bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dissemination of the
Acinetobacter baumannii
isolates belonging to global clone 2 containing AbGRI resistance islands in a referral hospital
Authors: Naderi Ghazal , Asadian Mahla , Seifi Arash , Ghourchian Sedigheh , Talebi Malihe , Rahbar Mohammad , Abdollahi Alireza , Douraghi Masoumeh 
Published: August 2023

ABSTRACT

Acinetobacter baumannii
strains belonging to global clone 2 (GC2) contain resistance islands (AbGRIs), which are composed of genes conferring resistance to older and newer antibiotics. Here, to locate these genes in AbGRIs, the GC2 strains from Tehran, Iran were examined. Among the 170
A
.
baumannii
, 90 isolates were identified as GC2. Of the genes that confer resistance to older antibiotics,
tetA(B
),
tetR(B)
(tetracyclines),
strA
, and
strB
(aminoglycosides) were located in AbGRI1 of 65 GC2 isolates (72.2%). Of the other aminoglycosides, the
aphA1b
was located in AbGRI2-12b (63.6%), AbGRI2-12a (21.2%), or AbGRI2-1 (15.1%). The
aacC1
and
aadA1
genes were co-located within AbGRI2-1 (5.5%). The
armA
was located in AbGRI3-4 (77.7%) and AbGRI3
ABI221
(22.2%). Of sulfonamides, the
sul1
was located within AbGRI2-1 (5.5%). Of beta-lactams, the

bla
TEM

was located in AbGRI2-12b (42%), AbGRI2-12a (14%), AbGRI2-1 (10%), or AbGRI2
ABI257
(34%). The
oxa23
gene conferring resistance to newer antibiotics (carbapenems) was located in AbaR4 (81.1%); of them, the AbaR4 was located within AbGRI1 in 45.2% of the isolates. This study showed that the GC2 isolates, which contained at least one AbGRI, disseminate in the hospital. Hence, it is likely that the AbGRIs play a significant role in conferring resistance to older and newer antibiotics in GC2 isolates from Iran.

IMPORTANCE

The majority of
Acinetobacter baumannii
isolates that are resistant to multiple antibiotics belong to one of the two major global clones, namely global clone 1 (GC1) and global clone 2 (GC2). The resistance islands, which contain variable assortments of transposons, integrons, and specific resistance genes, have been characterized in the genome of these GCs. In GC2
A. baumannii,
the chromosomally located
A. baumannii
genomic resistance islands (AbGRIs) carry the genes conferring resistance to older and newer antibiotics. In this context, we tested whether GC2 isolates collected from a referral hospital carry the AbGRIs containing these genes. This study provided evidence for the circulation of the GC2
A. baumannii
strains harboring AbGRI resistance islands between different wards of a referral hospital.
Sustainability of performance improvements after 26 Kaizen events in a large academic hospital system: a mixed methods study
Authors: Haapatalo Erik , Reponen Elina , Torkki Paulus 
Published: August 2023

IntroductionImplementing Kaizen can improve productivity in healthcare but maintaining long-term results has proven challenging. This study aimed to assess improved performance achieved and sustained by Kaizen events and find explanatory factors for the persistence or decline of long-term results.MethodsKaizen events were conducted in 26 specialised healthcare units in a large academic hospital system in southern Finland. Primary data for mixed methods analysis was collected from each unit with 21 semi-structured interviews, Kaizen report files and performance metrics.ResultsFifteen explanatory factors were found in this study. Work culture and motivation for continuous improvement stood out as the most important explanatory factor for the persistence of long-term results—lack of time for improvement activities and high workload for the decline. Success in preparation and follow-up was associated with sustained long-term results. Thirteen units achieved long-term results, three units could not sustain the performance improvements and five units struggled to make any improvements.ConclusionsThis study explains the long-term sustainability of performance improvements, bringing new insights to Kaizen research. Our findings can guide organising successful Kaizen events. The events can be worth organising even though long-term performance improvements are not guaranteed. Units with supportive working culture and motivation for the Kaizen event will likely succeed. A unit should aim to create a supportive foundation for Kaizen before organising a Kaizen event. Units that lack the foundation can be identified, trained and guided to increase their chances of success. Pitfalls like high workload and insufficient follow-up should be proactively identified and appropriately managed by allocating the required time and resources for the development work.
Stress and safety of maternal and newborn healthcare workers early in the COVID-19 pandemic: a repeat cross-sectional analysis from a global online survey from March 2020 to March 2021
Authors: Ezema Ashley , Caputo Matthew , Semaan Aline , Benova Lenka , Liang Shu-ting , Hirschhorn Lisa R 
Published: August 2023

