bluuebunny/crossref_metadata_2025 huggingface dataset:
Crystal structures of PigF, anO-methyltransferase involved in the prodigiosin synthetic pathway, reveal an induced-fit substrate-recognition mechanism
Authors: Qiu Shenshen , Xu Dongqing , Xu Mengxue , Zhou Huan , Sun Ning , Zhang Li , Zhao Mengmeng , He Jianhua , Ran Tingting , Sun Bo , Wang Weiwu
Published: March 2022

Prodigiosin, a red linear tripyrrole pigment, is a typical secondary metabolite with numerous biological functions, such as anticancer, antibacterial and immunosuppressant activities, and is synthesized through a bifurcated biosynthesis pathway from 4-methoxy-2,2′-bipyrrole-5-carbaldehyde (MBC) and 2-methyl-3-n-amylpyrrole (MAP). The last step in the biosynthetic pathway of MBC is catalysed by PigF, which transfers a methyl group to 4-hydroxy-2,20-bipyrrole-5-carbaldehyde (HBC) to form the final product MBC. However, the catalytic mechanism of PigF is still elusive. In this study, crystal structures of apo PigF andS-adenosylhomocysteine (SAH)-bound PigF were determined. PigF forms a homodimer and each monomer consists of two domains: a C-terminal catalytic domain and an N-terminal dimerization domain. Apo PigF adopts an open conformation, while the structure of the complex with the product SAH adopts a closed conformation. The binding of SAH induces dramatic conformational changes of PigF, suggesting an induced-fit substrate-binding mechanism. Further structural comparison suggests that this induced-fit substrate-recognition mechanism may generally exist inO-methyltransferases. Docking and mutation studies identified three key residues (His98, His247 and Asp248) that are crucial for enzyme activity. The essential function of His247 and Asp248 and structure analysis suggests that both residues are involved in activation of the HBC substrate of PigF. The invariance of Asp248 in PigF further confirmed its essential role. The invariance and essential role of His98 in PigF suggests that it is involved in correctly positioning the substrate. This study provides new insight into the catalytic mechanism of PigF, reveals an induced-fit substrate-recognition model for PigF and broadens the understanding ofO-methyltransferases.
Fragmentation and transferability in Hirshfeld atom refinement
Authors: Chodkiewicz Michał , Pawlędzio Sylwia , Woińska Magdalena , Woźniak Krzysztof
Published: March 2022

Hirshfeld atom refinement (HAR) is one of the most effective methods for obtaining accurate structural parameters for hydrogen atoms from X-ray diffraction data. Unfortunately, it is also relatively computationally expensive, especially for larger molecules due to wavefunction calculations. Here, a fragmentation approach has been tested as a remedy for this problem. It gives an order of magnitude improvement in computation time for larger organic systems and is a few times faster for metal–organic systems at the cost of only minor differences in the calculated structural parameters when compared with the original HAR calculations. Fragmentation was also applied to polymeric and disordered systems where it provides a natural solution to problems that arise when HAR is applied. The concept of fragmentation is closely related to the transferable aspherical atom model (TAAM) and allows insight into possible ways to improve TAAM. Hybrid approaches combining fragmentation with the transfer of atomic densities between chemically similar atoms have been tested. An efficient handling of intermolecular interactions was also introduced for calculations involving fragmentation. When applied in fragHAR (a fragmentation approach for polypeptides) as a replacement for the original approach, it allowed for more efficient calculations. All of the calculations were performed with a locally modified version of Olex2 combined with a development version of discamb2tsc and ORCA. Care was taken to efficiently use the power of multicore processors by simple implementation of load-balancing, which was found to be very important for lowering computational time.
Hirshfeld atom refinement based on projector augmented wave densities with periodic boundary conditions
Authors: Ruth Paul Niklas , Herbst-Irmer Regine , Stalke Dietmar
Published: March 2022

Hirshfeld atom refinement (HAR) is an X-ray diffraction refinement method that, in numerous publications, has been shown to give H-atom bond lengths in close agreement with neutron diffraction derived values. Presented here is a first evaluation of an approach using densities derived from projector augmented wave (PAW) densities with three-dimensional periodic boundary conditions for HAR. The results show an improvement over refinements that neglect the crystal environment or treat it classically, while being on a par with non-periodic approximations for treating the solid-state environment quantum mechanically. A suite of functionals were evaluated for this purpose, showing that the SCAN and revSCAN functionals are most suited to these types of calculation.
A cuboidal [Co4(SO4)4] structure supported by β-picoline ligands. Corrigendum
Authors: Park Ava M. , Golen James A. , Manke David R.
Published: March 2022

In the paper by Park et al. [Acta Cryst. (2022), E78, 108–110], there is an error in the chemical formula in the title.
Designers' perceptions of biophilia and testing of the biophilic interior design matrix in China
Authors: McGee Beth , Jin Xu , Park Nam-Kyu , Ball Skylar , Carr April
Published: March 2022

Purpose

The Biophilic Interior Design Matrix (BID-M) was created to assist designers with identifying biophilic interior design features for optimizing nature integration for evidence-based design. The BID-M was developed and tested with interior design practitioners in the United States. There was a need to further develop the BID-M for other cultures along with understanding the designers' perceptions of biophilia.

