bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of the addition of high‐temperature water on the bubble structure, rheological properties, and sensory characteristics of gluten‐free rice flour bread
Authors: Saito Kumiko , Okouchi Maya , Yamaguchi Mana , Takechi Tayori , Hatanaka Yoshiro , Kitsuda Koji , Mannari Takayo , Takamura Hitoshi
Published: September 2022

This study investigated the effect of hot water on the rheological properties of the batter, bubble structure, and sensory properties of the bread. We focused on the thickening effect of starch gelatinization and developed a method to produce gluten‐free rice flour bread without additives by increasing the temperature of the water used in the production of gluten‐free rice flour bread. Hot water at 50–80°C was more effective than 5°C in improving bubble number and bubble size. In batters prepared using water at 68 and 70°C, which had excellent bubble structure, the frequency‐dependent fluctuations of the storage and loss moduli were smaller, while the loss coefficient values were larger. The batters showed more favorable sensory qualities at higher temperatures than the cold‐water batters. Appropriate temperature control of the water added during batter preparation can enable easier and cost‐effective preparation of high‐quality gluten‐free rice flour bread.

Novelty impact statement

Appropriate temperature control of the water added during batter preparation improved the quality of gluten‐free rice flour bread.

Batter prepared with water at 68 and 70°C improved rheological properties, bubble structure, and sensory properties significantly.
The egg cell is preferentially fertilized in Arabidopsis double fertilization
Authors: Li Ling , Hou Saiying , Xiang Wei , Song Zihan , Wang Yuan , Zhang Li , Li Jing , Gu Hongya , Dong Juan , Dresselhaus Thomas , Zhong Sheng , Qu Li‐Jia
Published: September 2022

In flowering plants (angiosperms), fertilization of the egg cell by one sperm cell produces an embryo, whereas fusion of a second sperm cell with the central cell generates the endosperm. In most angiosperms like Arabidopsis, a pollen grain contains two isomorphic sperm cells required for this double fertilization process. A long‐standing unsolved question is whether the two fertilization events have any preference. A tool to address this question is the usage of the cyclin‐dependent kinase a1 (cdka;1) mutant pollen, which produces a single sperm‐like cell (SLC). Here, we first adopt a complementation‐based fluorescence‐labeling method to successfully separate and collect cdka;1 mutant pollen containing a single SLC. Single‐cell RNA‐sequencing analysis revealed that cdka;1 SLCs show a gene expression profile highly similar to that of sperm cells and not to the generative cell, precursor of the two sperm cells. Pollination assays using a limited number of cdka;1 mutant pollen revealed that in 98.2% of the ovules, single fertilization of the egg cell occurred. Pollination of pistils with excessive cdka;1 mutant pollen allowed the delivery of a second SLC via fertilization recovery, which fertilized the central cell, resulting in 20.7% double‐fertilized ovules. This indicates that cdka;1 SLCs are able to fertilize both the egg and the central cell. Taken together, our findings have answered a long‐standing question and support that preferential fertilization of the egg cell is evident in Arabidopsis.
To be or not to be heavier: The role of dermal bones in the buoyancy of the Late Triassic temnospondyl amphibian Metoposaurus krasiejowensis
Authors: Kalita Sudipta , Teschner Elżbieta M. , Sander P. Martin , Konietzko‐Meier Dorota
Published: September 2022

Stereospondyli are a clade of large aquatic temnospondyls known to have evolved a large dermal pectoral girdle. Among the Stereospondyli, metoposaurids in particular possess large interclavicles and clavicles relative to the rest of the postcranial skeleton. Because of the large size of these dermal bones, it was first proposed that they served as ballast during hydrostatic buoyancy control which assisted metoposaurids to live a bottom‐dwelling mode of life. However, a large bone need not necessarily be heavy, for which determining the bone compactness becomes crucial for understanding any such adaptation in these dermal bones. Previous studies on the evolution of bone adaptations to aquatic lifestyles such as osteosclerosis, pachyostosis, osteoporotic‐like pattern and pachyosteosclerosis have been observed in the long bones of secondarily aquatic amniotes. However, there are no known studies on the analysis of bone compactness in the dermal pectoral girdle of non‐amniote taxa including Temnospondyli. This study looks at evidence of changes in bone mass adaptations in the dermal bones of the pectoral girdle of two stereospondyls occurring in the Late Triassic Krasiejόw locality (Southwestern Poland), namely: Metoposaurus krasiejowensis and Cyclotosaurus intermedius. However, because of lack of research on bone compactness of temnospondyls in general, there is no existent frame of reference to infer bone mass increase (BMI) in the M. krasiejowensis samples, and thus the bone compactness results of this taxon are compared with that of the samples of C. intermedius. Results of this study indicate that the interclavicles of M. krasiejowensis partially evolved BMI‐like condition rendering these bones to be heavy enough to get selected as ballast during hydrostatic buoyancy control. Additionally, M. krasiejowensis shared its habitat with C. intermedius, however, the dermal pectoral girdle sample of the latter taxon does not display signs of BMI‐like condition. Furthermore, the absence of variation in hydrostatic buoyancy control in the ontogenetic series of interclavicles of M. krasiejowensis could imply lack of ontogenetic niche shift along the water column.
Identification of three Diaporthe species from Selenicereus sp. explants and their pathogenicity to three dragon fruit species
Authors: Cruz Maria Angela T. , Evallo Edzel S. , Taguiam John Darby W. , Bengoa Jennelyn C. , Balendres Mark Angelo O.
Published: September 2022

