bluuebunny/crossref_metadata_2025 huggingface dataset:
Harnessing the potentialities of probiotics, prebiotics, synbiotics, paraprobiotics, and postbiotics for shrimp farming
Authors: Goh Joanna Xuan Hui , Tan Loh Teng‐Hern , Law Jodi Woan‐Fei , Ser Hooi‐Leng , Khaw Kooi‐Yeong , Letchumanan Vengadesh , Lee Learn‐Han , Goh Bey‐Hing
Published: March 2022

The shrimp farming industry is receiving increasing attention globally. However, extending the frontiers of the industry has been a challenge as high stocking density often increases susceptibility to diseases and compromises shrimp quality. There has been a huge adoption of bacterial‐derived additives in recent decades, particularly in Asia. Accumulating evidence demonstrates the modulatory effect of these functional additives on the animal gut microbiota composition, thus making them potential alternatives to antibiotics in controlling infectious diseases, such as acute hepatopancreatic necrosis disease (AHPND). These functional additives could be introduced in various forms, such as probiotics, synbiotics, paraprobiotics, and postbiotics. This article aims to critically review previous studies that investigated the effects of these bacterial derivatives, particularly on shrimp species. The surge of research in recent years indirectly attested to the immense potentialities of these functional additives. Generally, the introduction of bacterial derivatives not only helped in disease control but also demonstrated encouraging outcomes, including better survival rate, immune enhancement, and growth promotion effects. It is interesting to note that the effectiveness of probiotics extended beyond the viability of the bacteria, thus leading to concepts such as paraprobiotics and postbiotics. Although this is a relatively new research area with limited information, this review aims to consolidate available data and provide a comprehensive overview of the state of the art of this research arena. The challenges in each research domain were also discussed towards the end of this review to provide insights into potential future research niches.
A decision support tool for parasite management in fish aquaculture
Authors: Hutson Kate Suzanne , Mooney Allan James , Ernst Ingo , Brazenor Alexander Karlis , Scheel Max , Atalah Javier
Published: March 2022

A decision support tool was developed to aid management of problematic parasites in marine fish aquaculture. The tool provides biologically relevant treatment intervals to interrupt the life cycle of ectoparasitic flatworms that occur in global kingfish and amberjack (Seriola spp.) aquaculture. Temperature‐dependent life cycle parameters for the ‘skin flukes’, Benedenia seriolae and Neobenedenia girellae, and the ‘gill fluke’, Zeuxapta seriolae, were derived from published data and modelled using non‐linear regressions. Increasing temperatures shortened the duration of most life cycle parameters of all parasites. Salinity had no effect on the timing of life cycle parameters but limited hatching success in hypo‐ and hypersaline conditions. The tool, named BeNeZe after the first two letters of each parasite genera, enables rapid determination of treatment intervals for two consecutive medicinal immersion or ‘bathing’ treatments—the first to kill adult flatworms attached to fish and the second to prevent maturity of new parasite recruits. As temperature increases, the interval between treatments and the ‘window’ within which the second treatment should be applied is reduced. The tool can be used for multi‐species infections. The inclusion of parasite taxonomy, biology and behaviour as part of an integrated management strategy is reviewed. Available through an open access app, BeNeZe is intended to be applied in conjunction with farm biosecurity, surveillance, management measures and recognition of independent management units. BeNeZe can be used to reduce infection burdens, improve fish welfare and production and reduce treatment number and frequency.
Restoring Palmer's agave in a Lehmann lovegrass dominated grassland in southeastern Arizona
Authors: Gill Amy S. , Oliver Jeffrey C. , Fitting Helen , Kubby Brooke K. , Gornish Elise S.
Published: March 2022

Dryland restoration is becoming increasingly challenging in arid and semiarid regions, such as in the southwestern United States, due to rapid land degradation, the spread of non‐native species, and climate change. The development of strategies to enhance restoration of native species, particularly culturally and ecologically important native plants like Palmer's agave (Agave palmeri), is particularly critical in southeastern arid lands where scarce rainfall, herbivory, and invasive species dominance pose unique challenges to land management. In a large field experiment in southeastern Arizona, U.S.A., we assessed the utility of several management techniques to promote restoration and revegetation outcomes for Palmer's agave survival and growth, including protection from solar insolation and herbivory, and reduction in the competitiveness of Lehmann lovegrass (Eragrostis lehmanniana). We found that the combination of herbivory protection and shade resulted in the highest survival of planted agaves, while the shade treatment alone resulted in the largest agaves. In fact, our results suggest that dense Lehmann lovegrass cover protects agaves from direct sunlight and predation. If land managers are challenged by widespread Lehmann lovegrass, they can opt to mechanically reduce it. However, if population recovery of Palmer's agave is a priority and fire hazard is minimal, our work suggests that stakeholders concerned with population recovery of Palmer's agave can forgo removing existing vegetation and plant agaves in a matrix of (and/or under the canopy of) existing vegetation.
Student performance and loss aversion*
Authors: Karle Heiko , Engelmann Dirk , Peitz Martin
Published: March 2022

We match data on performance in a multiple‐choice examination with data on risk preferences from a classroom experiment. Students who are more loss averse leave more questions unanswered and perform worse in the exam when an incorrect answer is penalized compared with no answer. Thus, loss aversion parameters extracted from lottery choices in a controlled experiment have predictive power in a field environment of decision‐making under uncertainty. Furthermore, the degree of loss aversion appears to be persistent over time, as the experiment was conducted three months prior to the exam. Important differences across genders are partly explained by differences in loss aversion.
Understanding suicide risk for youth who are both Black and Native American: The role of intersectionality and multiple marginalization
Authors: Wiglesworth Andrea , Clement Déjà N. , Wingate LaRicka R. , Klimes‐Dougan Bonnie
Published: March 2022

Introduction

Native American and multiracial youth experience elevated risk for suicide ideation (SI) and suicide attempts (SA); however, intersectional identities are often unexamined in suicide research.