Design/methodology/approach

A mixed methods approach was used with 101 interior designers/architects practicing in China using a pre- and post-questionnaire surrounding a room assessment using the BID-M.

Findings

The Chinese translation of the BID-M was perceived as beneficial to design practice, evaluated as reliable and valid. The Chinese designers perceived a significant increase in knowledge and importance of biophilia after using the BID-M and it was useful in assisting all parts of the design process. The designers had some prior experience with biophilic design and clients have been requesting suitable natural and artificial light features.

Practical implications

The BID-M was seen as a human centered design tool that is useful to evaluate biophilic design features in the built environment.

Originality/value

Overall, the BID-M appears to be useful throughout the design process to ultimately support well-being. The participants' cultural background expands use of the BID-M and provides opportunities for additional cultural applications of biophilic design and future research. The BID-M offers additional language for incorporating biophilic design as well as serving to educate and guide feature selection.
Moderating effect of project size on the relationship between COVID-19 safety protocols and economic performance of construction projects
Authors: Onubi Hilary Omatule , Hassan Ahmad Sanusi , Yusof Nor'Aini , Bahdad Ali Ahmed Salem
Published: March 2022

Purpose

The COVID-19 health crisis has brought about a set of extra health and safety regulations, and procedures to the construction industry which could influence projects' economic performance (EP). The aim of this paper is to examine the effect of adopting COVID-19 safety protocols on construction sites on the economic performance (EP) of construction projects.

Design/methodology/approach

Employing the survey method using a structured questionnaire, data were collected from small- and large-sized construction projects in Nigeria and analysed using partial least squares structural equation modelling (PLS-SEM) technique.

Findings

The findings reveal that job re-organization and sanitization have negative significant effects on EP, while social distancing and specific training have no effect on EP. Furthermore, project size moderates the relationship between job re-organization, sanitization, specific training and EP with the stronger effect on the relationships observed in big projects, except for the relationship between sanitization and EP where the moderating relationship is stronger in small projects. However, there is no significant moderating effect of project size on the relationship between social distancing and EP.

Practical implications

As construction project sites continue to operate amidst strict safety protocols, this study offers theoretical and practical insights on how construction projects can adhere to the safety protocols while performing economically.

Originality/value

The originality of this study's findings stems from the fact that it is among the first to provide greater insight on how construction projects have fared economically considering the impact of the various COVID-19 protocols.
The impact of balanced scorecard in estimating the performance of banks in Palestine
Authors: Abueid Raed , Rehman Shafique Ur , Nguyen Nhat Tan
Published: March 2022

Purpose

This study aims to see the influence of a balanced scorecard (BSC) to determine the performance of banks in Palestine. Among the institutions that influence the economy of any country is the banking sector. Despite the influence of this sector on the economic policies and implementation in Palestine, there appears to be the difficulty of the appropriate approach to measuring its performance. Various techniques have failed to be efficient and effective. It creates an impulse to investigate the impact of a BSC in estimating the performance of banks in Palestine.

Design/methodology/approach

This study adopted a descriptive design of the ex-post facto type with a sample of 126 senior bank staff randomly selected from fourteen Palestinian banks. In total, 3 hypotheses were raised and tested using Pearson's product-moment correlation analysis and multiple linear regression analysis at 0.05 level of significance.

Findings

The result showed that bank performance positively correlated with internal business process perspective (r = 0.633, p < 0.01), followed by customers’ perspective (r = 0.338, p < 0.01), financial perspective (r = 0.321, p < 0.01) and learning and growth perspective (r = 0.230, p < 0.01). While regression analysis showed that the most potent factor was internal business process perspective (Beta = 0.670, t = 10.320, p < 0.01), followed by learning and growth perspective (Beta = 0.185, t = 2.812, p < 0.01) and customers’ perspective (Beta = 0.150, t = 2.469, p < 0.05) and financial perspective (Beta = 0.100, t = 2.200, p < 0.05). This implies that a unit increase in internal business process perspective, learning and growth perspective and customer's perspective will increase bank performance by 67%, 18.5%, 15% and 10%, respectively.

Practical implications

Among others, it was recommended that employees be exposed to the BSC model and its principles through continuous train as to ensure adequate application and implementation for enhanced bank performance. Administrators and stakeholders should ensure that the properties of each dimension of the BSC model are adequately worked on for easy fulfillment of the potentials in the model. It creates an avenue for a full-fledge organization with a workable customer, financial, internal business process, learning and growth perspective.

Originality/value

This is an initial study that used a BSC to determine the performance of banks in Palestine. Prior researchers overlook BSC dimensions composite and relative effect on the prediction of bank performance in Palestine.
Do board characteristics play a moderating role in M&A decisions of family firms?
Authors: Raithatha Mehul , Ladkani Radha
Published: March 2022

Purpose

The purpose of this paper is to examine the moderating effect of the board of directors on the strategic decisions made by family firms, and to understand the board attributes that can alleviate the aversion of family-owned firms toward mergers and acquisitions (M&A).

Design/methodology/approach

The study uses a sample of several firms listed in India from 2006 to 2019 with 19,813 firm-year observations. The empirical tests have been performed using logistic and negative binomial regressions. The study also tests for endogeneity with the help of Heckman (1979) two-step treatment effects model.

