bluuebunny/crossref_metadata_2025_split huggingface dataset:
The evolution of antibiotic resistance in an incurable and ultimately fatal infection
Authors: Woods Robert J , Barbosa Camilo , Koepping Laura , Raygoza Juan A , Mwangi Michael , Read Andrew F 
Published: May 2023

Abstract

Background and objectives
The processes by which pathogens evolve within a host dictate the efficacy of treatment strategies designed to slow antibiotic resistance evolution and influence population-wide resistance levels. The aim of this study is to describe the underlying genetic and phenotypic changes leading to antibiotic resistance within a patient who died as resistance evolved to available antibiotics. We assess whether robust patterns of collateral sensitivity and response to combinations existed that might have been leveraged to improve therapy.

Methodology
We used whole-genome sequencing of nine isolates taken from this patient over 279 days of a chronic infection with Enterobacter hormaechei, and systematically measured changes in resistance against five of the most relevant drugs considered for treatment.

Results
The entirety of the genetic change is consistent with de novo mutations and plasmid loss events, without acquisition of foreign genetic material via horizontal gene transfer. The nine isolates fall into three genetically distinct lineages, with early evolutionary trajectories being supplanted by previously unobserved multi-step evolutionary trajectories. Importantly, although the population evolved resistance to all the antibiotics used to treat the infection, no single isolate was resistant to all antibiotics. Evidence of collateral sensitivity and response to combinations therapy revealed inconsistent patterns across this diversifying population.

Conclusions
Translating antibiotic resistance management strategies from theoretical and laboratory data to clinical situations, such as this, will require managing diverse population with unpredictable resistance trajectories.
Rapid, accurate publication and dissemination of clinical trial results: benefits and challenges
Authors: Zannad Faiez , Crea Filippo , Keaney John , Spencer Stuart , Hill Joseph A , Pfeffer Marc A , Pocock Stuart , Raderschadt Emma , Ross Joseph S , Sacks Chana A , Van Spall Harriette G C , Winslow Ron , Jessup Mariell 
Published: May 2023

Abstract
Large-scale clinical trials are essential in cardiology and require rapid, accurate publication, and dissemination. Whereas conference presentations, press releases, and social media disseminate information quickly and often receive considerable coverage by mainstream and healthcare media, they lack detail, may emphasize selected data, and can be open to misinterpretation. Preprint servers speed access to research manuscripts while awaiting acceptance for publication by a journal, but these articles are not formally peer-reviewed and sometimes overstate the findings. Publication of trial results in a major journal is very demanding but the use of existing checklists can help accelerate the process. In case of rejection, procedures such as easing formatting requirements and possibly carrying over peer-review to other journals could speed resubmission. Secondary publications can help maximize benefits from clinical trials; publications of secondary endpoints and subgroup analyses further define treatment effects and the patient populations most likely to benefit. These rely on data access, and although data sharing is becoming more common, many challenges remain. Beyond publication in medical journals, there is a need for wider knowledge dissemination to maximize impact on clinical practice. This might be facilitated through plain language summary publications. Social media, websites, mainstream news outlets, and other publications, although not peer-reviewed, are important sources of medical information for both the public and for clinicians. This underscores the importance of ensuring that the information is understandable, accessible, balanced, and trustworthy. This report is based on discussions held on December 2021, at the 18th Global Cardiovascular Clinical Trialists meeting, involving a panel of editors of some of the top medical journals, as well as members of the lay press, industry, and clinical trialists.
Association of healthy dietary patterns and cardiorespiratory fitness in the community
Authors: Mi Michael Y , Gajjar Priya , Walker Maura E , Miller Patricia , Xanthakis Vanessa , Murthy Venkatesh L , Larson Martin G , Vasan Ramachandran S , Shah Ravi V , Lewis Gregory D , Nayor Matthew 
Published: May 2023

Abstract

Aims
To evaluate the associations of dietary indices and quantitative cardiorespiratory fitness (CRF) measures in a large, community-based sample harnessing metabolomic profiling to interrogate shared biology.

