bluuebunny/crossref_metadata_2025_split huggingface dataset:
Viewpoint: Antimicrobial Resistance Diagnostics Use Accelerator: Qualitative Research on Adherence to Prescriptions
Authors: Compaoré Adélaïde , Ekusai-Sebatta Deborah , Kaawa-Mafigiri David , Kukula Vida , Odopey Selase , Kapisi James , Hopkins Heidi , Kiemde François , Tinto Halidou , Baiden Rita , Olliaro Piero , Nkeramahame Juvenal , Dittrich Sabine , Horgan Philip ,   the ADIP study group, Awor Phyllis , Ekusai-Sebatta Deborah , Hopkins Heidi , Kaawa-Mafigiri David , Kapisi James , Kitutu Freddy Eric , Rutebemberwa Elizeus , Sserwanga Asadu , Adjei Alexander , Baiden Rita , Kukula Vida , Compaoré Adélaïde , Kiemde François , Tinto Halidou , Valia Daniel 
Published: July 2023

Abstract
In this Viewpoint, the authors explore the determinants of patients’ prescription adherence behaviors as part of FIND's Advancing Access to Diagnostic Innovation essential for Universal Health Coverage and AMR Prevention (ADIP) trials (ClinicalTrials.gov identifier: NCT04081051). Research findings from Burkina Faso, Ghana, and Uganda show that basic knowledge and understanding of prescription instructions are essential for adherence and can be improved through better communication. However, there are a range of other factors that influence adherence, some of which can be influenced through tailored communication messages from healthcare workers. These messages may contribute to changes in adherence behavior but may require other reinforcing interventions to be effective. Finally, there are some drivers of nonadherence centered around costs and time pressure that require other forms of intervention.
A Qualitative Assessment of a Training and Communication Intervention on Antibiotic Prescription Practices Among Health Workers and Outpatients at Public Health Facilities in Uganda
Authors: Kaawa-Mafigiri David , Ekusai-Sebatta Deborah , Rutebemberwa Elizeus , Sserwanga Asadu , Kitutu Freddy Eric , Kapisi James , Hopkins Heidi , Salami Olawale , Nkeramahame Juvenal , Olliaro Piero , Horgan Philip 
Published: July 2023

Abstract

Background
Antibiotic prescribing practices are 1 of the contributing causes of antimicrobial resistance (AMR). The study explored the key drivers and barriers to adherence to prescribing instructions among healthcare workers and outpatient attendees with the aim of developing a training and communication intervention to improve adherence to prescription.

Methods
Prior to randomized trials at 3 health centers in Uganda (Aduku, Kihihi, and Nagongera), a pre-intervention qualitative assessment was conducted to explore behavioral drivers for adherence to prescriptions and the communication of adherence messages. Based on the findings, a training and communication package was developed for healthcare workers and patients at Day 0 of the trial. During the trial's Day 7 patient follow-up, in-depth interviews were conducted to further investigate adherence behaviors.

Results
Five main themes were identified that acted as drivers or barriers to prescription adherence. Key drivers included: drug availability at health facility, health worker knowledge, and communication to patients. Barriers included: care-seeker use of treatment resorts and an inability by care-seeker to buy drugs.

Conclusions
The T&C appeared to influence both health workers’ and patients’ behavior and improve adherence to prescription.
The adapted T&C should be considered a toolkit to improve antibiotic use across health facilities accompanied with appropriate guidelines to mitigate AMR.
A Randomized Trial to Assess the Impact of a Package of Diagnostic Tools and Diagnostic Algorithm on Antibiotic Prescriptions for the Management of Febrile Illnesses Among Children and Adolescents in Primary Health Facilities in Burkina Faso
Authors: Kiemde Francois , Valia Daniel , Kabore Berenger , Rouamba Toussaint , Kone Alima Nadine , Sawadogo Seydou , Compaore Adelaide , Salami Olawale , Horgan Philip , Moore Catrin E , Dittrich Sabine , Nkeramahame Juvenal , Olliaro Piero , Tinto Halidou 
Published: July 2023

Abstract

Background
Low- and middle-income countries face significant challenges in differentiating bacterial from viral causes of febrile illnesses, leading to inappropriate use of antibiotics. This trial aimed to evaluate the impact of an intervention package comprising diagnostic tests, a diagnostic algorithm, and a training-and-communication package on antibiotic prescriptions and clinical outcomes.

