bluuebunny/crossref_metadata_2025_split huggingface dataset:
A case report of atrial fibrillation in early adulthood: dig deeper
Authors: Masding Abigail , Hoschtitzky Andreas , Gatzoulis Michael 
Published: July 2022

Abstract

Background
Atrial fibrillation (AF) is a common cardiac arrhythmia, which is often associated with underlying risk factors and undiagnosed conditions, including congenital heart disease. Atrial septal defects (ASDs) come to mind, albeit arrhythmias usually present later in life. We present herewith a young patient with cor triatriatum sinister (CTS), with some delay in establishing the diagnosis, following new onset AF in early adulthood.

Case summary
A 31-year-old man presented with pre-syncope and coryzal symptoms and was newly diagnosed with AF in the context of an intercurrent viral illness. After treatment with oral anticoagulation and successful outpatient cardioversion, he was discharged from cardiology review. Two years later he re-presented with exercise intolerance and a 12-lead electrocardiogram revealing recurrence of AF. Subsequent investigation with transthoracic echocardiography revealed the underlying congenital cardiac defect of CTS, together with an ASD and patent foramen ovale. After corrective surgery, which involved membrane resection, a Cox-maze procedure and ASD closure, sinus rhythm was restored and at follow-up the patient had returned to baseline function.

Discussion
Young patients presenting with new onset AF should undergo thorough cardiovascular assessment to identify treatable causes and reversible risk factors. Cor triatriatum sinister is a rare congenital anomaly that may present in adulthood and give rise to symptomatic AF. Surgical correction including a Cox-maze procedure in our patient resulted in restoration of sinus rhythm and a return of the patient’s baseline functional status and improved quality of life.
Phylogenomic analysis and metabolic role reconstruction of mutualistic Rhizobiales hindgut symbionts of Acromyrmex leaf-cutting ants
Authors: Zhukova Mariya , Sapountzis Panagiotis , Schiøtt Morten , Boomsma Jacobus J 
Published: July 2022

Abstract
Rhizobiales are well-known plant-root nitrogen-fixing symbionts, but the functions of insect-associated Rhizobiales are poorly understood. We obtained genomes of three strains associated with Acromyrmex leaf-cutting ants and show that, in spite of being extracellular gut symbionts, they lost all pathways for essential amino acid biosynthesis, making them fully dependent on their hosts. Comparison with 54 Rhizobiales genomes showed that all insect-associated Rhizobiales lost the ability to fix nitrogen and that the Acromyrmex symbionts had exceptionally also lost the urease genes. However, the Acromyrmex strains share biosynthesis pathways for riboflavin vitamin, queuosine and a wide range of antioxidant enzymes likely to be beneficial for the ant fungus-farming symbiosis. We infer that the Rhizobiales symbionts catabolize excess of fungus-garden-derived arginine to urea, supplementing complementary Mollicutes symbionts that turn arginine into ammonia and infer that these combined symbiont activities stabilize the fungus-farming mutualism. Similar to the Mollicutes symbionts, the Rhizobiales species have fully functional CRISPR/Cas and R-M phage defenses, suggesting that these symbionts are important enough for the ant hosts to have precluded the evolution of metabolically cheaper defenseless strains.
Comprehensive Phylogenomics of Methylobacterium Reveals Four Evolutionary Distinct Groups and Underappreciated Phyllosphere Diversity
Authors: Leducq Jean-Baptiste , Sneddon David , Santos Malia , Condrain-Morel Domitille , Bourret Geneviève , Martinez-Gomez N Cecilia , Lee Jessica A , Foster James A , Stolyar Sergey , Shapiro B Jesse , Kembel Steven W , Sullivan Jack M , Marx Christopher J 
Published: July 2022

