bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Testing Strategies to Combat a Major Syphilis Outbreak Among Australian Aboriginal and Torres Strait Islander Peoples: A Mathematical Modeling Study
Authors: Hui Ben B , Ward James S , Guy Rebecca , Law Matthew G , Gray Richard T , Regan David G 
Published: March 2022

Abstract

Background
A syphilis outbreak among Australian Aboriginal and Torres Strait Islander people (respectfully referred to as Aboriginal) has resulted in almost 4000 notifications by 2020, with several congenital syphilis cases and infant deaths. Outbreak control efforts became coordinated under a National enhanced test and treat response in 2017. We evaluated the impact of these efforts and of expansion of testing interventions on syphilis prevalence.

Methods
We developed an individual-based mathematical model of infectious syphilis transmission among young heterosexual Aboriginal people aged 15–34 years living in and moving between regional and remote areas, and we assessed the impact of existing and hypothetical outbreak control responses on syphilis prevalence.

Results
The increased testing coverage achieved through the response (from 18% to 39% over 2011–2020) could stabilize the epidemic from 2021. To return to pre-outbreak prevalence (&lt;0.24%) by 2025, testing coverage must reach 60%. The addition of annual community-wide screening, where 30% of youth in communities are tested over 6 weeks, would reduce prevalence to the pre-outbreak level within 4 years. If testing coverage had been scaled-up to 60% at the start of outbreak in mid-2011, the outbreak would have been mitigated.

Conclusions
Our results suggest that to control the syphilis outbreak, the response needs to be delivered to enable the maximum coverage of testing to be reached in the shortest time to reduce the prevalence to pre-outbreak levels. Reduction could be hastened with community-wide screening at similar time periods across all communities together with increases in annual testing coverage.
Tracking metabolites at single-cell resolution reveals metabolic dynamics during plant mitosis
Authors: Okubo-Kurihara Emiko , Ali Ahmed , Hiramoto Mika , Kurihara Yukio , Abouleila Yasmine , Abdelazem Eman Muhammad , Kawai Takayuki , Makita Yuko , Kawashima Mika , Esaki Tsuyoshi , Shimada Hiroaki , Mori Tetsuya , Hirai Masami Yokota , Higaki Takumi , Hasezawa Seiichiro , Shimizu Yoshihiro , Masujima Tsutomu , Matsui Minami 
Published: March 2022

One-sentence summary
Analyzing only one cell allows the changes and characteristics of intracellular metabolites during the chromosome segregation process to be precisely captured and mitotic sub-phases to be dissected at the metabolite level.
Use of IMMPACT Recommendations to Explore Pain Phenotypes in People with Knee Osteoarthritis
Authors: Carlesso Lisa C , Feldman Debbie Ehrmann , Vendittoli Pascal-André , LaVoie Frédéric , Choinière Manon , Bolduc Marie-Ève , Fernandes Julio , Newman Nicholas , Sabouret Pierre 
Published: March 2022

Abstract

Objective
Knee osteoarthritis (OA) is a disease of multiple phenotypes of which a chronic pain phenotype (PP) is known. Previous PP studies have focused on one domain of pain and included heterogenous variables. We sought to identify multidimensional PPs using the IMMPACT recommendations and their relationship to clinical outcomes.

Methods
Participants &gt;40 years of age with knee OA having a first-time orthopedic consultation at five university affiliated hospitals in Montreal, Quebec, and Hamilton (Canada) were recruited. Latent profile analysis was used to determine PPs (classes) using variables recommended by IMMPACT. This included pain variability, intensity and qualities, somatization, anxiodepressive symptoms, sleep, fatigue, pain catastrophizing, neuropathic pain, and quantitative sensory tests. We used MANOVA and χ2 tests to assess differences in participant characteristics across the classes and linear and Poisson regression to evaluate the association of classes to outcomes of physical performance tests, self-reported function and provincial healthcare data.

Results
In total, 343 participants were included (mean age 64 years, 64% female). Three classes were identified with increasing pain burden (class3 &gt; class1), characterized by significant differences across most self-report measures and temporal summation, and differed in terms of female sex, younger age, lower optimism and pain self-efficacy. Participants in class2 and class3 had significantly worse self-reported function, stair climb and 40 m walk tests, and higher rates of healthcare usage compared to those in class1.

