bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hyperbaric Oxygen Enabled a Transition to Oral Steroids in an Acute Severe Ulcerative Colitis Flare
Authors: Hennessey Megan M , Zelman Sara R , Hannigan Pam M , Wilkinson Kimberly B , Siegel Corey A , Buckey Jay C 
Published: March 2024

Abstract

Background
Ulcerative colitis (UC) is characterized in part by a dysregulated response to tissue hypoxia. While intravenous (IV) steroids are the mainstay of treatment for acute severe UC (ASUC), up to one-third of patients are refractory to steroids alone and require rescue therapy.

Case Description
A 71-year-old female with extensive UC on infliximab presented with abdominal pain and more than 10 bloody bowel movements per day. Her infliximab concentration was undetectable with a positive antibody level. Flexible sigmoidoscopy on hospital day (HD)1 showed Mayo 3 colitis; biopsies for CMV were negative. She was started on hydrocortisone IV with improvement in her CRP from 56 to 40 mg/L. She also received 1 dose of vedolizumab. Hyperbaric treatments were offered but declined. By HD5, she was clinically improved, with a CRP of 9 mg/L. She was transitioned from IV to oral steroids. After starting oral steroids her symptoms relapsed, her CRP increased from 9 to 48 mg/L, and IV steroids were reinitiated on HD6. Hyperbaric medicine was reconsulted and she completed 5 hyperbaric oxygen (HBO2) treatments (HD 7–11) with prompt reduction in CRP, stool frequency, and bleeding. After 3 HBO2 treatments, she transitioned successfully from IV to oral steroids on HD9.

Conclusions
This case demonstrates the potential of HBO2 therapy to help UC patients transition successfully from IV to oral steroids who were previously refractory to de-escalation. HBO2 therapy may be considered as an adjunctive treatment for patients with ASUC to potentiate the effects of standard therapies and avoid progression to colectomy.
Influence of angiotensin II on the gut microbiome: modest effects in comparison to experimental factors
Authors: R Muralitharan Rikeish , Nakai Michael E , Snelson Matthew , Zheng Tenghao , Dinakis Evany , Xie Liang , Jama Hamdi , Paterson Madeleine , Shihata Waled , Wassef Flavia , Vinh Antony , Drummond Grant R , Kaye David M , Mackay Charles R , Marques Francine Z 
Published: March 2024

Abstract

Aims
Animal models are regularly used to test the role of the gut microbiome in hypertension. Small-scale pre-clinical studies have investigated changes to the gut microbiome in the angiotensin II hypertensive model. However, the gut microbiome is influenced by internal and external experimental factors, which are not regularly considered in the study design. Once these factors are accounted for, it is unclear if microbiome signatures are reproduceable. We aimed to determine the influence of angiotensin II treatment on the gut microbiome using a large and diverse cohort of mice and to quantify the magnitude by which other factors contribute to microbiome variations.

Methods and results
We conducted a retrospective study to establish a diverse mouse cohort resembling large human studies. We sequenced the V4 region of the 16S rRNA gene from 538 samples across the gastrointestinal tract of 303 male and female C57BL/6J mice randomized into sham or angiotensin II treatment from different genotypes, diets, animal facilities, and age groups. Analysing over 17 million sequencing reads, we observed that angiotensin II treatment influenced α-diversity (P = 0.0137) and β-diversity (i.e. composition of the microbiome, P &lt; 0.001). Bacterial abundance analysis revealed patterns consistent with a reduction in short-chain fatty acid producers, microbial metabolites that lower blood pressure. Furthermore, animal facility, genotype, diet, age, sex, intestinal sampling site, and sequencing batch had significant effects on both α- and β-diversity (all P &lt; 0.001). Sampling site (6.8%) and diet (6%) had the largest impact on the microbiome, while angiotensin II and sex had the smallest effect (each 0.4%).

Conclusion
Our large-scale data confirmed findings from small-scale studies that angiotensin II impacted the gut microbiome. However, this effect was modest relative to most of the other factors studied. Accounting for these factors in future pre-clinical hypertensive studies will increase the likelihood that microbiome findings are replicable and translatable.
Spondyloarthritis in First-Degree Relatives and Spouses of Patients with Inflammatory Bowel Disease: A Nationwide Population-based Cohort Study from Sweden
Authors: Shrestha Sarita , Brand Judith S , Osooli Mehdi , Eriksson Carl , Schoultz Ida , Askling Johan , Jess Tine , Montgomery Scott , Olén Ola , Halfvarson Jonas 
Published: March 2024

Abstract

Background and Aims
Register-based research suggests a shared pathophysiology between inflammatory bowel disease [IBD] and spondyloarthritis [SpA], but the role of familial [genetic and environmental] factors in this shared susceptibility is largely unknown. We aimed to compare the risk of SpA in first-degree relatives [FDRs] and spouses of IBD patients with FDRs and spouses of matched, population-based, reference individuals.