Abstract
Methylobacterium is a group of methylotrophic microbes associated with soil, fresh water, and particularly the phyllosphere, the aerial part of plants that has been well studied in terms of physiology but whose evolutionary history and taxonomy are unclear. Recent work has suggested that Methylobacterium is much more diverse than thought previously, questioning its status as an ecologically and phylogenetically coherent taxonomic genus. However, taxonomic and evolutionary studies of Methylobacterium have mostly been restricted to model species, often isolated from habitats other than the phyllosphere and have yet to utilize comprehensive phylogenomic methods to examine gene trees, gene content, or synteny. By analyzing 189 Methylobacterium genomes from a wide range of habitats, including the phyllosphere, we inferred a robust phylogenetic tree while explicitly accounting for the impact of horizontal gene transfer (HGT). We showed that Methylobacterium contains four evolutionarily distinct groups of bacteria (namely A, B, C, D), characterized by different genome size, GC content, gene content, and genome architecture, revealing the dynamic nature of Methylobacterium genomes. In addition to recovering 59 described species, we identified 45 candidate species, mostly phyllosphere-associated, stressing the significance of plants as a reservoir of Methylobacterium diversity. We inferred an ancient transition from a free-living lifestyle to association with plant roots in Methylobacteriaceae ancestor, followed by phyllosphere association of three of the major groups (A, B, D), whose early branching in Methylobacterium history has been heavily obscured by HGT. Together, our work lays the foundations for a thorough redefinition of Methylobacterium taxonomy, beginning with the abandonment of Methylorubrum.
Multimorbidity and Mental Health Trajectories Among Middle-Aged and Older U.S. Adults During the COVID-19 Pandemic: Longitudinal Findings From the COVID-19 Coping Study
Authors: Cheng Greta Jianjia , Wagner Abram L , O’Shea Brendan Q , Joseph Carly A , Finlay Jessica M , Kobayashi Lindsay C 
Published: July 2022

AbstractBackground and ObjectivesThis study aimed to examine the associations between multimorbidity at the COVID-19 pandemic onset and subsequent longitudinal trajectories of depressive symptoms, anxiety symptoms, and loneliness in middle-aged and older adults over a 12-month follow-up.Research Design and MethodsData were from monthly online questionnaires in the COVID-19 Coping Study of U.S. adults aged ≥55 from April/May 2020 through April/May 2021 (N = 4,024). Multimorbidity was defined as having ≥2 versus &lt;2 chronic conditions at baseline. Mental health outcomes were assessed monthly as depressive symptoms (8-item Center for Epidemiologic Studies Depression scale), anxiety symptoms (5-item Beck Anxiety Inventory), and loneliness (3-item UCLA Loneliness Scale). We used multivariable-adjusted population- and attrition-weighted mixed-effects linear models to examine the longitudinal associations between multimorbidity and mental health symptoms.ResultsMultimorbidity at the pandemic onset was associated with elevated depressive (b = 0.37; 95% CI: 0.16–0.59) and anxiety (b = 0.39; 95% CI: 0.15–0.62) symptoms at baseline. Changes in symptoms for all three mental health outcomes were nonlinear over time, with worsening symptoms over the first 6 months of the pandemic (April/May to September/October 2020), followed by improvement in symptoms over the subsequent 6 months (September/October 2020 to April/May 2021). Middle-aged and older adults with multimorbidity experienced faster rates of change in anxiety symptoms and loneliness than those without multimorbidity, with persistently elevated mental health symptomatology throughout the follow-up.Discussion and ImplicationsResults highlight the unique and persistent mental health risks experienced by middle-aged and older adults with multimorbidity during the COVID-19 pandemic. The observed improvements in symptoms underscore the mental resilience of these individuals, indicating their adaptation to the ongoing pandemic.
Antibiotic resistance genes are differentially mobilized according to resistance mechanism
Authors: Nielsen Tue Kjærgaard , Browne Patrick Denis , Hansen Lars Hestbjerg 
Published: July 2022

Abstract

Background
Screening for antibiotic resistance genes (ARGs) in especially environmental samples with (meta)genomic sequencing is associated with false-positive predictions of phenotypic resistance. This stems from the fact that most acquired ARGs require being overexpressed before conferring resistance, which is often caused by decontextualization of putative ARGs by mobile genetic elements (MGEs). Consequent overexpression of ARGs can be caused by strong promoters often present in insertion sequence (IS) elements and integrons and the copy number effect of plasmids, which may contribute to high expression of accessory genes.

Results
Here, we screen all complete bacterial RefSeq genomes for ARGs. The genetic contexts of detected ARGs are investigated for IS elements, integrons, plasmids, and phylogenetic dispersion. The ARG-MOB scale is proposed, which indicates how mobilized detected ARGs are in bacterial genomes. It is concluded that antibiotic efflux genes are rarely mobilized and even 80% of β-lactamases have never, or very rarely, been mobilized in the 15,790 studied genomes. However, some ARGs are indeed mobilized and co-occur with IS elements, plasmids, and integrons.