Conclusions
Three distinct PPs guided by IMMPACT recommendations were identified, predominated by self-report measures and temporal summation. Using this standardized approach may improve PP study variability and comparison.
Daniel versus Jonson: Books, Beasts and Birds
Authors: Pitcher John 
Published: March 2022

Abstract
The dispute between Samuel Daniel and Ben Jonson lasted two decades, until Daniel’s death in 1619. The story is usually told only from Jonson’s perspective. It began c. 1599 with Jonson’s vying with Daniel for the patronage of Lucy, Countess of Bedford. At the accession of James, Jonson presented himself as the decipherer of the court’s images. He was dismissive of Daniel’s learning and lack of sophistication, but it was Daniel who was chosen to write the first masque at court. The dispute became more vehement in 1605–1607. Jonson suggested Daniel was a brainless time-server and a plagiarist, and Daniel identified Jonson as a wolf trying to get under Lady Bedford’s skin (alluding to the goat emblem on the covers of the Countess’s books). This was when Jonson announced his claim to be the Horace of the age—not just in the public theatres (as in Poetaster), but to the elite of the Jacobean court. At this point Daniel was facing a Privy Council enquiry into his play, Philotas, but he survived. His tragicomedy, The Queen’s Arcadia, was successful when the King and court visited Oxford University in 1605, in events to which Jonson was probably not invited. The essay examines what Daniel said about (as he thought) Jonson’s indecorous fictions and his bullying—and how and why Daniel said these things, through allusions to Lady Bedford’s books, to the persona of the less judgemental Horace (i.e., not Jonson’s version) and to his own sickness and withdrawal from the debate.
Negative Symptom Domains in Children and Adolescents at Ultra-High Risk for Psychosis: Association With Real-Life Functioning
Authors: Giordano Giulia Maria , Palumbo Davide , Pontillo Maria , Mucci Armida , Galderisi Silvana , Vicari Stefano 
Published: March 2022

Abstract

Background
Negative symptoms (NS) appear early in subjects at ultra-high risk (UHR) for psychosis and may increase the risk of conversion to psychotic disorders and poor outcome. Contrary to schizophrenia, there is no consensus on the conceptualization and factor structure of NS in UHR subjects. This study aims to explore NS prevalence, factor structure, and impact on the outcome of UHR state in children and adolescents.

Methods
71 UHR were recruited at the Neuropsychiatry Unit of the Hospital Bambino Gesù in Rome. We examined the prevalence of NS of at least moderate severity, the factor structure of NS by Principal Component Analysis (PCA) and Confirmatory Factor Analysis (CFA), and correlations between extracted factors and functioning. We also evaluated the severity of baseline NS in subjects who converted to psychosis (converters) and in those who did not convert (nonconverters) at 1-year follow-up.

Results
At baseline, all participants showed at least one NS of at least moderate severity. PCA and CFA yielded a two-factor solution: an ‘‘Expressive” and an “Experiential” factor. Only the Experiential factor was associated with functioning. At baseline, severity of NS did not differ between converters (N = 16) and nonconverters (N = 55).

Conclusions
In UHR children and adolescents NS have a high prevalence, a significant impact on functioning, and cluster in two-factors. Replications by independent studies, with state-of-the-art instruments and longer duration of follow-up, are needed to improve the characterization of NS in this population, clarify their impact on the outcome and enhance their early identification, prevention, and treatment.
Amiodarone with or without N-Acetylcysteine for the Prevention of Atrial Fibrillation after Thoracic Surgery: A Double-blind, Randomized Trial
Authors: Amar David , Zhang Hao , Chung Mina K. , Tan Kay See , Desiderio Dawn , Park Bernard J. , Pedoto Alessia , Roistacher Nancy , Isbell James M. , Molena Daniela , Milne Ginger L. , Meyers Bryan F. , Fischer Gregory W. , Rusch Valerie W. , Jones David R. 
Published: March 2022

Background
Postoperative atrial fibrillation may identify patients at risk of subsequent atrial fibrillation, with its greater risk of stroke. This study hypothesized that N-acetylcysteine mitigates inflammation and oxidative stress to reduce the incidence of postoperative atrial fibrillation.

