bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergence of novel ST1299
vanA
lineages as possible cause for the striking rise of vancomycin resistance among invasive strains of
Enterococcus faecium
at a German university hospital
Authors: Valenza Giuseppe , Eisenberger David , Voigtländer Sven , Alsalameh Rayya , Gerlach Roman , Koch Sonja , Kunz Bernd , Held Jürgen , Bogdan Christian 
Published: October 2023

ABSTRACT

Since 2019, we have observed a remarkable rise of vancomycin resistance among invasive strains of
Enterococcus (E.) faecium
at the University Hospital Erlangen (UKER), a tertiary-care hospital in Germany. Here, we analyzed the genetic diversity of
E. faecium
isolated from blood cultures of in-patients by core genome multilocus sequence typing to see whether the occurrence of vancomycin resistance was associated with the spread of new clonal lineages. Between January and December 2022, 37 consecutive non-duplicate isolates were included in this study. Resistance to vancomycin was detected in 15 isolates (40.5%). The affected patients had a median age of 65 years, and 26 of them (70.3%) were males. Patients with bloodstream infection caused by vancomycin-resistant
E. faecium
(VREfm) or vancomycin-susceptible
E. faecium
(VSEfm) showed a similar in-hospital mortality rate (33.3% vs 27.3%,
P
= 0.692), indicating that VREfm were not more virulent than VSEfm. In contrast, the genetic diversity was higher in VSEfm (15 clonal lineages) than in VREfm isolates (seven clonal lineages). The majority of VREfm isolates (73.2%) belonged to only three clonal lineages: ST117/CT71
vanB
(
n
= 4), which is the most commonly detected vancomycin-resistant lineage in Germany, and two novel ST1299
vanA
lineages classified as CT3109 (
n
= 4) and CT1903 (
n
= 3). We conclude that the high rate of vancomycin resistance among invasive
E. faecium
isolates at UKER could be associated with the emergence of novel ST1299
vanA
lineages, which is likely to be relevant also for other hospitals and countries. Future studies will focus on the prevalence of ST1299
vanA
in the general population.

IMPORTANCE

The proportion of VREfm among all
Enterococcus faecium
isolated from blood cultures in German hospitals has increased in the period 2015–2020 from 11.9% to 22.3% with a country-wide spread of the clonal lineage ST117/CT71
vanB
. In this study, we provided useful information about the genetic diversity of invasive strains of
E. faecium
. Moreover, our findings confirm the nosocomial spread of novel ST1299
vanA
lineages, which recently had a rapid expansion in Austria and the south-eastern part of Germany.
Relationship between severe mental illness and physical multimorbidity: a meta-analysis and call for action
Authors: Pizzol Damiano , Trott Mike , Butler Laurie , Barnett Yvonne , Ford Tamsin , Neufeld Sharon AS , Ragnhildstveit Anya , Parris Christopher N , Underwood Benjamin R , López Sánchez Guillermo Felipe , Fossey Matt , Brayne Carol , Fernandez-Egea Emilio , Fond Guillaume , Boyer Laurent , Shin Jae Il , Pardhan Shahina , Smith Lee 
Published: October 2023

BackgroundPeople with severe mental illness (SMI) have a higher prevalence of several chronic physical health conditions, and the prevalence of physical multimorbidity is expected to rise. The aim of this study was to assess the strength of the association between SMI and physical multimorbidity.Study selection and analysisWe systematically searched PubMed/Medline, Scopus, Embase, Web of Science, PsycINFO and the behavioural sciences collection databases, from inception to 31 January 2023, for studies that investigated the association between SMI and physical multimorbidity. Humans of any age either clinically diagnosed and/or currently receiving treatment for SMI, specified as schizophrenia (and related psychotic disorders), bipolar disorder and psychotic depression, were eligible. Data from studies selected for inclusion were converted into ORs, with a subsequent meta-analysis conducted.FindingsWe included 19 studies with a total of 194 123 patients with SMI with different diagnoses and drawn from the general population. The pooled OR for physical multimorbidity in people with versus without SMI was 1.84 (95% CI 1.33 to 2.54), with the analysis indicating a high level of heterogeneity (98.38%). The other 15 studies included in the systematic review for which it was not possible to conduct a meta-analysis showed strong associations between SMI and physical multimorbidity.ConclusionsThe current evidence highlights the link between SMI and physical multimorbidity. A multidisciplinary approach is now urgent to develop the best models of services tailored to patients with SMI with physical multimorbidities to improve physical, mental and social outcomes.PROSPERO registration numberCRD42023395165.
First-in-human phase I/Ib study of NIZ985, a recombinant heterodimer of IL-15 and IL-15Rα, as a single agent and in combination with spartalizumab in patients with advanced and metastatic solid tumors
Authors: Leidner Rom , Conlon Kevin , McNeel Douglas G , Wang-Gillam Andrea , Gupta Sumati , Wesolowski Robert , Chaudhari Monica , Hassounah Nadia , Lee Jong Bong , Ho Lee Lang , O’Keeffe Jessica A , Lewis Nancy , Pavlakis George N , Thompson John A 
Published: October 2023

