bluuebunny/crossref_metadata_2025_split huggingface dataset:
Crude Mortality Associated With the Empirical Use of Polymyxins in Septic Patients in a Setting of High Prevalence of Carbapenem-Resistant Gram-negative Bacteria: Retrospective Analysis of a Cohort
Authors: Bezerra Camila L P A M , dos Santos Eusébio L , Oliveira Maura S , Dias Maria Beatriz S , Levin Anna S , Freire Maristela P , Boszczowski Icaro , Salomão Matias C 
Published: July 2023

Abstract

Background
Our aim in this retrospective cohort study was to assess the impact on mortality of the empirical use of polymyxin as therapy for carbapenem-resistant gram-negative bacteria (CR-GNB) in septic patients. The study was performed at a tertiary academic hospital in Brazil, from January 2018 to January 2020, the pre–coronavirus disease 2019 period.

Methods
We included 203 patients with suspected sepsis. The first doses of antibiotics were prescribed from a “sepsis antibiotic kit”, which contained a selection of drugs, including polymyxin, with no preapproval policy. We developed a logistic regression model to assess risk factors associated with 14-day crude mortality. Propensity score for polymyxin was used to control biases.

Results
Seventy (34%) of 203 patients had infections with at least 1 multidrug-resistant organism isolated from any clinical culture. Polymyxins in monotherapy or in combination therapy were prescribed to 140 of the 203 (69%) patients. The overall 14-day mortality rate was 30%. The 14-day crude mortality was associated with age (adjusted odds ratio [aOR], 1.03; 95% confidence interval [CI], 1.01–1.05; P = .01), SOFA (sepsis-related organ failure assessment) score value (aOR, 1.2; 95% CI, 1.09–1.32; P &lt; .001), CR-GNB infection (aOR, 3.94; 95% CI, 1.53–10.14; P = .005), and time between suspected sepsis and antibiotic administration (aOR, 0.73; 95% CI, .65–.83; P &lt; .001). The empirical use of polymyxins was not associated with decreased crude mortality (aOR, 0.71; 95% CI, .29–1.71; P = .44).

Conclusions
Empirical use of polymyxin for septic patients in a setting with high CR-GNB prevalence was not associated with decreased crude mortality.
Maternal Colonization Versus Nosocomial Transmission as the Source of Drug-Resistant Bloodstream Infection in an Indian Neonatal Intensive Care Unit: A Prospective Cohort Study
Authors: Robinson Matthew L , Johnson Julia , Naik Shilpa , Patil Sunil , Kulkarni Rajesh , Kinikar Aarti , Dohe Vaishali , Mudshingkar Swati , Kagal Anju , Smith Rachel M , Westercamp Matthew , Randive Bharat , Kadam Abhay , Babiker Ahmed , Kulkarni Vandana , Karyakarte Rajesh , Mave Vidya , Gupta Amita , Milstone Aaron M , Manabe Yukari C 
Published: July 2023

Abstract

Background
Drug-resistant gram-negative (GN) pathogens are a common cause of neonatal sepsis in low- and middle-income countries. Identifying GN transmission patterns is vital to inform preventive efforts.

Methods
We conducted a prospective cohort study, 12 October 2018 to 31 October 2019 to describe the association of maternal and environmental GN colonization with bloodstream infection (BSI) among neonates admitted to a neonatal intensive care unit (NICU) in Western India. We assessed rectal and vaginal colonization in pregnant women presenting for delivery and colonization in neonates and the environment using culture-based methods. We also collected data on BSI for all NICU patients, including neonates born to unenrolled mothers. Organism identification, antibiotic susceptibility testing, and next-generation sequencing (NGS) were performed to compare BSI and related colonization isolates.

Results
Among 952 enrolled women who delivered, 257 neonates required NICU admission, and 24 (9.3%) developed BSI. Among mothers of neonates with GN BSI (n = 21), 10 (47.7%) had rectal, 5 (23.8%) had vaginal, and 10 (47.7%) had no colonization with resistant GN organisms. No maternal isolates matched the species and resistance pattern of associated neonatal BSI isolates. Thirty GN BSI were observed among neonates born to unenrolled mothers. Among 37 of 51 BSI with available NGS data, 21 (57%) showed a single nucleotide polymorphism distance of ≤5 to another BSI isolate.