Methods
In this double-blind, placebo-controlled trial, patients at high risk of postoperative atrial fibrillation scheduled to undergo major thoracic surgery were randomized to N-acetylcysteine plus amiodarone or placebo plus amiodarone. On arrival to the postanesthesia care unit, N-acetylcysteine or placebo intravenous bolus (50 mg/kg) and then continuous infusion (100 mg/kg over the course of 48 h) was administered plus intravenous amiodarone (bolus of 150 mg and then continuous infusion of 2 g over the course of 48 h). The primary outcome was sustained atrial fibrillation longer than 30 s by telemetry (first 72 h) or symptoms requiring intervention and confirmed by electrocardiography within 7 days of surgery. Systemic markers of inflammation (interleukin-6, interleukin-8, tumor necrosis factor α, C-reactive protein) and oxidative stress (F2-isoprostane prostaglandin F2α; isofuran) were assessed immediately after surgery and on postoperative day 2. Patients were telephoned monthly to assess the occurrence of atrial fibrillation in the first year.

Results
Among 154 patients included, postoperative atrial fibrillation occurred in 15 of 78 who received N-acetylcysteine (19%) and 13 of 76 who received placebo (17%; odds ratio, 1.24; 95.1% CI, 0.53 to 2.88; P = 0.615). The trial was stopped at the interim analysis because of futility. Of the 28 patients with postoperative atrial fibrillation, 3 (11%) were discharged in atrial fibrillation. Regardless of treatment at 1 yr, 7 of 28 patients with postoperative atrial fibrillation (25%) had recurrent episodes of atrial fibrillation. Inflammatory and oxidative stress markers were similar between groups.

Conclusions
Dual therapy comprising N-acetylcysteine plus amiodarone did not reduce the incidence of postoperative atrial fibrillation or markers of inflammation and oxidative stress early after major thoracic surgery, compared with amiodarone alone. Recurrent atrial fibrillation episodes are common among patients with postoperative atrial fibrillation within 1 yr of major thoracic surgery.

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An Online, Modular Curriculum Enhances Surgical Education and Improves Learning Outcomes in East, Central, and Southern Africa: A Mixed-Methods Study
Authors: Parker Andrea S. , Steffes Bruce C. , Hill Katherine , Bachheta Niraj , Mangaoang Deirdre , Mwachiro Michael , Torbeck Laura , White Russell E. , Bekele Abebe , Parker Robert K. 
Published: March 2022

Objective:
We aimed to determine the impact of a standardized curriculum on learning outcomes for surgical trainees in East, Central, and Southern Africa (ECSA).

Background:
As surgical education expands throughout ECSA, there is a recognized need for a standardized curriculum. We previously described the design of a novel, large-scale, flipped-classroom, surgical curriculum for trainees in ECSA.

Methods:
In January 2020, the first year of curricular content for trainees of the College of Surgeons of ECSA was released, containing 11 monthly thematic topics, each with 2 to 5 weekly modular subtopics. We aimed to evaluate 3 outcomes utilizing data sources incorporated into the curriculum structure. Learner engagement was assessed by the number of trainees completing curriculum topics. User experience was evaluated using quantitative and qualitative feedback responses to embedded surveys for each content week. Curriculum impact on trainee examination performance was assessed by comparing certification examination scores stratified by the number of curricular topics each trainee completed.

Results:
Two hundred seventy-one trainees (96%) in 17 countries accessed at least 1 weekly module. Trainees completed a median of 9 topics (interquartile range: 6–10). The feedback survey response rate was 92% (5742/6233). Quantitative and qualitative responses were positive in overall module value (93.7% + 2.6%), amount of learning experienced (97.9% + 1.4%), confidence in achieving learning objectives (97.1% + 2.4%), and ease of use of the module (77.6% + 5.98%). Topic-related certification examination performance improved significantly with increased completion of thematic topics.

Conclusions:
A standardized surgical curriculum in ECSA demonstrated excellent trainee usage, positive feedback, and improved examination scores.
Design of a Novel Online, Modular, Flipped-classroom Surgical Curriculum for East, Central, and Southern Africa
Authors: Parker Andrea S. , Hill Katherine A. , Steffes Bruce C. , Mangaoang Deirdre , O’Flynn Eric , Bachheta Niraj , Bates Maria F. , Bitta Caesar , Carter Nicholas H. , Davis Richard E. , Dressler Jeremy A. , Eisenhut Deborah A. , Fadipe Akinniyi E. , Kanyi John K. , Kauffmann Rondi M. , Kazal Frances , Kyamanywa Patrick , Lando Justus O. , Many Heath R. , Mbithi Valentine C. , McCoy Amanda J. , Meade Peter C. , Ndegwa Wairimu Y.B. , Nkusi Emmy A. , Ooko Philip B. , Osilli Dixon J.S. , Parker Madison E.D. , Rankeeti Sinkeet , Shafer Katherine , Smith James D. , Snyder David , Sylvester Kimutai R. , Wakeley Michelle E. , Wekesa Marvin K. , Torbeck Laura , White Russell E. , Bekele Abebe , Parker Robert K. 
Published: March 2022