Methods
We identified 147 080 FDRs and 25 945 spouses of patients with incident IBD [N = 39 203] during 2006–2016, and 1 453 429 FDRs and 258 098 spouses of matched reference individuals [N = 390 490], by linking nationwide Swedish registers and gastrointestinal biopsy data. Study participants were followed 1987–2017. Cox regression was used to estimate hazard ratios [HRs] of SpA.

Results
During follow-up, 2430 FDRs of IBD patients [6.5/10 000 person-years] and 17 761 FDRs of reference individuals [4.8/10 000 person-years] were diagnosed with SpA, corresponding to an HR of 1.35 [95% CI:1.29, 1.41]. In subgroup analyses, the increased risk of SpA was most pronounced in FDRs of Crohn’s disease patients [HR = 1.44; 95% CI:1.34,1.5 6] and of IBD patients aged &lt;18 years at diagnosis [HR = 1.46; 95% CI: 1.27, 1.68]. IBD patients’ spouses also had a higher SpA rate than reference individuals’ spouses, but the difference was less pronounced [4.3 vs 3.5/10 000 person-years; HR = 1.22; 95% CI:1.09, 1.37]. No subgroup-specific risk pattern was identified among spouses.

Conclusions
The observed shared familial risks between IBD and SpA support shared genetic factors in their pathogenesis. However, spouses of IBD patients were also at increased risk for SpA, reflecting the influence of environmental exposures or similarities in health-seeking patterns.
Multireceptor phage cocktail against Salmonella enterica to circumvent phage resistance
Authors: Martinez-Soto Carlos E , McClelland Michael , Kropinski Andrew M , Lin Janet T , Khursigara Cezar M , Anany Hany 
Published: March 2024

Abstract
Non-Typhoidal Salmonella (NTS) is one of the most common food-borne pathogens worldwide, with poultry products being the major vehicle for pathogenesis in humans. The use of bacteriophage (phage) cocktails has recently emerged as a novel approach to enhancing food safety. Here, a multireceptor Salmonella phage cocktail of five phages was developed and characterized. The cocktail targets four receptors: O-antigen, BtuB, OmpC, and rough Salmonella strains. Structural analysis indicated that all five phages belong to unique families or subfamilies. Genome analysis of four of the phages showed they were devoid of known virulence or antimicrobial resistance factors, indicating enhanced safety. The phage cocktail broad antimicrobial spectrum against Salmonella, significantly inhibiting the growth of all 66 strains from 20 serovars tested in vitro. The average bacteriophage insensitive mutant (BIM) frequency against the cocktail was 6.22 × 10−6 in S. Enteritidis, significantly lower than that of each of the individual phages. The phage cocktail reduced the load of Salmonella in inoculated chicken skin by 3.5 log10 CFU/cm2 after 48 h at 25°C and 15°C, and 2.5 log10 CFU/cm2 at 4°C. A genome-wide transduction assay was used to investigate the transduction efficiency of the selected phage in the cocktail. Only one of the four phages tested could transduce the kanamycin resistance cassette at a low frequency comparable to that of phage P22. Overall, the results support the potential of cocktails of phage that each target different host receptors to achieve complementary infection and reduce the emergence of phage resistance during biocontrol applications.
The Natural History of Patients With Pre-Existing and De Novo Inflammatory Bowel Disease After Solid Organ Transplantation: EITOS Study of GETECCU
Authors: Bastón-Rey Iria , Rodríguez-Lago Iago , Luque Ana María , Caballol Berta , Soutullo-Castiñeiras Carlos , Bravo Ana , Castaño Andrés , Gros Beatriz , Bernal Lorena , Diz-Lois María Teresa , Alonso-Galán Horacio , Cañete Fiorella , Castro Beatriz , Pérez-Galindo Pablo , González-Muñoza Carlos , El Hajra Ismael , Martínez-Montiel Pilar , Alonso-Abreu Inmaculada , Mesonero Francisco , González-Vivo María , Peries Laia , Martín-Arranz Eduardo , Abril Carlos , Marín-Jiménez Ignacio , Baltar Ruth , Vicuña Miren , Moreno Nadia , Brunet Eduard , Rubín de Célix Cristina , Fajardo Ingrid , Cruz Noelia , Calvino-Suárez Cristina , Rojas-Feria María , Fernández-Clotet Agnes , Gimeno-Torres Marta , Nieto-Garcia Laura , de la Iglesia Daniel , Zabana Yamile , Suárez-Ferrer Cristina , Barreiro de Acosta Manuel 
Published: March 2024