Dragon fruit (Selenicereus spp.) is a cash fruit crop worldwide. One of the most effective techniques in producing clean planting materials and preventing disease infection is a plant tissue culture system. This study investigated the identity and characteristics of fungal contaminants in tissue‐cultured red‐fleshed dragon fruit (S. monacanthus) stem explants. Four fungal isolates were recovered from contaminated S. monacanthus cultures. The fungal isolates showed thick and white to greyish mycelia 7 days after incubation (dai) in potato dextrose agar medium with spore production 13 dai. The isolates were identified as Diaporthe sp., based on combined morphological and cultural characteristics. DNA analysis of the partial sequence of the ribosomal internal transcribed spacer (ITS), beta‐tubulin 2 (TUB) and transcription elongation factor 1‐α (TEF1‐α) gene regions revealed a high similarity of the isolates to D. passifloricola, D. limonicola and D. tectonae. In detached stem and glasshouse assays, the three Diaporthe species identified were found pathogenic to three dragon fruit species (S. megalanthus, S. undatus and S. monacanthus). Early symptoms observed were similar to the disease of dragon fruit (caused by the same fungal genus) previously reported in Malaysia. The fungi were re‐isolated from the inoculated stems, establishing Koch's postulate. This study confirms three Diaporthe species as contaminants in dragon fruit explants, reports the susceptibility of S. monacanthus and S. undatus to a stem disease, and the tolerance of S. megalanthus to the disease caused by Diaporthe species.
The AraC‐type transcription factor TagK is a new player in the signaling cascade that induces the anti‐eukaryotic T6SS of Xanthomonas citri
Authors: Lima Lídia dos Passos , de Santana Eliane Silva , Lorenzetti Alan Péricles Rodrigues , Lourenço Rogério Ferreira , Ceseti Lucas de Moraes , Riva Luana , Bayer‐Santos Ethel , Boechat Ana Laura , Baldini Regina Lúcia , Farah Chuck Shaker , Koide Tie , Alvarez‐Martinez Cristina Elisa
Published: September 2022

Type 6 secretion systems (T6SSs) are specialized multiprotein complexes that inject protein effectors into prokaryotic and/or eukaryotic cells. We previously described the role of the T6SS of the phytopathogen Xanthomonas citri pv. citri as an anti‐eukaryotic nanoweapon that confers resistance to predation by the amoeba Dictyostelium discoideum. Transcription of the X. citri T6SS genes is induced by a signaling cascade involving the Ser/Thr kinase PknS and the extracytoplasmic function sigma factor EcfK. Here, we used a strain overexpressing a phosphomimetic constitutively active version of EcfK (EcfKT51E) to identify the EcfK regulon, which includes a previously uncharacterized transcription factor of the AraC‐family (TagK), in addition to T6SS genes and genes encoding protein homeostasis factors. Functional studies demonstrated that TagK acts downstream of EcfK, binding directly to T6SS gene promoters and inducing T6SS expression in response to contact with amoeba cells. TagK controls a small regulon, consisting of the complete T6SS, its accessory genes and additional genes encoded within the T6SS cluster. We conclude that a singular regulatory circuit consisting of a transmembrane kinase (PknS), an alternative sigma factor (EcfK) and an AraC‐type transcriptional regulator (TagK) promotes expression of the X. citri T6SS in response to a protozoan predator.
Increasing efficiency and reducing bias in the sampling of seed–dispersal interactions based on mist‐netted birds
Authors: Rumeu Beatriz , González‐Varo Juan P. , de Castro Cristina , López‐Orta Antonio , Illera Juan Carlos , Miñarro Marcos , García Daniel
Published: September 2022

Efficient and unbiased sampling of ecological interactions is essential to our understanding of the functions they mediate. Seed dispersal by frugivorous birds is a key mutualism for plant regeneration and community dynamics. Mist‐netting is one of the most widely used methods to sample avian seed dispersal through the identification of seeds in droppings of captured birds kept inside cloth bags. However, birds may drop seeds on the ground before being extracted from the net, leading to a fraction of missing information due to ineffective sampling. Worryingly, this fraction could be unevenly distributed across bird and plant species, leading to sampling biases. Here, we assess the effectiveness of using a 1‐m wide mesh below mist nets to sample seeds dropped by entangled birds. We used data from birds mist‐netted during one‐year‐round. We sampled nearly 50% of interaction events and 75% of dispersed seeds on the mesh band below the mist nets (i.e. lost information without this optimization). The proportion of seeds sampled on the mesh bands was not evenly distributed among bird species but strongly related to bird size, ranging from 57–63% in warblers to 84–94% in thrushes. Moreover, the proportion of seeds sampled on the mesh was negatively related to seed size, although this relationship was weaker. We also evaluated accumulation curves of species and pairwise interactions with increasing sampling effort, both with and without using the mesh bands. The number of seed species sampled increased by 21% when using the mesh bands and the number of pairwise interactions by 36%. Our findings provide strong evidence on how inefficient and biased traditional mist‐netting can be for sampling community‐wide seed–dispersal interactions. We thus urge the use of mesh bands in future studies to increase sampling effectiveness and avoid biases, which will ultimately improve our understanding of the seed dispersal function.
Predictive potential of age‐group cut‐off values of N‐terminal pro‐brain natriuretic peptide in Kawasaki disease
Authors: Hirai Seiko , Nakamura Takahiro , Misawa Masahiro
Published: September 2022

Background

The relationship between serum N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) and the clinical features of patients with Kawasaki disease (KD) has been the subject of research. Recent studies have revealed that serum NT‐proBNP levels vary with age. We therefore aimed to determine the utility of age‐stratified cut‐off values for NT‐proBNP in predicting coronary artery lesions (CALs) in patients with KD.