Method

We examined the prevalence of SI and SA, and the impact of intersectional identities (sex, sexual minority identity, and economic insecurity) on these rates, in 496 biracial Black‐Native American, 2,804 Native American, 14,220 Black, 5,569 biracial Native American‐White, 4,076 biracial Black‐White, and 118,816 White youth who participated in the Minnesota Student Survey.

Results

Black‐Native American youth reports of SI and SA resembled other Native American youth and were significantly higher than those reported by Black, White, and Black‐White (SA only) youth. While sexual minority youth reported higher rates of SI and SA than heterosexual youth, this difference between sexual minority and heterosexual Black‐Native American youth was smaller as compared to their peers.

Conclusion

Though they largely resemble their mono/biracial Native American peers, Black‐Native American youth show some distinct patterns of SA when accounting for their intersectional identities. Despite presumed similarities in systemic risk factors, Black and Black‐Native American youth differ considerably in reported suicidality. The experiences of Black‐Native American teens warrant further examination.
Communication with Compassion as Positive Leadership Practices: The Case of Nutrifood Indonesia
Authors: Wijaya Bambang Sukma , Amir Muhammad Taufiq
Published: March 2022

The recent emergence of negative communication and apathetic behavior requires positive communication by considering empathy known as Komunikasih (In Indonesian, communication with compassion). Besides individuals, institutions, including companies, should apply Komunikasih to practice positive communication. This article examines the Rumah Kedua (second home) program of Nutrifood Indonesia as the embodiment of the company's value or culture, namely “i-care.” This study employed a case study method with a Komunikasih theory analysis. The data were collected using textual, visual, digital, manual, professional, and personal document search, and in-depth interviews with key informants: the CEO and several employees of Nutrifood. This study revealed that the Komunikasih spirit embodies in the form of 1) equality, 2) sincerity, 3) compassion, 4) affection, 5) respectfulness, 6) friendship, 7) sense of family, 8) meaningfulness, 9) wellness, and 10) loyalty. Consequently, the company created a comfortable working atmosphere that makes the office like a second home. Nutrifood has used multimedia and multi-sensory messages through videography, storytelling, books, wall quotes, and ambient layouts to communicate these values. Other companies can use the findings of this study as a reference to implement the idea of Komunikasih in their internal and external communication.
Piecewise-Focusing Collectors Reduce the Mirror Area in Concentrating Solar Thermal Power Plants
Authors: Bisset David K.
Published: March 2022

Piecewise-focusing (PWF) collectors replace the heliostat field and central tower receiver of Gen 2 concentrating solar thermal (CST) power plants. The PWF collector consists of a large base frame supporting a tiered array of reflectors that concentrate sunlight into a cavity receiver. The base frame rotates about a central pivot to track the sun in azimuth, while the reflectors rotate about individual nearly horizontal inclined axes to track the sun in elevation. Compressed gas such as CO2 is used as the heat transfer fluid (HTF) from the receiver to a conventional molten-salt thermal reservoir, which supplies heat for a steam turbine power block. Physical and numerical modeling of an approximately paraboloidal PWF collector shows that about 250 separate reflectors will be required for adequate focus on the entrance to a cavity receiver at a concentration ratio of 2000 with little spillage at all sun elevations. With an area of 10–20 times larger than the cavity entrance, the absorber functions at peak temperatures that are within range of standard stainless steel tubing, despite using a gaseous HTF. Reflectors of PWF collectors have significantly better cosine factors than heliostats, and cavity receivers lose much less heat than open cylindrical receivers, so that reflector area is reduced to about 62% of heliostat area. Thus, the capital cost of a CST plant can be reduced substantially. By continuing to use Gen 2 technology for thermal storage and the power block, PWF-based CST can be developed much sooner than “Gen 3” CST.
Investigation of Aloe Vera Latex Used as Natural Dye in TiO2-Based Heterojunction and Liquid-Electrolyte Dye-Sensitized Solar Cells
Authors: Hnawi Salma Kaotar , El Mansouri Abdelfattah , Abdallah Nayad , Agdad Abdelali , Tchenka Abdelaziz , Cheikh SambaVall , Mellalou Abderrahman , Oueriagli Amane , Ait Ali Mustapha
Published: March 2022