ObjectivesThis study aims to characterise the physical and psychological well-being of maternal and newborn healthcare workers (MNHCWs) during the COVID-19 pandemic.DesignObservational repeated cross-sectional study.SettingAn online questionnaire was distributed to MNHCWs around the globe in three separate rounds from March 2020 to March 2021.ParticipantsTotal samples of N=1357 (round 1) and N=420 (round 3) primarily consisted of doctors, midwives and nurses in maternal and newborn specialties. Samples represented all WHO regions, with 33% (round 1) and 42% (round 3) from low- or middle-income countries (LMICs).Primary and secondary outcome measuresResponses from rounds 1 (March–June 2020) and 3 (December 2020–March 2021) were analysed to measure self-reported levels of relative stress and workplace protection from COVID-19, while associated factors were determined through multivariable ordinal logistic regression.ResultsIn round 1, 90% of MNHCWs reported increased stress levels and 45% reported insufficient personal protective equipment (PPE) access. Nurses and physicians were less likely to report increased stress than midwives at the pandemic onset. Factors associated with increased stress included being female, being from an LMIC and insufficient PPE. In round 3, 75% reported similar or increased stress while 10% reported insufficient PPE. In both rounds, over 50% of MNHCWs felt relatively or completely unprotected from COVID-19 in the workplace. Those from LMICs were more likely to report feeling unprotected, while receiving organisational information that valued safety was associated with better feelings of protection in the workplace.ConclusionsAmong our international sample of MNHCWs, we observed high rates of self-reported stress increase at the start of the pandemic with persistence or increase up to a year later. High rates of feeling unprotected persisted even as PPE became more available. These results may inform interventions needed to support and protect MNHCWs during this and future pandemics.
Maternal and neonatal antibody levels on pertussis vaccination in pregnant women on immune-modulating therapy for rheumatic disease
Authors: Ghalandari Nafise , Immink Maarten M , Röder Esther , Bruijning-Verhagen Patricia C J , Smeele Hieronymus , Crijns Hubertina , van der Maas Nicoline A T , Bekker Mireille N , Sanders Elisabeth A M , Dolhain Radboud J E M 
Published: August 2023

ObjectivesWhile protection against pertussis following maternal tetanus-diphtheria-and-acellular-pertussis (Tdap) vaccination was demonstrated in healthy term-born infants, no evidence is available on Tdap vaccination in combination with immune-modulating therapy during pregnancy. In this pilot study, we explored whether treatment with tumour necrosis factor alpha inhibitors (TNFis) in pregnant patients with rheumatic disease interferes with Tdap vaccine responses and affects maternal anti-pertussis IgG antibody levels in newborns.MethodsPatients were included by a rheumatologist during pregnancy in case they received maternal Tdap vaccination in the late-second or early-third trimester of pregnancy. Blood samples were obtained from mothers during the first pregnancy trimester, 3 months after delivery and from the umbilical cord. IgG antibody levels against Tdap-included antigens were measured using a bead-based multiplex immunoassay. Findings on patients exposed to TNFis were compared with those from TNFi-unexposed patients and with data from a historical comparator study among healthy Tdap vaccinated mother–infant pairs (n=53).Results66 patients (46 exposed and 20 unexposed to TNFIs) were enrolled. No major differences in IgG antibody levels were observed between TNFi-exposed and unexposed mothers before maternal Tdap vaccination and 3 months after delivery. In cord sera, however, antibody levels against pertussis toxin were significantly lower after TNFi-treatment (35.94 IU/mL, 95% CI 20.68 to 62.45) compared with no TNFi-treatment of mothers with rheumatic disease (94.61 IU/mL, 95% CI 48.89 to 183.07) and lower compared with a cohort of healthy mothers (125.12 IU/mL, 95% CI 90.75 to 172.50). We observed similar differences for filamentous haemagglutinin, pertactin, tetanus toxoid and diphtheria toxoid.ConclusionThese preliminary data indicate no major differences in IgG antibody levels on maternal Tdap vaccination in pregnant women with or without immune-modulating treatment, although our findings suggest that TNFis during pregnancy induce lower maternal anti-pertussis-specific protective antibody levels in newborns.
Palliative care delivery in India during COVID-19 pandemic: role of faith-based hospitals – a qualitative study
Authors: Sundararaj Jenifer Jeba , Singh Ashita , Priscilla Ruby Angeline , John Priya , Duomai Savita , Munday Daniel , Powys Ruth , Boyd Kirsty J , Grant Liz , Murray Scott A 
Published: August 2023

