bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genetic diversity and recombination of bovine enterovirus strains in China
Authors: Chang Xiaoran , Zhang Zhiyuan , Cui Xuyuan , Zhang Qun , Lin Qian , Hu Junying , Guo Yidi , Wang Xinping 
Published: February 2024

ABSTRACT

Bovine enterovirus (BEV) consisting of enterovirus species E (EV-E) and F (EV-F) is the causative agent associated with respiratory and gastrointestinal diseases in cattle. Here, we reported the characterization, genetic diversity, and recombination of novel BEV strains isolated from the major cattle-raising regions in China during 2012–2018. Twenty-seven BEV strains were successfully isolated and characterized. Molecular characterization demonstrated that the majority of these novel BEV strains (24/27) were EV-E, while only few strains (3/27) were EV-F. Sequence analysis revealed the diversity of the circulating BEV strains such as species and subtypes where different species or subtype coinfections were detected in the same regions and even in the same cattle herds. For the EV-E, two novel subtypes, designated as EV-E6 and EV-E7, were revealed in addition to the currently reported EV-E1–EV-E5. Comparative genomic analysis revealed the intraspecies and interspecies genetic exchanges among BEV isolates. The representative strain HeN-B62 was probably from AN12 (EV-F7) and PS-87-Belfast (EV-F3) strains. The interspecies recombination between EV-E and EV-F was also discovered, where the EV-F7-AN12 might be from EV-E5 and EV-F1, and EV-E5-MexKSU/5 may be recombined from EV-F7 and EV-E1. The aforementioned results revealed the genetic diversity and recombination of novel BEV strains and unveiled the different BEV species or subtype infections in the same cattle herd, which will broaden the understanding of enterovirus genetic diversity, recombination, pathogenesis, and prevention of disease outbreaks.

IMPORTANCE
Bovine enterovirus (BEV) infection is an emerging disease in China that is characterized by digestive, respiratory, and reproductive disorders. In this study, we first reported two novel EV-E subtypes detected in cattle herds in China, unveiled the coinfection of two enterovirus species (EV-E/EV-F) and different subtypes (EV-E2/EV-E7, EV-E1/EV-E7, and EV-E3/EV-E6) in the same cattle herds, and revealed the enterovirus genetic exchange in intraspecies and interspecies recombination. These results provide an important update of enterovirus prevalence and epidemiological aspects and contribute to a better understanding of enterovirus genetic diversity, evolution, and pathogenesis.
Klebsiella pneumoniae
ST147 harboring
bla
NDM-1
, multidrug resistance and hypervirulence plasmids
Authors: Ofosu-Appiah Frederick , Acquah Ezra E. , Mohammed Jibril , Sakyi Addo Comfort , Agbodzi Bright , Ofosu Dorcas A. S. , Myers Charles J. , Mohktar Quaneeta , Ampomah Opoku-Ware , Ablordey Anthony , Amissah Nana Ama 
Published: February 2024

ABSTRACT

The spread of hypervirulent (hv) and carbapenem-/multidrug-resistant
Klebsiella pneumoniae
is an emerging problem in healthcare settings. The New Delhi metallo-β-lactamase-1 (
bla
NDM-1
) is found in Enterobacteriaceae including
K. pneumoniae.
The
bla
NDM-1
is capable of hydrolyzing β-lactam antibiotics which are used for treatment of severe infections caused by multidrug-resistant Gram-negative bacteria. This is associated with the unacceptably high mortality rate in immunocompromised burn injury patients. This study reports on the characterization of
bla
NDM-1
gene and virulence factors in hv carbapenem-/multidrug-resistant
K. pneumoniae
ST147 in the burns unit of a tertiary teaching hospital during routine surveillance. Two
K. pneumoniae
strains were obtained from wounds of burn-infected patients from May 2020 to July 2021. The hypervirulence genes and genetic context of the
bla
NDM-1
gene and mobile genetic elements potentially involved in the transposition of the gene were analyzed. We identified a conserved genetic background and an IS
26
and open reading frame flanking the
bla
NDM-1
gene that could suggest its involvement in the mobilization of the gene. The plasmid harbored additional antibiotic resistance predicted regions that were responsible for resistance to almost all the routinely used antibiotics. To ensure the identification of potential outbreak strains during routine surveillance, investigations on resistance genes and their environment in relation to evolution are necessary for molecular epidemiology.