The use of naturally extracted compounds as dye sensitizers is a very promising alternative for the manufacture of low-cost solar cells. These directly convert solar energy to electricity. In the present study, aloe latex solid (ALS), which is an orange-yellow solid compound extracted from aloe vera leaves, was deposited on a TiO2 thin film (TiO2/ALS) for the construction of two different solar cell configurations. The UHPLC-DAD-ESI-MS analysis, UV–Vis, and FTIR spectroscopic studies were performed for the prepared dye sensitizer. In fact, the performance of the TiO2/ALS composite was investigated in a heterojunction dye-sensitized solar cell (HJ-DSSC) and a liquid-electrolyte-based dye-sensitized solar cell (LE-DSSC) to identify the architecture with the highest efficiency of sunlight conversion. The solar cells’ photovoltaic performance in terms of short-circuit current, open-circuit voltage, fill factor, and energy conversion efficiency was tested with photocurrent density–voltage measurements. Interesting solar conversion efficiencies were obtained for both architectures with a maximum value of about 1.17% corresponding to the LE-DSSC configuration.
Study on Surface Adhesive Wear and Wear Life of Double Involute Gears Under Mixed Elastohydrodynamic Lubrication
Authors: Yin Zhaoming , Fan Zhimin
Published: March 2022

To slow down the surface wear process of double involute gears (DIG), the surface adhesive wear model and wear life prediction model are established according to its meshing characteristics, combined with the modified Archard wear model and mixed elastohydrodynamic lubrication (EHL) model. This paper studies the surface wear and wear life of DIG, compares it with common involute gears (CIG), and discusses the influence of different factors on its surface wear. Results show that the adhesive wear distribution of DIG is similar to that of CIG. Properly reducing l* and increasing y* can reduce surface wear and prolong wear life. The reasonable selection of lubrication states and working conditions can be beneficial to enhance its tooth surface wear resistance.
Inlet Flow Distortion in an Advanced Civil Transport Boundary Layer Ingesting Engine Installation
Authors: Hall D. K. , Greitzer E. M. , Uranga A. , Drela M. , Pandya S. A.
Published: March 2022

This article presents first-of-a-kind measurements, and complementary computations, of the flow through the propulsion system of a boundary layer ingesting, twin-engine advanced civil transport aircraft configuration. The experiments were carried out in the NASA Langley 14- by 22-foot Subsonic Tunnel, using a 1:11 scale model of the D8 “double-bubble” aircraft with electric ducted fans providing propulsive power. Overall force and moment measurements and flow field surveys at the inlet and nozzle exit planes were obtained. The computations were carried out with the NASA OVERFLOW code. The measurements and computations were conducted for a range of aircraft angles of attack and propulsor powers representing operating points during the aircraft mission. Velocity and pressure distributions at the propulsor inlet and exit, and integral inlet distortion metrics, are presented to quantify the flow nonuniformity due to boundary layer ingestion. The distorted inflow exhibits qualitative and quantitative changes over the mission, from a unidirectional stratified stagnation pressure at cruise to a streamwise vortex structure at climb conditions. The computations capture these flow features and reveal the interactions between airframe and propulsor that create these three-dimensional flow variations.
Application of Population Pharmacokinetic Modeling, Exposure-Response Analysis, and Classification and Regression Tree Analysis to Support Dosage Regimen and Therapeutic Drug Monitoring of Plazomicin in Complicated Urinary Tract Infection Patients with Renal Impairment
Authors: Zhuang Luning , Wu Kunyi , Jang Seong H. , Reynolds Kellie S. , Mishra Shrimant , Iarikov Dmitri
Published: March 2022

In 2018, the FDA approved plazomicin for the treatment of complicated urinary tract infections (cUTI) including pyelonephritis in adult patients with limited or no alternative treatment options. The objective of this article is to provide the scientific rationales behind the recommended dosage regimen and therapeutic drug monitoring (TDM) of plazomicin in cUTI patients with renal impairment.
The Major Autolysin Atl Regulates the Virulence of Staphylococcus aureus by Controlling the Sorting of LukAB
Authors: Zheng Xuhui , Ma Sheya Xiao , St. John Amelia , Torres Victor J.
Published: March 2022

Infections caused by the Gram-positive bacterium
Staphylococcus aureus
remain a significant health threat globally. The production of bicomponent pore-forming leukocidins plays an important role in
S. aureus
pathogenesis.
Transcriptome-Wide Effects of NusA on RNA Polymerase Pausing in Bacillus subtilis
Authors: Jayasinghe Oshadhi T. , Mandell Zachary F. , Yakhnin Alexander V. , Kashlev Mikhail , Babitzke Paul
Published: March 2022

NusA is an essential transcription elongation factor that was assumed to play a major role in RNAP pausing. NusA stimulates pausing
in vitro
; however, the essential nature of NusA had prevented an assessment of its role in pausing
in vivo
.
Genome Sequences of Marichromatium gracile HOL-1 and Its Purple Photosynthetic Coisolate,
Afifella
sp. H1R
Authors: Kyndt J. A. , Dubey S. , Frazier N. , Meyer T. E.
Published: March 2022

We sequenced the genomes of both the purple sulfur gammaproteobacterium
Marichromatium gracile
HOL-1 and another purple photosynthetic organism, strain H1R, that was originally isolated as an unidentified contaminant. Through genome sequencing, we have now identified organism H1R as a species of
Afifella
. A whole-genome-based phylogenetic analysis of both species is provided.
Draft Genome Sequence of the Lignocellulolytic and Thermophilic Bacterium Thermobacillus xylanilyticus XE
Authors: Rakotoarivonina Harivony , Loux Valentin , Doliwa Christelle , Martin Véronique , Rémond Caroline
Published: March 2022

