 6–16 years was conducted. Participants were randomly recruited from five provinces in China. The Child Behavior Checklist was used to screen students at high risk for mental disorders. The final diagnosis was made based on the Diagnostic and Statistical Manual-IV. The point prevalence and comorbidity rate of anxiety disorder were calculated, and the difference between age, sex and socioeconomic status groups was also compared.ResultsGeneralised anxiety disorder (GAD) was the most common anxiety disorder in school-attending children and adolescents, with a prevalence rate of 1.3% (95% CI: 1.2 to 1.3). Separation anxiety and specific phobia were more common in children than in adolescents. Girls had a higher prevalence of panic disorder (0.3% vs 0.2%, χ2=14.6, p<0.001) and agoraphobia (0.9% vs 0.8%, χ2=4.3, p=0.03) than that of boys. We found no significant difference between developed and less developed areas. Girls were more likely to have panic disorder and GAD than boys, with ratios of 2.13:1 and 1.01:1, respectively. The co-occurrence of anxiety disorder and attention-deficit and disruptive behaviour disorder was very common, ranging from 40% to 85%.ConclusionsAnxiety disorder was prevalent among school students in China, and comorbidity with attention-deficit and disruptive disorder was very common. The data imply that screening for anxiety disorder is needed in school settings. Policies should be adapted to provide psychological services to children and adolescents. A comprehensive assessment is recommended in clinical practice.
Injury patterns and healthcare utilisation by runners of the New York City Marathon
Authors: McGrath Todd Michael , Fontana Mark Alan , Toresdahl Brett Gregory 
Published: March 2024

ObjectivesThe purpose of this study was to describe injury patterns and healthcare utilisation of marathon runners.MethodsThis was a previously reported 16-week prospective observational study of runners training for the New York City Marathon. Runners completed a baseline survey including demographics, running experience and marathon goal. Injury surveys were collected every 4 weeks during training, as well as 1 week before and 1 week after the race. Injury details collected included anatomic location, diagnosis, onset, and treatment received.ResultsA total of 1049 runners were enrolled. Injuries were reported by 398 (38.4%) during training and 128 (14.1%) during the marathon. The overall prevalence of injury was 447/1049 (42.6%). Foot, knee and hip injuries were most common during training, whereas knee, thigh and foot injuries were most common during the race. The most frequent tissue type affected was the category of muscle, tendon/fascia and bursa. The prevalence of overuse injuries increased, while acute injuries remained constant throughout training. Hamstring injuries had the highest prevalence of diagnosis with 38/564 injuries (6.7%). Of the 447 runners who reported an injury, 224 (50.1%) received medical care. Physical therapy was the most common medical care received with 115/1037 (11.1%) runners during training and 44/907 (4.9%) postrace.ConclusionRunners training and participating in a marathon commonly experience injuries, especially of the foot and knee, which often are overuse soft tissue injuries. Half of the injured runners sought out medical care for their injury. Understanding the patterns of injuries affecting marathon runners could help guide future injury prevention efforts.
Poor clinical outcomes and immunoevasive contexture in CD161+CD8+T cells barren human pancreatic cancer
Authors: Chen Qiangda , Yin Hanlin , Jiang Zhenlai , He Taochen , Xie Yuqi , Mao Weilin , Han Jiande , Liu Siyao , Lou Wenhui , Wu Wenchuan , Habib Joseph R , Yu Jun , Liu Liang , Pu Ning 
Published: March 2024