Methods
Patients aged 6 months to 18 years with fever or history of fever within the past 7 days with no focus, or a suspected respiratory tract infection, arriving at 2 health facilities were randomized to either the intervention package or standard practice. The primary outcomes were the proportions of patients who recovered at day 7 (D7) and patients prescribed antibiotics at day 0.

Results
Of 1718 patients randomized, 1681 (97.8%; intervention: 844; control: 837) completed follow-up: 99.5% recovered at D7 in the intervention arm versus 100% in standard practice (P = .135). Antibiotics were prescribed to 40.6% of patients in the intervention group versus 57.5% in the control arm (risk ratio: 29.3%; 95% CI: 21.8–36.0%; risk difference [RD]: −16.8%; 95% CI: −21.7% to −12.0%; P &lt; .001), which translates to 1 additional antibiotic prescription saved every 6 (95% CI: 5–8) consultations. This reduction was significant regardless of test results for malaria, but was greater in patients without malaria (RD: −46.0%; −54.7% to −37.4%; P &lt; .001), those with a respiratory diagnosis (RD: −38.2%; −43.8% to −32.6%; P &lt; .001), and in children 6–59 months old (RD: −20.4%; −26.0% to −14.9%; P &lt; .001). Except for the period July–September, the reduction was consistent across the other quarters (P &lt; .001).

Conclusions
The implementation of the package can reduce inappropriate antibiotic prescription without compromising clinical outcomes.

Clinical Trials Registration
clinicaltrials.gov; NCT04081051.
Epigenetic regulation of vascular smooth muscle cell phenotypic switch and neointimal formation by PRMT5
Authors: Zhu Ni , Guo Zhi-Fu , Kazama Kyosuke , Yi Bing , Tongmuang Nopprarat , Yao Huijuan , Yang Ruifeng , Zhang Chen , Qin Yongwen , Han Lin , Sun Jianxin 
Published: July 2023

Abstract

Aims
Phenotypic transition of vascular smooth muscle cells (VSMCs) from a contractile to a synthetic state is involved in the development of cardiovascular diseases, including atherosclerosis, hypertension, and post-angioplasty restenosis. Arginine methylation catalyzed by protein arginine methyltransferases (PRMTs) has been implicated in multiple cellular processes, however, its role in VSMC biology remains undetermined. The objective of this study was to determine the role of PRMTs in VSMC phenotypic switch and vascular remodelling after injury.

Methods and results
Our results show that PRMT5 is the most abundantly expressed PRMT in human aortic SMCs, and its expression is up-regulated in platelet-derived growth factor (PDGF)-stimulated VSMCs, human atherosclerotic lesions, and rat carotid arteries after injury, as determined by western blot and immunohistochemical staining. PRMT5 overexpression inhibits the expression of SMC marker genes and promotes VSMC proliferation and migration, while silencing PRMT5 exerts the opposite effects. Mechanistically, we found that PRMT5 overexpression led to histone di-methylation of H3R8 and H4R3, which in turn attenuates acetylation of H3K9 and H4, thus limiting recruitment of the SRF/myocardin complexes to the CArG boxes of SMC marker genes. Furthermore, both SMC-specific deletion of PRMT5 in mice and local delivery of lentivirus expressing shPRMT5 to rat carotid arteries significantly attenuated neointimal formation after injury. Likewise, pharmacological inhibition of PRMT5 by EPZ015666 markedly inhibited carotid artery ligation-induced neointimal formation in mice.

Conclusions
Our results identify PRMT5 as a novel regulator in VSMC phenotypic switch and suggest that inhibition of PRMT5 may represent an effective therapeutic strategy for proliferative vascular diseases.
Implementation of patient education for patients with atrial fibrillation: nationwide cross-sectional survey and one-year follow-up
Authors: Qvist Ina , Lane Deirdre A , Risom Signe Stelling , Hendriks Jeroen M , Højen Anette Arbjerg , Johnsen Søren Paaske , Frost Lars 
Published: July 2023

Abstract

Aims
Clinical practice guidelines recommend patient education for patients with atrial fibrillation (AF) as a part of holistic care, however, clinical guidelines lack detailed specification on the content, structure, and delivery of AF education programmes. To examine the implementation of education for patients with AF in Denmark in relation to coverage, organization, and content.

Methods and results
A cross-sectional survey was conducted from February to May 2021. The survey contained questions on the organization, delivery, and content of education for patients with AF from all 29 AF outpatient hospital sites in Denmark. The survey was conducted by email and telephone. One-year follow-up was done in May 2022 by email. Patient education was provided by healthcare professionals in 16 (55%) hospitals. Nurse workforce issues, management, non-prioritization, and lack of guidance for implementation were reasons for the absence of patient education in 13 (45%) hospitals. The structure of patient education differed in relation to group or individual teaching methods and six different education models were used. Content of the AF disease education was generally similar. At 1-year follow-up, another four hospitals reported offering patient education (69% in total).