Thermobacillus xylanilyticus
is a thermophilic and hemicellulolytic bacterium able to use several lignocelluloses as its main carbon source. This draft genome sequence gives insight into the genomic potential of this bacterium and provides new resources to understand the enzymatic mechanisms used by the bacterium during lignocellulose degradation and will allow the identification of robust lignocellulolytic enzymes.
Integrative Genome-Scale Metabolic Modeling Reveals Versatile Metabolic Strategies for Methane Utilization in Methylomicrobium album BG8
Authors: Villada Juan C. , Duran Maria F. , Lim Chee Kent , Stein Lisa Y. , Lee Patrick K. H.
Published: March 2022

A genome-scale metabolic model (GEM) is an integrative platform that enables the incorporation of a wide range of experimental data. It is used to reveal system-level metabolism and, thus, clarify the link between the genotype and phenotype.
Expanding Culturomics from Gut to Extreme Environmental Settings
Authors: Sood Utkarsh , Kumar Roshan , Hira Princy
Published: March 2022

With the advent of metagenomics, a quest began to identify the dynamics of the microbial communities in different ecological niches. Altogether, this has resulted in identification of microorganisms but is limited to only a small number of phylogenetic groups that can be easily cultured.
Quantifying and Cataloguing Unknown Sequences within Human Microbiomes
Authors: Modha Sejal , Robertson David L. , Hughes Joseph , Orton Richard J.
Published: March 2022

Advances in genome sequencing technologies and lower costs have enabled the exploration of a multitude of known and novel environments and microbiomes. This has led to an exponential growth in the raw sequence data that are deposited in online repositories. Metagenomic and metatranscriptomic data sets are typically analysed with regard to a specific biological question.
Long-Term Cellulose Enrichment Selects for Highly Cellulolytic Consortia and Competition for Public Goods
Authors: Lewin Gina R. , Davis Nicole M. , McDonald Bradon R. , Book Adam J. , Chevrette Marc G. , Suh Steven , Boll Ardina , Currie Cameron R.
Published: March 2022

Microbial communities are a key driver of the carbon cycle through the breakdown of complex polysaccharides in diverse environments including soil, marine systems, and the mammalian gut. However, due to the complexity of these communities, the species-species interactions that impact community structure and ultimately shape the rate of decomposition are difficult to define.
Linking metamorphism and plate boundaries over the past 2 billion years
Authors: Liu Yebo , Mitchell Ross N. , Brown Michael , Johnson Tim E. , Pisarevsky Sergei
Published: March 2022

Since the Jurassic, there has been a clear spatiotemporal correlation between different types of metamorphism and active convergent plate margins. However, the extent to which this relationship extends into the past is poorly understood. We compared paleogeographic reconstructions and inferred plate kinematics with the age and thermobaric ratio (temperature/pressure [T/P]) of metamorphism over the past 2 b.y. The null hypothesis—that there is no spatiotemporal link between inferred plate margins and metamorphism—can be rejected. Low-T/P metamorphism is almost exclusively located near plate margins, whereas intermediate- and high-T/P metamorphism skews toward increasingly greater distances from these margins, consistent with three different tectonic settings: the subduction zone, the mountain belt, and the orogenic hinterland, respectively. However, paleogeographic reconstructions suggest that so-called “paired metamorphic belts” are rare and that high- and low-T/P localities more commonly occur along strike from each other. The observation that bimodal metamorphism is largely a function of distance from the trench and that end-member T/P types rarely occur in the same place can be explained if the style of orogenesis has evolved from hotter to colder, consistent with the abrupt emergence of low-T/P metamorphism in the Cryogenian. The widespread development of high-T/P rocks in orogenic hinterlands in the Proterozoic was followed by the production and efficient exhumation of low-T/P rocks in subduction channels in the Phanerozoic.
COVID-19 encephalopathy: an unusual presentation with new-onset seizure causing convulsive status epilepticus
Authors: Siddiqui Aisha Fareed , Saadia Sheema , Ejaz Taymmia , Mushtaq Zain
Published: March 2022

Although neurological manifestations such as headache and myalgias have been observed with COVID-19, presentation with more serious neurological illness is uncommon and rare. We report a case of a middle-aged woman who presented to the emergency department of a tertiary care hospital. Her clinical presentation was primarily neurological rather than the more common presentation with respiratory manifestations. She presented with generalised tonic–clonic seizures, along with history of undocumented low-grade fever and generalised body aches. The positive SARS-CoV-2 RT-PCR nasal swab, the cerebrospinal fluid analysis (lymphocytic pleocytosis) and electroencephalogram were consistent with viral encephalitis; brain imaging was unremarkable. This case highlights the variable presenting features of COVID-19 infection as patients can primarily present with neurological manifestations in the absence of significant respiratory symptoms. We believe it is important to recognise neurological disease associated with SARS-CoV-2 in patients with asymptomatic respiratory infection.
ARHGEF-10 gene mutation presenting as orbital inflammatory syndrome
Authors: Tam Emily K , Laver Nora V , Thakore-James Manisha , Mooney Michael A , Daly Mary K , Lefebvre Daniel R
Published: March 2022