Abstract

Background
Limited data are available on the outcome of inflammatory bowel disease (IBD) in patients with solid organ transplantation (SOT). We describe the natural history of pre-existing IBD and de novo IBD after SOT.

Methods
This was a retrospective, multicenter study that included patients with pre-existing IBD at the time of SOT and patients with de novo IBD after SOT. The primary outcome was IBD progression, defined by escalation of medical treatment, surgical therapy, or hospitalization due to refractory IBD. Risk factors were identified using multivariate Cox proportional hazard analysis.

Results
A total of 177 patients (106 pre-existing IBD and 71 de novo IBD) were included. Most patients with pre-existing IBD (92.5%) were in remission before SOT. During follow-up, 32% of patients with pre-existing IBD had disease progression, with a median time between SOT and IBD progression of 2.2 (interquartile range, 1.3-4.6) years. In the de novo cohort, 55% of patients had disease progression with a median time to flare of 1.9 (interquartile range, 0.8-3.9) years after diagnosis. In the pre-existing IBD cohort, active IBD at the time of SOT (hazard ratio, 1.80; 95% confidence interval, 1.14-2.84; P = .012) and the presence of extraintestinal manifestations (hazard ratio, 3.10; 95% confidence interval, 1.47-6.54; P = .003) were predictive factors for IBD progression.

Conclusions
One-third of patients with pre-existing IBD and about half of patients with de novo IBD have disease progression after SOT. Active IBD at the time of SOT and the presence of extraintestinal manifestations were identified as risk factors for IBD progression.
Dielectric elastomer actuator-based valveless pump as Fontan failure assist device: introduction and preliminary study
Authors: Benouhiba Amine , Walter Armando , Jahren Silje Ekroll , Martinez Thomas , Clavica Francesco , Heinisch Paul Philipp , Obrist Dominik , Civet Yoan , Perriard Yves 
Published: March 2024

Abstract

OBJECTIVES
Fontan failure refers to a condition in which the Fontan circulation, a surgical procedure used to treat certain congenital heart defects, becomes insufficient, leading to compromised cardiac function and potential complications. This in vitro study therefore investigates the feasibility of bladeless impedance-driven cavopulmonary assist device via dielectric elastomer actuator (DEA) as a means to address Fontan failure.

METHODS
A cavopulmonary assist device, constructed using DEA technologies and employing the impedance pump concept, is subjected to in vitro testing within a closed-loop setup. This study aims to assess the device's functionality and performance under controlled conditions, providing valuable insights into its potential application as a cavopulmonary assistive technology.

RESULTS
The DEA-based pump, measuring 50 mm in length and 30 mm in diameter, is capable of achieving substantial flow rates within a closed-loop setup, reaching up to 1.20 l/min at an activation frequency of 4 Hz. It also provides a broad range of working internal pressures (&lt;10 to &gt;20 mmHg). Lastly, the properties of the flow (direction, magnitude, etc.) can be controlled by adjusting the input signal parameters (frequency, amplitude, etc.).

CONCLUSIONS
In summary, the results suggest that the valveless impedance-driven pump utilizing DEA technology is promising in the context of cavopulmonary assist devices. Further research and development in this area may lead to innovative and potentially more effective solutions for assisting the right heart, ultimately benefiting patients with heart-related health issues overall, with a particular focus on those experiencing Fontan failure.
Impact of intraoperative haemoadsorption on outcomes of patients undergoing aortic surgery: a single-centre, prospective, observational study
Authors: Mehta Yatin , Singh Ajmer , Singh Mandeep , Bhan Anil , Trehan Naresh 
Published: March 2024

Abstract

OBJECTIVES
To investigate the impact of a cytokine haemoadsorption (HA) device (CytoSorb®) on inflammatory markers and patients’ outcome during aortic root surgery.