Methods

We retrospectively assessed the electronic medical records of patients who were hospitalized for KD or incomplete KD between January 1, 2015, and August 31, 2019. The patients were divided into high and normal NT‐proBNP groups using age‐stratified cut‐off based on serum NT‐proBNP levels measured immediately before KD treatment initiation.

Results

The study comprised 242 cases, including 71 and 171 cases in high and normal NT‐proBNP groups, respectively. Thirty‐seven of them (15.3%) were resistant to treatment; 15 (6.2%) had CALs, with a higher incidence in the high NT‐proBNP group than in the normal NT‐proBNP group. On multivariate logistic regression analysis, high serum NT‐proBNP levels were significantly correlated to CALs (OR, 9.76; 95% CI, 2.64–36.2). On logistic regression analysis to compare the predictive accuracy of the age‐stratified and fixed cut‐off for CALs, the age‐stratified cut‐off values showed a larger area under the receiver operating characteristic curve than fixed cut‐off value.

Conclusions

Based on age‐stratified cut‐off values for serum NT‐proBNP, high NT‐proBNP levels at the time of diagnosis were significantly associated with CALs in patients with KD. Higher predictive accuracy for CALs of the age‐stratified cut‐off values was also suggested.
Susceptibility of Italian olive cultivars to various Colletotrichum species associated with fruit anthracnose
Authors: Riolo Mario , Pane Antonella , Santilli Elena , Moricca Salvatore , Cacciola Santa Olga
Published: September 2022

Fruit anthracnose caused by Colletotrichum species is a major disease of olive (Olea europaea) worldwide. In this study, we tested in vitro the susceptibility of eight widely grown Italian olive cultivars and one Spanish cultivar to five Colletotrichum species. The Italian cultivars were Carolea, Cassanese, Coratina, Dolce Agogia, Frantoio, Leccino, Ottobratica and Sant'Agostino. The Spanish cultivar, included as a reference, was Picual. The five Colletotrichum species, included in pathogenicity tests, were C. acutatum, C. gloeosporioides, C. godetiae, C. karsti and C. nymphaeae. Olive drupes at comparable ripening stage were wound‐inoculated with a conidial suspension and the severity of infections was rated at various time intervals after inoculation using a scale of 0 to 6. The results were expressed in terms of relative area under disease progress curve (rAUDPC). C. acutatum was the most aggressive while C. karsti was the least aggressive among the Colletotrichum species tested. Frantoio and Leccino were the least susceptible cultivars while Ottobratica, Coratina and Carolea were the most susceptible to all Colletotrichum species. Separate experiments aimed to evaluate the effect of both inoculation method and drupe ripening stage on the interaction between Colletotrichum species and olive cultivars. Only C. acutatum and C. nymphaeae induced symptoms in nonwounded drupes. In general, the disease severity in green drupes was significantly lower than in mature drupes; however, the rankings of olive cultivars for their susceptibility to Colletotrichum species on both green and mature drupes showed similar trends.
Web‐based assessment of social and emotional competence in the late elementary grades
Authors: McKown Clark , Russo‐Ponsaran Nicole , Karls Ashley
Published: September 2022

This paper presents evidence of the score reliability, factor structure, criterion‐related validity, and measurement equivalence of a web‐based assessment of several important social and emotional competencies for children in fourth through sixth grades. The assessment, SELweb LE (Late Elementary), is designed to measure children's understanding of other's thoughts and feelings, their ability to solve social problems, and their ability to engage in self‐control. SELweb LE satisfies a need for a direct assessment that measures theoretically relevant social and emotional competencies specifically for youth in the late elementary grades. The competencies measured are associated with youth outcomes, are reflected in state education standards, and are the targets of instruction in widely used social and emotional learning (SEL) curricula. Analyses support SELweb LE's factor structure, score reliability, measurement equivalence, and convergent, discriminant, and criterion‐related validity. More broadly, evidence supports the use of SELweb LE to characterize student competencies.
Outcome of cranial cruciate ligament replacement with an enhanced polyethylene terephthalate implant in the dog: A pilot clinical trial
Authors: Johnson Tiffany A. , Conzemius Michael G.
Published: September 2022

Objective

To assess the 6‐month outcome and survival of enhanced polyethylene terephthalate (PET) implants as a replacement for the cranial cruciate ligament (CCL) in dogs with spontaneous CCL disease (CCLD).

Study design

Pilot, prospective case series.

Animals

Ten client‐owned large breed dogs with unilateral spontaneous CCLD.

Methods

Dogs were evaluated before and 6 months after intra‐articular placement of a PET implant with the Liverpool Osteoarthritis in Dogs questionnaire and force platform gait analysis. Arthroscopy was performed 6 months after surgery to visually assess implant integrity.

Results

Scores on owner questionnaires and limb asymmetry improved in all dogs that reached the 6‐month time point, by 51.7% (p = .008) and 86% (p = .002), respectively. The PET implant appeared intact and functioning in two stifles, partially intact and functioning in four stifles and completely torn in three stifles. One dog had an implant infection and was removed from the study. Evidence of deterioration and tearing occurred in the midbody of the implant.

