bluuebunny/crossref_metadata_2025 huggingface dataset:
Biological impact of an enhanced recovery after surgery programme in liver surgery
Authors: Gonvers S , Jurt J , Joliat G -R , Halkic N , Melloul E , Hübner M , Demartines N , Labgaa I
Published: March 2021

Background

The clinical and economic impacts of enhanced recovery after surgery (ERAS) programmes have been demonstrated extensively. Whether ERAS protocols also have a biological effect remains unclear. This study aimed to investigate the biological impact of an ERAS programme in patients undergoing liver surgery.

Methods

A retrospective analysis of patients undergoing liver surgery (2010–2018) was undertaken. Patients operated before and after ERAS implementation in 2013 were compared. Surrogate markers of surgical stress were monitored: white blood cell count (WBC), C-reactive protein (CRP) level, albumin concentration, and haematocrit. Their perioperative fluctuations were defined as Δvalues, calculated on postoperative day (POD) 0 for Δalbumin and Δhaematocrit and POD 2 for ΔWBC and ΔCRP.

Results

A total of 541 patients were included, with 223 and 318 patients in non-ERAS and ERAS groups respectively. Groups were comparable, except for higher rates of laparoscopy (24.8 versus 11.2 per cent; P < 0.001) and major resection (47.5 versus 38.1 per cent; P = 0.035) in the ERAS group. Patients in the ERAS group showed attenuated ΔWBC (2.00 versus 2.75 g/l; P = 0.013), ΔCRP (60 versus 101 mg/l; P <0.001) and Δalbumin (12 versus 16 g/l; P < 0.001) compared with those in the no-ERAS group. Subgroup analysis of open resection showed similar results. Multivariable analysis identified ERAS as the only independent factor associated with high ΔWBC (odds ratio (OR) 0.65, 95 per cent c.i. 0.43 to 0.98; P = 0.038), ΔCRP (OR 0.41, 0.23 to 0.73; P = 0.003) and Δalbumin (OR 0.40, 95 per cent c.i. 0.22 to 0.72; P = 0.002).

Conclusion

Compared with conventional management, implementation of ERAS was associated with an attenuated stress response in patients undergoing liver surgery.
Impact of surgical resection rate on survival in gastric cancer: nationwide study
Authors: Kung C -H , Jestin Hannan C , Linder G , Johansson J , Nilsson M , Hedberg J , Lindblad M
Published: March 2021

Background

There are marked geographical variations in the proportion of patients undergoing resection for gastric cancer. This study investigated the impact of resection rate on survival.

Methods

All patients with potentially curable gastric cancer between 2006 and 2017 were identified from the Swedish National Register of Oesophageal and Gastric Cancer. The annual resection rate was calculated for each county per year. Resection rates in all counties for all years were grouped into tertiles and classified as low, intermediate or high. Survival was analysed using the Cox proportional hazards model.

Results

A total of 3465 patients were diagnosed with potentially curable gastric cancer, and 1934 (55.8 per cent) were resected. Resection rates in the low (1261 patients), intermediate (1141) and high (1063) tertiles were 0–50.0, 50.1–62.5 and 62.6–100 per cent respectively. The multivariable Cox analysis revealed better survival for patients diagnosed in counties during years with an intermediate versus low resection rate (hazard ratio (HR) 0.81, 95 per cent c.i. 0.74 to 0.90; P < 0.001) and high versus low resection rate (HR 0.80, 0.73 to 0.88; P < 0.001).

Conclusion

This national register study showed large regional variation in resection rates for gastric cancer. A higher resection rate appeared to be beneficial with regard to overall survival for the entire population.
Beyond the hashtag: describing and understanding the full impact of the #BJSConnect tweet chat May 2019
Authors: Mackenzie G , Grossman R , Mayol J
Published: March 2021

Background

Twitter engagement between surgeons provides opportunities for international discussion of research and clinical practice. Understanding how surgical tweet chats work is important at a time when increasing reliance is being placed on virtual engagement because of the COVID-19 pandemic.

Methods

Individual tweets from the May 2019 #BJSConnect tweet chat were extracted using NodeXL, complemented by Twitter searches in an internet browser to identify responses that had not used the hashtag. Aggregate estimates of tweet views were obtained from a third-party social media tool (Twitonomy) and compared with official Twitter Analytics measurements.

Results

In total 37 Twitter accounts posted 248 tweets or replies relating to the tweet chat. A further 110 accounts disseminated the tweets via retweeting. Only 58.5 per cent of these tweets and 35 per cent of the tweeters were identified through a search for the #BJSConnect hashtag. The rest were identified by searching for replies (61), quoting tweets (20), and posts by @BJSurgery that used the hashtag but did not appear in the Twitter search (22). Studying all tweets revealed complex branching discussions that went beyond the discussed paper’s findings. Third-party estimates of potential reach of the tweet chat were greatly exaggerated.