BackgroundPreclinically, interleukin-15 (IL-15) monotherapy promotes antitumor immune responses, which are enhanced when IL-15 is used in combination with immune checkpoint inhibitors (ICIs). This first-in-human study investigated NIZ985, a recombinant heterodimer comprising physiologically active IL-15 and IL-15 receptor α, as monotherapy and in combination with spartalizumab, an anti-programmed cell death protein-1 (anti-PD-1) monoclonal antibody, in patients with advanced solid tumors.MethodsThis phase I/Ib study had two dose-escalation arms: single-agent NIZ985 administered subcutaneously thrice weekly (TIW, 2 weeks on/2 weeks off) or once weekly (QW, 3 weeks on/1 week off), and NIZ985 TIW or QW administered subcutaneously plus spartalizumab (400 mg intravenously every 4 weeks (Q4W)). The dose-expansion phase investigated NIZ985 1 µg/kg TIW/spartalizumab 400 mg Q4W in patients with anti-PD-1–sensitive or anti-PD-1–resistant tumor types stratified according to approved indications. The primary objectives were the safety, tolerability, and the maximum tolerated doses (MTDs) and/or recommended dose for expansion (RDE) of NIZ985 for the dose-expansion phase.ResultsAs of February 17, 2020, 83 patients (median age: 63 years; range: 28–85) were treated in dose escalation (N=47; single-agent NIZ985: n=27; NIZ985/spartalizumab n=20) and dose expansion (N=36). No dose-limiting toxicities occurred nor was the MTD identified. The most common treatment-related adverse event (TRAE) was injection site reaction (primarily grades 1–2; single-agent NIZ985: 85% (23/27)); NIZ985/spartalizumab: 89% [50/56]). The most common grade 3–4 TRAE was decreased lymphocyte count (single-agent NIZ985: 7% [2/27]; NIZ985/spartalizumab: 5% [3/56]). The best overall response was stable disease in the single-agent arm (30% (8/27)) and partial response in the NIZ985/spartalizumab arm (5% [3/56]; melanoma, pancreatic cancer, gastric cancer). In dose expansion, the disease control rate was 45% (5/11) in the anti-PD-1–sensitive and 20% (5/25) in the anti-PD-1–resistant tumor type cohorts. Pharmacokinetic parameters were similar across arms. The transient increase in CD8+ T cell and natural killer cell proliferation and induction of several cytokines occurred in response to the single-agent and combination treatments.ConclusionsNIZ985 was well tolerated in the single-agent and NIZ985/spartalizumab regimens. The RDE was established at 1 µg/kg TIW. Antitumor activity of the combination was observed against tumor types known to have a poor response to ICIs.Trial registration numberNCT02452268.
Self-orthogonal codes over a non-unital ring from two class association schemes
Authors: Alahmadi Adel , Melaibari Asmaa , Solé Patrick 
Published: October 2023

There is a non-unital ring [Formula: see text] of order 4 defined by generators and relations as [Formula: see text] In this paper, we present special constructions of linear codes over [Formula: see text] from the adjacency matrices of two class association schemes. These consist of either Strongly Regular Graphs (SRGs) or Doubly Regular Tournaments (DRTs). We investigate the conditions under which these codes are self-orthogonal, quasi self-dual, or Type IV. As a byproduct of this study, some diophantine relations on the weight of sum of vectors with coefficients in [Formula: see text] are derived. Some examples of codes with minimum distance better than that of Type IV codes over unital rings of the same order in modest lengths are given.
‘Practically useful, scientifically important, and to the honour of the country’: geological maps and services provided by the Geological Survey of Norway these past 165 years
Authors: Smelror Morten 
Published: October 2023