Conclusion

Although function improved over the course of this study, only 2/10 implants appeared intact 6 months after placement.

Clinical significance

Implant survivability prohibits further clinical investigation using this implant.
Barriers and facilitators to cancer clinical trial enrollment and participation among rural populations: a scoping review protocol
Authors: Palokas Michelle , Christian Robin , Hinton Elizabeth , Duhe Roy , Thomas Toms , Torres Elisa , Jordan Christina , Gordy Xiaoshan Z. , Sharma Manvi , Gomillia Courtney , Stefanek Michael , Robinson William “Rusty”
Published: September 2022

Objective:

The objective of this scoping review is to identify barriers and facilitators related to cancer clinical trial enrollment and participation among rural populations.

Introduction:

Advancing the effectiveness of cancer treatment and increasing early detection of cancer relies on enrollment and participation of individuals in cancer clinical trials. Lack of enrollment and participation in trials is a concern, and there is evidence that individuals living in rural areas are unlikely to participate in such trials. Information on barriers to, and facilitators of, enrollment and participation in cancer clinical trials is needed for the development of evidence-based interventions to increase the enrollment and participation of rural populations.

Inclusion criteria:

The review will consider studies on adults aged 18 years or older living in rural areas. Studies that report on barriers and facilitators to enrollment and participation in cancer clinical trials, including both cancer therapeutic and cancer early detection trials, will be included in the review. The review will consider quantitative, qualitative, and text and opinion papers for inclusion.

Methods:

The search strategy will aim to locate published primary studies, reviews, and opinion papers, the latter including those by professional oncology organizations. The databases to be searched include MEDLINE, CINAHL, Embase, Web of Science, and Cochrane Library. Gray literature databases will also be searched. Two independent reviewers will retrieve full-text studies and extract data. The results will be presented in diagrammatic format with a narrative summary.
High-Pressure Laminar Flame Speeds and Markstein Lengths of Syngas Flames Diluted in Carbon Dioxide and Helium
Authors: Turner Mattias A. , Petersen Eric L.
Published: September 2022

New laminar flame speed and burned-gas Markstein length data for H2–CO–O2–CO2–He mixtures have been measured from spherically expanding flames. Experiments were conducted at 10 atm and room temperature for H2:CO ratios ranging from 2:1 to 1:4 and for overall CO2 mole fractions from 0% to 30%. CO2 dilution had little effect on Markstein length, but CO2 dilutions of 10%, 20%, and 30% caused average reductions in flame speed of 47%, 73%, and 89%, respectively, regardless of H2:CO ratio. The study was designed to isolate the dilution effect of CO2 on flame speed, and a detailed analysis using the FCO2 method was used to show that the chemical-kinetic participation of CO2 was responsible for up to 20% of the reduction in flame speed. Hence, the majority (80% or more) of the reduction in flame speed due to CO2 is from the thermal effect. Accurate flame speed predictions were produced by five different chemical kinetics mechanisms for most conditions, with the slight exception of high-CO, high-CO2 mixtures. A thorough sensitivity analysis highlighted the larger effect of CO2 dilution on the important kinetics reactions than the effect of changing H2:CO. Sensitivity analysis also showed that the chain branching reaction H2O + O ⇌ OH + OH could be modified (albeit beyond its uncertainty) to achieve more accurate flame speed predictions, but also indicated that further improvement of flame speed modeling would require changes to many lesser reactions.
Optimize multilayer matching layer design for tone-burst underwater acoustic transducers
Authors: Wang Chunying , Wang Cong , Liu Naitao , Lan Yu , Cao Wenwu
Published: September 2022

In this study, a theoretical model has been constructed to address the optimization of matching layers for tone burst excitation underwater acoustic transducers and to investigate the functional mechanism change of matching layers. Single, double, and triple matching layers are attached to piezoelectric composite plates, and tone burst signals with a different number of burst-cycles are applied. Acoustic pressure function (Sp) and acoustic pressure transient response (PTR) are compared among these transducers. The results demonstrated that when the cycle number M ≤ 2, more matching layers lead to shorter ringdown with similar PTR amplitude. Since the objective is for better axial resolution, three matching layers have noticeable advantage, whereas for the case of M > 5, far detection distance is the main objective, and more matching layers caused the decrease in PTR amplitude. Besides, matching layers become part of the resonance structure; they do not serve as a transmission medium anymore. Therefore, the transducer with single matching is optimal for the long tone burst excitation. For the case of 2–5 cycle excitation, one may use double matching layers, which has a balance between the transmitting voltage response amplitude and bandwidth. With the increase in M, the role of matching layers changes from a bridging transmission medium to amplifying vibration velocity and introducing additional vibration modes to broaden the bandwidth.
Stress with ketamine tackles depression
Authors: Ferrarelli Leslie K.
Published: September 2022

A stress hormone enables the antidepressant action of ketamine.
A One Health Genomic Investigation of Gentamicin Resistance in Escherichia coli from Human and Chicken Sources in Canada, 2014 to 2017
Authors: Cox Graham W. , Avery Brent P. , Parmley E. Jane , Irwin Rebecca J. , Reid-Smith Richard J. , Deckert Anne E. , Finley Rita L. , Daignault Danielle , Zhanel George G. , Mulvey Michael R. , Bharat Amrita
Published: September 2022