IMPORTANCE

Data obtained from this study will aid in the prompt identification of disease outbreaks including evolving resistance and virulence of the outbreak bacteria. This will help establish and implement antimicrobial stewardship programs and infection prevention protocols in fragile health systems in countries with limited resources. Integration of molecular surveillance and translation of whole-genome sequencing in routine diagnosis will provide valuable data for control of infection. This study reports for the first time a high-risk clone
K. pneumoniae
ST147 with hypervirulence and multidrug-resistance features in Ghana.
A high-throughput target-based screening approach for the identification and assessment of
Mycobacterium tuberculosis
mycothione reductase inhibitors
Authors: Smiejkowska Natalia , Oorts Lauren , Van Calster Kevin , De Vooght Linda , Geens Rob , Mattelaer Henri-Philippe , Augustyns Koen , Strelkov Sergei V. , Lamprecht Dirk , Temmerman Koen , Sterckx Yann G.-J. , Cappoen Davie , Cos Paul 
Published: February 2024

ABSTRACT

The World Health Organization’s goal to combat tuberculosis (TB) is hindered by the emergence of anti-microbial resistance, therefore necessitating the exploration of new drug targets. Multidrug regimens are indispensable in TB therapy as they provide synergetic bactericidal effects, shorten treatment duration, and reduce the risk of resistance development. The research within our European RespiriTB consortium explores
Mycobacterium tuberculosis
energy metabolism to identify new drug candidates that synergize with bedaquiline, with the aim of discovering more efficient combination drug regimens. In this study, we describe the development and validation of a luminescence-coupled, target-based assay for the identification of novel compounds inhibiting
Mycobacterium tuberculosis
mycothione reductase (Mtr
Mtb
), an enzyme with a role in the protection against oxidative stress. Recombinant Mtr
Mtb
was employed for the development of a highly sensitive, robust high-throughput screening (HTS) assay by coupling enzyme activity to a bioluminescent readout. Its application in a semi-automated setting resulted in the screening of a diverse library of ~130,000 compounds, from which 19 hits were retained after an assessment of their potency, selectivity, and specificity. The selected hits formed two clusters and four fragment molecules, which were further evaluated in whole-cell and intracellular infection assays. The established HTS discovery pipeline offers an opportunity to deliver novel Mtr
Mtb
inhibitors and lays the foundation for future efforts in developing robust biochemical assays for the identification and triaging of inhibitors from high-throughput library screens.

IMPORTANCE

The growing anti-microbial resistance poses a global public health threat, impeding progress toward eradicating tuberculosis. Despite decades of active research, there is still a dire need for the discovery of drugs with novel modes of action and exploration of combination drug regimens. Within the European RespiriTB consortium, we explore
Mycobacterium tuberculosis
energy metabolism to identify new drug candidates that synergize with bedaquiline, with the aim of discovering more efficient combination drug regimens. In this study, we present the development of a high-throughput screening pipeline that led to the identification of
M. tuberculosis
mycothione reductase inhibitors.
Place of birth and postnatal transfers in infants with congenital diaphragmatic hernia in England and Wales: a descriptive observational cohort study
Authors: Nezafat Maldonado Behrouz , Lanoue Julia , Allin Benjamin , Hargreaves Dougal , Knight Marian , Gale Chris , Battersby Cheryl 
Published: February 2024

