bluuebunny/crossref_metadata_2025_split huggingface dataset:
Higher Levels of SARS-CoV-2 Genetic Variation in Immunocompromised Patients: A Retrospective Case-Control Study
Authors: Guilbaud Romane , Franco Yusti Anna-Maria , Leducq Valentin , Zafilaza Karen , Bridier-Nahmias Antoine , Todesco Eve , Soulie Cathia , Fauchois Antoine , Le Hingrat Quentin , Kramer Laura , Goulenok Tiphaine , Salpin Mathilde , Daugas Eric , Dorent Richard , Ottaviani Sébastien , Zalcman Gérard , Ghosn Jade , Choquet Sylvain , Cacoub Patrice , Amoura Zahir , Barroux Benoit , Pourcher Valérie , Spano Jean-Philippe , Louet Martine , Marcelin Anne-Geneviève , Calvez Vincent , Charpentier Charlotte , Descamps Diane , Marot Stéphane , Ferré Valentine Marie , Coppée Romain 
Published: November 2023

Abstract

Background
A severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection lasts longer in immunocompromised hosts than in immunocompetent patients. Prolonged infection is associated with a higher probability of selection for novel SARS-CoV-2 mutations, particularly in the spike protein, a critical target for vaccines and therapeutics.

Methods
From December 2020 to September 2022, respiratory samples from 444 immunocompromised patients and 234 health care workers positive for SARS-CoV-2, diagnosed at 2 hospitals in Paris, France, were analyzed using whole-genome sequencing using Nanopore technology. Custom scripts were developed to assess the SARS-CoV-2 genetic diversity between the 2 groups and within the host.

Results
Most infections were SARS-CoV-2 Delta or Omicron lineages. Viral genetic diversity was significantly higher in infections of immunocompromised patients than those of controls. Minor mutations were identified in viruses sequenced from immunocompromised individuals, which became signature mutations for newer SARS-CoV-2 variants as the epidemic progressed. Two patients were coinfected with Delta and Omicron variants. The follow-up of immunocompromised patients revealed that the SARS-CoV-2 genome evolution differed in the upper and lower respiratory tracts.

Conclusions
This study found that SARS-CoV-2 infection in immunocompromised patients is associated with higher genetic diversity, which could lead to the emergence of new SARS-CoV-2 variants with possible immune evasion or different virulence characteristics.
Oiling the War Machine? The Fuel Dilemma and Warfighting Capability
Authors: Kim Inwook 
Published: November 2023

AbstractOil is a double-edged sword in modern warfare for its usage enables greater firepower and mobility in combats while imposing tremendous operational and strategic burden to run and defend Wartime Fuel Network. The tension between the two generates a fuel dilemma, a consequential trade-off between fuel-powered capability and fuel sustainability. States facing the dilemma address it with three fuel management practices: minimalism, control, and gamble. I describe promises and pitfalls of each measure with three illustrative case studies—the Japanese “gamble” during WWII, Chinese “control” in the Korean War, and Vietnamese “minimalism” during the Vietnam War. The theory and evidence have important implications for future research on military logistics, warfighting capability, and the study of conventional warfare.
Antimicrobial prescribing in a secondary care setting during the COVID-19 pandemic
Authors: Tadros Michael M , Boshra Marian S , Scott Michael , Fleming Glenda , Magee Fidelma , Hamed Mohammad I , Abuelhana Ahmed , Courtenay Aaron , Salem Heba F , Burnett Kathryn 
Published: November 2023

Abstract

Background
Increased antimicrobial resistance patterns lead to limited options for antimicrobial agents, affecting patient health and increasing hospital costs.

Objectives
To investigate the antimicrobial prescribing patterns at two district hospitals in Northern Ireland before and during the COVID-19 pandemic.

Methods
A mixed prospective-retrospective study was designed to compare pre- and during pandemic antimicrobial prescribing data in both hospitals using a Global Point Prevalence Survey.

Results
Of the 591 patients surveyed in both hospitals, 43.8% were treated with 402 antimicrobials. A total of 82.8% of antimicrobial prescriptions were for empirical treatment. No significant difference existed in numbers of patients treated or antimicrobials used before and during the pandemic. There was a slight decrease of 3.3% in the compliance rate with hospital antimicrobial guidelines during the pandemic when compared with the pre-pandemic year of 2019, when it was 69.5%. Treatment based on patients’ biomarker data also slightly decreased from 83.5% pre-pandemic (2019) to 81.5% during the pandemic (2021).