We investigated whether gentamicin resistance (Gen
r
) in
Escherichia coli
isolates from human infections was related to Gen
r
E. coli
in chicken and whether resistance may be due to coselection from use of lincomycin-spectinomycin in chickens on farms. Whole-genome sequencing was performed on 483 Gen
r
E. coli
isolates isolated between 2014 and 2017.
Spatial Structure Formation by RsmE-Regulated Extracellular Secretions in Pseudomonas fluorescens Pf0-1
Authors: Evans Anton F. , Wells Meghan K. , Denk Jordan , Mazza William , Santos Raziel , Delprince Amber , Kim Wook
Published: September 2022

In densely populated colonies of the bacterium
Pseudomonas fluorescens
Pf0-1, diverse mutations in the
rsmE
gene are naturally selected by solving the problem of overcrowding. Here, we show that RsmE-regulated secretions function together to create and protect space of low cell density.
Small Molecule Antibiotics Inhibit Distinct Stages of Bacterial Outer Membrane Protein Assembly
Authors: Peterson Janine H. , Doyle Matthew Thomas , Bernstein Harris D.
Published: September 2022

There is a clear need to develop novel broad-spectrum antibiotics to address the global problem of antimicrobial resistance. Multiple compounds that have strong antibacterial activity have recently been described that appear to inhibit the activity of the
b
arrel
a
ssembly
m
achinery (BAM), an essential complex that catalyzes the assembly (i.e., folding and membrane insertion) of outer membrane proteins (OMPs) in all Gram-negative bacteria.
Hybrid Vigor: Importance of Hybrid λ Phages in Early Insights in Molecular Biology
Authors: Feiss Michael , Young Ryland , Ramsey Jolene , Adhya Sankar , Georgopoulos Costa , Hendrix Roger W. , Hatfull Graham F. , Gilcrease Eddie B. , Casjens Sherwood R.
Published: September 2022

Laboratory-generated hybrids between phage λ and related phages played a seminal role in establishment of the λ model system, which, in turn, served to develop many of the foundational concepts of molecular biology, including gene structure and control. Important λ hybrids with phages 21 and 434 were the earliest of such phages. To understand the biology of these hybrids in full detail, we determined the complete genome sequences of phages 21 and 434.
New Methods for Preparation of the Monofluorosubstituted Derivative of the closo-Borate Anion [2-B10H9F]2–, Its Properties, and Analysis of Its Reactivity
Authors: Neumolotov N. K. , Selivanov N. A. , Bykov A. Yu. , Klyukin I. N. , Novikov A. S. , Zhdanov A. P. , Zhizin K. Yu. , Kuznetsov N. T.
Published: September 2022

New methods for the preparation of a monofluoro-substituted derivative of the closo-decaborate anion [2-B10H9F]2– have been developed. Various synthetic strategies have been used, where Bu4NF, Me4NF, KF/18-crown-6, and NH4HF2 act as sources of the F– anion. A feature of the proposed methods is the absence of HF as a fluorinating agent in the reaction mixture. In the course of the work, the optimal conditions for the synthesis of [2-B10H9F]2– have been determined and the reaction products have been characterized. Using theoretical modeling methods, the main indices of reactivity of monofluorinated derivatives of the closo-decaborate anion have been calculated. The influence of solvation effects on the nucleophilicity of target objects has been studied. The structure of the obtained compounds has been confirmed by 1H, 11B, 19F NMR spectroscopy, and ESI mass spectroscopy.
Erratum to: On Numerical Modeling of Fiber Deformation and Destruction under Impact Load
Authors: Petrov I. B. , Vasyukov A. V. , Beklemysheva K. A. , Onuchin E. S. , Tovarnova N. A.
Published: September 2022

An Erratum to this paper has been published: https://doi.org/10.1134/S1064562422050027
Hypercalcaemia caused by calcium sulfate beads
Authors: Epstein Samuel , Vanegas Acosta Diego E
Published: September 2022

Hypercalcaemia is a relatively common metabolic disturbance seen in hospitalised patients; however, given the complicated systems of calcium regulation, it can take a significant amount of time and testing to pinpoint the aetiology. This case discusses a patient who developed acute hypercalcaemia from calcium sulfate-containing antibiotic beads placed during an orthopaedic procedure. These beads are used in surgical procedures to fill gaps/voids in bony structures and for local delivery of antibiotics. The case highlights the importance of careful review of a patient’s hospital course, including the administration of medical products that may not be clearly documented on a patient’s medicine administration record when working up an unexplained finding.
Use of artificial intelligence to assess the risk of coronary artery disease without additional (non-invasive) testing: validation in a low-risk to intermediate-risk outpatient clinic cohort
Authors: Eurlings Casper G M J , Bektas Sema , Sanders-van Wijk Sandra , Tsirkin Andrew , Vasilchenko Vasily , Meex Steven J R , Failer Michael , Oehri Caroline , Ruff Peter , Zellweger Michael J , Brunner-La Rocca Hans-Peter
Published: September 2022

Objectives

Predicting the presence or absence of coronary artery disease (CAD) is clinically important. Pretest probability (PTP) and CAD consortium clinical (CAD2) model and risk scores used in the guidelines are not sufficiently accurate as the only guidance for applying invasive testing or discharging a patient. Artificial intelligence without the need of additional non-invasive testing is not yet used in this context, as previous results of the model are promising, but available in high-risk population only. Still, validation in low-risk patients, which is clinically most relevant, is lacking.