Conclusions
In this study, ARGs in all complete bacterial genomes are classified by their association with MGEs, using the proposed ARG-MOB scale. These results have consequences for the design and interpretation of studies screening for resistance determinants, as mobilized ARGs pose a more concrete risk to human health. An interactive table of all results is provided for future studies targeting highly mobilized ARGs.
Are informal healthcare providers knowledgeable in tuberculosis care? A cross-sectional survey using vignettes in West Bengal, India
Authors: Thapa Poshan , Jayasuriya Rohan , Hall John J , Mukherjee Partha Sarathi , Beek Kristen , Briggs Nancy , Das Dipesh Kr , Mandal Tushar , Narasimhan Padmanesan 
Published: July 2022

Abstract

Background
India accounts for one-quarter of the world's TB cases. Despite efforts to engage the private sector in India's National TB Elimination Program, informal healthcare providers (IPs), who serve as the first contact for a significant TB patients, remain grossly underutilised. However, considering the substantial evidence establishing IPs' role in patients' care pathway, it is essential to expand the evidence base regarding their knowledge in TB care.

Methods
We conducted a cross-sectional study in the Birbhum district of West Bengal, India. The data were collected using the TB vignette among 331 IPs (165 trained and 166 untrained). The correct case management was defined following India's Technical and Operational Guidelines for TB Control.

Results
Overall, IPs demonstrated a suboptimal level of knowledge in TB care. IPs exhibited the lowest knowledge in asking essential history questions (all four: 5.4% and at least two: 21.7%) compared with ordering sputum test (76.1%), making a correct diagnosis (83.3%) and appropriate referrals (100%). Nonetheless, a statistically significant difference in knowledge (in most domains of TB care) was observed between trained and untrained IPs.

Conclusions
This study identifies gaps in IPs' knowledge in TB care. However, the observed significant difference between the trained and untrained groups indicates a positive impact of training in improving IPs’ knowledge in TB care.
Imipenem/cilastatin/relebactam pharmacokinetics in critically ill patients with augmented renal clearance
Authors: Fratoni Andrew J , Mah John W , Nicolau David P , Kuti Joseph L 
Published: July 2022

Abstract

Background
Imipenem and relebactam are predominantly excreted via glomerular filtration. Augmented renal clearance (ARC) is a common syndrome in critically-ill patients with sepsis, and sub-therapeutic antibiotic concentrations are of concern. Herein, we describe the pharmacokinetics of imipenem/relebactam in critically-ill patients with ARC.

Methods
Infected patients in the ICU with ARC (CLCR ≥ 130 mL/min) received a single dose of imipenem/cilastatin/relebactam 1.25 g as a 30 min infusion. Blood samples were collected over 6 h for concentration determination. Protein binding was assessed by ultrafiltration. An 8 h urine creatinine collection confirmed ARC. Population pharmacokinetic models with and without covariates were fit using the non-parametric adaptive grid algorithm in Pmetrics. A 5000 patient Monte Carlo simulation assessed joint PTA using relebactam fAUC/MIC ≥8 and imipenem ≥40% fT&gt;MIC.

Results
Eight patients with ARC completed the study. A base population pharmacokinetic model with two-compartments fitted the data best. The mean ± SD parameters were: CL, 17.31 ± 5.76 L/h; Vc, 16.15 ± 7.75 L; k12, 1.62 ± 0.99 h−1; and k21, 3.53 ± 3.31 h−1 for imipenem, and 11.51 ± 4.79 L/h, 16.54 ± 7.43 L, 1.59 ± 1.12 h−1, and 2.83 ± 2.91 h−1 for relebactam. Imipenem/cilastatin/relebactam 1.25 g as a 30 min infusion every 6 h achieved 100% and 93% PTA at MICs of 1 and 2 mg/L, respectively.

Conclusions
Despite enhanced clearance of both imipenem and relebactam, the currently approved dosing regimen for normal renal function was predicted to achieve optimal exposure in critically-ill patients with ARC sufficient to treat most susceptible pathogens.
Development and pilot evaluation of an electronic health record usability and safety self-assessment tool
Authors: Pruitt Zoe , Howe Jessica L , Krevat Seth A , Khairat Saif , Ratwani Raj M 
Published: July 2022

Abstract

Objective
Poor electronic health record (EHR) usability contributes to clinician burnout and poses patent safety risks. Site-specific customization and configuration of EHRs require individual EHR system usability and safety testing which is resource intensive. We developed and pilot-tested a self-administered EHR usability and safety assessment tool, focused on computerized provider order entry (CPOE), which can be used by any facility to identify specific issues. In addition, the tool provides recommendations for improvement.