Conclusions
Prospective assessment of maternal GN colonization did not demonstrate linkage to neonatal BSI. Organism-relatedness among neonates with BSI suggests nosocomial spread, highlighting the importance of NICU infection prevention and control practices to reduce GN BSI.
Effectiveness of Adjunctive High-Dose Infliximab Therapy to Improve Disability-Free Survival Among Patients With Severe Central Nervous System Tuberculosis: A Matched Retrospective Cohort Study
Authors: Manesh Abi , Gautam Priyanka , Kumar D Selwyn Selva , Mannam Pavithra , Jasper Anitha , Gunasekaran Karthik , Thomas Naveen Cherian , Benjamin Rohit Ninan , Inbaraj Leeberk Raja , Devasagayam Emily , George Mithun Mohan , Karthik Rajiv , Abraham Ooriapadickal Cherian , Vanjare Harshad A , Sivadasan Ajith , Appaswamy Prabhakar Thirumal , Jonathan Edmond , Michael Joy S , Samuel Prasanna , Varghese George M 
Published: July 2023

Abstract

Background
Few treatment options exist for patients with severe central nervous system (CNS) tuberculosis (TB) worsening due to inflammatory lesions, despite optimal antitubercular therapy (ATT) and steroids. Data regarding the efficacy and safety of infliximab in these patients are sparse.

Methods
We performed a matched retrospective cohort study based on Medical Research Council (MRC) grading system and modified Rankin Scale (mRS) scores comparing 2 groups of adults with CNS TB. Cohort A received at least 1 dose of infliximab after optimal ATT and steroids between March 2019 and July 2022. Cohort B received only ATT and steroids. Disability-free survival (mRS score ≤2) at 6 months was the primary outcome.

Results
Baseline MRC grades and mRS scores were similar between the cohorts. Median duration before initiation of infliximab therapy from start of ATT and steroids was 6 (IQR: 3.7–13) months and for neurological deficits was 4 (IQR: 2–6.2) months. Indications for infliximab were symptomatic tuberculomas (20/30; 66.7%), spinal cord involvement with paraparesis (8/30; 26.7%), and optochiasmatic arachnoiditis (3/30; 10%), worsening despite adequate ATT and steroids. Severe disability (5/30 [16.7%] and 21/60 [35%]) and all-cause mortality (2/30 [6.7%] and 13/60 [21.7%]) at 6 months were lower in cohort A versus cohort B, respectively. In the combined study population, only exposure to infliximab was positively associated (aRR: 6.2; 95% CI: 2.18–17.83; P = .001) with disability-free survival at 6 months. There were no clear infliximab-related side effects noted.

Conclusions
Infliximab may be an effective and safe adjunctive strategy among severely disabled patients with CNS TB not improving despite optimal ATT and steroids. Adequately powered phase 3 clinical trials are required to confirm these early findings.
Estimated Prevalence and Awareness of Hepatitis C Virus Infection Among US Adults: National Health and Nutrition Examination Survey, January 2017–March 2020
Authors: Lewis Karon C , Barker Laurie K , Jiles Ruth B , Gupta Neil 
Published: July 2023

Abstract
During January 2017–March 2020, approximately 2.2 million noninstitutionalized civilian US adults had hepatitis C; one-third were unaware of their infection. Prevalence was substantially higher among persons who were uninsured or experiencing poverty. Unrestricted access to testing and curative treatment is needed to reduce disparities and achieve 2030 elimination goals.
Needs and demands for mHealth cardiac health promotion among individuals with cardiac diseases: a patient-centred design approach
Authors: Jahre Lisa Maria , Lortz Julia , Rassaf Tienush , Rammos Christos , Mallien Charlotta , Skoda Eva-Maria , Teufel Martin , Bäuerle Alexander 
Published: July 2023

Abstract

Aims
Cardiovascular diseases are one of the main contributors to disability and mortality worldwide. Meanwhile, risk factors can be modified by lifestyle changes. mHealth is an innovative and effective way to deliver cardiac health promotion. This study aims to examine the needs and demands regarding the design and contents of an mHealth intervention for cardiac health promotion among individuals with cardiac diseases. Different clusters were determined and analysed in terms of the intention to use an mHealth intervention.