Methods and results
Framingham Heart Study (FHS) participants underwent maximum effort cardiopulmonary exercise tests for CRF quantification (via peak VO2) and completed semi-quantitative food frequency questionnaires. Dietary quality was assessed by the Alternative Healthy Eating Index (AHEI) and Mediterranean-style Diet Score (MDS), and fasting blood concentrations of 201 metabolites were quantified. In 2380 FHS participants (54 ± 9 years, 54% female, body mass index 28 ± 5 kg/m2), 1 SD higher AHEI and MDS were associated with 5.2% (1.2 mL/kg/min, 95% CI 4.3–6.0%, P &lt; 0.0001) and 4.5% (1.0 mL/kg/min, 95% CI 3.6–5.3%, P &lt; 0.0001) greater peak VO2 in linear models adjusted for age, sex, total daily energy intake, cardiovascular risk factors, and physical activity. In participants with metabolite profiling (N = 1154), 24 metabolites were concordantly associated with both dietary indices and peak VO2 in multivariable-adjusted linear models (FDR &lt; 5%). Metabolites that were associated with lower CRF and poorer dietary quality included C6 and C7 carnitines, C16:0 ceramide, and dimethylguanidino valeric acid, and metabolites that were positively associated with higher CRF and favourable dietary quality included C38:7 phosphatidylcholine plasmalogen and C38:7 and C40:7 phosphatidylethanolamine plasmalogens.

Conclusion
Higher diet quality is associated with greater CRF cross-sectionally in a middle-aged community-dwelling sample, and metabolites highlight potential shared favourable effects on cardiometabolic health.
Protecting and promoting the rights of the ‘reserve army of labour’: a policy analysis of structural determinants of migrant worker health in Pakistan and Qatar
Authors: Hawkes Sarah , Evagora-Campbell Mireille , Zahidie Aysha , Rabbani Fauziah , Buse Kent 
Published: May 2023

Abstract
Labour migrants who travel overseas for employment can face deep health inequities driven in large part by upstream social and structural determinants of health. We sought to study the ‘labour migrant health ecosystem’ between one sending country (Pakistan) and one host country (Qatar), with a focus on how the ecosystem realizes the rights of labour migrants when addressing the social and structural determinants (e.g. housing, employment law, etc.) of health. Study objectives were to (1) undertake an in-depth review of policies addressing the structural and social determinants of the health of labour migrants in both Pakistan and Qatar, analysing the extent to which these policies align with global guidance, are equity-focused and have clear accountability mechanisms in place, and (2) explore national stakeholder perspectives on priority setting for labour migrant health. We used a mixed methods approach, combining policy content analysis and interviews with stakeholders in both countries. We found a wide range of guidance from the multilateral system on addressing structural determinants of the health of labour migrants. However, policy responses in Pakistan and Qatar contained a limited number of these recommended interventions and had low implementation potential and minimal reference to gender, equity and rights. Key national stakeholders had few political incentives to act and lacked inter-country coordination mechanisms required for an effective and cohesive response to labour migrant health issues. Effectively addressing such determinants to achieve health equity for labour migrants will depend on a shift in governments’ attitudes towards migrants—from a reserve army of transient, replaceable economic resources to rights-holding members of society deserving of equality, dignity and respect.
On-pump beating-heart technique for managing a ruptured left coronary artery aneurysm
Authors: Hiromoto Atsushi , Sakamoto Shun-Ichiro , Suzuki Kenji , Ishii Yosuke 
Published: May 2023

Abstract
We present the case of an 86-year-old woman with a ruptured left coronary artery aneurysm associated with coronary-pulmonary artery fistula. She was transferred to our hospital with complaints of chest discomfort. Echocardiography revealed cardiac tamponade, and subsequently, a bloody pericardial effusion was drained. Coronary angiography and computed tomography revealed a ruptured left coronary artery aneurysm originating from a branch of the proximal left anterior descending artery and a coronary-pulmonary artery fistula. In the emergency operation, under cardiopulmonary bypass, the inlet and outlet vessels were ligated, and the aneurysm was closed without arresting the heart. By utilizing cardiopulmonary bypass, the pulmonary trunk was easily decompressed, and dissection around the aneurysm and identification of the inlet and outlet vessels was facilitated without cardiac arrest. Thus, to conclude, an on-pump beating-heart technique should be considered in such cases.
Outcomes of the arterial switch for transposition during infancy using a standardized approach over 30 years
Authors: Drury Nigel E , Mussa Shafi , Stickley John , Stumper Oliver , Crucean Adrian , Dhillon Rami , Seale Anna N , Botha Phil , Khan Natasha E , Barron David J , Brawn William J , Jones Timothy J ,   Collaborators†, Miller Paul A , Chikermane Ashish , Desai Tarak , Mehta Chetan , Bhole Vinay K , Chaudhari Milind P , Harris Michael , McGuirk Simon P 
Published: May 2023