Abstract
Geological maps document knowledge of considerable value (economic, cultural and aesthetic) for societies, enterprises and people in general. Knowledge illustrated in geological maps also helps us to foresee how landscape interventions and climate change may affect our living ground and make us vulnerable to geohazards. The present paper presents an overview of geological mapping carried out by the Geological Survey of Norway since 1858 while also focusing on mapping activities and products produced in the present millennium. Key issues to consider are how we are moving into the digital world, how we use geological mapping to follow up on national agendas like Green Shift and Blue Growth and how national agreements and cooperation help us to make geological and other geographic information available to everyone through open access web portals and services.
Moral Twin Earth Strikes Back: Against a Neo-Aristotelian Hope
Authors: Rubin Michael 
Published: October 2023

Abstract
A key objection to naturalistic versions of moral realism is that the (meta)semantics to which they are committed yields incorrect semantic verdicts about so-called Moral Twin Earth cases. Recently, it has been proposed that the Moral Twin Earth challenge can be answered by adopting a neo-Aristotelian semantics for moral expressions. In this paper, I argue that this proposal fails. First, however attractive the central claims of neo-Aristotelianism are, they do not for us have the status of analytic constraints on the use of ethical expressions, as they must if they are to block Moral Twin Earth counterexamples. Second, even when the neo-Aristotelian’s claims are taken as non-negotiable analytic constraints, the semantics faces a dilemma: if characteristic human functioning is understood in an ethically neutral way, the semantics yields an incorrect intension for ‘good human.’ If human functioning is understood in an ethically partisan way, the semantics fails to avoid problematic Moral Twin Earth counterexamples.
Fashioning a Persianate Offspring for a Modern India: Urdu Visions of Persian Pasts, 1890s–1950s
Authors: Fatima Maryam , Amstutz Andrew 
Published: October 2023

Abstract
This article addresses how some influential Indian Muslim intellectuals conceptualized and imagined the Urdu language as the linguistic offspring and heir of the Persian language and Persianate textual cultures from the late nineteenth century through the early 1950s. As the symbolic and material value of Persian gradually declined in India, select Persianate idioms, genres, and histories were drafted for Urdu’s modernity. This article considers the significance of Persian as it was variously construed as either a burden or a model by Urdu scholars and as either a worthy or unworthy predecessor for Urdu from the 1890s to the 1950s. It traces the shifting textual processes by which three prominent Indian Muslim intellectuals constructed a parent-offspring relationship between Persian and Urdu in response to colonial education reforms, competing national projects, and pan-Islamic intellectual currents. In summary, this article excavates the many uses that Persian served as it was simultaneously erased from and encoded into Urdu’s anticipated futures.
A Modification of the American Joint Committee on Cancer Nomogram for Undifferentiated Sarcoma With External Validation and Risk Stratification
Authors: Yuan Jin , Zhang Xinxin , Zhang Shuguang , Yu Shengji 
Published: October 2023

Background The aim of this study is to establish a model to predict the overall survival (OS) and stratify the risk of postoperative patients with undifferentiated sarcoma. Methods A total of 452 postoperative patients with undifferentiated sarcoma in the trunk and extremity from the Surveillance, Epidemiology, and End Results database were enrolled as the training cohort. We collected a group of 163 undifferentiated sarcoma patients from our center as the external validation cohort. Cox proportional hazards regression model was used to screen survival-associated factors for the construction of the nomogram. Concordance-indexes (C-indexes), calibration curves, and receiver operating characteristics (ROCs) curves were applied for the discrimination and calibration of the nomogram. The cutoff value of nomogram-based total points was applied to stratify the risk of patients. Results A nomogram was developed incorporating four independent factors: age, tumor site, eighth AJCC stage, and radiotherapy. The nomogram showed good prognostic accuracy and excellent agreement in the training and validation cohort, with C-indexes of .701 (95% confidence interval [CI]: .683-.719) and .700 (95% CI: 0.659-.741), respectively. Furthermore, we identified the best cutoff value of nomogram total points (103.2) as the predicted risk and divided the patients into a high-risk group and a low-risk group. Significant differences in OS between the two groups were indicated in the training cohort and external validation cohort, showing the appreciable clinical validity and clinical utility of the nomogram ( P < .001). Conclusion This nomogram provides an insightful and applicable tool for individual evaluations and the distinguishment of risk for patients with undifferentiated sarcoma.
Multi-robot, multi-sensor exploration of multifarious environments with full mission aerial autonomy
Authors: Best Graeme , Garg Rohit , Keller John , Hollinger Geoffrey A. , Scherer Sebastian 
Published: October 2023