Findings

The study shows that board characteristics like smaller board-size, presence of outside directors, lower intensity of board activity, presence of busier board members and separation of board chair and CEO positions alleviate the inhibition of family firms toward M&A.

Research limitations/implications

The findings imply that investors and policymakers can encourage family firms to have smaller boards, more independent directors, passive boards and CEO nonduality to reduce their aversion toward risky activities. Family-owned firms could consider a board comprising members with multiple directorships who can bring wider knowledge and expertise which can reduce the perceived threat to socioemotional wealth (SEW) and alleviate their aversion toward M&A.

Originality/value

Ownership concentration in family firms posits a unique challenge in terms of their aversion toward M&A. This study is one of the few that highlight the relevance of the monitoring and advisory role of the board in alleviating this aversion in an emerging market like India.
Developing a learning-to-learn capability: insights on conditions for Industry 4.0 adoption
Authors: Saabye Henrik , Kristensen Thomas Borup , Wæhrens Brian Vejrum
Published: March 2022

Purpose

This paper investigates how manufacturers can develop a learning-to-learn capability for enabling Industry 4.0 adoption.

Design/methodology/approach

This research design is guided by our research question: How can manufacturers develop a learning-to-learn capability that enables Industry 4.0 adoption? The authors adopt action research to generate actionable knowledge from a two-year-long action learning intervention at the Danish rooftop window manufacturer VELUX.

Findings

Drawing on emergent insights from the action learning intervention, it was found that a learning-to-learn capability based on lean was a core construct and enabler for manufacturers to adopt Industry 4.0 successfully. Institutionalizing an organizational learning scaffold encompassing the intertwined learning processes of systems Alpha, Beta and Gamma served as a significant way to develop a learning-to-learn capability for Industry 4.0 adoption (systematic problem-solving abilities, leaders as learning facilitators, presence of a supportive learning environment and Industry 4.0 knowledge). Moreover, group coaching is a practical action learning intervention for invoking system Gamma and developing leaders to become learning facilitators – an essential leadership role during Industry 4.0 adoption.

Originality/value

The study contributes to theory and practice by adopting action research and action learning to explore learning-to-learn as a core construct for enabling Industry 4.0 adoption and providing a set of conditions for developing a learning-to-learn capability. Furthermore, the study reveals that leaders are required to act as learning facilitators instead of relying on learning about and implementing Industry 4.0 best practices for enabling adoption.
Demographic correction—A tool for inference from individuals to populations
Authors: Klimeš Adam , Klimešová Jitka , Janovský Zdeněk , Herben Tomáš
Published: March 2022

Estimation of responses of organisms to their environment using experimental manipulations, and comparison of such responses across sets of species, is one of the primary tools in ecology research. The most common approach is to compare the response of a single life stage of species to an environmental factor and use this information to draw conclusions about population dynamics of these species. Such approach ignores the fact that interspecific fitness differences measured at a single life stage are not directly comparable and cannot be extrapolated to lifetime fitness of individuals and thus species’ population dynamics. Comparison of one life stage only while omitting demographic information can strongly bias conclusions, both in experimental studies with a few species and in large comparative studies.

We illustrate the effect of this omission using both an exaggerated fictitious example and biological data on congeneric species differing in their demography. We are showing, taking simple assumptions, that different demography can completely revert conclusions reached by a comparison based on an experiment focusing on a single life stage.

We show that a ‘demographic correction’, namely translating observed effects into differences in outcomes of demographic models, is a solution to this problem. It requires turning the detected effects from the experiment into changes of transition probabilities of projection matrix models. Although such solution is limited by the low number of species with demographic data available, we believe that existing data (and data likely to be collected in the near future) permit at least approximate handling of this problem.

Read the free Plain Language Summary for this article on the Journal blog.
Blood trail of expansion? Long‐term patterns of livestock depredation by wolves in Poland
Authors: Fedyń Izabela , Bojarska Katarzyna , Gerber Nina , Okarma Henryk
Published: March 2022

As the wolf Canis lupus populations continue to recover across Europe, livestock depredation becomes increasingly challenging for their effective conservation. We aim to (1) analyze the spatiotemporal variation in wolf attacks on livestock in relation to the landscape structure, livestock species, and the phase of wolf expansion in Poland and (2) discuss the implications for conservation and management in an expanding, protected wolf population. From 2008 to 2018, farmers reported 5499 attacks on livestock with 13,164 killed individuals, and the number of attacks increased 2.7‐fold at the country scale. Sheep were among the most frequently killed livestock, and surplus killing (>2 killed individuals) was relatively common in captive deer and sheep depredation. The attacks were patchily distributed; 59% of all kills occurred in municipalities constituting 1% of the country surface. The probability and number of attacks were positively influenced by forest and pasture cover, and by the occurrence of depredation in previous years. Spatial variation and long‐term dynamics in livestock depredation by wolves can be attributed to different husbandry practices and phases of wolf recovery in three regions of the country. Our results indicate that accelerating increase in depredation rates during the initial phases of wolf recovery is likely to be followed by stabilization or decrease in attacks. A detailed spatiotemporal analysis of wolf–livestock conflict can help in management decisions in areas with ongoing wolf population recovery.
Towards standardized and reproducible research in skin microbiomes
Authors: Ruuskanen Matti O. , Vats Deepti , Potbhare Renuka , RaviKumar Ameeta , Munukka Eveliina , Ashma Richa , Lahti Leo
Published: March 2022