Abstract

OBJECTIVES
The aim of this study was to describe the early and late outcomes of the arterial switch for transposition.

METHODS
A single-centre retrospective cohort study was conducted to assess the early and late outcomes of arterial switch performed during infancy using a standardized institutional approach between 1988 and 2018, compared by morphological groups.

RESULTS
A total of 749 consecutive patients undergoing arterial switch during infancy were included, 464 (61.9%) with intact septum, 163 (21.8%) with isolated ventricular septal defect and 122 (16.3%) with complex transposition with associated lesions, including 67 (8.9%) with Taussig–Bing anomaly. There were 34 early deaths [4.5%, 95% confidence interval (CI) 3.1–6.1] with only 10 (2.6%) early deaths since 2000. Complex morphology (odds ratio 11.44, 95% CI 4.76–27.43) and intramural coronary artery (odds ratio 5.17, 95% CI 1.61–15.91) were identified as the most important risk factors for 90-day mortality. Overall survival was 92.7% (95% CI 90.8–94.6) at 5 years and 91.9% (95% CI 89.9–94.1) at 20 years; in hospital survivors, there were 15 (2.1%) late deaths during a median follow-up of 13.7 years. Cumulative incidence of surgical or catheter reintervention was 16.0% (95% CI 14.5–17.5) at 5 years and 22.7% (95% CI 21.0–24.0) at 20 years; early and late reinterventions were more common in the complex group, with no difference between the other groups.

CONCLUSIONS
Using a standardized approach, the arterial switch can be performed with low early mortality, moderate rates of reintervention and excellent long-term survival. Concomitant lesions were the most important risk factor for early death and were associated with increased risk of late reintervention.
Asymmetric time-varying dependence and variable structure dependence measurement and analysis of EUA and CER
Authors: Yang Xing , Ye Yi-ting , Li Jia-wen , Mi Jun-long 
Published: May 2023

Abstract
This paper analyzed the time-varying dependence and structural dependence between EU allowances (EUAs) and certified emission reductions (CERs) by using price fluctuation data from 2008 to 2021 on EU ETS. It was found that (1) there was a strong nonlinear spillover relationship between EUAs and CERs. From 14 March 2008 to 16 March 2012, the time-varying dependence values of EUAs and CERs were mostly between 0.6 and 1 and the mean coefficient of dependence was 0.86, showing a strong interdependence. From 17 March 2012 to 2 January 2017, the correlation between them was mostly below 0.6 and the mean coefficient of dependence fell to 0.25. This indicates that the dependency between EUA futures and CER futures was very low at this stage. However, in general, the mean value of dependence was above 0.55, that is, there was a dependency between them. (2) From 14 March 2008 to 2 January 2017, there were 12 structural mutation points in EUA and CER yield sequences. After four mutation points, the dependence coefficient increased and the structural dependence enhanced. Meanwhile, after eight mutation points, the dependence coefficient decreased and the structural dependence weakened. The overall level remained above 0.6, showing the existence of structural dependence. (3) Abrupt changes in EUA and CER prices were closely related to the promulgation of major policies and unpredictable emergencies. The former caused carbon prices to fluctuate slightly. When the period of change was short and the recovery was rapid, it caused sharp fluctuations in carbon prices. When the duration of change was long, and the recovery was slow, it yielded impacts that extend far beyond the publication of important information.
Bacterial Vaginosis and Spontaneous Clearance of Chlamydia trachomatis in the Longitudinal Study of Vaginal Flora
Authors: Brown Sarah E , Tuddenham Susan , Shardell Michelle D , Klebanoff Mark A , Ghanem Khalil G , Brotman Rebecca M 
Published: May 2023

Abstract

Background
Up to 26% of urogenital Chlamydia trachomatis infections spontaneously resolve between detection and treatment. Mechanisms governing natural resolution are unknown. We examined whether bacterial vaginosis (BV) was associated with greater chlamydia persistence versus spontaneous clearance in a large, longitudinal study.