Rho guanine nucleotide exchange factor 10 (ARHGEF-10) is a RHO GTPase that has a role for neural morphogenesis, however its effect on the eyes remains unknown. Here, we report a 44-year-old man who presented with eyelid swelling along with a history of bilateral hand contractures, high-arched feet and muscle wasting, who was found to have an ARHGEF-10 mutation. Neuroimaging was significant for numerous nerve-based cystic abnormalities in the bilateral orbits and throughout the neuraxis, and an orbital biopsy revealed S-100 and SOX-10 positive lesion consistent with pseudocysts. While the role of ARHGEF-10 remains unclear, further research is warranted to further describe its clinical manifestations.
Management of intracardiac bullet embolisation and review of literature
Authors: Nguyen Peter , Sirinit Jitsupa , Milia David , Davis Christopher Stephen
Published: March 2022

Vascular injury is a common complication in firearm injuries; however, intravascular missile embolism is relatively rare. There are only 38 documented cases of intravascular missile embolisation to the heart. Bullet embolisms are difficult to diagnose even with multiple diagnostic modalities and even once identified, the most optimal choice of surgical management is debated. Our patient presented with a gunshot wound to the right posterior shoulder. Cardiac focused assessment with sonography for trauma, chest X-ray, CT and echocardiogram were performed, showing missile location adjacent to the right ventricle with inconclusive evidence of pericardial injury. Exploratory median sternotomy was performed, revealing intact pericardium and injury to the superior vena cava (SVC) with bullet embolisation to the right ventricle. The patient became temporarily asystolic secondary to haemorrhage from the SVC injury. Cardiac massage was performed, dislodging the missile into the inferior vena cava. A venotomy was performed to retrieve the bullet and vascular injuries were primarily repaired.
‘Extended tibia osteotomy’: a technical tip for removal of incarcerated reamer with broken guide wire bead during tibia nailing and literature review
Authors: Vatsya Pulak , Mittal Samarth , Karpe Aashraya , Trikha Vivek
Published: March 2022

Intramedullary nailing has become a standard of care for tibia fractures. Reaming is an essential part of this technique due to its multiple advantages like a better fit and earlier union. In young bone, with a narrow cortical canal, incarceration and breakage of reamer is a possibility. This can be removed with a ball-tip guidewire. In our case, the broken incarcerated reamer was complicated by a broken ball-tip of the guidewire, leading us to invent a novel medial tibial osteotomy window for the reamer removal. This can be a handy tool for a stuck surgeon intraoperatively.
Intracardiac versus extracardiac shunt in a young man with ischaemic stroke
Authors: Carrington Mafalda , Pereira Ana Rita , Mendes Inês Carmo , Anjos Rui
Published: March 2022

A 24-year-old man with a history of recent ischaemic stroke was diagnosed with patent foramen ovale (PFO) and referred for closure at our hospital. At admission, besides low peripheral oxygen saturation (88%), physical examination was otherwise normal. We performed intraprocedural transoesophageal echocardiogram that revealed no PFO, although agitated saline injection demonstrated bubbles lately on the left atrium. The atrial septum could not be crossed. We suspected an extracardiac shunt, so pulmonary angiograms were performed that revealed the presence of a left pulmonary arteriovenous malformation (PAVM). A Konar-MF Occluder was used to occlude the PAVM, with a satisfactory result. At 6 months follow-up, the patient had normal peripheral oxygen saturation and a new pulmonary angiogram showed no residual shunt. Intrapulmonary shunts are a rare and under-recognised cause of paradoxical emboli in young patients; physicians should be aware of this diagnosis as percutaneous occlusion is indicated and critical to avoid recurrent ischaemic episodes.
Case of coexistingNocardia cyriacigeorgicaandAspergillus fumigatuslung infection with metastatic disease of the central nervous system
Authors: Roy Moni , Lin Rone-Chun , Farrell John Joseph
Published: March 2022

Nocardiosis is a rare opportunistic gram-positive bacterial infection. The genusNocardiaconsists of non-motile, aerobic, non-spore-forming, catalase-positive, filamentous-branching bacteria with fragmentation into coccoid or bacillary forms. Opportunistic infections due toNocardiaare reported in immunocompromised patients.Aspergillus fumigatusis a conidia forming fungus that can be found in soil, plant matter and dust, causing invasive pulmonary and disseminated infection in immunocompromised patients. BothNocardia cyriacigeorgicaandA. fumigatusare known to cause pulmonary infection with metastatic dissemination to the central nervous system. We present a case ofNocardiaandAspergillusco-infection in a patient who presented within a few days of initiation of immunosuppressants for suspected systemic lupus erythematosus.
Risk of breast cancer with HRT depends on therapy type and duration
Authors: Saul Helen , Gursul Deniz , Cassidy Samantha , Vinogradova Yana
Published: March 2022

The study

Vinogradova Y, Coupland C, Hippisley-Cox J. Use of hormone replacement therapy and risk of breast cancer: nested case-control studies using the QResearch and CPRD databases.
BMJ
2020;371:m3873.