Conclusions
There was no overall significant impact of the pandemic on the antimicrobial prescribing patterns in either hospital when compared with the pre-pandemic findings. The antimicrobial stewardship programmes would appear to have played an important role in controlling antimicrobial consumption during the pandemic.
Determining mating type and ploidy in Rhodotorula toruloides and its effect on growth on sugars from lignocellulosic biomass
Authors: Lopes Daiane Dias , Dien Bruce S , Hector Ronald E , Singh Vijay , Thompson Stephanie R , Slininger Patricia J , Boundy-Mills Kyria , Jagtap Sujit S , Rao Christopher V 
Published: November 2023

Abstract

Rhodotorula toruloides is being developed for the use in industrial biotechnology processes because of its favorable physiology. This includes its ability to produce and store large amounts of lipids in the form of intracellular lipid bodies. Nineteen strains were characterized for mating type, ploidy, robustness for growth, and accumulation of lipids on inhibitory switchgrass hydrolysate (SGH). Mating type was determined using a novel polymerase chain reaction (PCR)-based assay, which was validated using the classical microscopic test. Three of the strains were heterozygous for mating type (A1/A2). Ploidy analysis revealed a complex pattern. Two strains were triploid, eight haploid, and eight either diploid or aneuploid. Two of the A1/A2 strains were compared to their parents for growth on 75%v/v concentrated SGH. The A1/A2 strains were much more robust than the parental strains, which either did not grow or had extended lag times. The entire set was evaluated in 60%v/v SGH batch cultures for growth kinetics and biomass and lipid production. Lipid titers were 2.33–9.40 g/L with a median of 6.12 g/L, excluding the two strains that did not grow. Lipid yields were 0.032–0.131 (g/g) and lipid contents were 13.5–53.7% (g/g). Four strains had significantly higher lipid yields and contents. One of these strains, which had among the highest lipid yield in this study (0.131 ± 0.007 g/g), has not been previously described in the literature.

Summary
The yeast Rhodotorula toruloides was used to produce oil using sugars extracted from a bioenergy grass.
Digital PCR to Measure SARS-CoV-2 RNA, Variants, and Outcomes in Youth
Authors: Hijano Diego R , Ferrolino Jose A , Gu Zhengming , Brazelton Jessica N , Zhu Haiqing , Suganda Sri , Glasgow Heather L , Dallas Ronald H , Allison Kim J , Maron Gabriela ,   St. Jude COVID-19 Patients Study Team, Turner Paige , Peterson Megan , Ross Hailey S , Burton Madeline , Pardasani Sapna , Hankins Jane S , Takemoto Clifford , Inaba Hiroto , Helmig Sara , Vinitsky Anna , Hines Melissa R , Suliman Ali Y , Thomas Paul G , Allen E Kaitlynn , Wolf Joshua , Hakim Hana , Patel Nehali , Knapp Katherine , Adderson Elisabeth E , Darji Himani , Tang Li , Fabrizio Thomas P , Webby Richard J , Hayden Randall T 
Published: November 2023

Abstract

Background
The role of SARS-CoV-2 viral load in predicting contagiousness, disease severity, transmissibility, and clinical decision-making continues to be an area of great interest. However, most studies have been in adults and have evaluated SARS-CoV-2 loads using cycle thresholds (Ct) values, which are not standardized preventing consistent interpretation critical to understanding clinical impact and utility. Here, a quantitative SARS-CoV-2 reverse-transcription digital PCR (RT-dPCR) assay normalized to WHO International Units was applied to children at risk of severe disease diagnosed with COVID-19 at St. Jude Children’s Research Hospital between March 28, 2020, and January 31, 2022.

Methods
Demographic and clinical information from children, adolescents, and young adults treated at St. Jude Children’s Research Hospital were abstracted from medical records. Respiratory samples underwent SARS-CoV-2 RNA quantitation by RT-dPCR targeting N1 and N2 genes, with sequencing to determine the genetic lineage of infecting virus.