BackgroundThe role of CD161 expression on CD8+T cells in tumor immunology has been explored in a few studies, and the clinical significance of CD161+CD8+T cells in pancreatic ductal adenocarcinoma (PDAC) remains unclear. This study seeks to clarify the prognostic value and molecular characteristics linked to CD161+CD8+T cell infiltration in PDAC.MethodsThis study included 186 patients with confirmed PDAC histology after radical resection. CD161+CD8+T cell infiltration was assessed using immunofluorescence staining on tumor microarrays. Flow cytometry and single-cell RNA sequencing were used to evaluate their functional status.ResultsWe observed significant associations between tumor-infiltrating CD161+CD8+T cells and clinicopathological factors, such as tumor differentiation, perineural invasion, and serum CA19-9 levels. Patients with higher tumor-infiltrating CD161+CD8+T cell levels had longer overall survival (OS) and recurrence-free survival (RFS) than those with lower levels. Multivariable analysis confirmed tumor-infiltrating CD161+CD8+T cell as an independent prognostic indicator for both OS and RFS. Notably, a combination of tumor-infiltrating CD161+CD8+T cell and CA19-9 levels showed a superior power for survival prediction, and patients with low tumor-infiltrating CD161+CD8+T cell and high CA19-9 levels had the worst survival. Furthermore, lower tumor-infiltrating CD161+CD8+T cells were associated with a better response to adjuvant chemotherapy. Finally, we identified tumor-infiltrating CD161+CD8+T cells as a unique subtype of responsive CD8+T cells characterized by increased levels of cytotoxic cytokines and immune checkpoint molecules.ConclusionCD161+CD8+T cells exhibit elevated levels of both cytotoxic and immune-checkpoint molecules, indicating as a potential and attractive target for immunotherapy. The tumor-infiltrating CD161+CD8+T cell is a valuable and promising predictor for survival and therapeutic response to adjuvant chemotherapy in PDAC. Further research is warranted to validate its role in the risk stratification and optimization of therapeutic strategies.
Mechanical thrombectomy in basilar artery occlusions: impact of first-line strategy as a function of the occlusion level
Authors: Tournier Louis , Cortese Jonathan , Consoli Arturo , Spelle Laurent , Marnat Gaultier , Sarov Mariana , Zhu Francois , Soize Sebastien , Burel Julien , Forestier Géraud , Escalard Simon , Pop Raoul , Bonnet Baptiste , Alias Quentin , Ognard Julien , Naggara Olivier , Kyheng Maeva , Lapergue Bertrand , Caroff Jildaz 
Published: March 2024

BackgroundRetrospective studies suggest the superiority of first-line contact aspiration (CA) thrombectomy over stent-retriever (SR) in basilar artery occlusions (BAO). We aimed to investigate the impact of first-line mechanical thrombectomy per the occlusion level, considering differences in stroke etiology prevalence between proximal and distal BAO.MethodsA retrospective, multicentric analysis of the Endovascular Treatment in Ischemic Stroke Registry (ETIS) included consecutive BAO patients treated from January 2016 to May 2022. Patients were categorized into SR (±aspiration) and CA alone groups. Occlusion levels were determined through digital subtraction angiography. Favorable clinical outcome was defined as 90-day modified Rankin Scale (mRS) 0–3.ResultsA total of 380 patients were analyzed (251 CA alone, 129 SR±aspiration). Globally, first-line SR showed lower recanalization rates (89.1% vs 94.8%, OR=0.29, 95% CI 0.16 to 0.53; p<0.001) and worse clinical outcomes (mRS 0–3: 46.0% vs 52.2%, OR=0.62, 95% CI 0.44 to 0.87; p=0.006) compared with CA. In proximal occlusions, SR was significantly associated with poorer clinical outcomes (mRS 0–3: 20.9% vs 37.1%; OR=0.40, 95% CI 0.19 to 0.83; p=0.014) despite similar recanalization rates. Conversely, in distal occlusions there was no difference in clinical outcomes although recanalization rates were higher with CA (modified Thrombolysis in Cerebral Infarction score (mTICI 2b/3): 97.7% vs 91.7%; OR=0.17, 95% CI 0.05 to 0.66; p=0.01).ConclusionsIn our BAO population, CA demonstrated better angiographic outcomes in middle and distal occlusions and better clinical outcomes in proximal occlusions. This translated into better angiographic and clinical results in the global study population. Clinical results were particularly influenced by the negative impact of SR on 90-day mRS, independently of recanalization rates in proximal BAO.
Comparison of rescue intracranial stenting versus best medical treatment alone in acute refractory large vessel occlusion: study protocol for the PISTAR multicenter randomized trial
Authors: Premat Kévin , Dechartres Agnès , Baptiste Amandine , Guedon Alexis , Mazighi Mikael , Spelle Laurent , Denier Christian , Tuilier Titien , Hosseini Hassan , Lapergue Bertrand , Di Maria Federico , Bricout Nicolas , Henon Hilde , Gory Benjamin , Richard Sébastien , Chivot Cyril , Courselle Audrey , Velasco Stéphane , Lamy Mathias , Costalat Vincent , Arquizan Caroline , Marnat Gaultier , Sibon Igor , Lenck Stephanie , Shotar Eimad , Allard Julien , Sourour Nader , Degos Vincent , Alamowitch Sonia , Clarençon Frédéric 
Published: March 2024