Objective:
We describe a structured approach to developing a standardized curriculum for surgical trainees in East, Central, and Southern Africa (ECSA).

Summary Background Data:
Surgical education is essential to closing the surgical access gap in ECSA. Given its importance for surgical education, the development of a standardized curriculum was deemed necessary.

Methods:
We utilized Kern’s 6-step approach to curriculum development to design an online, modular, flipped-classroom surgical curriculum. Steps included global and targeted needs assessments, determination of goals and objectives, the establishment of educational strategies, implementation, and evaluation.

Results:
Global needs assessment identified the development of a standardized curriculum as an essential next step in the growth of surgical education programs in ECSA. Targeted needs assessment of stakeholders found medical knowledge challenges, regulatory requirements, language variance, content gaps, expense and availability of resources, faculty numbers, and content delivery method to be factors to inform curriculum design. Goals emerged to increase uniformity and consistency in training, create contextually relevant material, incorporate best educational practices, reduce faculty burden, and ease content delivery and updates. Educational strategies centered on developing an online, flipped-classroom, modular curriculum emphasizing textual simplicity, multimedia components, and incorporation of active learning strategies. The implementation process involved establishing thematic topics and subtopics, the content of which was authored by regional surgeon educators and edited by content experts. Evaluation was performed by recording participation, soliciting user feedback, and evaluating scores on a certification examination.

Conclusions:
We present the systematic design of a large-scale, context-relevant, data-driven surgical curriculum for the ECSA region.
EVALUATION OF MORNING GLORY SYNDROME BY SWEPT SOURCE OPTICAL COHERENCE TOMOGRAPHY
Authors: Ohno-Matsui Kyoko , Akiba Masahiro , Ishibashi Tatsuro , Hirakata Akito 
Published: March 2022

Purpose:
The purpose of this study was to investigate the deep structural abnormalities in the patients with morning glory syndrome by using swept source optical coherence tomography.

Methods:
The papillary and peripapillary areas of the four eyes (four patients) with morning glory syndrome were examined with a prototype swept source optical coherence tomography system with a center wavelength of 1,050 nm. In particular, the abnormalities of the lamina cribrosa and peripapillary sclera were evaluated.

Results:
The lamina cribrosa was posteriorly displaced in all the four eyes, and the disk area was filled with herniated retinal tissue. A bump-like protrusion near the papillary margin or within the cup area was observed in three eyes. Some tissues were observed to exist between the retina and the sclera surrounding the papillary margin annularly. In one case, swept source optical coherence tomography detected intrascleral adipose tissue in a relatively wide area around the fovea and the optic nerve.

Conclusion:
Swept source optical coherence tomography clearly delineated the papillary and peripapillary abnormalities of morning glory syndrome. Scleral structural abnormalities were present outside the optic nerve as well.
Preventing Potentially Inappropriate Use of Antibiotics Using the World Health Organization AWaRe Tool
Authors: Maria Lis , Thomas Femy , Thomas Maria , Shibuchan Diya , Mathew Meby Susan , Warrier Anup R. , Karunakaran Priya , Xavier Adhin Antony 
Published: March 2022

Background
To avert the rise in antimicrobial resistance, the World Health Organization (WHO) introduced the AWaRe (Access, Watch, Reserve) tool to its Essential Medicines List in 2017. In India, only few studies analyzing the antibiotic prescribing pattern according to AWaRe tool were conducted, most of which included data from wholesale databases.

Aim
This study was aimed at analyzing the antibiotic prescriptions in the outpatient (OP) clinic of a quaternary care hospital as per the WHO AWaRe tool.