Results
Four hundred and sixty-two patients aged 0–24 years (median 11 years old) were included during the study period. Most patients were infected by the omicron variant (43.72%), followed by ancestral strain (22.29%), delta (13.20%), and alpha (2.16%). Viral load at presentation ranged from 2.49 to 9.14 log10 IU/mL, and higher viral RNA loads were associated with symptoms (OR 1.32; CI 95% 1.16–1.49) and respiratory disease (OR 1.23; CI 95% 1.07–1.41). Viral load did not differ by SARS-CoV-2 variant, vaccination status, age, or baseline diagnosis.

Conclusions
SARS-CoV-2 RNA loads predict the presence of symptomatic and respiratory diseases. The use of standardized, quantitative methods is feasible, allows for replication, and comparisons across institutions, and has the potential to facilitate consensus quantitative thresholds for risk stratification and treatment.
Rupture of the bilateral and simultaneous tendon of the pectoralis major muscle. Description of three cases
Authors: de Castro Pochini Alberto , Ejnisman Benno , Andreoli Carlos V , Lara Paulo H S , Ribeiro Leandro M , Cohen Moises , Belangero Paulo S , Hipolide Debora C 
Published: November 2023

Abstract
Pectoralis major muscle tendon ruptures associated with physical activity or effort are no longer uncommon in the medical literature. Treatment has also evolved significantly in the last 20 years. However, simultaneous bilateral rupture has only been described in a few cases. This article reports three cases with simultaneous bilateral rupture and describes the examinations and treatment performed. Bilateral lesions, although infrequent, also require early diagnosis and treatment in the acute phase. The chronic phase requires tendon grafting for full correction and a slow rehabilitation process.
Importance of optimizing duration of adjuvant immune checkpoint inhibitor therapy to treat postoperative hepatocellular carcinoma after conversion therapy: a case report
Authors: Li Jian-Rong , Yang Da-Long , Wang Jin-Ming , Tian Wei , Wei Wei , Luo Cheng-Piao , Qi Lu-Nan , Ma Liang , Zhong Jian-Hong 
Published: November 2023

Abstract
Patients with hepatocellular carcinoma at high risk of recurrence after hepatic resection or local ablation often undergo adjuvant immunotherapy with immune checkpoint inhibitors for 1 year in randomized controlled trials, but the appropriateness of this duration is controversial, especially given the risk of adverse events. Here we report the case of a 52-year-old Chinese man with initially unresectable multinodular recurrent hepatocellular carcinoma who underwent two cycles of transarterial chemoembolization, followed by hepatic resection and 24 months of adjuvant therapy with the PD-1 inhibitor tislelizumab. The patient achieved a recurrence-free survival time of 24 months, but he experienced elevated alpha fetoprotein, Grade 2 hypothyroidism and pruritus while on adjuvant therapy. This case highlights the need to optimize the duration of adjuvant immunotherapy after curative treatment for hepatocellular carcinoma in order to minimize risk of not only recurrence but also adverse events.
A case of primary conjunctival follicular lymphoma presenting as nasolacrimal obstruction
Authors: Amir Amaar , Amir Baraa , Sheikh Salwa 
Published: November 2023

Abstract
We herein report a 76-year-old male who presented to the ophthalmology clinic after complaining from excessive lacrimation for ~6 months prior to presentation. He reports previously undergoing a nasolacrimal recanalization procedure in attempts to resolve his symptoms, but reported no improvement. On examination, a mass on the nasal conjunctiva around the medial canthus of the right eye was noted and subsequently excised. The findings support the diagnosis of low-grade follicular lymphoma. The patient was referred to radiation oncology for radiation therapy and received a total dose of 2400 cGy. Most ocular adnexal lymphomas are B-cell in origin, with follicular lymphomas being one of the rarest forms of such lymphomas. The most common translocation reported in over 85% of follicular lymphomas of the ocular adnexa is t(14; 18) (q32; q21). Traditional treatment options typically include a mix of chemical, surgical, and radio-oncological interventions.
A Highly Integrated AFM-SEM Correlative Analysis Platform
Authors: Alipour A , Arat K T , Alemansour H , Montes L , Gardiner J , Diederichs J , Colvin B , Amann A , Jensen K , Neils W , Spagna S , Stühn L , Seibert S , Frerichs H , Wolff M , Schwalb C H 
Published: November 2023