To read the full NIHR Alert, go to:
https://evidence.nihr.ac.uk/alert/risk-of-breast-cancer-with-hrt-depends-therapy-type-and-duration/
Landscape of official development assistance for nutrition data and information systems
Authors: Farina Alexandra , Rana Yashodhara , Flory Augustin , Borces Kyle , Snead Caroline , Heidkamp Rebecca
Published: March 2022

Nutrition data and information systems (ND&IS) are critical to guide the prioritisation, collection, analysis and dissemination of nutrition data in countries. However, there is limited guidance for countries regarding how to invest in their ND&IS and little is known about current financing allocations by both countries and donors. This hinders our ability to identify the most critical funding gaps and to effectively advocate for increased financial commitments to ND&IS. To better characterise donor investments, we conducted a review of Official Development Assistance (ODA) financing for ND&IS between the years 2017 and 2019. The analysis showed overall donor financing for ND&IS is not trending up between 2017 and 2019 with the majority of funding being channelled through multilateral organisations to the health sector and spent on global initiatives and emergency early warning system and surveillance activities. Given these findings, donors should dedicate at least 5% (4%–6%) of nutrition investments, alongside country governments, to support country capacity building and strengthening of ND&IS. Donors should also consider channelling a larger part of ODA for ND&IS activities through public institutions to build their capacity to manage ND&IS strengthening.
Protocol summary and statistical analysis plan forIntensiveNutritionTherapy comparEd to usual care iNcriTically ill adults (INTENT): a phase II randomised controlled trial
Authors: Ridley Emma J , Bailey Michael , Chapman Marianne , Chapple Lee-anne S , Deane Adam M , Hodgson Carol , King Victoria L , Marshall Andrea , Miller Eliza G , McGuinness SP , Parke Rachael , Udy Andrew A
Published: March 2022

Introduction

It is plausible that a longer duration of nutrition intervention may have a greater impact on clinical and patient-centred outcomes. The Intensive Nutrition care Therapy comparEd to usual care iN criTically ill adults (INTENT) trial will determine if a whole hospital nutrition intervention is feasible and will deliver more total energy compared with usual care in critically ill patients with at least one organ system failure.

Methods and analysis

This study is a prospective, multicentre, unblinded, parallel-group, phase II randomised controlled trial (RCT) conducted in 23 hospitals in Australia and New Zealand. Mechanically ventilated critically ill adult patients with at least one organ failure who have been in intensive care unit (ICU) for 72–120 hours and meet all of the inclusion and none of the exclusion criteria will be randomised to receive either intensive or usual nutrition care. INTENT started recruitment in October 2018 and a sample size of 240 participants is anticipated to be recruited in 2022. The study period is from randomisation to hospital discharge or study day 28, whichever occurs first, and the primary outcome is daily energy delivery from nutrition therapy. Secondary outcomes include daily energy and protein delivery during ICU and in the post-ICU period, duration of ventilation, ventilator-free days, total bloodstream infection rate and length of hospital stay. All other outcomes are considered tertiary and results will be analysed on an intention-to-treat basis.

Ethics and dissemination

Ethics approval has been received in Australia (Alfred Hospital Ethics Committee (HREC/18/Alfred/101) and Human Research Ethics Committee of the Northern Territory Department of Health (2019-3372)) and New Zealand (Northern A Health and Disability Ethics Committee (18/NTA/222). Results will be disseminated in an international peer-reviewed journal(s), at scientific meetings and via social media.

Trial registration number

NCT03292237.
Protocol for psychometric evaluation of the Amyotrophic Lateral Sclerosis - Bulbar Dysfunction Index (ALS-BDI): a prospective longitudinal study
Authors: Yunusova Yana , Waito Ashley , Barnett Carolina , Huynh Anna , Martino Rosemary , Abrahao Agessandro , Pattee Gary L , Berry James D , Zinman Lorne , Green Jordan R
Published: March 2022

Introduction

Early detection and tracking of bulbar dysfunction in amyotrophic lateral sclerosis (ALS) are critical for directing management of the disease. Current clinical bulbar assessment tools are lacking, while existing physiological instrumental assessments are often inaccessible and cost-prohibitive for clinical application. The goal of our research is to develop and validate a brief and reliable, clinician-administered assessment tool—the ALS-Bulbar Dysfunction Index (ALS-BDI). This publication describes the study protocol that has been established to ascertain the tools’ psychometric properties.

Methods and analysis

The ALD-BDI’s development closely follows guidelines outlined by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). Through the proposed study protocol, we expect to establish psychometric properties of both individual test items of the ALS-BDI as well as the final version of the entire tool, including test–retest and inter-rater reliability, construct validity using gold-standard assessment methods and responsiveness.

Ethics and dissemination

This study has been reviewed and approved by research ethics boards at two data collection sites: Sunnybrook Health Science Centre, primary (Toronto, Canada; ID3080) and Mass General Brigham (#2013P001746, Boston, USA). Prior to participation in the study, the participants sign the informed consent in accordance with the Declaration of Helsinki. Once validated, the ALS-BDI will be disseminated to key stakeholders. Following validation, the ALS-BDI and any required training material will be implemented for clinical use in a context of a multidisciplinary ALS clinic and used as an outcome measure for clinical trials in ALS research.
Primary and secondary care approach to paediatric mental health conditions: a novel model of care
Authors: Power Edmond , Taaffe Sarah , McLoughlin Patricia , Sharif Farhana
Published: March 2022

The enforced isolation caused by the COVID-19 pandemic has led to an increase in mental health issues and severity of presentations to emergency departments in Ireland. Long waiting lists for both Psychology and Psychiatry are further impacting on children’s mental well-being. We proposed the creation of a ‘Happiness Toolkit’ that can be given to children on presentation to their primary or secondary care provider with a mental health issue. The toolkit is comprised of six evidence-based techniques that are proven to boost self-esteem, develop resilience and promote positive mental health. A leaflet detailing the practices along with a physical ‘box’ that the children must make were created. This resource may therefore provide immediate support to those children that may endure long waiting periods, sometimes greater than a year and a half, for referral to tertiary services. Our toolkit allows children and their families to engage in positive mental health practices that may prevent regression during this waiting period and lead to improved mental health or cessation of symptoms.
Safety implications of remote assessments for suspected COVID-19: qualitative study in UK primary care
Authors: Wieringa Sietse , Neves Ana Luisa , Rushforth Alexander , Ladds Emma , Husain Laiba , Finlay Teresa , Pope Catherine , Greenhalgh Trisha
Published: March 2022

Background

The introduction of remote triage and assessment early in the pandemic raised questions about patient safety. We sought to capture patients and clinicians’ experiences of the management of suspected acute COVID-19 and generate wider lessons to inform safer care.