BackgroundMechanical thrombectomy (MT) has become a standard treatment for acute ischemic strokes (AIS). However, MT failure occurs in approximately 10–30% of cases, leading to severe repercussions (with mortality rates up to 40% according to observational data). Among the available rescue techniques, rescue intracranial stenting (RIS) appears as a promising option.ObjectiveThis trial is poised to demonstrate the superiority of RIS in addition to the best medical treatment (BMT) in comparison with BMT alone, in improving the functional outcomes at 3 months for patients experiencing an AIS due to a large vessel occlusion refractory to MT (rLVO).MethodsPermanent Intracranial STenting for Acute Refractory large vessel occlusions (PISTAR) is a multicenter prospective randomized open, blinded endpoint trial conducted across 11 French University hospitals. Adult patients (≥18 years) with an acute intracranial occlusion refractory to standard MT techniques will be randomized 1:1 during the procedure to receive either RIS+BMT (intervention arm) or BMT alone (control arm).ResultsThe primary outcome is the rate of good clinical outcome at 3 months defined as a modified Rankin Scale score ≤2 and evaluated by an independent assessor blinded to the randomization arm. Secondary outcomes include hemorrhagic complications, all adverse events, and death. The number of patients to be included is 346. Two interim analyses are planned with predefined stopping rules.ConclusionThe PISTAR trial is the first randomized controlled trial focusing on the benefit of RIS in rLVOs. If positive, this study will open new insights into the management of AIS.Trial registration numberNCT06071091.
Trends in transcatheter aortic valve implantation practice and clinical outcomes at an Irish tertiary referral centre
Authors: Tanner Richard , Giacoppo Daniele , Saber Hassan , Barton David , Sugrue Declan , Roy Andrew , Blake Gavin , Spence Mark S , Margey Ronan , Casserly Ivan P 
Published: March 2024

ObjectiveA paucity of data exists on how transcatheter aortic valve implantation (TAVI) practice has evolved in Ireland. This study sought to analyse temporal trends in patient demographics, procedural characteristics, and clinical outcomes at an Irish tertiary referral centre.MethodsThe prospective Mater TAVI database was divided into time tertiles based on when TAVI was performed: Group A, November 2008–April 2013; Group B, April 2013–September 2017; and Group C, September 2017–February 2022. Patient and procedural characteristics and clinical outcomes were compared across groups.ResultsA total of 1063 (Group A, 59; Group B, 268; and Group C:, 736) patients were treated with TAVI during the study period (mean age 81.1±7.4, mean Society of Thoracic Surgeons score 5.9±5.1).Conscious sedation (Group A, 0%; Group B, 59.9%; and Group C, 90.2%, p<0.001) and femoral artery access (Group A, 76.3%; Group B, 90.7%; and Group C, 96.6%, p<0.001) were used more frequently over time. The median length of hospital stay reduced from 9 days (IQR 7, 18) in Group A to 2 days (IQR 2, 3) in Group C. In-hospital death was numerically higher in Group A compared with Group C (6.8% vs 1.9%, p=0.078). At 1-year follow-up, the rate of death and/or stroke was similar in Group A and Group C (20.3% vs 12.0%, adjusted HR 1.49, 95% CI (0.59 to 3.74)).ConclusionThere was exponential growth in TAVI procedural volume during the study period. A minimalist approach to TAVI emerged, and this was associated with significantly shorter procedure duration and hospital stay. Clinical outcomes at 1-year follow-up did not change significantly over time.