Design

Retrospective cohort study.

Setting

Secondary outpatient clinic care in one Dutch academic hospital.

Participants

We included 696 patients referred from primary care for further testing regarding the presence or absence of CAD. The results were compared with PTP and CAD2 using receiver operating characteristic (ROC) curves (area under the curve (AUC)). CAD was defined by a coronary stenosis >50% in at least one coronary vessel in invasive coronary or CT angiography, or having a coronary event within 6 months.

Outcome measures

The first cohort validating the memetic pattern-based algorithm (MPA) model developed in two high-risk populations in a low-risk to intermediate-risk cohort to improve risk stratification for non-invasive diagnosis of the presence or absence of CAD.

Results

The population contained 49% male, average age was 65.6±12.6 years. 16.2% had CAD. The AUCs of the MPA model, the PTP and the CAD2 were 0.87, 0.80, and 0.82, respectively. Applying the MPA model resulted in possible discharge of 67.7% of the patients with an acceptable CAD rate of 4.2%.

Conclusions

In this low-risk to intermediate-risk population, the MPA model provides a good risk stratification of presence or absence of CAD with a better ROC compared with traditional risk scores. The results are promising but need prospective confirmation.
Extracurricular work experience and its association with training and confidence in emergency medicine procedures among medical students: a cross-sectional study from a Norwegian medical school
Authors: Scott Remi William , Fredriksen Knut
Published: September 2022

Objective

Proficiency in basic emergency procedures is important for junior doctors, but the amount of practical exposure may vary. We studied the association between students’ extracurricular healthcare-related (ECHR) work experience and self-reported practical training and confidence in selected emergency medicine procedures.

Study design

Cross-sectional study.

Materials and methods

Medical students and first-year graduates answered a Likert-based questionnaire probing self-reported amount of exposure to (‘training amount’) and confidence with selected emergency medicine procedures. Participants also reported ECHR work experience, year of study, previous healthcare-related education, military medic training and participation in the local student association for emergency medicine (Tromsø Acute Medicine Students’ Association (TAMS)). Differences within variables were analysed with independent samples t-tests, and correlation between training amount and confidence was calculated. Analysis of covariance and mixed models were applied to study associations between training amount and confidence, and work experience (primary outcomes) and the other reported factors (secondary outcomes), respectively.

Results

539 participants responded (70%). Among these, 81% had ECHR work experience. There was a strong correlation (r=0.878) between training amount and confidence. Work experience accounted for 5.9% and 3.5% of the total variance in training amount and confidence (primary outcomes), and respondents with work experience scored significantly higher than respondents without work experience. Year of study, previous education, military medic training and TAMS participation accounted for 49.3%, 8.7%, 6.8% and 23.6%, and 58.5%, 5.1%, 4.7% and 12.3% of the total variance in training amount and confidence, respectively (secondary outcomes). Cohen’s D was 0.48 for training amount and 0.32 for confidence level, suggesting medium and weak medium-sized associations with work experience, respectively.

Conclusion

ECHR work experience is common among medical students and was associated with more training amount and higher confidence in the procedures. Year of study, previous relevant education and TAMS participation, but not military medic training, were also significantly associated with training amount and confidence.
Impact of gestational hypertension and pre-eclampsia on preterm birth in China: a large prospective cohort study
Authors: An Hang , Jin Ming , Li Zhiwen , Zhang Le , Li Hongtian , Zhang Yali , Ye Rongwei , Li Nan
Published: September 2022

Objective

To investigate the impact of gestational hypertension and pre-eclampsia on preterm birth.

Design

The data were collected from the China–US Collaborative Project for Neural Tube Defect Prevention; this was a large population-based cohort study.

Setting and participants

We selected participants registered in two southern provinces, for whom we had exact information on gestational blood pressure and pregnancy outcomes, and who were not affected by chronic hypertension. In total, 200 103 participants were recruited from 1993 to 1995.

Outcome measures

Preterm birth was defined as a singleton pregnancy and birth before 37 gestational weeks.

Results

The incidences of gestational hypertension and pre-eclampsia were 5.47% and 5.44%, respectively, for women who gave birth at full term, and 5.63% and 7.33%, respectively, for those who gave birth preterm. After adjusting for potential confounders, the risk ratios (RRs) of preterm birth in women with gestational hypertension and pre-eclampsia were 1.04 (95% CI 0.98 to 1.11) and 1.39 (95% CI 1.25 to 1.55), respectively. The associations were stronger for early-onset (<28 weeks of gestation) gestational hypertension (adjusted RR=2.13, 95% CI 1.71 to 2.65) and pre-eclampsia (adjusted RR=8.47, 95% CI 5.59 to 12.80).

Conclusions

Pre-eclampsia was associated with a higher risk of preterm birth. The early-onset gestational hypertension and pre-eclampsia were associated with more severe risks than late-onset conditions.
Multicentre evaluation of renal impairment in thoracic surgery (MERITS): a retrospective cohort study
Authors: Naruka Vinci , McKie Mikel Alexander , Ahmadi Navid , Pama E A Claudia , Coonar Aman S , Collaborators MERITS
Published: September 2022

Objectives

To measure the unit-level variation in Acute Kidney Injury (AKI) incidence post-thoracic surgery over a contemporary 1-year period. Secondary aims include examining the associations with sex, age group, operation type, length of stay and mortality.