We present a coordinated autonomy pipeline for multi-sensor exploration of confined environments. We simultaneously address four broad challenges that are typically overlooked in prior work: (a) make effective use of both range and vision sensing modalities, (b) perform this exploration across a wide range of environments, (c) be resilient to adverse events, and (d) execute this onboard teams of physical robots. Our solution centers around a behavior tree architecture, which adaptively switches between various behaviors involving coordinated exploration and responding to adverse events. Our exploration strategy exploits the benefits of both visual and range sensors with a generalized frontier-based exploration algorithm and an OpenVDB-based map processing pipeline. Our local planner utilizes a dynamically feasible trajectory library and a GPU-based Euclidean distance transform map to allow fast and safe navigation through both tight doorways and expansive spaces. The autonomy pipeline is evaluated with an extensive set of field experiments, with teams of up to three robots that fly up to 3 m/s and distances exceeding 1 km in confined spaces. We provide a summary of various field experiments and detail resilient behaviors that arose: maneuvering narrow doorways, adapting to unexpected environment changes, and emergency landing. Experiments are also detailed from the DARPA Subterranean Challenge, where our proposed autonomy pipeline contributed to us winning the “Most Sectors Explored” award. We provide an extended discussion of lessons learned, release software as open source, and present a video that illustrates our extensive field trials.
Vertical Stenosis as a Morphological Risk Factor for Anterior Cruciate Ligament Ruptures in Children: A Magnetic Resonance Imaging–Based Comparison
Authors: Manhard Claire E. , Fogleman Sarah A. , Bryan Tracey P. , Edmonds Eric W. 
Published: October 2023

Background: There are known anatomic variations that may lead to traumatic disruption of the anterior cruciate ligament (ACL) identified within adult and adolescent patients. Purpose/Hypothesis: The purpose of this study was to compare the parameters of pediatric knees diagnosed with and without an ACL injury by magnetic resonance imaging. The hypothesis was that children with ACL abnormalities would demonstrate an equivalent notch width index (NWI), but a larger notch height index (NHI), in comparison with age-matched patients without ACL abnormalities, suggesting an association with congenital morphology. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A retrospective comparison cohort study of pediatric knees was performed by evaluating those with a confirmed ACL rupture/deficiency and those with a benign diagnosis on magnetic resonance imaging. Overall, 6 osseous and cartilaginous measurements and 3 ratios (2 newly described) were determined. They were then grouped for statistical purposes by age: children aged 5 to 11 years and adolescents aged 12 to 19 years. Results: A total of 119 (49 children) consecutive patients with an ACL injury and 139 (72 children) healthy patients met inclusion criteria. The interaction between ACL status and age was significant for condylar measurements ( P≤ .001), tibial spine height ( P = .003), vertical space above tibial spine ( P≤ .001), and NWI ( P≤ .001) by 2-way analysis of variance. Although the NHI ( P < 0.001) and tibial spine prominence ( P = 0.039) demonstrated stenosis in the adolescent group, they did not have significant interactions with age and ACL status ( P > 0.05). Regarding the transcondylar width, only the children's group had a significant difference regarding ACL status ( P < .001), and the mean values in the children's group with ACL tears were nearly identical to those in the adolescent group both with and without ACL tears. The children's group with ACL tears also had a significantly larger tibial spine height compared with healthy children ( P < .001). Conclusion: Children, similar to adolescents, demonstrated the effect of the NWI on the risk of ACL tears, but only the adolescent group demonstrated stenosis with the NHI. The morphology of the knee in a child at risk for ACL rupture was not the same as that of an adolescent when considering all dimensions, but it did seem that it was more adolescent-like than child-like at the time of an ACL rupture, refuting the idea of congenital hypoplasia as a common cause.
Comparative study between mitomycin C versus Bacillus Calmette-Guérin (BCG) in high-risk non-muscle-invasive bladder cancer
Authors: Zaza Mohamed Mahmoud Abdelfatah , Salem Tarek Abd El-Mageed , El-Sadat Ahmed Mohamed , Hassan Ali Mohammed 
Published: October 2023