Abstract
We describe the first truly correlative atomic force micro­scopy-scanning electron microscopy (AFM-SEM) platform designed from first principles and from the ground up for the study of sample properties under a wide range of magnifications. Combining these two microscopy techniques, “in situ,” into a highly integrated workstation opens unprecedented measurement capabilities at the nanoscale, while simplifying experiment workflows to yield a higher level of data throughput. Unlike SEM, the AFM offers true three-dimensional topo­graphy images, something SEM can only provide indirectly. This allows for the characterization of nano-mechanical properties, as well as for magnetic and electrical characterization of samples, which are increasingly of interest in material science, multi-component technologies (that is, solar cell and battery research), and pharmaceutical investigations. On the other hand, the SEM’s wide field-of-view is critical in identifying regions of interest with feature sizes of less than a micron, which are notoriously difficult to find over large spatial scales in conventional AFM systems. In addition, the SEM’s ability to visualize the AFM tip facilitates its navigation to aid the characterization of samples with challenging three-dimensional topographies. In this paper, we describe the major elements of the system design and demonstrate how correlative microscopy can help the characterization of samples with challenging morphologies such as the edge of a razor blade or the nanomechanical analysis of platinum nanopillars.
Periop 101: Improving Perioperative Nursing Knowledge and Competence in Labor and Delivery Nurses Through an Evidence-Based Education and Training Program
Authors: Stucky Christopher H , Knight Albert R , Dindinger Rebeccah A , Maio Shannon , House Sherita , Wymer Joshua A , Barker Amber J 
Published: November 2023

ABSTRACT

Introduction
To reach the highest levels of health care quality, all nurses providing intraoperative care to surgical patients should have a firm grasp of the complex knowledge, skills, and guidelines undergirding the perioperative nursing profession. In military treatment facilities, either perioperative registered nurses or labor and delivery (L&D) nurses provide skilled intraoperative nursing care for cesarean deliveries. However, L&D and perioperative nurses occupy vastly different roles in the continuum of care and may possess widely differing levels of surgical training and experience.

Materials and Methods
The purpose of this project was to improve surgical care quality by standardizing and strengthening L&D nurse perioperative training, knowledge, and competence. Our population, intervention, comparative, and outcome question was, “For labor and delivery nurses of a regional military medical center (P), does implementing an evidence-based training program (I), as compared to current institutional nursing practices (C), increase nursing knowledge and perioperative nursing competence (O)?” We implemented Periop 101: A Core Curriculum—Cesarean Section training for 17 L&D nurses, measured knowledge using product-provided testing, and assessed competence using the Perceived Perioperative Competence Scale-Revised.

Results
We found that perioperative nursing knowledge and competence significantly improved and were less varied among the nurses after completing the training program. Nurses demonstrated the greatest knowledge area improvements in scrubbing, gowning, and gloving; wound healing; and sterilization and disinfection, for which median scores improved by more than 100%. Nurses reported significantly greater perceived competence across all six domains of the Perioperative Competence Scale-Revised, with the largest improvements realized in foundational skills and knowledge, leadership, and proficiency.

Conclusions
We recommend that health care leaders develop policies to standardize perioperative education, training, and utilization for nurses providing intraoperative care to reduce clinician role ambiguity, decrease inefficiencies, and enhance care.
Perioperative Pressure Injury Prevention Program in a Military Medical Treatment Facility: A Quality Improvement Project
Authors: Romito Kenneth , Talbot Laura A , Metter E. Jeffrey , Smith Amber L , Hartmann J. Michael , Bradley David F 
Published: November 2023

ABSTRACT

Introduction
The incidence of perioperative pressure injuries (PPIs) at a military medical treatment facility (MTF) increased from three PPI events in 2018 to five PPI events in the first half of 2019. The purpose of this quality improvement initiative was to determine whether an evidence-based PPI prevention program introduced during the second half of 2019 reduced pressure injuries compared to the previous 1.5 years that followed the standard of care for perioperative patient positioning.

Methods
We used a multidisciplinary quality improvement PPI prevention approach that included education, Scott Triggers® patient risk assessment, application of a five-layer silicone dressing to at-risk surgical position sites, and feedback via multidisciplinary postoperative rounding.