Design

A multicentre, observational, retrospective study in thoracic surgery.

Setting

17 of 35 Society for Cardiothoracic Surgery of Great Britain and Ireland (SCTS) units participated. The student wing, known as SCTS STUDENTS, supported data collection.

Participants

Overall, 15 229 patients were collected of which 15 154 were included for analysis after exclusions. All patients (age≥18 years) undergoing any thoracic surgery from 1 April 2016 to 31 March 2017 were included. For analysis, we excluded patients with preoperative end-stage renal failure and those with incomplete data.

Main outcome measures

The primary outcome is the incidence of AKI within 7 days of the procedure or discharge date if earlier. Secondary outcomes include assessing associations with patient demographics (age, sex), type of procedure (open and minimally invasive), length of stay and mortality.

Results

Out of 15 154 patients AKI was diagnosed in 1090 patients (7.2%) within 7 days of surgery with AKI stage 1 (4.8%), stage 2 (1.7%) and stage 3 (0.7%). There was a statistically significant variation in AKI incidence between units from 3.1 to 16.1% (p<0.05). Significant differences between AKI and non-AKI were found in post-operative length of stay (7 vs 3 days, p<0.001), 30-day mortality (9 vs 1.6%, p<0.001), 90-day mortality (14.7 vs 4.4%, p<0.001) and 1-year mortality (23.1 vs 12.2 %, p<0.001).

Conclusions

Following thoracic surgery, AKI incidence ranged from 3.1% to 16.1% between units (p<0.05) with associations between AKI and both length of stay and mortality. We propose AKI as a suitable comparative and absolute quality measure in thoracic surgery. Reducing rates of AKI may improve patient outcomes, length of stay and reduce costs.
Acupuncture for emotional disorders in patients with inflammatory bowel disease: a systematic review protocol
Authors: Zhou Yuan-Fang , Zhang Gui-Long , Sun Ning , Wang Zhong-Quan , Ye Xiang-Yin , Xiong Jian , Deng Xiao-Dong , Lin Xin , Zhang Pei , Zheng Hao , Zhang Yong , Yang Kun , Gao Ze-Da , Sun Rui-Rui , Liang Fan-Rong
Published: September 2022

Introduction

Emotional disorders are often observed in inflammatory bowel disease (IBD). IBD with emotional disorders leads to poor quality of life. This systematic review aims to assess the effectiveness of acupuncture in patients with IBD with emotional disorders.

Methods and analysis

Nine electronic databases, including Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Allied and Complementary Medicine Database, Cumulative Index to Nursing & Allied Health Literature, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, VIP Database and Wanfang Database, will be searched from inception to October 2021 without language restriction. The grey literature containing conference proceedings, as well as systematic reviews listed in the reference of definite publications, will also be retrieved. Randomised controlled trials either in English or Chinese reporting acupuncture therapy for IBD with emotional disorders will be included. The primary outcome is changes of emotional functioning outcomes. The Colitis Activity Index, Crohn’s Disease Activity Index, C reactive protein and adverse events will be assessed as the secondary outcomes. More than two assessors will conduct the study retrieval and selection, as well as the data extraction and evaluation of the risk of bias. Data synthesis will be performed using a random-effects model based on the results of heterogeneity. Data analysis will be performed using RevMan software (V.5.4). Moreover, the dichotomous data will be presented as risk ratios, and the continuous data will be calculated using weighted mean difference or standard mean difference.

Ethics and dissemination

This systematic review contains no individual patient data; thus, ethical approval is not required. Moreover, this review will be disseminated in a peer-reviewed journal or relevant conference.

PROSPERO registration number

CRD42020176340.
Effectiveness of interventions to improve health behaviours of health professionals: a systematic review
Authors: Hobby Julie , Crowley Jennifer , Barnes Katelyn , Mitchell Lana , Parkinson Joy , Ball Lauren
Published: September 2022

Objective

To evaluate the effectiveness of interventions designed to improve the health behaviours of health professionals.

Design

Systematic review.

Data sources

Database searches: Medline, Cochrane library, Embase and CINAHL.

Review methods

This systematic review used Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to compare randomised controlled trials of health professionals, published between 2010 and 2021, which aimed to improve at least one health behaviour such as physical activity, diet, smoking status, mental health and stress. Two independent reviewers screened articles, extracted data and assessed quality of studies and reporting. The quality of articles was assessed using the Effective Public Health Practice Project quality assessment tool and the completeness of intervention reporting was assessed.

Outcome measures

The outcome assessed was change in behaviour between intervention and control groups from baseline to follow-up.

Results

Nine studies met the eligibility criteria, totalling 1107 participants. Health behaviours targeted were mental health and stress, physical activity, and smoking cessation, physical activity and nutrition. Six interventions observed significant improvements in the health behaviour in the intervention compared with control groups. Seven of the studies selected in person workshops as the mode of intervention delivery. The quality of the included studies was high with 80% (7/9) graded as moderate or strong.

Conclusions

Although high heterogeneity was found between interventions and outcomes, promising progress has occurred across a variety of health behaviours. Improving reporting and use of theories and models may improve effectiveness and evaluation of interventions. Further investigation is needed to recommend effective strategies.