Setting and sample

UK primary healthcare. A subset of relevant data was drawn from five linked in-pandemic qualitative studies. The data set, on a total of 87 participants recruited via social media, patient groups and snowballing, comprised free text excerpts from narrative interviews (10 survivors of acute COVID-19), online focus groups (20 patients and 30 clinicians), contributions to a Delphi panel (12 clinicians) and fieldnotes from an online workshop (15 patients, clinicians and stakeholders).

Methods

Data were uploaded onto NVivo. Coding was initially deductive and informed by WHO and Institute of Medicine frameworks of quality and safety. Further inductive analysis refined our theorisation using a wider range of theories—including those of risk, resilience, crisis management and social justice.

Results

In the early weeks of the pandemic, patient safety was compromised by the driving logic of ‘stay home’ and ‘protect the NHS’, in which both patients and clinicians were encouraged to act in a way that helped reduce pressure on an overloaded system facing a novel pathogen with insufficient staff, tools, processes and systems. Furthermore, patients and clinicians observed a shift to a more transactional approach characterised by overuse of algorithms and decision support tools, limited empathy and lack of holistic assessment.

Conclusion

Lessons from the pandemic suggest three key strategies are needed to prevent avoidable deaths and inequalities in the next crisis: (1) strengthen system resilience (including improved resourcing and staffing; support of new tools and processes; and recognising primary care’s role as the ‘risk sink’ of the healthcare system); (2) develop evidence-based triage and scoring systems; and (3) address social vulnerability.
Throwing in the deep end: athletes, coaches and support staff experiences, perceptions and beliefs of upper limb injuries and training load in elite women’s water polo
Authors: King Marguerite Helen , Costa Nathalia , Lewis Amy , Watson Kate , Vicenzino Bill
Published: March 2022

To understand elite athlete, coach and support staff experiences, perceptions and beliefs in women’s water polo with managing upper limb injuries and monitoring training loads. Inductive qualitative design. Twenty athletes, coaches and support staff were purposively recruited and participated in semistructured interviews. Participants either had experienced an upper limb injury or had experience managing athletes with upper limb injuries. Interviews were conducted in-person or virtually, audio-recorded, deidentified, transcribed verbatim and cleaned to ensure accuracy. Data were thematically analysed. Analysis identified five cohesive themes: (1) upper limb injury management is adequate—but prevention, communication and knowledge need improving, (2) current training load monitoring generates uncertainty and lack of consistency of processes—due to reliance on internal, and lack of external load monitoring, (3) optimal training load monitoring requires objective measurement of training load—that accurately measures the external load of athletes’ upper limbs, (4) athlete-centred philosophy matters—including athlete-centred care to facilitate individually tailored rehabilitation programmes and their inclusion in management decisions, (5) mental, social and emotional aspects of upper limb injury management matter—acknowledging feelings of loss of team inclusion, fear of missing out and frustration felt by athletes as well as the emotional labour felt by coaches when supporting athletes with an upper limb injury. Upper limb injury management and training load monitoring are evolving areas where objective measurement of training load may assist in increasing consistency of communication, collaboration and coordination between all stakeholders, and to address uncertainty. Stakeholders placed value in intangible qualities such as trust and care in their relationships with other collaborators—facilitating athlete physical, mental and emotional recovery following upper limb injuries.
Impact of direct-access IBD physician delivered endoscopy on clinical outcomes: a pre-implementation and post-implementation study
Authors: Stammers Matthew , Rahmany Sohail , Downey Louise , Borca Florina , Harris Clare , Harris Richard , McDonnell Martin , Sartain Stephanie , Coleman Nicolas , Stacey Bernard , Smith Trevor R , Cummings Fraser , Felwick Richard , Gwiggner Markus
Published: March 2022

Introduction

Patients with suspected inflammatory bowel disease (IBD) referred from primary care often face diagnostic and treatment delays. This study aimed to compare a novel direct-access IBD endoscopy pathway with the traditional care model.

Method

Single centre real-world study analysing primary care referrals with suspected IBD. Group A: patients triaged to direct-access IBD endoscopy. Group B: patients undergoing traditional outpatient appointments before the availability of direct-access IBD endoscopy. Demographics, fecal calprotectin (FCP), C-reactive protein (CRP), disease activity score, endoscopy findings, treatment and follow-up were collected and statistically analysed. Ranked semantic analysis of IBD symptoms contained within referral letters was performed.

Results

Referral letters did not differ significantly in Groups A and B. Demographic data, FCP and CRP values were similar. Referral to treatment time (RTT) at the time of IBD endoscopy was reduced from 177 days (Group B) to 24 days (Group A) (p<0.0001). Diagnostic yield of IBD was 35.6% (Group B) versus 62.0% (Group A) (p=0.0003). 89.2% of patients underwent colonoscopy in Group B versus 46.4% in Group A. DNA rates were similar in both groups. The direct to IBD endoscopy pathway saved 100% of initial IBD consultant clinics with a 2.5-fold increase in IBD nurse-led follow-up.