Methods
Between 1999 and 2003, the Longitudinal Study of Vaginal Flora followed reproductive-age women quarterly for 1 year. Baseline chlamydia screening and treatment were initiated after ligase chain reaction testing became available midstudy, and unscreened endocervical samples were tested after study completion. Chlamydia clearance and persistence were defined between consecutive visits without chlamydia-active antibiotics (n = 320 persistence/n = 310 clearance). Associations between Nugent score (0–3, no BV; 4–10, intermediate/BV), Amsel-BV, and chlamydia persistence versus clearance were modeled with alternating and conditional logistic regression.

Results
Of chlamydia cases, 48% spontaneously cleared by the next visit (310/630). Nugent-intermediate/BV was associated with higher odds of chlamydia persistence (adjusted odds ratio [aOR] = 1.89; 95% confidence interval [CI], 1.30–2.74), and the findings were similar for Amsel-BV (aOR 1.39; 95% CI, .99–1.96). The association between Nugent-intermediate/BV and chlamydia persistence was stronger in a within-participant analysis of 67 participants with both clearance/persistence intervals (aOR = 4.77; 95% CI, 1.39–16.35). BV symptoms did not affect any results.

Conclusions
BV is associated with greater chlamydia persistence. Optimizing the vaginal microbiome may promote chlamydia clearance.
Lipopolysaccharide and Glycolipoprotein Coordinately Triggered Necroptosis Contributes to the Pathogenesis of Leptospira Infection in Mice
Authors: Du Lin , Wu Yunqiang , Pan Yuqing , Wang Lingxia , Zhang Haiwei , Li Jiayin , Liu Ya’nan , Zhang Haibing , He Ping 
Published: May 2023

Abstract
Leptospirosis is a recurring but neglected zoonotic disease caused by pathogenic Leptospira. The explicit underlying mechanism of necroptosis and its role in Leptospira infection have not yet been elucidated. Here we reported that leptospiral pathogen-associated molecular patterns, lipopolysaccharide, and glycolipoprotein activate the necroptotic RIPK1-RIPK3-MLKL cascade through the TLR4 signaling pathway in mouse macrophages. Using the murine acute leptospirosis model, we reveal that abolition of necroptosis exhibited significantly improved outcomes in acute phases, with enhanced eradication of Leptospira from liver, mild clinical symptoms, and decreased cytokine production. RIPK3 was also found to exert a necroptosis-independent function in CXCL1 production and neutrophil recruitment, with the consequence of improved Leptospira control. These findings improve our understanding of the mechanism of Leptospira-macrophage interactions, indicating potential therapeutic values by targeting necroptosis signaling pathways.
The Sympathetic Nervous System Is Necessary for Development of CD4+ T-Cell Memory Following Staphylococcus aureus Infection
Authors: Reel Jessica M , Abbadi Jumana , Bueno A Jesse , Cizio Katarazyna , Pippin Richard , Doyle D Annie , Mortan Laura , Bose Jeffrey L , Cox Maureen A 
Published: May 2023

Abstract
Lymph nodes and spleens are innervated by sympathetic nerve fibers that enter alongside arteries. Despite discovery of these nerve fibers nearly 40 years ago, the role of these nerves during response to infection remains poorly defined. We have found that chemical depletion of sympathetic nerve fibers compromises the ability of mice to develop protective immune memory to a Staphylococcus aureus infection. Innate control of the primary infection was not impacted by sympathectomy. Germinal center formation is also compromised in nerve-depleted animals; however, protective antibody responses are still generated. Interestingly, protective CD4+ T-cell memory fails to form in the absence of sympathetic nerves after S aureus infection.
Respiratory Virus–Specific Nasopharyngeal Lipidome Signatures and Severity in Infants With Bronchiolitis: A Prospective Multicenter Study
Authors: Kyo Michihito , Zhu Zhaozhong , Shibata Ryohei , Fujiogi Michimasa , Mansbach Jonathan M , Camargo Carlos A , Hasegawa Kohei 
Published: May 2023