PROSPERO registration number

CRD42021238684.
Quality Output Checklist and Content Assessment (QuOCCA): a new tool for assessing research quality and reproducibility
Authors: Héroux Martin E , Butler Annie A , Cashin Aidan G , McCaughey Euan J , Affleck Andrew J , Green Michael A , Cartwright Andrew , Jones Matthew , Kiely Kim M , van Schooten Kimberley S , Menant Jasmine C , Wewege Michael , Gandevia Simon C
Published: September 2022

Research must be well designed, properly conducted and clearly and transparently reported. Our independent medical research institute wanted a simple, generic tool to assess the quality of the research conducted by its researchers, with the goal of identifying areas that could be improved through targeted educational activities. Unfortunately, none was available, thus we devised our own. Here, we report development of the Quality Output Checklist and Content Assessment (QuOCCA), and its application to publications from our institute’s scientists. Following consensus meetings and external review by statistical and methodological experts, 11 items were selected for the final version of the QuOCCA: research transparency (items 1–3), research design and analysis (items 4–6) and research reporting practices (items 7–11). Five pairs of raters assessed all 231 articles published in 2017 and 221 in 2018 by researchers at our institute. Overall, the results were similar between years and revealed limited engagement with several recommended practices highlighted in the QuOCCA. These results will be useful to guide educational initiatives and their effectiveness. The QuOCCA is brief and focuses on broadly applicable and relevant concepts to open, high-quality, reproducible and well-reported science. Thus, the QuOCCA could be used by other biomedical institutions and individual researchers to evaluate research publications, assess changes in research practice over time and guide the discussion about high-quality, open science. Given its generic nature, the QuOCCA may also be useful in other research disciplines.
Developing and validating a risk prediction model for preterm birth at Felege Hiwot Comprehensive Specialized Hospital, North-West Ethiopia: a retrospective follow-up study
Authors: Feleke Sefineh Fenta , Anteneh Zelalem Alamrew , Wassie Gizachew Tadesse , Yalew Anteneh Kassa , Dessie Anteneh Mengist
Published: September 2022

Objective

To develop and validate a risk prediction model for the prediction of preterm birth using maternal characteristics.

Design

This was a retrospective follow-up study. Data were coded and entered into EpiData, V.3.02, and were analysed using R statistical programming language V.4.0.4 for further processing and analysis. Bivariable logistic regression was used to identify the relationship between each predictor and preterm birth. Variables with p≤0.25 from the bivariable analysis were entered into a backward stepwise multivariable logistic regression model, and significant variables (p<0.05) were retained in the multivariable model. Model accuracy and goodness of fit were assessed by computing the area under the receiver operating characteristic curve (discrimination) and calibration plot (calibration), respectively.

Setting and participants

This retrospective study was conducted among 1260 pregnant women who did prenatal care and finally delivered at Felege Hiwot Comprehensive Specialised Hospital, Bahir Dar city, north-west Ethiopia, from 30 January 2019 to 30 January 2021.

Results

Residence, gravidity, haemoglobin <11 mg/dL, early rupture of membranes, antepartum haemorrhage and pregnancy-induced hypertension remained in the final multivariable prediction model. The area under the curve of the model was 0.816 (95% CI 0.779 to 0.856).

Conclusion

This study showed the possibility of predicting preterm birth using maternal characteristics during pregnancy. Thus, use of this model could help identify pregnant women at a higher risk of having a preterm birth to be linked to a centre.
Using FIB-4 score as a screening tool in the assessment of significant liver fibrosis (F2) in patients with transfusion-dependent beta thalassaemia: a cross-sectional study
Authors: Padeniya Padmapani , Ediriweera Dileepa Senajith , De Silva Arjuna P. , Niriella Madunil Anuk , Premawardhena Anuja
Published: September 2022

Objective

To evaluate the performance of the fibrosis-4 (FIB-4) score as a screening tool to detect significant liver fibrosis (F2) compared with transient elastography (TE), among chronic transfusion-dependent beta-thalassaemia (TDT) patients in a resource-poor setting.

Design

A cross-sectional study.

Setting

Adolescent and Adult Thalassaemia Care Centre (University Medical Unit), Kiribathgoda, Sri Lanka.

Participants

45 TDT patients who had undergone more than 100 blood transfusions with elevated serum ferritin >2000 ng/mL were selected for the study. Patients who were serologically positive for hepatitis C antibodies were excluded.

Outcome measures

TE and FIB-4 scores were estimated at the time of recruitment in all participants. Predefined cut-off values for F2, extracted from previous TE and FIB-4 scores studies, were compared. A new cut-off value for the FIB-4 score was estimated using receiver operating characteristics curve analysis to improve the sensitivity for F2 prediction.

Results

Of the selected 45 TDT patients, 22 (49%) were males. FIB-4 score showed a significant linear correlation with TE (r=0.52;p<0.0003). The FIB-4 score was improbable to lead to a false classification of TDT patients to have F2 when the FIB-4 cut-off value was 1.3. On the other hand, it had a very low diagnostic yield in missing almost all (except one) of those who had F2. Using a much-lowered cut-off point of 0.32 for FIB-4, we improved the pick-up rate of F2 to 72%.

Conclusions

Regardless of the cut-off point, the FIB-4 score cannot be used as a good screening tool to pick up F2 in patients with TDT, irrespective of their splenectomy status. On the contrary, at a 1.3 cut-off value, though FIB-4 is a very poor detector for F2 fibrosis, it will not erroneously diagnose F2 fibrosis in those who do not have it.