Skin is a complex organ serving a critical role as a barrier and mediator of interactions between the human body and its environment. Recent studies have uncovered how resident microbial communities play a significant role in maintaining the normal healthy function of the skin and the immune system. In turn, numerous host‐associated and environmental factors influence these communities' composition and diversity across the cutaneous surface. In addition, specific compositional changes in skin microbiota have also been connected to the development of several chronic diseases. The current era of microbiome research is characterized by its reliance on large data sets of nucleotide sequences produced with high‐throughput sequencing of sample‐extracted DNA. These approaches have yielded new insights into many previously uncharacterized microbial communities. Application of standardized practices in the study of skin microbial communities could help us understand their complex structures, functional capacities, and health associations and increase the reproducibility of the research. Here, we overview the current research in human skin microbiomes and outline challenges specific to their study. Furthermore, we provide perspectives on recent advances in methods, analytical tools and applications of skin microbiomes in medicine and forensics.
Microplastics reduce soil microbial network complexity and ecological deterministic selection
Authors: Shi Jia , Sun Yuanze , Wang Xiang , Wang Jie
Published: March 2022

Microplastics have been proposed as emerging threats for terrestrial systems as they may potentially alter the physicochemical/biophysical soil environments. Due to the variety of properties of microplastics and soils, the microplastic‐induced effects in soil ecosystems are greatly manifold. Here, we studied effects of three polymer microplastics (polyamide‐6, polyethylene, and polyethylene terephthalate) on soil properties with four different soil types. The success patterns, interaction relationships, and assembly processes of soil bacterial communities were also studied. Microplastics have the potential to promote CO2 emissions and enhance the soil humification. Even though microplastics did not significantly alter the diversity and composition of the soil microbial community, the application of microplastics decreased the network complexity and stability, including network size, connectivity, and the number of module and keystone species. The bacterial community assembly was governed by deterministic selection (77.3%–90.9%) in all treatments, while microplastics increased the contribution of stochastic processes from 9.1% in control to 13.6%–22.7%. The neutral model results also indicated most of the bacterial taxa were present in the predicted neutral region (approximately 98%), suggesting the importance of stochastic processes. These findings provided a fundamental insight in understanding the effects of microplastics on soil ecosystems.
Substrate composition influences amino acid carbon isotope profiles of fungi: implications for tracing fungal contributions to food webs
Authors: Arsenault Emily R. , Liew Jia Huan , Hopkins Jacob R.
Published: March 2022

Fungi link detrital resources and metazoan consumers through their role as decomposers. However, fungal contributions to metazoans may be misestimated in amino acid isotope studies because fungi are capable of both synthesizing amino acids (AAs)de novoand absorbing AAs from their environment. While fungi cultured in AA‐free media have been used to represent fungi in studies of natural environments, fungi likely gain energetic benefits by taking up substrate AAs directlyin situ. Consequently, fungi cultured on AA‐free media may not be representative of the true variability of natural fungal δ13CAAprofiles. Therefore, the objective of this experiment was to determine the effect of substrate AA availability on yeast δ13CAAprofiles. We found that yeasts cultured in media of relatively higher AA content had different δ13CAAprofiles than yeasts grown in AA‐free media, in part because yeasts utilized two essential AAs (Leu and Val) directly from media substrates when available in sufficient amounts. Furthermore, these differences among yeast δ13CAAprofiles remained after normalization of δ13CAAvalues. We recommend further characterization of the variation in fungal δ13CAAprofiles and the incorporation of this potential variability into interpretations of basal resource use by metazoans.
Exploring the influence of gender dysphoria in eating disorders among gender diverse individuals
Authors: Joy Phillip , White Megan , Jones Shaleen
Published: March 2022

Aim

Eating concerns, disordered eating and eating disorders have been noted to negatively impact the health and wellbeing of sexual and gender diverse individuals. The aim of this study was to explore the experiences of gender diverse Canadians accessing treatment for eating disorders or disordered eating concerns to gain a deeper understanding of how dietitians and other health providers can provide gender affirming care.

Methods

Seven self‐identifying gender diverse participants were recruited and took part in semi‐structured interviews. Most participants identified as white. Data was analysed using thematic analysis.

Results

Four themes around gender dysphoria were constructed from the data, including gender dysphoria and eating disorders, barriers to accessing eating disorder treatments, harmful eating disorder treatment strategies and suggestions for eating disorder programmers and health professionals.