Conclusion
Initially, almost half of the hospitals did not provide patient education, but at 1-year follow-up, 69% of hospitals delivered patient education. Patient education was heterogeneous in relation to delivery, frequency, and duration. Future research should address individualized patient education that may demonstrate superiority in relation to quality of life, less hospital admissions, and increased longevity.
REducing INFectiOns thRough Cardiac device Envelope: insight from real world data. The REINFORCE project
Authors: Ziacchi Matteo , Biffi Mauro , Iacopino Saverio , di Silvestro Michele , Marchese Procolo , Miscio Francesca , Caccavo Vincenzo Paolo , Zanotto Gabriele , Tomasi Luca , Dello Russo Antonio , Donazzan Luca , Boriani Giuseppe 
Published: July 2023

Abstract

Aims
Infections resulting from cardiac implantable electronic device (CIED) implantation are severely impacting on patients’ and on health care systems. The use of TYRXTM absorbable antibiotic-eluting envelope has proven to decrease major CIED infections within 12 months of CIED surgery. The aim is to evaluate the impact of the envelope use on infection-related clinical events in a real-world contemporary patient population.

Methods and results
Data on patients undergoing CIED surgery were collected prospectively by participating centers of the One Hospital ClinicalService project. Patients were divided into two groups according to whether TYRXTM absorbable antibiotic-eluting envelope was used or not. Out of 1819 patients, 872 (47.9%) were implanted with an absorbable antibiotic-eluting envelope and included in the Envelope group and 947 (52.1%) patients who did not receive an envelope were included in the Control group. Compared to control, patients in the Envelope group had higher thrombo-embolic or hemorrhagic risk, higher BMI, lower LVEF and more comorbidities. During a mean follow-up of 1.4 years, the incidence of infection-related events was significantly higher in the control compared to the Envelope group (2.4% vs. 0.8%, P = 0.007). The five-year cumulative incidence of infection-related events was 8.1% in the control and 2.1% in the Envelope group (HR: 0.34, 95%CI: 0.14–0.80, P = 0.010).

Conclusion
In our analysis, the use of an absorbable antibiotic-eluting envelope in the general CIED population was associated with a lower risk of systemic and pocket infection.
Sedation strategies for pulsed-field ablation of atrial fibrillation: focus on deep sedation with intravenous ketamine in spontaneous respiration
Authors: Iacopino Saverio , Colella Jacopo , Dini Daniele , Mantovani Lorenzo , Sorrenti Paolo Francesco , Malacrida Maurizio , Filannino Pasquale 
Published: July 2023

Abstract

Aims
A standardized sedation protocol for pulsed-field ablation (PFA) of atrial fibrillation (AF) through irreversible cellular electroporation has not been well established. We report our experience of a protocol for deep sedation with ketamine in spontaneous respiration during the PFA of AF.

Methods and results
All consecutive patients undergoing PFA for AF at our center were included. Our sedation protocol involves the intravenous administration of fentanyl (1.5 mcg/kg) and midazolam (2 mg) at low doses before local anesthesia with lidocaine. A ketamine adjunct (1 mg/kg) was injected about 5 minutes before the first PFA delivery. We enrolled 66 patients (age = 59 ± 9 years, 78.8% males, body mass index = 28.8 ± 5 kg/m2, fluoroscopy time = 21[15–30] min, skin-to-skin time = 75[60–100] min and PFA LA dwell time = 25[22–28] min). By the end of the procedure, PVI had been achieved in all patients by means of PFA alone. The mean time under sedation was 56.4 ± 6 min, with 50 (76%) patients being sedated for less than 1 hour. A satisfactory Ramsey Sedation Scale level before ketamine infusion was achieved in all patients except one (78.8% of the patients with rank 3; 19.7% with rank 2). In all procedures, the satisfaction level was found to be acceptable by both the patient and the primary operator (Score = 0 in 98.5% of cases). All patients reported none or mild pain. No major procedure or anesthesia-related complications were reported.

Conclusion
Our standardized sedation protocol with the administration of drugs with rapid onset and pharmacological offset at low doses was safe and effective, with an optimal degree of patient and operator satisfaction.