AbstractBackgroundIn infant bronchiolitis, recent evidence indicates that respiratory viruses (eg, respiratory syncytial virus [RSV], rhinovirus [RV]) contribute to the heterogeneity of disease severity. Of the potential pathobiological molecules, lipids serve as signaling molecules in airway inflammation. However, little is known about the role of the airway lipidome in between-virus heterogeneity and disease severity.MethodsIn this multicenter prospective study of 800 infants hospitalized for RSV or RV bronchiolitis, we analyzed nasopharyngeal lipidome data. We examined discriminatory lipids between RSV and RV infection and the association of the discriminatory lipids with bronchiolitis severity, defined by positive pressure ventilation (PPV) use.ResultsWe identified 30 discriminatory nasopharyngeal lipid species and 8 fatty acids between RSV and RV infection. In the multivariable models adjusting for patient-level confounders, 8 lipid species—for example, phosphatidylcholine (18:2/18:2) (adjusted odds ratio [aOR], 0.23 [95% confidence interval {CI}, .11–.44]; false discovery rate [FDR] = 0.0004) and dihydroceramide (16:0) (aOR, 2.17 [95% CI, 1.12–3.96]; FDR = 0.04)—were significantly associated with the risk of PPV use. Additionally, 6 fatty acids—for example, eicosapentaenoic acid (aOR, 0.27 [95% CI, .11–.57]; FDR = 0.01)—were also significantly associated with the risk of PPV use.ConclusionsIn infants hospitalized for bronchiolitis, the nasopharyngeal lipidome plays an important role in the pathophysiology of between-virus heterogeneity and disease severity.
Prevalence of neonatal near miss in Africa: a systematic review and meta-analysis
Authors: Haile Teklehaimanot Gereziher , Gebregziabher Dawit , Gebremeskel Gebreamlak Gebremedhn , Mebrahtom Guesh , Aberhe Woldu , Hailay Abrha , Zereabruk Kidane , Gebrewahd Gebremeskel Tukue , Getachew Tamirat 
Published: May 2023

Abstract

Background
Neonatal near miss (NNM) applies to cases where newborns almost died during the first 28 d of life but survived life-threatening conditions following birth. The most vulnerable time for infant survival is the neonatal stage, corresponding to almost 50% of deaths occurring at &lt;5 y of age. No study indicates the overall pooled prevalence of NNM in Africa. Thus this review aimed to estimate the overall pooled prevalence of NNMs in Africa.

Methods
Articles were retrieved through a comprehensive search strategy using PubMed/MEDLINE, Embase, Health InterNetwork Access to Research Initiative, Cochrane Library and Google Search. Data extraction was done independently by all authors. Forest plots and tables were used to represent the original data. The statistical heterogeneity was evaluated using I2 statistics. There was heterogeneity between the included articles. Therefore the authors used a meta-analysis of random effects to estimate the aggregate pooled prevalence of NNM in Africa. Funnel plot and Egger regression test methods were used to assess possible publication bias. R software version 3.5.3 and R studio version 1.2.5003 were used to analyse the data. The guideline of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used to publish this article. The review was registered on the International Prospective Register of Systematic Reviews (registration ID: CRD42021290223).

Results
Through an exhaustive search, we found 835 articles. However, we considered only eight full-text articles to be included in this meta-analysis. The analysis of included studies showed that the overall pooled prevalence of NNM in Africa was 30% (95% confidence interval [CI] 16 to 44). The subgroup analysis by study year showed that the prevalence of NNM from 2012–2015 and 2018–2019 was 36% (95% CI 23 to 49) and 20% (95% CI 1 to 39), respectively.

Conclusion
This finding suggests that the pooled prevalence of NNM is high in Africa as compared with other studies. Therefore the government and other stakeholders working on maternal and child health should assist in the design of interventions and strategies for improving the quality of neonatal care.