Conclusion

Gender dysphoria considerations were believed to be lacking in traditional eating disorder treatment programs. Participants saw the need for more awareness and training in this area for dietitians and other health professionals.
Plant collections for conservation and restoration: Can they be adapted and adaptable?
Authors: Bragg Jason G. , van der Merwe Marlien , Yap Jia‐Yee Samantha , Borevitz Justin , Rossetto Maurizio
Published: March 2022

Plant collections are important for the conservation of threatened species, and can provide material for ecological restoration. Typically we want collections to have high genetic diversity so populations founded from it are adaptable to future challenges. Sometimes, we have additional objectives for collections, such as enrichment for desirable traits controlled by adaptive alleles. We used landscape genomic data sets for two plants,Westringia fruticosaandWilkiea huegeliana, to design collections that are genetically diverse, and that are adapted to warming climates. We characterized temperature adaptation by: (i) using the mean annual temperature of the sites of origin of the plants, and (ii) using the representation of alleles that are associated with warm temperatures. InWestringia fruticosa, there was a negative correlation, or tradeoff, between designing a collection that was both genetically diverse and adapted to warm temperatures. This tradeoff was weaker inWilkiea huegeliana. We hypothesized this was because neutral genetic variation was strongly correlated with temperature inWestringia fruticosa, and not inWilkiea huegeliana. Accordingly, when we shuffled the temperature data, breaking up the covariance betweenWestringia fruticosagenetic variation and temperature, there was a relaxation of the observed tradeoff. In summary, we explore tradeoffs between promoting genetic diversity and selecting for a specific trait in plant collections, and show that the strength of this tradeoff varies between two species. This represents a useful step towards understanding when selection will have a large cost in genetic diversity, and when it will be possible to design a collection that is both adapted and adaptable.
Sex moderates effects of alcohol and cannabis co‐use on alcohol and stress reactivity
Authors: Claus Eric D. , Blaine Sara K. , Witkiewitz Katie , Ansell Emily B.
Published: March 2022

Background

Simultaneous or concurrent use (co‐use) of alcohol and cannabis is associated with greater use of both substances over time, academic difficulties, more severe substance use consequences, and adverse impacts on cognitive functioning than the use of a single substance or no substance use. This study examined potential neural mechanisms underlying co‐use behaviors in comparison to single substance use. Specifically, we compared alcohol cue reactivity and stress‐cue reactivity among individuals who reported frequent same‐day co‐use of alcohol and cannabis and individuals who reported only alcohol use.

Methods

The sample included 88 individuals (41 women) who reported only alcohol use and 24 individuals (8 women) who reported co‐use of alcohol and cannabis on at least 50% of drinking occasions. All participants completed fMRI stress and alcohol cue reactivity tasks. Because of known sex effects on stress reactivity and alcohol cue reactivity, we tested sex by co‐use interactions.

Results

During alcohol cue presentation, co‐users had less activation in the thalamus and dorsomedial prefrontal cortex than alcohol‐only users, effects that were driven by differences in responses to neutral cues. Examination of stress cue reactivity revealed sex by co‐use interactions in the lingual gyrus, with women co‐users showing a greater difference between negative and neutral cue reactivity than all other groups. In addition, women co‐users had greater connectivity between the nucleus accumbens and both the medial orbitofrontal cortex and the rostral anterior cingulate cortex during negative cue presentation than the other groups.

Conclusions

These results provide preliminary evidence of enhanced stress cue reactivity in individuals reporting co‐use of alcohol and cannabis, particularly women co‐users.
Cost stickiness and stock price crash risk
Authors: Habib Ahsan , Costa Mabel D
Published: March 2022

We examine the association between cost stickiness and the risk of stock price crash, defined as asymmetry in the distribution of weekly stock returns. We use information opaqueness and heterogeneous investor beliefs as our two theoretical frameworks. Using a sample of US firms, we find a positive association between cost stickiness and crash risk. This association is more pronounced for firms with an opaque information environment as proxied by fewer analysts following. As efficient cost management is key to profit maximisation, studying the implications of cost stickiness makes a valuable contribution to the literature on cost management.
Random amplified polymorphic DNA analysis reveals no clear link between Staphylococcus epidermidis and acute mastitis
Authors: Cullinane Meabh , Scofield Lauren , Murray Gerald L. , Payne Matthew S. , Bennett Catherine M. , Garland Suzanne M. , Amir Lisa H. ,   for the CASTLE Study team
Published: March 2022

Mastitis is commonly experienced by breastfeeding women. While Staphylococcus aureus is usually implicated in infectious mastitis, coagulase‐negative staphylococci (CoNS) are a possible alternative pathogen. This case‐control study examined the role of CoNS in mastitis using isolates cultured from breast milk of 20 women with mastitis and 16 women without mastitis. Gene sequencing determined bacterial species, and random amplified polymorphic DNA (RAPD) analysis investigated strain‐level variation. The majority of CoNS isolates were Staphylococcus epidermidis (182/199; 91%). RAPD analysis identified 33 unique S. epidermidis profiles, with no specific profile associated with mastitis cases.
Paediatric dog bite injuries: a 10‐year retrospective cohort analysis from Sydney Children's Hospital
Authors: Sulaiman Ahmad , Liang Derek , Gianoutsos Mark , Moradi Pouria
Published: March 2022

Background

Dog bite injuries are largely preventable yet present the most common animal related cause of hospitalisation. This study examines the demographics and clinical cost of patients with dog bite related injuries who presented to Sydney Children's Hospital (SCH) from 2010 to 2020. The results from our study will be used to raise awareness regarding the impact of dog bite injuries in our community.

Methods

Data was obtained from the SCH database using ICD‐10‐AM code W54.0, which captures all patients presenting to SCH with dog bite injuries from 2010 to 2020. A chart review was then performed to retrieve demographic data for analysis. Data analysis was performed using SAS® software version 9.4 and cost for each patient retrieved from the SCH clinical costing department.