ObjectiveTo describe clinical pathways for infants with congenital diaphragmatic hernia (CDH) and short-term outcomes.DesignRetrospective observational cohort study using the UK National Neonatal Research Database (NNRD).PatientsBabies with a diagnosis of CDH admitted to a neonatal unit in England and Wales between 2012 and 2020.Main outcome measuresClinical pathways defined by place of birth (with or without colocated neonatal and surgical facilities), transfers, clinical interventions, length of hospital stay and discharge outcome.ResultsThere were 1319 babies with a diagnosis of CDH cared for in four clinical pathways: born in maternity units with (1) colocated tertiary neonatal and surgical units (‘neonatal surgical units’), 50% (660/1319); (2) designated tertiary neonatal unit and transfer to stand-alone surgical centre (‘tertiary designated’), 25% (337/1319); (3) non-designated tertiary neonatal unit (‘tertiary non-designated’), 7% (89/1319); or (4) non-tertiary unit (‘non-tertiary’), 18% (233/1319)—the latter three needing postnatal transfers. Infant characteristics were similar for infants born inneonatal surgicalandtertiary designatedunits. Excluding 149 infants with minimal data due to early transfer (median (IQR) 2.2 (0.4–4.5) days) to other settings, survival to neonatal discharge was 73% (851/1170), with a median (IQR) stay of 26 (16–44) days.ConclusionsWe found that half of the babies with CDH were born in hospitals that did not have on-site surgical services and required postnatal transfer. Similar characteristics between infants born in neonatal surgical units and tertiary designated units suggest that organisation rather than infant factors influence place of birth. Future work linking the NNRD to other datasets will enable comparisons between care pathways.
Prediction of retinopathy progression using deep learning on retinal images within the Scottish screening programme
Authors: Mellor Joseph , Jiang Wenhua , Fleming Alan , McGurnaghan Stuart J , Blackbourn Luke A K , Styles Caroline , Storkey Amos , McKeigue Paul M , Colhoun Helen M 
Published: February 2024

Background/aimsNational guidelines of many countries set screening intervals for diabetic retinopathy (DR) based on grading of the last screening retinal images. We explore the potential of deep learning (DL) on images to predict progression to referable DR beyond DR grading, and the potential impact on assigned screening intervals, within the Scottish screening programme.MethodsWe consider 21 346 and 247 233 people with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), respectively, each contributing on average 4.8 and 4.4 screening intervals of which 1339 and 4675 intervals concluded with a referable screening episode. Information extracted from fundus images using DL was used to predict referable status at the end of interval and its predictive value in comparison to screening-assigned DR grade was assessed.ResultsThe DL predictor increased the area under the receiver operating characteristic curve in comparison to a predictor using current DR grades from 0.809 to 0.87 for T1DM and from 0.825 to 0.87 for T2DM. Expected sojourn time—the time from becoming referable to being rescreened—was found to be 3.4 (T1DM) and 2.7 (T2DM) weeks less for a DL-derived policy compared with the current recall policy.ConclusionsWe showed that, compared with using the current retinopathy grade, DL of fundus images significantly improves the prediction of incident referable retinopathy before the next screening episode. This can impact screening recall interval policy positively, for example, by reducing the expected time with referable disease for a fixed workload—which we show as an exemplar. Additionally, it could be used to optimise workload for a fixed sojourn time.
Responsiveness of services rendered at primary healthcare facilities of Bharatpur, Nepal: a cross-sectional study
Authors: Adhikari Anup , Paneru Damaru Prasad , Pokhrel Amshu 
Published: February 2024

IntroductionResponsiveness of services refers to the way healthcare systems and providers interact with patients and how well they meet patients’ non-clinical expectations and needs. The responsiveness is a crucial aspect of a well-functioning health system while primary healthcare is considered as its foundational cornerstone. However, in low and middle-income countries, there are numerous obstacles to its efficient operation and a very limited understanding of the concept of service responsiveness. This study aimed to assess the responsiveness of services and identify associated factors at primary healthcare facilities of Bharatpur, Nepal.MethodsA facility-based cross-sectional study was carried out among 358 patients visiting outpatient department (OPD) of primary healthcare facilities of Bharatpur. A pretested structured interview schedule was used to conduct a face-to-face interview to obtain the information per the study’s objective. Univariate as well as bivariable and multivariable logistic regressions were carried out to obtain the result per our objectives.ResultsThe overall performance of the responsiveness of services was 74.6% (95% CI 70.1 to 78.8), dignity being the highest performing domain (97.2%) and choice being the lowest (22.6%). Respondents aged more than or equal to 50 (adjusted OR (AOR)=4.107, 95% CI 1.28 to 13.14), those who are satisfied with the service (AOR=7.02, 95% CI 3.21 to 15.36), those who perceive high quality of care (AOR=5.69, 95% CI 2.54 to 12.73) and those who did not have to pay for transportation (AOR=4.63, 95% CI 2.20 to 9.72) showed higher responsiveness.ConclusionThe primary healthcare facilities of Bharatpur, Nepal demonstrated nearly three-quarters of the respondents reporting good responsiveness of services at OPD. To further enhance the level of responsiveness, strengthening the referral networks, empowering patients in decision-making and prioritising patient satisfaction and quality of services can help.
Multimodal strategies to hand hygiene in Ghanaian hospitals: a cross-sectional study in the Eastern Region of Ghana
Authors: Dubik Stephen Dajaan , Amegah Kingsly E , Owusu-Asare Ama Akyampomaa , Kwakye Akosua Takyiwa , Akufo Christiana , Amponsah Joyce , Awekeya Hectoria , Vander Puije Leslie , Asibey Jocelyn , Twum Seth , Akwetey Francis Mensa , Sam Portia , Ofosu Winfred , Ackon Angela , Asrat Sofonias , Kwesi Hedidor George , Ohene Sally-Ann , Ashinyo Mary Eyram 
Published: February 2024