Conclusion

Understanding the extent of the discussion generated by the #BJSConnect tweet chat required looking beyond the hashtag to identify replies and other responses, which was time-consuming. Estimates of reach using a third-party tool were unreliable.
Value of regular endosonography and [18F]fluorodeoxyglucose PET–CT after surgery for gastro-oesophageal junction, stomach or pancreatic cancer
Authors: Bjerring O S , Hess S , Petersen H , Fristrup C W , Lundell L , Mortensen M B
Published: March 2021

Background

Most patients undergo follow-up after surgery for cancers of the gastro-oesophageal junction, stomach or pancreas, but data to support which modalities to use and the frequency of investigation are limited.

Methods

Patients in the EUFURO study were randomized to either visits to the outpatient clinic at 3, 6, 9, 12, 18, and 24 months after surgery (standard), or to the addition of [18F]fluorodeoxyglucose (FDG) PET–CT and endoscopic ultrasonography (EUS) with guided fine-needle aspiration biopsy to clinical assessments (intervention). Data from the intervention arm were used to analyse the diagnostic performance of endosonography or [18F]FDG PET–CT in detecting recurrences.

Results

During the scheduled follow-up, 42 of 89 patients developed recurrence; PET–CT and EUS in combination detected 38 of these recurrences. EUS detected 23 of the 42 patients with recurrent disease during follow-up and correctly diagnosed 17 of 19 locoregional recurrences. EUS was able to detect isolated locoregional recurrence in 11 of 13 patients. In five patients, EUS was false-positive for isolated locoregional recurrence owing to missed distant metastases. PET–CT detected locoregional recurrence in only 12 of 19 patients, and isolated locoregional recurrence in only 7 of 13. False-positive PET–CT results in 23 patients led to a total of 44 futile procedures.

Conclusion

Accuracy in detecting recurrences by concomitant use of PET–CT and EUS was high (90 per cent). PET–CT had moderate to high sensitivity for overall recurrence detection, but low specificity. EUS was superior to PET–CT in the detection of locoregional and isolated locoregional recurrences.
Evaluating cognitive profiles of patients undergoing clinical amyloid-PET imaging
Authors: Loreto Flavia , Gunning Stephen , Golemme Mara , Watt Hilary , Patel Neva , Win Zarni , Carswell Christopher , Perry Richard J , Malhotra Paresh A
Published: March 2021

Episodic memory impairment and brain amyloid-beta are two of the main hallmarks of Alzheimer’s Disease. In the clinical setting, these are often evaluated through neuropsychological testing and amyloid PET imaging, respectively. The use of amyloid PET in clinical practice is only indicated in patients with substantial diagnostic uncertainty due to atypical clinical presentation, multiple comorbidities and/or early age of onset. The relationship between amyloid-beta and cognition has been previously investigated, but no study has examined how neuropsychological features relate to the presence of amyloid pathology in the clinical population that meets the appropriate use criteria for amyloid PET imaging. In this study, we evaluated a clinical cohort of patients (n = 107) who presented at the Imperial Memory Clinic and were referred for clinical amyloid PET and neuropsychological assessment as part of their diagnostic workup. We compared the cognitive performance of amyloid-positive patients (Aβ-pos, n = 47) with that of stable amyloid-negative (stableAβ-neg, n = 26) and progressive amyloid-negative (progAβ-neg, n = 34) patients. The amyloid-positive group performed significantly worse than both amyloid-negative groups in the visuospatial and working memory domains. Episodic memory performance, however, effectively differentiated the amyloid-positive group from the stable but not the progressive amyloid-negative group. On affective questionnaires, the stable amyloid-negative group reported significantly higher levels of depression than the amyloid-positive group. In our clinical cohort, visuospatial dysfunction and working memory impairment were better indicators of amyloid positivity than episodic memory dysfunction. These findings highlight the limited value of isolated cognitive scores in patients with atypical clinical presentation, comorbidities and/or early age of onset.
Quantification of Human Epidermal Growth Factor Receptor 2 by Immunopeptide Enrichment and Targeted Mass Spectrometry in Formalin-Fixed Paraffin-Embedded and Frozen Breast Cancer Tissues
Authors: Kennedy Jacob J , Whiteaker Jeffrey R , Kennedy Laura C , Bosch Dustin E , Lerch Melissa L , Schoenherr Regine M , Zhao Lei , Lin ChenWei , Chowdhury Shrabanti , Kilgore Mark R , Allison Kimberly H , Wang Pei , Hoofnagle Andrew N , Baird Geoffrey Stuart , Paulovich Amanda G
Published: March 2021