Results

A total of 628 patients presented to SCH with dog bites during the study period. 273 (43.5%) patients received treatment in ED only with the remaining 355 (56.5%) patients admitted for treatment. The average age was 5.69 years old. There were 321 males (51.1%) and 307 females (48.9%). Facial and other head & neck injuries were most common (64.4%). Pitbull, Labrador and Rottweiler were the most commonly documented offending breeds (25%) with the family dog most likely to offend (49%). The mean clinical cost for per dog bite injury was $2968.

Conclusion

As part of the largest single centre study exploring dog bite injuries, we expect that this study will stimulate potential public health campaigns targeted at educating parents and children on interacting with dogs to minimise these injuries.
Nutrition during extracorporeal life support: A review of pathophysiological bases and application of guidelines
Authors: D'Alesio Mark , Martucci Gennaro , Arcadipane Antonio , Lorusso Roberto , Amrein Karin
Published: March 2022

Background

Patients on extracorporeal life support (ECLS), either for respiratory or cardiac support, are at high risk of malnutrition; guidelines on nutrition in critical care have not incorporated solid evidence regarding these settings. The aim of this narrative review is to gather the available evidence in the existing literature and transpose general principles to the ECLS population.

Methods

A literature review of observational and interventional studies on nutrition during ECLS, and evaluation of nutrition guidelines in this perspective.

Results

Nutrition is paramount for improving outcomes in ECLS, as well as in critically ill patients. The caloric needs during ECLS can vary according to the severity of the clinical state, sedation, paralysis, and temperature stability. Precise evaluation of energy expenditure by indirect calorimetry is difficult because ECLS is a system dedicated to removing carbon dioxide; however, modified equations composed of carbon dioxide values taken from the membrane lung are available. Guidelines suggest starting early enteral nutrition (EN) with a hypocaloric (70%–80% of the needs) strategy, also in acute states such as septic or cardiogenic shock. Moreover, EN, despite previous concerns, is feasible in prone position, an increasingly adopted strategy during mechanical ventilation. The catabolic state is maximal in these patients, causing a protein and muscular reduction. Therefore, adequate protein delivery should be guaranteed by administering a high protein intake of up to 2 g/kg/day.

Conclusions

Studies on nutrition tailored to ECLS patients are warranted. Early hypocaloric EN with high protein intake, tailored on indirect calorimetry, may be the most appropriate option.
Lung thermography during the initial reperfusion period to assess pulmonary function in cellular ex vivo lung perfusion
Authors: Kosaka Ryo , Sakota Daisuke , Niikawa Hiromichi , Ohuchi Katsuhiro , Arai Hirokuni , McCurry Kenneth R. , Okamoto Toshihiro
Published: March 2022

Background

Thermography is a noninvasive technology to detect low temperatures in poorly circulated areas. In ex vivo lung perfusion (EVLP), lungs are rewarmed to body temperature during the initial 1 h. Currently, the effect of graft thermal changes during the rewarming phase on pulmonary function is unknown. In this study, we evaluated the correlation of lung surface temperature with physiological parameters, wet/dry ratio, and transplant suitability in Lund‐type EVLP.

Methods

Fifteen pigs were divided into three groups: control group (no warm ischemia) or donation after circulatory death groups with 60 or 90 min of warm ischemia (n = 5, each). Thermal images of the lower lobes were continuously collected from the bottom of an organ chamber using infrared thermography throughout EVLP.

Results

At 8 min, lung surface temperatures of nonsuitable cases were significantly lower than in suitable cases (25.1 ± 0.6 vs. 27.8 ± 1.2°C, p < 0.001), while there was no difference in lung surface temperatures between the two groups at 0–4 min and 12–120 min. There was a significant negative correlation between lung surface temperatures at 8 min and wet/dry ratio at 2 h in the lower lobes (R = −0.769, p < 0.001, cutoff = 26°C, area under the curve = 1.0). A lung surface temperature of <26°C was significantly correlated with poor pulmonary function and transplant nonsuitability.

Conclusion

A lung surface temperature of ≥26°C at 8 min is a good early predictor of transplant suitability in cellular EVLP and might be applicable in clinical EVLP.
Anemia and outcomes following left ventricular assist device implantation
Authors: Imamura Teruhiko , Narang Nikhil , Besser Stephanie , Rodgers Daniel , Combs Pamela , Siddiqi Umar , Stonebraker Corinne , Jeevanandam Valluvan
Published: March 2022

Background

Patients with concomitant anemia and congestive heart failure have poor outcomes. The prevalence and clinical risk of anemia in patients receiving durable left ventricular assist devices (LVAD) remain unknown.

Methods

We retrospectively analyzed patients who underwent LVAD implantation between 2014 and 2018. The association between hemoglobin level at the time of index discharge and the one‐year composite endpoint of heart failure readmissions or hemocompatibility‐related adverse events was investigated.

Results

A total of 168 patients (57 [48, 66] years old, 123 males) were included and stratified into a classification of anemia (hemoglobin <9.7 g/dl, N = 99) or non‐anemia (N = 69). The anemia group had a higher one‐year incidence of the composite endpoint (56% vs 36%, p = .013) with an adjusted hazard ratio of 1.83 (95% confidence interval 1.08–2.82). Patients with anemia also experienced suboptimal bi‐ventricular unloading.