Results
There was an observed decrease in the rate of PPIs from 0.62 to 0.00 per 1,000 patient surgeries during the 26-month period that this protocol was implemented.

Conclusion
This project was conducted at a major MTF using a multidisciplinary PPI prevention approach that may be of value in reducing PPIs in other settings. This approach seems worthy of further investigation and may be applicable to other military MTFs and in deployed settings.
Military Nursing Evidence-Based Practice Summit: A Descriptive Analysis of EBP Barriers and Solutions Within the Military Healthcare System
Authors: King Heather C , White Tonya , Leyden Christine , Martinez Stephanie , Yauger Young J 
Published: November 2023

ABSTRACT

Background
Evidence-based practice (EBP) is an innovative systematic problem-solving methodology that incorporates the best research evidence into clinical practice to improve patient outcomes, job satisfaction, and reduced healthcare costs. Although there are significant advances to implement EBP into military healthcare and operational settings, many barriers and challenges still exist. Civilian healthcare organizations have examined barriers and solutions to integrate EBP into clinical practice, but limited data exists to identify barriers and solutions to integrate EBP into military healthcare settings. Advancing the implementation of EBPs within military healthcare settings has the power to transform the administrative processes of healthcare management and most importantly, the delivery of healthcare for service members and beneficiaries. The purpose of this article is to present findings from a qualitative descriptive research study which analyzed data obtained during an EBP military summit.

Methods
A qualitative descriptive research study was used to examine EBP barriers and solutions to implement EBP in military healthcare settings. Participants attended a virtual 1-day military EBP summit (n = 182). As part of the summit, participants were invited to voluntarily participate in focus groups. Focus groups were conducted to gain an understanding of EBP barriers and solutions from military and civilian nurses and medics with interest and experience conducting EBP within military healthcare settings (n = 42). Focus group discussions were transcribed and analyzed by the study team.

Results
The study analysis identified six themes: leadership, command culture, EBP barriers (specific to MTF/operational environments), communication, infrastructure support, and outcome measures. Sub-themes identified additional dimensions military-specific barriers and solutions within the six identified themes.

Conclusions
The results of this research study identify actionable tasks and recommendations to advance EBP within the military healthcare system. EBP is currently underutilized in the military healthcare system, and supportive implementation of EBP can be accomplished through enhanced leadership engagement, changing command culture, addressing EBP barriers, infrastructure, communication planning, and integration of existing national clinical and financial outcome measures. Given the critical need to further transition of military healthcare to evidence-based data driven decisions, the knowledge gained from this study can optimize readiness and advance healthcare delivered to service members and beneficiaries within the military healthcare system.
Key Factors to Consider When Implementing an Advanced Practice Registered Nurse-Led Heart Failure Clinic
Authors: Anderson Amanda J , Anderson Jeanette M , Cengiz Adem , Yoder Linda H 
Published: November 2023

ABSTRACT
Advanced practice registered nurses (APRNs) such as clinical nurse specialists and nurse practitioners excel at chronic disease management. Development of an APRN-led heart failure (HF) clinic is an ideal way to manage complex HF patients. However, there are important factors to consider when implementing an APRN-led HF clinic. The purpose of this paper is to provide a consolidation of recommendations to consider when developing and implementing an APRN-led HF clinic. A review of applicable literature within the last 10 years was conducted to determine the key factors to be considered when developing organizational structures and processes for an APRN-led HF clinic. The increasing need for primary care and internal medicine providers supports using APRNs to fill the gap and provide disease management for HF patients. Also, APRNs can impact the overall costs of HF treatment by optimizing postdischarge care and preventing hospitalizations and readmissions. Multiple studies supported implementation of APRN-led HF clinics for disease management to provide complex treatment strategies and comprehensive care to these patients.
Does Non-Measurability Favour Imprecision?
Authors: Dorr Cian 
Published: November 2023

Abstract
In a recent paper, Yoaav Isaacs, Alan Hájek, and John Hawthorne argue for the rational permissibility of ’credal imprecision’ by appealing to certain propositions associated with non-measurable spatial regions: for example, the proposition that the pointer of a spinner will come to rest within a certain non-measurable set of points on its circumference. This paper rebuts their argument by showing that its premises lead to implausible consequences in cases where one is trying to learn, by making multiple observations, whether a certain outcome is associated with a non-measurable region or a measurable one.