Methods and results
A cross-sectional study was conducted via a web-based survey. Three hundred and four individuals with coronary artery diseases (CADs) and/or congestive heart failure (CHF) were included in the data analysis. Descriptive statistics were applied to evaluate needs and demands regarding an mHealth intervention. A k-medoids cluster analysis was performed. Individuals with CAD and CHF favoured an mHealth intervention that supports its users permanently and is easily integrated into everyday life. Handheld devices and content formats that involve active user participation and regular updates were preferred. Three clusters were observed and labelled high, moderate, and low burden, according to their psychometric properties. The high burden cluster indicated higher behavioural intention towards use of an mHealth intervention than the other clusters.

Conclusion
The results of the study are a valuable foundation for the development of an mHealth intervention for cardiac health promotion following a user-centred design approach. Individuals with cardiac diseases report positive attitudes in the form of high usage intention regarding mHealth. Highly burdened individuals report a high intention to use such interventions.
Fully automatic estimation of global left ventricular systolic function using deep learning in transoesophageal echocardiography
Authors: Berg Erik Andreas Rye , Taskén Anders Austlid , Nordal Trym , Grenne Bjørnar , Espeland Torvald , Kirkeby-Garstad Idar , Dalen Håvard , Holte Espen , Stølen Stian , Aakhus Svend , Kiss Gabriel 
Published: July 2023

Abstract

Aims
To improve monitoring of cardiac function during major surgery and intensive care, we have developed a method for fully automatic estimation of mitral annular plane systolic excursion (auto-MAPSE) using deep learning in transoesophageal echocardiography (TOE). The aim of this study was a clinical validation of auto-MAPSE in patients with heart disease.

Methods and results
TOE recordings were collected from 185 consecutive patients without selection on image quality. Deep-learning-based auto-MAPSE was trained and optimized from 105 patient recordings. We assessed auto-MAPSE feasibility, and agreement and inter-rater reliability with manual reference in 80 patients with and without electrocardiogram (ECG) tracings. Mean processing time for auto-MAPSE was 0.3 s per cardiac cycle/view. Overall feasibility was &gt;90% for manual MAPSE and ECG-enabled auto-MAPSE and 82% for ECG-disabled auto-MAPSE. Feasibility in at least two walls was ≥95% for all methods. Compared with manual reference, bias [95% limits of agreement (LoA)] was −0.5 [−4.0, 3.1] mm for ECG-enabled auto-MAPSE and −0.2 [−4.2, 3.6] mm for ECG-disabled auto-MAPSE. Intra-class correlation coefficient (ICC) for consistency was 0.90 and 0.88, respectively. Manual inter-observer bias [95% LoA] was −0.9 [−4.7, 3.0] mm, and ICC was 0.86.

Conclusion
Auto-MAPSE was fast and highly feasible. Inter-rater reliability between auto-MAPSE and manual reference was good. Agreement between auto-MAPSE and manual reference did not differ from manual inter-observer agreement. As the principal advantages of deep-learning-based assessment are speed and reproducibility, auto-MAPSE has the potential to improve real-time monitoring of left ventricular function. This should be investigated in relevant clinical settings.
Policy-induced expansion of organic farmland: implications for food prices and welfare
Authors: Mérel Pierre , Qin Zhiran , Sexton Richard J 
Published: July 2023

Abstract
Public policies increasingly support the expansion of organic agriculture as part of a menu of food and environmental initiatives. A little-studied yet crucial element of such expansion, especially in light of scientific evidence on lower yields of organic crops, is its impact on overall food production and food prices, especially for poorer households. In this paper, we first establish a positive empirical relationship between countries’ propensity to produce and consume organic foods and their per-capita income. Such correlation suggests that, even if rich countries’ consumers can benefit from an increase in the organic farmland share, poor countries’ consumers would likely face higher conventional food prices. We then develop and calibrate a model of world food demand and supply to assess the implications of a policy-driven expansion in organic farmland. Our results for four major grains and oilseeds show that raising the organic cropland share in rich countries from 3 to 15 per cent increases food prices in poor countries by up to 6.3 per cent, with central values of 1.2–2.5 per cent, and a commensurate reduction in consumer welfare. Model parameterisations indicate that farmers in poor countries benefit from higher crop prices, while consumers in rich countries are largely unaffected and sometimes benefit. In all cases, poor countries’ consumers bear most of the distortion burden. In our preferred parameterisation, a 3 per cent increase in cropland in rich countries is needed to offset the food price increase in poor countries.
Selective and non-selective right bundle pacing for the diagnosis of bundle branch reentry ventricular tachycardia
Authors: Nageh Maged F , Murdock Robert 
Published: July 2023

Abstract

Aims and background
Bundle branch reentry ventricular tachycardia (BBRVT) can be seen in patients with conduction disease. In this report, we describe the use of conduction system pacing for its diagnosis.