Conclusions

Anemia was prevalent in LVAD patients and associated with a greater risk of heart failure and hemocompatibility‐related adverse events. The optimal threshold for therapeutic intervention in response to post‐LVAD anemia needs further investigation.
Interdependence, bonding and support are associated with improved mental wellbeing following an outdoor team challenge
Authors: Cohen Emma , Davis Arran J. , Taylor Jacob
Published: March 2022

Social relationships and mental health are functionally integrated throughout the lifespan. Although recent laboratory‐based research has begun to reveal psychological pathways linking social interaction, interdependence, bonding and wellbeing, more evidence is needed to integrate and understand the potential significance of these accounts for real‐world events and interventions. In a questionnaire‐based, repeated measures design, we measured the wellbeing of 13‐ to 19‐year‐old participants (n = 226) in the Ten Tors Challenge (United Kingdom) 7–10 days before (T1) and after (T4) the event. Immediately before (T2) and after (T3) the event, we administered measures of team bonding, perceived and experienced interdependence, perceived and received support, physical pain and fatigue, and performance satisfaction. There was a significant increase in participants' wellbeing (pre‐to‐post event). Post‐event social bonding and performance satisfaction positively predicted the wellbeing increase. Bonding was, in turn, positively predicted by experienced interdependence, received support, pain and fatigue, and the sense of having done better as a team than expected. Results provide novel field‐based evidence on the associations between meaningful bonds of mutual reliance in a challenging team event and adolescent wellbeing. Team challenge events potentially offer effective contexts for forging social interactions, interdependencies, and bonds that can support mental and physical health.
Applying Lyon Consensus criteria in the work‐up of patients with proton pump inhibitory‐refractory heartburn
Authors: Frazzoni Marzio , Frazzoni Leonardo , Ribolsi Mentore , Bortoli Nicola De , Tolone Salvatore , Russo Salvatore , Conigliaro Rita , Penagini Roberto , Fuccio Lorenzo , Zagari Rocco Maurizio , Savarino Edoardo
Published: March 2022

Background

A hierarchical approach for gastro‐oesophageal reflux disease (GERD) diagnosis by impedance‐pH monitoring was proposed by the Lyon Consensus, based on acid exposure time (AET) and supportive impedance metrics.

Aims

To establish the clinical value of Lyon Consensus criteria in the work‐up of patients with proton pump inhibitory (PPI)‐refractory heartburn.

Methods

Expert review of off‐therapy impedance‐pH tracings from unproven GERD patients with PPI‐refractory heartburn prospectively evaluated at referral centers. Impedance metrics, namely total reflux episodes, postreflux swallow‐induced peristaltic wave index, and mean nocturnal baseline impedance, were assessed. Expert review of on‐therapy preoperative impedance‐pH tracings from a separate cohort of surgically treated erosive/nonerosive GERD cases.

Results

Off‐therapy, normal, inconclusive, and abnormal AET was found in 59%, 17%, and 23% of 317 cases. Supportive evidence of GERD was provided by abnormal impedance metrics in up to 22% and 62% of cases in the normal and inconclusive AET groups, respectively. Adding the cases with inconclusive AET and abnormal impedance metrics to the abnormal AET group, a significant increase in GERD evidence was observed (from 23% to 37% of cases, p < 0.0002). At the on‐therapy presurgical evaluation, abnormal/inconclusive AET and supraphysiological values of impedance metrics showed ongoing reflux in 21% and 90% of 96 cases, respectively (p < 0.00001); a relationship between on‐therapy ongoing reflux and PPI‐refractory heartburn was confirmed by the favorable surgical outcome at 3‐year follow‐up, 88% of cases being in persistent off‐PPI heartburn remission.

Conclusions

Impedance‐pH monitoring, off‐ and on‐therapy, is of high clinical value in the work‐up of patients with PPI‐refractory heartburn.
Comparative efficacy of an optimal exam between ultrasound versus abbreviated MRI for HCC screening in NAFLD cirrhosis: A prospective study
Authors: Huang Daniel Q. , Fowler Kathryn J. , Liau Joy , Cunha Guilherme M. , Louie Ashley L. , An Julie Y. , Bettencourt Ricki , Jung Jinho , Gitto Zachary , Hernandez Christie , Lopez Scarlett J. , Gupta Hersh , Sirlin Claude B. , Marks Robert M. , Loomba Rohit
Published: March 2022

Background

Retrospective studies report that visualisation of the liver may be severely limited using ultrasound (US), potentially contributing to diminished sensitivity for detection of hepatocellular carcinoma (HCC) among patients with nonalcoholic fatty liver disease (NAFLD) and cirrhosis, but there are limited prospective data.

Aims

To compare liver visualisation scores prospectively for US and abbreviated hepatobiliary phase (HBP) magnetic resonance imaging (AMRI) in a cohort of participants with NAFLD cirrhosis and a clinical indication for HCC surveillance.

Methods

This prospective multicenter study included 54 consecutive participants (67% women) with NAFLD cirrhosis who underwent contemporaneous US as well as HBP‐AMRI with gadoxetic acid. Primary outcome was the proportion of imaging examinations with severe limitations in liver visualisation (visualisation score C) compared head‐to‐head between US and AMRI.