Objectives: We aimed to compare the efficacy and adverse events of Bacillus Calmette-Guérin (BCG) versus Mitomycin C (MMC) in high-risk Non-Muscle-Invasive Bladder Cancer (NMIBC) patients. Methods: This randomized controlled study was conducted over 24 months in four hospitals in Egypt. A sample of 90 patients was randomly assigned to either treatment group, with procedures including baseline examinations, a single postoperative instillation of chemotherapy, a 6-week induction cycle of the assigned drug, and regular follow-up cystoscopies and upper urinary tract imaging. Treatment results and side effects were monitored, with data analyzed via Statistical Package for Social Sciences (SPSS). Results: No significant differences were observed in mean age or tumor characteristics ( p > 0.05). However, adverse reactions were significantly higher in the BCG group, including cystitis (40% vs. 17.78%, p = 0.020), hematuria (24.44% vs. 4.44%, p = 0.007), overall local reactions (75.56% vs. 26.67%, p < 0.001), fever (13.33% vs. 2.22%, p = 0.049), and fatigue (17.78% vs. 2.22%, p = 0.014). The MMC group had a slightly higher recurrence rate (28.89% vs. 17.78%, hazard ratio 1.89, 95% CI: 0.78–4.55, p = 0.15) with a shorter median time to recurrence (six vs. 12 months). Progression rates were similar (8.89% MMC vs. 4.44% BCG, p = 0.398). Conclusion: Although BCG and MMC have comparable efficacy in managing high-risk NMIBC, BCG demonstrated a higher rate of adverse reactions. Decision-making should consider this balance, patient preferences, and health status. Further research is needed for the validation and exploration of these findings.
In-situ spray impregnation of poly(pentamethylene oxamide) onto carbon fibers and their composites
Authors: Mutua Fredrick Nzioka , Wambua Paul Mwanzia , He Yong 
Published: October 2023

Polyoxamides are a class of polyamides that exhibit superior mechanical, chemical, UV light resistance, and low water absorption properties than their conventional counterparts. In this study, a novel in-situ spray polycondensation techniques is developed and used to impregnate poly (pentamethylene oxamide) (PA52) prepolymer into carbon fibers (CF). The prepolymer impregnated CFs are subjected to solid state polycondensation to increase the molecular of PA52 resin thus obtain prepregs for fabrication of carbon fiber reinforced polyoxamide composites. The effects of preparation parameters on the mechanical properties of PA52/CF composites are studied and reported. The results showed that, PA52/CF composites prepared at molding temperature of 325°C, pressure of 3.0 MPa, and time of 10 min exhibits good tensile strength at break, flexural strength, and interlaminar shear strength (ILSS) of 435 MPa, 364 MPa, and 51 MPa, respectively. SEM results suggest good adhesion between the PA52 and CF which is supported by the high storage modulus results obtained from dynamic mechanical analysis (DMA) results, depicting the potential of in-situ spray impregnation in preparation of carbon fiber reinforced polyoxamide composites.
Dry needling, trigger point electroacupuncture and motor point electroacupuncture for the treatment of myofascial pain syndrome involving the trapezius: a randomised clinical trial
Authors: Moro Marlene Zuccolotto , de Oliveira Vidal Edison Iglesias , Pinheiro Módolo Norma Sueli , Bono Fukushima Fernanda , Moreira de Barros Guilherme Antonio 
Published: October 2023

Objective: The objective of this study was to compare trigger point (TrP) dry needling, TrP electroacupuncture and motor point electroacupuncture of the trapezius muscle for the treatment of myofascial pain syndrome (MPS). Methods: This randomised clinical trial included 90 patients divided into three groups. Group 1 was treated with dry needling of TrPs, group 2 with intramuscular electrical stimulation of TrPs, and group 3 with electroacupuncture of motor points and/or the spinal accessory nerve. Each group received seven treatment sessions. The outcomes were the pain score measured by visual analogue scale (VAS) and quality of life evaluated by the 12-item short form (SF-12) health questionnaire. We compared the pain outcome over serial time points using growth curve analysis methods. Results: Participants in the three groups experienced significant improvements in pain scores over time. The average pain level of participants in group 3 across the repeated assessments was 0.98 units lower than in group 1 (mean difference (95% confidence interval (CI) = 1.74–0.23)), p = 0.012). There were no significant differences in pain scores between participants in groups 1 and 2, and there were no significant differences in quality of life across the three groups at the end of the treatment period. Conclusion: Our results provide evidence that electrical stimulation of motor points and/or of the spinal accessory nerve may be superior in terms of pain relief (but not quality of life) to dry needling and possibly electrical stimulation of trigger points for the management of MPS involving the trapezius. Trial registration number: TRIAL-RBR-43R7RF (Brazilian Clinical Trials Registry)