Conclusion

Our novel pathway resulted in an 86% reduction in RTT with associated increased diagnostic yield while saving 100% of initial IBD consultant outpatient appointments. Replication in other trusts may improve patient experience and accelerate time to diagnosis/treatment while optimising the use of healthcare resources.
Generalizable design parameters for soluble T cell receptor-based T cell engagers
Authors: Froning Karen J , Sereno Arlene , Huang Flora , Demarest Stephen J
Published: March 2022

While most biological and cellular immunotherapies recognize extracellular targets, T cell receptor (TCR) therapeutics are unique in their ability to recognize the much larger pool of intracellular antigens found on virus-infected or cancerous cells. Recombinant T cell receptor (rTCR)-based therapeutics are gaining momentum both preclinically and clinically highlighted by recent positive phase III human clinical trial results for a TCR/CD3 bifunctional protein in uveal melanoma. Unlike antibody-based T cell engagers whose molecular formats have been widely and extensively evaluated, little data exist describing the putative activities of varied bifunctional formats using rTCRs. Here we generate rTCR/anti-CD3 bifunctionals directed toward NY-ESO-1 or MAGE-A3 with a variety of molecular formats. We show that inducing strong redirected lysis activity against tumors displaying either NY-ESO-1 or MAGE-A3 is highly restricted to small, tandem binding formats with an rTCR/antiCD3 Fab demonstrating the highest potency, rTCR/anti-CD3 single chain variable domain fragment showing similar but consistently weaker potency, and IgG-like or IgG-Fc-containing molecules demonstrating poor activity. We believe this is a universal trait of rTCR bifunctionals, given the canonical TCR/human leukocyte antigen structural paradigm.
Medical leadership development during the COVID-19 pandemic
Authors: Frich Jan C , Bratholm Clara , Ravnestad Håvard , Friberg Morten L , Mjåset Christer , Kaarbøe Oddvar M
Published: March 2022

Background

A leadership development programme (The Health Leadership School) was launched in 2018 for junior doctors and medical students in Norway.

Objective

To study participants’ experiences and self-assessed learning outcomes, and if there were any differences in outcome among participants who met face-to-face versus and those who had to complete half of the programme in a virtual classroom due to the COVID-19 pandemic.

Methods

Participants who completed The Health Leadership School in 2018–2020 were invited to respond to a web-based questionnaire.

Results

A total of 33 (83%) out of 40 participants responded. The majority of respondents (97%) somewhat agreed or strongly agreed that they had gained knowledge and skills they did not learn in medical school. Respondents reported a high learning outcome for most competency domains, and there was no difference in outcome when comparing scores of those who met face-to-face versus and those who had to complete half of the programme in a virtual classroom. Among participants who participated in virtual classroom sessions due to the COVID-19 pandemic, the majority agreed that the programme could be run as a combination of face-to-face and virtual sessions.

Conclusion

This brief report suggests that leadership development programmes for junior doctors and medical students can be run in-part using virtual classroom sessions, but that face-to-face sessions are important to foster relational and teamwork skills.
Microscopic mechanism analysis of calcareous sand in electrolysis desaturation using 1H L-F NMR
Authors: Chen Runze , Chen Yumin , Liu Hanlong , Cai Xiaoguang , Wu Kang , Zhang Zhe
Published: March 2022

Electrolysis desaturation is a novel method to improve the liquefaction resistance of liquefiable foundations. The microscopic mechanism of the horizontal-layered electrolysis desaturation of calcareous sand specimens was revealed using a low-field nuclear magnetic resonance (1H L-F NMR) apparatus. The expansion and recovery of sand pores was detected, and variation pattern of saturation distribution was explored, as well as the generation and migration of gas bubbles. The test results show that the electrolysis mainly discharged free water from the specimen, and the content of bound water or mechanical bound water kept basically unchanged. The rapid generation of the bubbles could lead to the expansion of the sand pores. Within 3 h after stopping electrolysis, the macropores in the calcareous sand essentially returned to the initial state, and the expansion of micropores and mesopores also remained basically stable. The construction method of prolonged low-current electrolysis or short-time multiple electrolysis could be applied for on-site desaturated foundation treatment. The shape and size of the bubbles produced by electrolysis were related to the calcareous sand pores. The migration of gas after stopping electrolysis was mainly in the vertically upward direction, resulting in the fusion of bubbles and the formation of larger bubbles.
Molecular dynamics calculations of partial molar volumes of amino acids in aqueous solutions
Authors: Sentell Zachary , Penner Jordan , Spooner Jacob , Weinberg Noham
Published: March 2022

Partial molar volumes of amino acids in their zwitterionic and molecular forms were calculated using molecular dynamics simulations of these systems in aqueous solutions. Calculations performed with the TIP4P, SPC (rigid and flexible), SPC/E, and polarizable water models showed that the choice of water model can have a significant impact on the calculated volumes. The effect of treatment of long-range electrostatic interactions on the calculated results was also investigated. The volumes obtained in simulations with a properly chosen water model fit well the experimental data for both molecular and zwitterionic forms of amino acids.