Materials and Methods
An assessment tool consisting of 104 questions was developed and pilot-tested at 2 hospitals, one using a Cerner EHR and the other using Epic. Five physicians at each site participated in and completed the assessment. Participant response accuracy compared to actual EHR interactions, consistency across participants, and usability issues identified through the tool were measured at each site.

Results
Across sites, participants answered an average of 46 questions in 23 min with 89.9% of responses either correct or partially correct. The tool identified 8 usability and safety issues at one site and 7 at the other site across medication, laboratory, and radiology CPOE functions.

Discussion
The tool shows promise as a method to rapidly evaluate EHR usability and safety and provide guidance on specific areas for improvement. Important improvements to the evaluation tool were identified including the need to clarify certain questions and provide definitions for usability terminology.

Conclusion
A self-administered usability and safety assessment tool can serve to identify specific usability and safety issues in the EHR and provide guidance for improvements.
The Date of Codex Sinaiticus
Authors: Nongbri Brent 
Published: July 2022

Abstract
Codex Sinaiticus is generally described as one of ‘the great fourth century majuscule Bibles’, and its construction is often assigned to a more precise date in the middle of the fourth century. This essay surveys the evidence for the date of production of the codex and concludes that it could have been produced at any point from the early fourth century to the early fifth century. This time span may seem uncomfortably wide, but this particular range of dates makes Codex Sinaiticus an ideal candidate for AMS radiocarbon analysis. The shape of the radiocarbon calibration curve during this period means that a well-executed radiocarbon analysis of the codex should have the potential to shed further light on the date the codex was produced.
Galaxy pairs in the three hundred simulations: a study on the performance of observational pair-finding techniques
Authors: Contreras-Santos Ana , Knebe Alexander , Cui Weiguang , Haggar Roan , Pearce Frazer , Gray Meghan , De Petris Marco , Yepes Gustavo 
Published: July 2022

ABSTRACT
Close pairs of galaxies have been broadly studied in the literature as a way to understand galaxy interactions and mergers. In observations, they are usually defined by setting a maximum separation in the sky and in velocity along the line of sight, and finding galaxies within these ranges. However, when observing the sky, projection effects can affect the results, by creating spurious pairs that are not close in physical distance. In this work, we mimic these observational techniques to find pairs in the three hundred simulations of clusters of galaxies. The galaxies’ 3D coordinates are projected into 2D, with Hubble flow included for their line-of-sight velocities. The pairs found are classified into ‘good’ or ‘bad’ depending on whether their 3D separations are within the 2D spatial limit or not. We find that the fraction of good pairs can be between 30 and 60 per cent depending on the thresholds used in observations. Studying the ratios of observable properties between the pair member galaxies, we find that the likelihood of a pair being ‘good’ can be increased by around 40, 20, and 30 per cent if the given pair has, respectively, a mass ratio below 0.2, metallicity ratio above 0.8, or colour ratio below 0.8. Moreover, shape and stellar-to-halo mass ratios, respectively, below 0.4 and 0.2 can increase the likelihood by 50 to 100 per cent. These results suggest that these properties can be used to increase the chance of finding good pairs in observations of galaxy clusters and their environment.
Identifying active galactic nuclei via brightness temperature with sub-arcsecond international LOFAR telescope observations
Authors: Morabito Leah K , Sweijen F , Radcliffe J F , Best P N , Kondapally Rohit , Bondi Marco , Bonato Matteo , Duncan K J , Prandoni Isabella , Shimwell T W , Williams W L , van Weeren R J , Conway J E , Calistro Rivera G 
Published: July 2022