Methods and results
BBRVT was induced in two patients with infra-nodal conduction disease. Bundle branch reentry ventricular tachycardia with a left bundle branch block morphology was observed in the first patient (type A), whereas the second patient had a right bundle branch block morphology (type C).
The diagnosis of BBRVT was confirmed in both patients by ventriculo-atrial dissociation, and the interdependence of the conduction system and the ventricular tachycardia cycle length variations.
Selective and non-selective RB pacing was observed in the two patients during apical right ventricular pacing for entrainment of BBRVT with evidence of manifest entrainment with non-selective RB capture in the first patient, and concealed entrainment by selective RB capture in the second patient. Other criteria for entrainment including a short post-pacing interval at the right bundle pacing site were noted.

Conclusion
Right bundle pacing is feasible in patients with BBRVT and may be a helpful manoeuver for the diagnosis of BBRVT.
A resource of human coronavirus protein-coding sequences in a flexible, multipurpose Gateway Entry clone collection
Authors: Weller Benjamin , Lin Chung-Wen , Pogoutse Oxana , Sauer Mayra , Marin-de la Rosa Nora , Strobel Alexandra , Young Veronika , Knapp Jennifer J , Rayhan Ashyad , Falter Claudia , Kim Dae-Kyum , Roth Frederick P , Falter-Braun Pascal 
Published: July 2023

Abstract
The COVID-19 pandemic has catalyzed unprecedented scientific data and reagent sharing and collaboration, which enabled understanding the virology of the SARS-CoV-2 virus and vaccine development at record speed. The pandemic, however, has also raised awareness of the danger posed by the family of coronaviruses, of which 7 are known to infect humans and dozens have been identified in reservoir species, such as bats, rodents, or livestock. To facilitate understanding the commonalities and specifics of coronavirus infections and aspects of viral biology that determine their level of lethality to the human host, we have generated a collection of freely available clones encoding nearly all human coronavirus proteins known to date. We hope that this flexible, Gateway-compatible vector collection will encourage further research into the interactions of coronaviruses with their human host, to increase preparedness for future zoonotic viral outbreaks.
Analysis of reconstructed multisource and multiscale 3-D digital rocks based on the cycle-consistent generative adversarial network method
Authors: Yan Weichao , Chi Peng , Golsanami Naser , Sun Jianmeng , Xing Huilin , Li Sanzhong , Dong Huaimin 
Published: July 2023

SUMMARY
Digital rock physics (DRP) is important for characterizing the pore characteristics and petrophysical parameters of rocks from a microscopic perspective. Among the digital rock reconstruction methods, the most widely used is the computer tomography (CT) scan method. However, the pore structure of rocks has multiscale features, and CT scan images with a single resolution cannot completely describe the pore structure characteristics of rocks. In this paper, we analysed reconstructed multisource and multiscale 3-D digital rocks based on the cycle-consistent generative adversarial network (CycleGAN) method. This method fully integrates the advantages of the large field of view of low-resolution images and the high-precision features of high-resolution images. To investigate the performance of the method, two sequences of CT scan images of a sandstone (sample A) and a carbonate rock (sample B) collected from oilfields were studied. Moreover, due to the high resolution of scanning electron microscope (SEM) images, we also constructed 3-D digital rocks with different resolutions of the Berea sandstone based on the combination of CT scan images and SEM images. Finally, the statistical properties and absolute permeabilities were calculated to evaluate the accuracies of reconstructed multisource and multiscale 3-D digital rocks. The results show that the reconstructed multiscale digital rocks based on the CycleGAN method have good accuracy in terms of statistical properties and petrophysical properties. Considering the computational cost and computational accuracy, for high- and low-resolution CT scan images and CT scan images with SEM images as training image data sources, we suggest that the resolution of the reconstructed multiscale digital cores is 4–8 times and 4–16 times higher than that of the low-resolution CT scan images, respectively. The findings of our research will be helpful in gaining insight into the petrophysical properties of heterogeneous rocks.
Doctors for the people? The problematic distribution of rural service doctors in Ecuador
Authors: Romero-Alvarez Daniel , López-Cevallos Daniel F , Torres Irene 
Published: July 2023