METHODS
Prospective, observational study including all-comers with quasi-randomization by strictly alternating inclusion (1:1 basis). Sixty patients undergoing elective aortic surgery were assigned to either HA group (n = 30) with intraoperative HA, or a control (C) group (n = 30). Primary outcomes were: (i) impact of HA on haemodynamic stability and need for vasopressors (vasoactive–inotropic score) and (ii) sequential organ failure assessment (SOFA) score. Secondary parameters included the impact of HA on the course of hyperinflammation using interleukin-6 and procalcitonin, duration of mechanical ventilation, and lengths of intensive care unit and hospital stay.

RESULTS
Noradrenaline requirement was significantly reduced in the HA group postoperatively compared to the C group (HA: 0.03 µg/kg/min vs C: 0.08 µg/kg/min, P = 0.004 at 2 h, and HA: 0.02 µg/kg/min vs C: 0.04 µg/kg/min, P = 0.004 at 24 h). This translated into a significantly lower vasoactive–inotropic score in the HA group. SOFA score was less in the HA group at all time points and reached statistical significance 2 h postoperatively (HA: 5.77 vs C: 7.43, P &lt; 0.001). Intraoperative HA significantly reduced interleukin-6 levels (P &lt; 0.05) at all time points, and procalcitonin at 2 h after discontinuation from cardiopulmonary bypass (P = 0.005). The duration of ventilation, intensive care unit and hospital stays were shorter in the HA group compared to the C group.

CONCLUSIONS
Intraoperative HA has the potential to mitigate hyperinflammatory response leading to improved haemodynamics after aortic root surgery, thereby shortening the duration of ventilation, and lengths of intensive care unit and hospital stay. However, it must be evaluated in larger cohorts.
Short-term exposure to air pollution and hospital admission after COVID-19 in Catalonia: the COVAIR-CAT study
Authors: Alari Anna , Ranzani Otavio , Olmos Sergio , Milà Carles , Rico Alex , Ballester Joan , Basagaña Xavier , Dadvand Payam , Duarte-Salles Talita , Nieuwenhuijsen Mark , Vivanco-Hidalgo Rosa Maria , Tonne Cathryn 
Published: March 2024

Abstract

Background
A growing body of evidence has reported positive associations between long-term exposure to air pollution and poor COVID-19 outcomes. Inconsistent findings have been reported for short-term air pollution, mostly from ecological study designs. Using individual-level data, we studied the association between short-term variation in air pollutants [nitrogen dioxide (NO2), particulate matter with a diameter of &lt;2.5 µm (PM2.5) and a diameter of &lt;10 µm (PM10) and ozone (O3)] and hospital admission among individuals diagnosed with COVID-19.

Methods
The COVAIR-CAT (Air pollution in relation to COVID-19 morbidity and mortality: a large population-based cohort study in Catalonia, Spain) cohort is a large population-based cohort in Catalonia, Spain including 240 902 individuals diagnosed with COVID-19 in the primary care system from 1 March until 31 December 2020. Our outcome was hospitalization within 30 days of COVID-19 diagnosis. We used individual residential address to assign daily air-pollution exposure, estimated using machine-learning methods for spatiotemporal prediction. For each pandemic wave, we fitted Cox proportional-hazards models accounting for non-linear-distributed lagged exposure over the previous 7 days.

Results
Results differed considerably by pandemic wave. During the second wave, an interquartile-range increase in cumulative weekly exposure to air pollution (lag0_7) was associated with a 12% increase (95% CI: 4% to 20%) in COVID-19 hospitalizations for NO2, 8% (95% CI: 1% to 16%) for PM2.5 and 9% (95% CI: 3% to 15%) for PM10. We observed consistent positive associations for same-day (lag0) exposure, whereas lag-specific associations beyond lag0 were generally not statistically significant.

Conclusions
Our study suggests positive associations between NO2, PM2.5 and PM10 and hospitalization risk among individuals diagnosed with COVID-19 during the second wave. Cumulative hazard ratios were largely driven by exposure on the same day as hospitalization.
Race and International Organizations
Authors: Oksamytna Kseniya , von Billerbeck Sarah 
Published: March 2024