ABSTRACT
Identifying active galactic nuclei (AGNs) and isolating their contribution to a galaxy’s energy budget is crucial for studying the co-evolution of AGNs and their host galaxies. Brightness temperature (Tb) measurements from high-resolution radio observations at GHz frequencies are widely used to identify AGNs. Here, we investigate using new sub-arcsecond imaging at 144 MHz with the International LOFAR Telescope to identify AGNs using Tb in the Lockman Hole field. We use ancillary data to validate the 940 AGN identifications, finding 83 percent of sources have AGN classifications from SED fitting and/or photometric identifications, yielding 160 new AGN identifications. Considering the multiwavelength classifications, brightness temperature criteria select over half of radio-excess sources, 32 percent of sources classified as radio-quiet AGNs, and 20 percent of sources classified as star-forming galaxies. Infrared colour–colour plots and comparison with what we would expect to detect based on peak brightness in 6 arcsec LOFAR maps imply that the star-forming galaxies and sources at low flux densities have a mixture of star-formation and AGN activity. We separate the radio emission from star-formation and AGN in unresolved, Tb-identified AGNs with no significant radio excess and find the AGN comprises 0.49 ± 0.16 of the radio luminosity. Overall, the non-radio excess AGNs show evidence for having a variety of different radio emission mechanisms, which can provide different pathways for AGNs and galaxy co-evolution. This validation of AGN identification using brightness temperature at low frequencies opens the possibility for securely selecting AGN samples where ancillary data are inadequate.
A model to visualize the fate of iron after intracranial hemorrhage using isotopic tracers and elemental bioimaging
Authors: Bücker Patrick , Buzzi Raphael M , Akeret Kevin , Mosberger Leila , Richter Henning , Sperling Michael , Hugelshofer Michael , Schaer Dominik J , Karst Uwe 
Published: July 2022

Abstract
Hemoglobin–iron is a red blood cell toxin contributing to secondary brain injury after intracranial bleeding. We present a model to visualize an intracerebral hematoma and secondary hemoglobin–iron distribution by detecting 58Fe-labeled hemoglobin (Hb) with laser ablation–inductively coupled plasma-mass spectrometry on mouse brain cryosections after stereotactic whole blood injection for different time periods. The generation of 58Fe-enriched blood and decisive steps in the acute hemorrhage formation and evolution were evaluated. The model allows visualization and quantification of 58Fe with high spatial resolution and striking signal-to-noise ratio. Script-based evaluation of the delocalization depth revealed ongoing 58Fe delocalization in the brain even 6 days after hematoma induction. Collectively, the model can quantify the distribution of Hb-derived iron post-bleeding, providing a methodological framework to study the pathophysiological basis of cell-free Hb toxicity in hemorrhagic stroke.
Pathogen Detection by Metagenomic Next-Generation Sequencing During Neutropenic Fever in Patients With Hematological Malignancies
Authors: Schulz Eduard , Grumaz Silke , Hatzl Stefan , Gornicec Maximilian , Valentin Thomas , Huber-Kraßnitzer Bianca , Kriegl Lisa , Uhl Barbara , Deutsch Alexander , Greinix Hildegard , Krause Robert , Neumeister Peter 
Published: July 2022

Abstract

Background
Febrile neutropenia (FN) after chemotherapy is a major cause of morbidity during cancer treatment. The performance of metagenomic next-generation sequencing (mNGS) of circulating cell-free deoxyribonucleic acid from plasma may be superior to blood culture (BC) diagnostics for identification of causative pathogens. The aim of this study was to validate mNGS (DISQVER test) for the detection of pathogens in hematologic patients with FN.

Methods
We collected paired whole blood specimens from central venous catheter and peripheral vein during FN for BC and mNGS testing. We repeated paired sampling at the earliest after 3 days of fever, which was defined as 1 FN episode. All clinical data were retrospectively reviewed by an infectious disease expert panel. We calculated percent positive agreement (PPA), percent negative agreement (PNA), percent overall agreement (POA), and sensitivity and specificity.

Results
We analyzed a total of 98 unselected FN episodes in 61 patients who developed predominantly FN after conditioning therapy for allogeneic (n = 22) or autologous (n = 21) hematopoietic stem cell transplantation. Success rate of mNGS was 99% (97 of 98). Positivity rate of mNGS was 43% (42 of 97) overall and 32% (31 of 97) excluding viruses compared to 14% (14 of 98) in BC. The PPA, PNA, and POA between mNGS and BC were 84.6% (95% confidence interval [CI], 54.6% to 98.1%), 63.1% (95% CI, 51.9% to 73.4%), and 66% (95% CI, 55.7% to 75.3%), respectively. Sensitivity for bacteria or fungi was 40% (95% CI, 28.0% to 52.9%) and 18.5% (95% CI, 9.9% to 30.0%), respectively.

Conclusions
Pathogen detection by mNGS (DISQVER) during unselected FN episodes shows 2-fold higher sensitivity and a broader pathogen spectrum than BC.