BackgroundHand hygiene (HH) is one of the core components of infection prevention and control and is critical for a high quality of care. Multimodal approaches are recommended to strengthen and drive HH systems in healthcare facilities (HCFs). We aimed to assess the extent of implementation of the WHO HH multimodal improvement strategy in HCFs in the Eastern Region of Ghana.MethodsThis study was a descriptive cross-sectional study involving 22 HCFs from 17 districts in the Eastern Region of Ghana. We collected data from 22 hospitals using the WHO Hand Hygiene Self-Assessment Framework (HHSAF). Data were analysed through descriptive statistics.ResultsThe HHSAF median score denotes an intermediate HH implementation level (53.5%, IQR 48.8%–58.3%). Fourteen HCFs attained an intermediate level, five attained basic level, one attained advanced level and no facility exhibited inadequate HH implementation level. Evaluation and feedback had the highest score (64.3%, IQR 50%–71.4%), as ward-based audits for the availability of HH resources have become standard practice in many of the HCFs. Reminders in the workplace had the lowest score (33.3%, IQR 25.9%–37.0%), whereby less than half (46%) of the HCFs had posters explaining the indications for HH and the correct use of alcohol-based hand rubs. HH implementation level did not differ significantly among government (M=49.97, SD=12.30) and non-government (M=53.32, SD=18.73) facilities, (t (20)=−0.503, p=0.621).ConclusionMost HCFs had an intermediate HH implementation level. The provision of HH resources, including posters, HH rounds in patient care areas, introduction of HH corners, leadership, financial and organisational support are key elements for increased compliance with the WHO HH multimodal improvement strategy.
Current practice, guideline adherence, and barriers to implementation for Achilles tendinopathy rehabilitation: a survey of physical therapists and people with Achilles tendinopathy
Authors: Merry Kohle , MacPherson Megan M , Blazey Paul , Fearon Angie , Hunt Michael , Morrissey Dylan , Napier Christopher , Reid Duncan , Whittaker Jackie L , Willy Richard W , Scott Alex 
Published: February 2024

ObjectiveTo explore clinical practice patterns of physical therapists (PTs) who treat people with Achilles tendinopathy (AT), and identify perceived barriers and facilitators for prescribing and engaging with therapeutic exercise among PTs and people with AT.MethodsTwo cross-sectional surveys were electronically distributed between November 2021 and May 2022; one survey was designed for PTs while the second was for people with AT. Survey respondents answered questions regarding their physical therapy training and current practice (PTs), injury history and management (people with AT), and perceived barriers and facilitators (PTs and people with AT).Results341 PTs and 74 people with AT completed the surveys. In alignment with clinical practice guidelines, more than 94% of PTs surveyed (97% of whom had some form of advanced musculoskeletal training) prioritise patient education and therapeutic exercise. Patient compliance, patient knowledge, and the slow nature of recovery were barriers to prescribing therapeutic exercise reported by PTs, while time, physical resources, and a perceived lack of short-term treatment effectiveness were barriers for people with AT.ConclusionsConsistent with clinical practice guidelines, PTs with advanced training reported prioritising therapeutic exercise and education for managing AT. However, both PTs and people with AT identified many barriers to prescribing or engaging with therapeutic exercise. By addressing misconceptions about the time burden and ineffectiveness of exercise, and by overcoming access issues to exercise space and equipment, PTs may be able to improve intervention adherence and subsequently outcomes for people with AT.
External validation of a rapid algorithm using high-sensitivity troponin assay results for evaluating patients with suspected acute myocardial infarction
Authors: Cullen Louise , Greenslade Jaimi H , Stephensen Laura , Ranasinghe Isuru , Gaikwad Niranjan , Khorramshahi Bayat Maryam , Mahmoodi Ehsan , Than Martin , Apple Fred , Parsonage William 
Published: February 2024