Abstract
While International Relations scholarship has increasingly addressed questions of race, the literature on international organizations (IOs) has been slower to do so. In particular, it has neglected how race functions within IO workforces. Building on sociological theories of racialized organizations, we develop the concept of racialized IOs. Like domestic organizations, racialized IOs are characterized by enhanced or inhibited agency of racial groups, racialized distribution of resources, credentialing of whiteness, and decoupling of formal rules and informal practices along racial lines. However, there are also two important differences. First, since IOs rely on member states for resources, their secretariats need to accommodate powerful white-majority countries (macro-level pressures). Second, since IO workforces are diverse, their employees may bring a range of racial stereotypes that exist in their societies into their professional practice (micro-level pressures). Using the case of UN peacekeeping, we demonstrate how the four features of racialized organizations operate in light of these macro- and micro-level pressures. We show that locally hired peacekeeping staff face constraints on exercising agency; that non-white peacekeepers perform more dangerous jobs than their white counterparts; that whiteness serves as a proxy for desirable skills while non-white peacekeepers’ knowledge is devalued; and that peacekeepers from white-majority countries receive special treatment or deviate from UN-wide procedures.
Investigating the cause of increased tetracycline-resistant Neisseria gonorrhoeae in England, 2016–20
Authors: Pitt-Kendall Rachel , Sun Suzy , Hughes Stephen , Merrick Rachel , Donaldson Hugo , Rayment Michael , Ivanov Zdravko , Day Michaela , Bari Aisha , Rebec Monica , Callan Emma , Mohammed Hamish , Sinka Katy , Cole Michelle , Fifer Helen 
Published: March 2024

Abstract

Background
Antimicrobial resistance in Neisseria gonorrhoeae is a global public health concern. Tetracycline resistance (TetR) increased from 39.4% to 75.2% between 2016 and 2021 in N. gonorrhoeae isolates collected through national surveillance in England, despite the absence of use of tetracyclines for the treatment of gonorrhoea.

Objectives
We investigated whether there was correlation between bacterial sexually transmitted infection (STI) tests performed and treatment with antimicrobials, with increased TetR in N. gonorrhoeae.

Methods
We examined correlations between bacterial STI tests, antimicrobial treatment and TetR in N. gonorrhoeae, using national surveillance data from three large sexual health services (SHS) in London during 2016–20. Doxycycline prescribing data and antibiograms of a non-STI pathogen from distinct patient groups (sexual health, obstetric and paediatric), at a large London hospital, were analysed to identify if doxycycline use in SHS was associated with resistance in a non-STI organism.

Results
A substantial increase in TetR was observed, particularly in isolates from gay, bisexual and other MSM (GBMSM). Strong positive correlations were observed exclusively in GBMSM between N. gonorrhoeae TetR and both bacterial STI tests (r = 0.97, P = 0.01) and antimicrobial treatment (r = 0.87, P = 0.05). Doxycycline prescribing increased dramatically during the study period in SHS. Prevalence of TetR in Staphylococcus aureus was higher in isolates sourced from SHS attendees than those from other settings.

Conclusions
Frequent screening of GBMSM at higher risk of STIs, such as those on pre-exposure prophylaxis (PrEP) leading to/and increased use of doxycycline for the treatment of diagnosed infections, may account for the increase in TetR in N. gonorrhoeae.
The antibiotic knowledge, attitudes and behaviours of patients purchasing antibiotics with prescription in Russia: a qualitative, comparative analysis
Authors: Rachina Svetlana , Zakharenkova Polina , Kozlov Roman , Palagin Ivan , Shishkina Ksenia , Strelkova Daria , Mamchich Daria 
Published: March 2024

Abstract

Objectives
The study aimed to investigate behaviour, knowledge and practices towards antibiotic (AB) use among patients who purchased ABs with a prescription across Russia.

Methods
Semi-structured interviews conducted in all eight Federal Districts, Moscow and Saint Petersburg in 2022 by 21 researchers trained specifically for this study. Data were analysed using a directed content analysis approach.

Results
In total, 151 respondents were interviewed. Respiratory symptoms were the most common reason for AB prescription. The majority of patients discussed their complaints with family members or friends before consulting the physician and occasionally looked for information on antimicrobial treatment on the internet. The decision to use an AB was usually made by the physician, although patients often anticipated its prescription. Respondents typically chose to go to the nearest drug store to pick up the medicines, not seeking any recommendation from the local pharmacists. The level of knowledge about the effects of ABs was generally low. In most cases, patients were not aware of antimicrobial resistance and rarely recalled any information campaigns targeting prudent AB use. Respondents admitted COVID-19 had an impact on their behaviour: they have become more caring towards their health, but less likely to seek medical care because of the risk of infection.

Conclusions
Our findings, in particular low awareness of the population about the effects of ABs and antimicrobial resistance, peculiarities of attitudes and behaviour (significant influence of the environment, tendency to self-diagnose, fairly high level of trust in doctors etc.) can be useful for the development of effective initiatives aiming for prudent AB use.