Results

The mean (± standard deviation) age was 63.3 years (±8.4) and body mass index was 32.0 kg/m2 (±6.0). Nineteen participants (35%) had severe visualisation limitations on US, compared with 10 (19%) with AMRI, p < 0.0001. Nine (17%) participants had <90% of the liver visualised on US, compared with only 1 (2%) participant with AMRI, p < 0.0001. Obesity was a strong and independent predictor for severe visualisation limitation on US (OR 5.1, CI 1.1–23.1, p = 0.03), after adjustment for age, sex and ethnicity.

Conclusion

More than one‐third of participants with NAFLD cirrhosis had severe visualisation limitations on US for HCC screening, compared with one‐sixth on AMRI. US adequacy should be reported in all clinical studies and when suboptimal then AMRI may be considered for HCC screening.
Subcutaneous injection of infliximab CT‐P13 results in stable drug levels within 14‐day treatment cycle in Crohn’s disease
Authors: Roblin Xavier , Veyrard Pauline , Bastide Laetitia , Berger Anne E. , Barrau Mathilde , Paucelle Anne‐Sophie , Waeckel Louis , Kwiatek Sany , Flourie Bernard , Nancey Stephane , Paul Stéphane
Published: March 2022

The new subcutaneous (sc) formulation of the infliximab (IFX) biosimilar CT‐P13 results in homogeneous serum trough concentrations of IFX at steady state. The present study aimed to investigate in Crohn’s disease (CD) patients the intra‐individual variations of IFX drug levels at multiple time‐points during 2 consecutive cycles of maintenance therapy with CT‐P13 sc.

Patients and Methods

CD patients in clinico‐biological remission under maintenance therapy with intravenous (iv) IFX/CT‐P13 were switched to CT‐P13 sc 8 weeks (W) after the last infusion. They were treated with CT‐P13 sc, 120 mg every 2 W. Assessments were performed from 8 W after starting CT‐P13 sc and patients had to attend 6 visits on 2 consecutive cycles of treatment (cycles A and B). Visits were scheduled on days 4–6 (visit 1), days 7–9 (visit 2) and day 14 (visit 3) of each cycle, where days 1 and 14 were the days of sc injection of CT‐P13. At each visit, peripheral blood was collected to measure serum IFX levels and anti‐drug antibodies.

Results

Twenty patients underwent 120 evaluations. Large intra‐individual variations of serum drug levels of IFX were observed. When pooling the 120 evaluations, the mean drug level was 11.3 ± 4.9 μg/ml, and the median drug level was 10.9 μg/ml (IQR 7.5–15.5). During each cycle, the median drug levels were similar between visits 1 and 2 as well as between visits 1 and 3 and between visits 2 and 3. In cycle A, median drug levels were 11.1 μg/ml (7.8–14.5), 12.0 μg/ml (7.2–16.1) and 11.0 μg/ml (7.5–15.1) at V1, V2 and V3, respectively. Similar results were obtained in cycle B, where median drug levels were 11.6 μg/ml (7.9–14.9), 11.4 μg/ml (8.1–15.2) and 10.9 μg/ml (7.9–15.6) at V1, V2 and V3, respectively. In univariate analysis, we failed to identify factors predictive of low drug levels.

Conclusions

IFX drug levels are quite stable within 14‐day treatment cycle, without trough levels in CD patients in remission during the maintenance therapy with CT‐P13 sc. In patients with inactive CD under maintenance therapy with CT‐P13 sc, therapeutic drug monitoring of IFX can be performed at any time between two CT‐P13 sc injections.
Immunomodulatory effects of pharmaceutical opioids and antipyretic analgesics: Mechanisms and relevance to infection
Authors: Abdel Shaheed Christina , Beardsley Justin , Day Richard O. , McLachlan Andrew J.
Published: March 2022

Understanding how pharmaceutical opioids and antipyretic analgesics interact with the immune system potentially has major clinical implications for management of patients with infectious diseases and surgical and critical care patients. An electronic search was carried out on MEDLINE, EMBASE, PsycINFO, CENTRAL and the Cochrane library to identify reports describing the immunomodulatory effects of opioid analgesics and antipyretic analgesics, and their effects in infectious diseases. In adaptive immunity, nonsteroidal anti‐inflammatory drugs have divergent effects: augmenting cell‐mediated immunity but inhibiting humoral immunity. Nonsteroidal anti‐inflammatory drugs have demonstrated a beneficial role in Mycobacterium tuberculosis infection and histoplasmosis in animals, and may be plausible adjuvants to antimicrobial agents in these diseases. There is a need to evaluate these findings rigorously in human clinical trials. There is preliminary evidence demonstrating antiviral effects of indomethacin in SARS CoV‐2 in vitro; however, uncertainty regarding its clinical benefit in humans needs to be resolved in large clinical trials. Certain opioid analgesics are associated with immunosuppressive effects, with a developing understanding that fentanyl, morphine, methadone and buprenorphine suppress innate immunity, whilst having diverse effects on adaptive immunity. Morphine suppresses key cells of the innate immunity and is associated with greater risk of infection in the postsurgical setting. Efforts are needed to achieve adequate analgesia whilst avoiding suppression of the innate immunity in the immediate postoperative period caused by certain opioids, particularly in cancer surgery.