ObjectivesThe COVID-19 pandemic challenged palliative care (PC) services globally. We studied the ways healthcare professionals (HCPs) working in faith-based hospitals (FBHs) experienced and adapted care through the pandemic, and how this impacted patients with PC needs.MethodsIn-depth interviews were conducted with HCPs from FBHs serving rural and urban population across India. Thematic analysis was conducted.ResultsA total of 10 in-depth interviews were conducted during the COVID-19 pandemic, first wave (4), second wave (4) and between them (2). HCPs described fear and stigma in the community early in the pandemic. Migrant workers struggled, many local health services closed and cancer care was severely affected. Access and availability of healthcare services was better during the second wave. During both waves, FBHs provided care for non-COVID patients, earning community appreciation. For HCPs, the first wave entailed preparation and training; the second wave was frightening with scarcity of hospital beds, oxygen and many deaths. Eight of the 10 FBHs provided COVID-19 care. PC teams adapted services providing teleconsultations, triaging home visits, delivering medications, food at home, doing online teaching for adolescents, raising funds. Strengths of FBHs were dedicated teamwork, staff care, quick response and adaptations to community needs, building on established community relationship.ConclusionFBHs remained open and continued providing consistent, good quality, person-centred care during the pandemic. Challenges were overcome innovatively using novel approaches, often achieving good outcomes despite limited resources. By defining and redefining quality using a PC lens, FBHs strengthened patient care services.
Identification of Human Ventricular Tachycardia Demarcated by Fixed Lines of Conduction Block in a 3-Dimensional Hyperboloid Circuit
Authors: Nishimura Takuro , Shatz Nathan , Weiss J. Peter , Zawaneh Michael , Bai Rong , Beaser Andrew D. , Upadhyay Gaurav A. , Aziz Zaid A. , Nayak Hemal M. , Shatz Dalise Y. , Miyazaki Shinsuke , Goya Masahiko , Sasano Tetsuo , Su Wilber , Raiman Michael , Tung Roderick 
Published: August 2023

BACKGROUND:
The circuit boundaries for reentrant ventricular tachycardia (VT) have been historically conceptualized within a 2-dimensional (2D) construct, with their fixed or functional nature unresolved. This study aimed to examine the correlation between localized lines of conduction block (LOB) evident during baseline rhythm with lateral isthmus boundaries that 3-dimensionally constrain the VT isthmus as a hyperboloid structure.

METHODS:
A total of 175 VT activation maps were correlated with isochronal late activation maps during baseline rhythm in 106 patients who underwent catheter ablation for scar-related VT from 3 centers (42% nonischemic cardiomyopathy). An overt LOB was defined by a deceleration zone with split potentials (≥20 ms isoelectric segment) during baseline rhythm. A novel application of pacing within deceleration zone (≥600 ms) was implemented to unmask a concealed LOB not evident during baseline rhythm. LOB identified during baseline rhythm or pacing were correlated with isthmus boundaries during VT.

RESULTS:
Among 202 deceleration zones analyzed during baseline rhythm, an overt LOB was evident in 47%. When differential pacing was performed in 38 deceleration zones without overt LOB, an underlying concealed LOB was exposed in 84%. In 152 VT activation maps (2D=53, 3-dimensional [3D]=99), 69% of lateral boundaries colocalized with an LOB in 2D activation patterns, and the depth boundary during 3D VT colocalized with an LOB in 79%. In VT circuits with isthmus regions that colocalized with a U-shaped LOB (n=28), the boundary invariably served as both lateral boundaries in 2D and 3D. Overall, 74% of isthmus boundaries were identifiable as fixed LOB during baseline rhythm or differential pacing.

CONCLUSIONS:
The majority of VT circuit boundaries can be identified as fixed LOB from intrinsic or paced activation during sinus rhythm. Analysis of activation while pacing within the scar substrate is a novel technique that may unmask concealed LOB, previously interpreted to be functional in nature. An LOB from the perspective of a myocardial surface is frequently associated with intramural conduction, supporting the existence of a 3D hyperboloid VT circuit structure. Catheter ablation may be simplified to targeting both sides around an identified LOB during sinus rhythm.
Impact of inhaled treprostinil on risk stratification with noninvasive parameters: a post hoc analysis of the TRIUMPH and BEAT studies
Authors: Tonelli Adriano R. , Sahay Sandeep , Gordon Kathryn W. , Edwards Lisa D. , Allmon Andrew G. , Broderick Meredith , Nelsen Andrew C. 
Published: August 2023