Clinical trial registration
Advanced TecHnologies For SuccEssful AblatioN of AF in Clinical Practice (ATHENA). URL: http://clinicaltrials.gov/Identifier: NCT05617456.
Repeatable randomness, invariant properties, and the design of biological signatures of identity
Authors: Dixit Tanmay , Chen Kuan-Chi , Stoddard Mary Caswell , Mahadevan Lakshminarayanan , Town Christopher P , Spottiswoode Claire N 
Published: July 2023

Abstract
What makes a perfect signature? Optimal signatures should be consistent within individuals and distinctive between individuals. In defense against avian brood parasitism, some host species have evolved “signatures” of identity on their eggs, comprising interindividual variation in color and pattern. Tawny-flanked prinia (Prinia subflava) egg signatures facilitate recognition and rejection of parasitic cuckoo finch (Anomalospiza imberbis) eggs. Here, we show that consistency and distinctiveness of patterns are negatively correlated in prinia eggs, perhaps because non-random, repeatable pattern generation mechanisms increase consistency but limit distinctiveness. We hypothesize that pattern properties which are repeatable within individuals but random between individuals (“invariant properties”) allow hosts to circumvent this trade-off. To find invariant properties, we develop a method to quantify entire egg phenotypes from images taken from different perspectives. We find that marking scale (a fine-grained measure of size), but not marking orientation or position, is an invariant property in prinias. Hosts should therefore use differences in marking scale in egg recognition, but instead field experiments show that these differences do not predict rejection of conspecific eggs by prinias. Overall, we show that invariant properties allow consistency and distinctiveness to coexist, yet receiver behavior is not optimally tuned to make use of this information.
Hands on Biofilm! Utilizing a public audience in a citizen science project to assess yield variability when culturing kombucha pellicle
Authors: Verran Joanna , Redfern James , Cunliffe Alex , Romachney Anna , Wood Jane 
Published: July 2023

Abstract
The pellicle biofilm generated during the Kombucha tea fermentation process has, when dried, textile-like properties that may have real-life applications. However, pellicle yield can vary depending on inoculation and incubation conditions, which affects research investigations on the properties of the pellicle. To generate data on variability to help define optimum pellicle growth conditions, as part of a public engagement event about biofilm, a citizen science activity was hosted whereby visitors to a science festival were invited to select incubation conditions and inoculate different media with liquid or solid (pellicle). More than 220 samples were inoculated (in excess of 1200 visitors, mainly in family groups). The most popular incubation conditions were coconut water or tea medium, 30°C/room temperature and liquid inoculum. The most productive/reproducible in terms of yield and variability were tea medium, 30°C, and liquid inoculum, which reflect some of the conditions most used in the domestic setting for kombucha culture. The event provided both useful research data and generated public interest in a research area of which many will have been unaware. Interest in the results of the activity, available several weeks after the activity, was sustained using email contact and FlickR for the dissemination of images and data.
Arbitration chambers and technology: witness tampering and perceived effectiveness in videoconferenced dispute resolution proceedings
Authors: Brantes Ferreira Daniel , Giovannini Cristiane , Gromova Elizaveta A , Ferreira Jorge Brantes 
Published: July 2023

Abstract
Ongoing technological advance brings change and arise trust issues in several traditional environments. Attitude and experience towards present and future use of online digital technologies and services in ADR proceedings may colour user perception of the effectiveness and trustworthiness of the technology employed. This study presents an exploratory analysis on issues related to non-presential ADR hearings and proceedings considering trust and assurance issues that intermediating technologies may bring. The data, collected in conjunction with an online survey and analysed using content analysis, points to that virtual hearings are in the early stages and users still suffer from technology anxieties and lack of practical experience. Also, human nature plays an important part in raising reliability issues for witness hearings and virtual proceedings.
Rolipram Ameliorates Memory Deficits and Depression-Like Behavior in APP/PS1/tau Triple Transgenic Mice: Involvement of Neuroinflammation and Apoptosis via cAMP Signaling
Authors: Cong Yi-Fan , Liu Fu-Wang , Xu Li , Song Shuang-Shuang , Shen Xu-Ri , Liu Dong , Hou Xue-Qin , Zhang Han-Ting 
Published: July 2023

Abstract

Background
Alzheimer disease (AD) and depression often cooccur, and inhibition of phosphodiesterase-4 (PDE4) has been shown to ameliorate neurodegenerative illness. Therefore, we explored whether PDE4 inhibitor rolipram might also improve the symptoms of comorbid AD and depression.