Abstract
Primary health care is at the core of health systems that aim to ensure equitable health outcomes. With an estimated 36% of rural population, Ecuador has a service year programme (created in 1970) for recently graduated doctors to provide primary care services in rural and remote communities. However, little has been done to monitor or evaluate the programme since its inception. The aim of this study was to assess Ecuador’s rural medical service implementation with a focus on equitable distribution of doctors across the country. For this purpose, we analysed the distribution of all doctors, including rural service doctors, in health-care facilities across rural and remote areas of Ecuador in the public sector at the canton level for 2015 and 2019, by level of care (primary, secondary and tertiary). We used publicly available data from the Ministry of Public Health, the Ecuadorian Institute of Social Security and the Peasant Social Security. Our analyses show that two of every three rural service doctors are concentrated at the secondary level, while almost one in five rural service doctors, at the tertiary level. Moreover, cantons concentrating most rural service doctors were in the country’s major urban centres (Quito, Guayaquil, Cuenca). To our knowledge, this is the first quantitative assessment of the mandatory rural service year in Ecuador in its five-decade existence. We provide evidence of gaps and inequities impacting rural communities and present decision makers with a methodology for placement, monitoring and support of the rural service doctors programme, provided that legal and programmatic reforms come into place. Changing the programme’s approach would be more likely to fulfill the intended goals of rural service and contribute to strengthening primary health care.
Loss of collagen gene expression in the notochord of the tailless tunicate Molgula occulta
Authors: Popsuj Sydney , Di Gregorio Anna , Swalla Billie J , Stolfi Alberto 
Published: July 2023

Synopsis
In tunicates, several species in the Molgulidae family have convergently lost the tailed, swimming larval body plan, including the morphogenesis of the notochord, a major chordate-defining trait. Through the comparison of tailless M. occulta and a close relative, the tailed species M. oculata, we show that notochord-specific expression of the Collagen Type I/II Alpha (Col1/2a) gene appears to have been lost specifically in the tailless species. Using CRISPR/Cas9-mediated mutagenesis in the tailed laboratory model tunicate Ciona robusta, we demonstrate that Col1/2a plays a crucial role in the convergent extension of notochord cells during tail elongation. Our results suggest that the expression of Col1/2a in the notochord, although necessary for its morphogenesis in tailed species, is dispensable for tailless species. This loss is likely a result of the accumulation of cis-regulatory mutations in the absence of purifying selective pressure. More importantly, the gene itself is not lost, likely due to its roles in other developmental processes, including during the adult stage. Our study further confirms the Molgulidae as an interesting family in which to study the evolutionary loss of tissue-specific expression of indispensable genes.
Spatial distributional shifts and associated body condition changes of haddock (Melanogrammus aeglefinus) following population expansion
Authors: Jónsdóttir I G , Björnsson B , Ragnarsson S Á , Elvarsson B Þ , Sólmundsson J 
Published: July 2023

Abstract
Temperature fluctuations impact the distribution of various marine fish species and typically result in distributional changes, seeing either a geographical expansion or, possibly, a retraction. Survival and fitness in the new habitat depend, however, on the species’ adaptability capacity. Here, we describe changes in geographical distribution of Icelandic haddock (Melanogrammus aeglefinus) based on annual survey data for a 38-year period, 1985–2022. Most of the stock is in the warm waters off the south and west coasts of Iceland (south area), but a small proportion in colder water masses off the north and east coasts (north area). Due to high recruitment, density increased greatly in both areas in the years 2001–2005. Haddock density was usually higher in the south area in 1985–2004, in the north area in 2005–2014, but similar in both areas in 2015–2022. Haddock condition was found to be influenced by both temperature and haddock density. Density-dependent factors influenced haddock mean weight, which dropped considerable during times of high haddock density. Capelin was of great importance as a diet, especially in the south, where stomach fullness decreased considerably when capelin was not a part of the diet. Food availability seems to be highly variable between the two areas but more stable in the north, where fluctuations in capelin fullness were small. Even though favourable environmental conditions may result in increased haddock density in the colder waters in the north, lower condition indicates that the northern area may be less suitable for this species.