Method
This observational study collected the details of patients who received at least 1 oral/intravenous antibiotic and visited the OP clinic during August 2018 to August 2019. The data were collected from electronic medical record, and it included patient demographics, department, and name of antibiotics prescribed. The proportion of antibiotic use was measured as per WHO AWaRE tool.

Results
A total of 23,088 antibiotic prescriptions were collected from 58 departments. It was found that 41.32% of antibiotics were from the Access group, whereas 51.01% were from the Watch group and 1.19% from the Reserve group. Amoxicillin-clavulanic acid (Access), azithromycin (Watch), and linezolid (Reserve) were the commonly prescribed antibiotics in the OP department.

Conclusions
Considering the overall use, the Watch group antibiotics were used to a great extent compared with that of the Access antibiotics, which contradicts the recommended WHO AWaRe criteria. This simple and easy-to-apply antibiotic use monitoring tool, “AWaRe,” must be aligned with the local antibiogram to serve the patient best.
When to Use Amisulpride in Adolescents
Authors: Tuncturk Mustafa , Ermis Cagatay , Saglam Yesim , Can Merve , Yuksel Ayse Sena , Akca Dilara , Alarslan Sezen , Atay Ayca , Ciray Remzi Ogulcan , Turan Serkan , Karacetin Gul 
Published: March 2022

Abstract

Purpose/Background
Despite increasing interest in amisulpride, current knowledge about its use in the pediatric population is scarce. This chart review aimed to investigate the use of amisulpride in a naturalistic adolescent population.

Methods/Procedures
Electronic medical records of a tertiary care adolescent inpatient unit were screened between January 2015 and April 2021. Sociodemographic data and all clinical information were collected via data collection forms, and targeted symptoms were obtained from patients' files. Patients with early-onset psychotic disorders (n = 58), bipolar I disorder (n = 29), major depressive disorder (n = 14), and other psychiatric diagnoses (n = 9) were included. Treatment response was defined as a Clinical Global Impression–Improvement of at least much improvement after treatment.

Findings/Results
Median titration rate of amisulpride was 400 mg/wk, and the maximum administered daily dose ranged between 100 and 1200 mg/d. The maximum daily dose and number of previous antipsychotics were higher in the early-onset psychotic disorder group. Persistent positive symptoms and resistance to previous treatments were leading causes for amisulpride treatment. Other indications were also impulsive/disruptive behaviors, antipsychotic adverse effects, depressive symptoms, somatic complaints, and abnormalities in liver function tests. Finally, patients with lower daily treatment doses and more previous antipsychotic trials are less likely to benefit from the treatment.

Implications/Conclusions
Persistent psychotic/mood symptoms, impulsive/disruptive behaviors, and abnormalities in liver function tests were reasons for the amisulpride treatment in adolescents. Randomized placebo-controlled trials are needed to evaluate the efficacy and safety of the treatment in adolescents.
Aripiprazole as First-Line Therapy for Late-Life Depression
Authors: Sonal Akanksha , Srivastava Shrikant 
Published: March 2022

Abstract

Background
Aripiprazole, structurally considered a third-generation antipsychotic agent, is an effective adjuvant strategy for managing treatment-resistant depression. It has been used successfully as an add-on agent in late-life depression (LLD), but there are no controlled trials on its use as first-line therapy, either alone or in combination with an antidepressant.

Methods
This is a case note review of aripiprazole prescribed to outpatients with LLD as a first-line therapy either in combination with an antidepressant or as a monotherapy. The local ethics committee approved the audit. Case notes of subjects with Hamilton Rating Scale for Depression scores of ≥11 and with at least 1 follow-up visit were included in the review. Remission was defined as the first occurrence of achieving a Hamilton Rating Scale for Depression score of <10.

Results
Case notes of 54 subjects (mean age, 68.6 ± 6.9 years) were included, 52 of whom had unipolar depression. Aripiprazole alone was prescribed in 21 subjects, and with an antidepressant in the remaining subjects. The overall remission rate was 59% over 21 weeks, and in the remitted subjects (n = 32), the cumulative remission rate increased from 22% at week 2 to 82% at week 10. No subject discontinued treatment because of poor tolerability or serious adverse events.

Conclusions
Aripiprazole was found to be an effective first-line antidepressant in LLD. The remission rates in the present study were considerably higher than the published literature on antidepressant monotherapy in fresh episodes of LLD. This warrants controlled trials of aripiprazole as a first-line antidepressant for this disease entity.