The 2015 European Society of Cardiology/European Respiratory Society treatment guidelines recommend frequent risk assessment in pulmonary arterial hypertension utilizing risk variables. Our objectives were: (1) to investigate the impact of inhaled treprostinil on risk stratification using the French noninvasive approach and REVEAL 2.0, and (2) to analyze the prognostic utility of both risk stratification methods in the predominantly New York Heart Association/World Health Organization functional class III/IV cohorts of TRIUMPH and BEAT. A post hoc analysis was performed to assess risk at baseline and follow‐up at Week 12 in the TRIUMPH cohort (n = 148) and at Week 16, 21, and 30 in the inhaled treprostinil naïve placebo BEAT cohort (n = 73). Overall survival, clinical worsening‐free survival, and pulmonary arterial hypertension‐related hospitalization‐free survival were all assessed in the pooled TRIUMPH and inhaled treprostinil naïve placebo BEAT cohorts based on risk group/strata at Week 12/16 follow‐up. Inhaled treprostinil improved REVEAL 2.0 risk stratum (OR: 2.38, 95% CI: 1.09–5.19, p = 0.0298) and REVEAL 2.0 score (p = 0.0008) compared to placebo in the TRIUMPH cohort at Week 12. REVEAL 2.0 risk stratum and the number of low‐risk criteria by the French approach improved at Weeks 16, 21, and 30 in the inhaled treprostinil naïve placebo BEAT cohort. Combining cohorts, REVEAL 2.0 risk stratification at follow‐up was prognostic for clinical worsening‐free, pulmonary arterial hypertension hospitalization‐free, and overall survival, whereas the number of low‐risk criteria was not. These post‐hoc pooled analyses suggest inhaled treprostinil improves risk status and indicates that the REVEAL 2.0 calculator may be more suitable than the French noninvasive method for evaluating short‐term clinical change in the New York Heart Association/World Health Organization functional class III/IV population.
GPRC5C drives branched-chain amino acid metabolism in leukemogenesis
Authors: Zhang Yu Wei , Velasco-Hernandez Talia , Mess Julian , Lalioti Maria-Eleni , Romero-Mulero Mari Carmen , Obier Nadine , Karantzelis Nikolaos , Rettkowski Jasmin , Schönberger Katharina , Karabacz Noémie , Jäcklein Karin , Morishima Tatsuya , Trincado Juan Luis , Romecin Paola , Martinez Alba , Takizawa Hitoshi , Shoumariyeh Khalid , Renders Simon , Zeiser Robert , Pahl Heike L. , Béliveau François , Hébert Josée , Lehnertz Bernhard , Sauvageau Guy , Menendez Pablo , Cabezas-Wallscheid Nina 
Published: August 2023

Abstract
Leukemia stem cells (LSCs) share numerous features with healthy hematopoietic stem cells (HSCs). G-protein coupled receptor family C group 5 member C (GPRC5C) is a regulator of HSC dormancy. However, GPRC5C functionality in acute myeloid leukemia (AML) is yet to be determined. Within patient AML cohorts, high GPRC5C levels correlated with poorer survival. Ectopic Gprc5c expression increased AML aggression through the activation of NF-κB, which resulted in an altered metabolic state with increased levels of intracellular branched-chain amino acids (BCAAs). This onco-metabolic profile was reversed upon loss of Gprc5c, which also abrogated the leukemia-initiating potential. Targeting the BCAA transporter SLC7A5 with JPH203 inhibited oxidative phosphorylation and elicited strong antileukemia effects, specifically in mouse and patient AML samples while sparing healthy bone marrow cells. This antileukemia effect was strengthened in the presence of venetoclax and azacitidine. Our results indicate that the GPRC5C–NF-κB-SLC7A5–BCAAs axis is a therapeutic target that can compromise leukemia stem cell function in AML.
Disparities in survival of hematologic malignancies in the context of social determinants of health: a systematic review
Authors: Miranda-Galvis Marisol , Tjioe Kellen C. , Balas E. Andrew , Agrawal Gagan , Cortes Jorge E. 
Published: August 2023