ObjectiveWe sought to validate the clinical performance of a rapid assessment pathway incorporating the Siemens Atellica IM high sensitivity cardiac troponin I (hs-cTnI) assay in patients presenting to the emergency department (ED) with suspected acute myocardial infarction (AMI).MethodsThis was a multicentre prospective observational study of adult ED patients presenting to five Australian hospitals between November 2020 and September 2021. Participants included those with symptoms of suspected AMI (without ST-segment elevation MI on presentation ECG). The Siemen’s Atellica IM hs-cTnI laboratory-based assay was used to measure troponin concentrations at admission and after 2–3 hours and cardiologists adjudicated final diagnoses. The HighSTEACS diagnostic algorithm was evaluated, incorporating hs-cTnI concentrations at presentation and absolute changes within the first 2 to 3 hours. The primary outcome was index AMI, including type 1 or 2 non-ST segment elevation MI (NSTEMI) or ST-elevation MI (STEMI) following presentation. 30-day major adverse cardiac outcomes (including AMI, urgent revascularisation or cardiac death) were also reported. The trial was registered with the Australian and New Zealand Clinical Trials Registry.Results1994 patients were included. The average age was 56.2 years (SD=15.6), and 44.9% were women. 118 (5.9%) patients had confirmed index AMI. The 2-hour algorithm defined 61.3% of patients as low risk. Sensitivity was 99.1% (94.0%–99.9%) and negative predictive value was 99.9% (99.3%–100%). 24.4% of patients were deemed intermediate risk. When applying the parameters for high risk, 252 (14.3%) were identified, with a specificity of 91.5% (88.7%–93.6%) and a PPV of 42.0% (35.6–48.7%).ConclusionsA 2-hour algorithm based on the HighSTEACS strategy using the Siemens Atellica IM hs-cTnI laboratory-based assay enables safe and efficient risk assessment of emergency patients with suspected AMI.Trial registration numberACTRN12621000053820.
Efficacy and safety of novel left ventricular pacing leads: 1-year analysis of the NAVIGATOR trial
Authors: Martinez Juan Gabriel , De Sousa Joao , Dompnier Antoine , Martins -Oliveira Mario , Israel Carsten W , Teijeira Elvis , Rubin José Manuel , Sebag Frederic , Martino Maria , Michel Yann , Marques Pedro 
Published: February 2024

ObjectivesAssess safety and performance of novel quadripolar preshaped left ventricular (LV) leads: NAVIGO 4LV 2D (‘S shaped’) and NAVIGO 4LV ARC (‘U shaped’).MethodsPatients indicated for cardiac resynchronisation therapy were enrolled in a multicentre, prospective, controlled study (NAVIGATOR,NCT03279484). Patients were implanted with either a NAVIGO 4LV 2D or ARC lead, and assessed at 10 weeks, 6, 12 and 24 months post-implant. Co-primary safety and performance endpoints were assessed at 10 weeks. Safety endpoint was the patients’ rate free from lead-related complications. Performance endpoint was the rate of patients with successful lead performance, defined as LV pacing threshold ≤2.5 V at 0.5 ms on at least one pacing vector, and the absence of phrenic nerve stimulation at the final programmed configuration. Lead-related complications and electrical parameters were monitored throughout study.ResultsA NAVIGO 4LV lead was successfully implanted in 211 out of 217 patients (97.2%). The safety endpoint was met, with 100% and 96.1% of patients free from complications for NAVIGO 4LV 2D and ARC, respectively. The performance endpoint was met with 98.1% and 98.9% of patients with a successful lead performance for NAVIGO 4LV 2D and ARC, respectively. Over 12 months, the global complication-free rate for both leads was 97.1% (95% CI: 93.71% to 98.70%), with a mean pacing capture threshold of 1.23 V±0.73 V and a mean impedance of 951 Ω±300.1 Ω.ConclusionA high implantation success rate and low complication rate was reported for the novel NAVIGO 4LV 2D and ARC leads, along with successful performance up to 12 months.