Methods
APP/PS1/tau mice (10 months old) were treated with or without daily i.p. injections of rolipram for 10 days. The animal groups were compared in behavioral tests related to learning, memory, anxiety, and depression. Neurochemical measures were conducted to explore the underlying mechanism of rolipram.

Results
Rolipram attenuated cognitive decline as well as anxiety- and depression-like behaviors. These benefits were attributed at least partly to the downregulation of amyloid-β, Amyloid precursor protein (APP), and Presenilin 1 (PS1); lower tau phosphorylation; greater neuronal survival; and normalized glial cell function following rolipram treatment. In addition, rolipram upregulated B-cell lymphoma-2 (Bcl-2) and downregulated Bcl-2-associated X protein (Bax) to reduce apoptosis; it also downregulated interleukin-1β, interleukin-6, and tumor necrosis factor-α to restrain neuroinflammation. Furthermore, rolipram increased cAMP, PKA, 26S proteasome, EPAC2, and phosphorylation of ERK1/2 while decreasing EPAC1.

Conclusions
Rolipram may mitigate cognitive deficits and depression-like behavior by reducing amyloid-β pathology, tau phosphorylation, neuroinflammation, and apoptosis. These effects may be mediated by stimulating cAMP/PKA/26S and cAMP/exchange protein directly activated by cAMP (EPAC)/ERK signaling pathways. This study suggests that PDE4 inhibitor rolipram can be an effective target for treatment of comorbid AD and depression.
Trauma, Home, and Geopolitical Bordering: A Lacanian Approach to the COVID-19 Crisis
Authors: Kinnvall Catarina , Svensson Ted 
Published: July 2023

Abstract
In this article, we read the COVID-19 pandemic from a Lacanian perspective, in which trauma and ontological insecurity are at the heart of the analysis. Using a psychoanalytical approach allows us to grasp why the most common response to the pandemic consisted of intensified commitments to home, nationalism, and exclusionary bordering practices and, in effect, a return to geopolitical notions of “sovereignty.” This can be read in light of Lacan’s discussion of memory as a form of repetition, implying that any attempt to construe history in terms of a coherent narrative misses the unconscious, traumatic compulsion to repeat. In light of this, we consider populist responses to the pandemic as well as how the pandemic has worked as a “great unequalizer.” Such developments, we argue, must be read as representing a fragmentation of the national body and as heightening the vulnerabilities and asymmetric structures of power that inhere in what Lacan refers to as the symbolic order. Here, we propose that a postcolonial re-conceptualization of Lacan’s understanding of the mirror image and the Real is necessary if we wish to establish how the pandemic has reinforced existing patterns of abjectification and marginalization.
Impact of veterinary antibiotics on plasmid-encoded antibiotic resistance transfer
Authors: Hallal Ferreira Raro Otávio , Poirel Laurent , Tocco Maurine , Nordmann Patrice 
Published: July 2023

Abstract

Objectives
Resistance genes can be genetically transmitted and exchanged between commensal and pathogenic bacterial species, and in different compartments including the environment, or human and animal guts (One Health concept). The aim of our study was to evaluate whether subdosages of antibiotics administered in veterinary medicine could enhance plasmid transfer and, consequently, resistance gene exchange in gut microbiota.

Methods
Conjugation frequencies were determined with Escherichia coli strains carrying IncL- (blaOXA-48) or IncI1-type (blaCTX-M-1) plasmids subjected to a series of subinhibitory concentrations of antibiotics used in veterinary medicine, namely amoxicillin, ceftiofur, apramycin, neomycin, enrofloxacin, colistin, erythromycin, florfenicol, lincomycin, oxytetracycline, sulfamethazine, tiamulin and the ionophore narasin. Treatments with subinhibitory dosages were performed with and without supplementation with the antioxidant edaravone, known as a mitigator of the inducibility effect of several antibiotics on plasmid conjugation frequency (PCF). Expression of SOS-response associated genes and fluorescence-based reactive oxygen species (ROS) detection assays were performed to evaluate the stress oxidative response.

Results
Increased PCFs were observed for both strains when treating with florfenicol and oxytetracycline. Increased expression of the SOS-associated recA gene also occurred concomitantly, as well as increased ROS production. Addition of edaravone to the treatments reduced their PCF and also showed a decreasing effect on SOS and ROS responses for both plasmid scaffolds.

Conclusions
We showed here that some antibiotics used in veterinary medicine may induce transfer of plasmid-encoded resistance and therefore may contribute to the worldwide spread of antibiotic resistance genes.