Abstract
Social determinants of health (SDHs) have been reported as relevant factors responsible for health inequity. We sought to assess clinical data from observational studies conducted in the United States evaluating the impact of SDHs on the outcomes of patients with hematologic malignancies. Thus, we performed a systematic review in 6 databases on 1 September 2021, in which paired reviewers independently screened studies and included data from 41 studies. We assessed the risk of bias using the Joanna Briggs Institute appraisal tools and analyzed the data using a descriptive synthesis. The most common SDH domains explored were health care access and quality (54.3%) and economic stability (25.6%); others investigated were education (19%) and social and community context (7.8%). We identified strong evidence of 5 variables significantly affecting survival: lack of health insurance coverage or having Medicare or Medicaid insurance, receiving cancer treatment at a nonacademic facility, low household income, low education level, and being unmarried. In contrast, the reports on the effect of distance traveled to the treatment center are contradictory. Other SDHs examined were facility volume, provider expertise, poverty, and employment rates. We identified a lack of data in the literature in terms of transportation, debt, higher education, diet, social integration, environmental factors, or stress. Our results underscore the complex nature of social, financial, and health care barriers as intercorrelated variables. Therefore, the management of hematologic malignancies needs concerted efforts to incorporate SDHs into clinical care, research, and public health policies, identifying and addressing the barriers at a patient-based level to enhance outcome equity (PROSPERO CRD42022346854)
AQP3-mediated activation of the AMPK/SIRT1 signaling pathway curtails gallstone formation in mice by inhibiting inflammatory injury of gallbladder mucosal epithelial cells
Authors: Wang Ganggang , Zhang Hao , Zhou Zhijie , Jin Wenzhi , Zhang Xin , Ma Zenghui , Wang Xiaoliang 
Published: August 2023

AbstractBackgroundInflammatory injury of gallbladder mucosal epithelial cells affects the development of cholelithiasis, and aquaporin 3 (AQP3) is an important regulator of inflammatory response. This study reports a mechanistic insight intoAQP3regulating gallstone formation in cholelithiasis based on high-throughput sequencing.MethodsA mouse model of cholelithiasis was induced using a high-fat diet, and the gallbladder tissues were harvested for high-throughput sequencing to obtain differentially expressed genes. Primary mouse gallbladder mucosal epithelial cells were isolated and induced with Lipopolysaccharides (LPS) to mimic an in vitro inflammatory injury environment. Cell biological phenotypes were detected by TdT-mediated dUTP Nick-End Labeling (TUNEL) assay, flow cytometry, Cell Counting Kit-8 (CCK-8) assay, and Trypan blue staining. In addition, enzyme linked immunosorbent assay (ELISA) determined the production of inflammatory factors in mouse gallbladder mucosa.ResultsWhole-transcriptome sequencing data analysis identified 489 up-regulated and 1007 down-regulated mRNAs. Bioinformatics analysis revealed thatAQP3was significantly down-regulated in mice with cholelithiasis.AQP3might also confer an important role in LPS-induced gallbladder mucosal injury. Overexpression ofAQP3activated theAMPK(adenosine monophosphate-activated protein kinase) /SIRT1(sirtuin-1) signaling pathway to reduce LPS-induced inflammatory injury of the gallbladder mucosa epithelium, thereby ameliorating gallbladder damage and repressing gallstone formation in mice.ConclusionData from our study highlight the inhibitory role ofAQP3in gallbladder damage and gallstone formation in mice by reducing inflammatory injury of gallbladder mucosal epithelial cells, which is achieved through activation of theAMPK/SIRT1signaling pathway.
Model of Surface Texture for Honed Gear Considering Motion Path and Geometrical Shape of Abrasive Particle
Authors: Liu Yuhu , Huang Xiaohui , Cao Huajun , Wang Jiacheng , Xiao Huapan 
Published: August 2023

AbstractGear power-honing is mainly applied to finish small and medium-sized automotive gears, especially in new energy vehicles. The distinctive curved surface texture greatly improves the noise emission and service life of honed gears. The surface texture for honed gear considering the motion path and geometrical shape of abrasive particles has not been investigated. In this paper, the kinematics of the gear honing process is analyzed, and the machining marks produced by the abrasive particles of honing wheel scratching abrasive particles against the workpiece gear are calculated. The tooth surface roughness is modeled considering abrasive particle shapes and material plastic pile-ups. This results in a mathematical model that characterizes the structure of the tooth surface and the orientation of the machining marks. Experiments were used to verify the model, with a maximum relative error of less than 10% when abrasive particles are spherical. Based on this model, the effects of process parameters on the speeds of discrete points on the tooth flank, orientations of machining marks and roughness are discussed. The results show that the shaft angle between the workpiece gear and the honing wheel and the speed of the honing wheel is the main process parameters affecting the surface texture. This research proposes a surface texture model for honed gear, which can provide a theoretical basis for optimizing process parameters for gear power-honing.