Background

Conventional HER2-targeting therapies improve outcomes for patients with HER2-positive breast cancer (BC), defined as tumors showing HER2 protein overexpression by immunohistochemistry and/or ERBB2 gene amplification determined by in situ hybridization (ISH). Emerging HER2-targeting compounds show benefit in some patients with neither HER2 protein overexpression nor ERBB2 gene amplification, creating a need for new assays to select HER2-low tumors for treatment with these compounds. We evaluated the analytical performance of a targeted mass spectrometry-based assay for quantifying HER2 protein in formalin-fixed paraffin-embedded (FFPE) and frozen BC biopsies.

Methods

We used immunoaffinity-enrichment coupled to multiple reaction monitoring-mass spectrometry (immuno-MRM-MS) to quantify HER2 protein (as peptide GLQSLPTHDPSPLQR) in 96 frozen and 119 FFPE BC biopsies. We characterized linearity, lower limit of quantification (LLOQ), and intra- and inter-day variation of the assay in frozen and FFPE tissue matrices. We determined concordance between HER2 immuno-MRM-MS and predicate immunohistochemistry and ISH assays and examined the benefit of multiplexing the assay to include proteins expressed in tumor subcompartments (e.g., stroma, adipose, lymphocytes, epithelium) to account for tissue heterogeneity.

Results

HER2 immuno-MRM-MS assay linearity was ≥103, assay coefficient of variation was 7.8% (FFPE) and 5.9% (frozen) for spiked-in analyte, and 7.7% (FFPE) and 7.9% (frozen) for endogenous measurements. Immuno-MRM-MS-based HER2 measurements strongly correlated with predicate assay HER2 determinations, and concordance was improved by normalizing to glyceraldehyde-3-phosphate dehydrogenase. HER2 was quantified above the LLOQ in all tumors.

Conclusions

Immuno-MRM-MS can be used to quantify HER2 in FFPE and frozen BC biopsies, even at low HER2 expression levels.
A New Equation Based on the Standard Lipid Panel for Calculating Small Dense Low-Density Lipoprotein-Cholesterol and Its Use as a Risk-Enhancer Test
Authors: Sampson Maureen , Wolska Anna , Warnick Russell , Lucero Diego , Remaley Alan T
Published: March 2021

Background

Increased small dense low-density lipoprotein-cholesterol (sdLDL-C) is a risk factor for atherosclerotic cardiovascular disease (ASCVD) but typically requires advanced lipid testing. We describe two new equations, first one for calculating large buoyant LDL-C (lbLDL-C), based only upon results from the standard lipid panel, and the second one for sdLDL-C.

Methods

Equations for sdLDL-C and lbLDL-C were generated with least-squares regression analysis using the direct Denka sdLDL-C assay as reference (n = 20 171). sdLDL-C was assessed as a risk-enhancer test in the National Heart and Nutrition Examination Survey (NHANES), and for its association with ASCVD in the Multi-Ethnic Study of Atherosclerosis (MESA).

Results

The newly derived equations depend on two terms, namely LDL-C as determined by the Sampson equation, and an interaction term between LDL-C and the natural log of triglycerides (TG). The lbLDL-C equation (lbLDLC=1.43 × LDLC-0.14 ×(ln⁡(TG)× LDLC)- 8.99) was more accurate (R2 = 0.933, slope = 0.94) than the sdLDL-C equation (sdLDLC=LDLC- lbLDLC; R2 = 0.745, slope = 0.73). Using the 80th percentile (46 mg/dL) as a cut-point, sdLDL-C identified in NHANES additional high-risk patients not identified by other risk-enhancer tests based on TG, LDL-C, apolipoprotein B, and nonHDL-C. By univariate survival-curve analysis, estimated sdLDL-C was superior to other risk-enhancer tests in predicting ASCVD events in MESA. After multivariate adjustment for other known ASCVD risk factors, estimated sdLDL-C had the strongest association with ASCVD compared to other lipid parameters, including measured sdLDL-C.

Conclusions

Estimated sdLDL-C could potentially be calculated on all patients tested with a standard lipid panel to improve ASCVD risk stratification.
A Federated Learning Approach for Privacy Protection in Context-Aware Recommender Systems
Authors: Ali Waqar , Kumar Rajesh , Deng Zhiyi , Wang Yansong , Shao Jie
Published: March 2021

Privacy protection is one of the key concerns of users in recommender system-based consumer markets. Popular recommendation frameworks such as collaborative filtering (CF) suffer from several privacy issues. Federated learning has emerged as an optimistic approach for collaborative and privacy-preserved learning. Users in a federated learning environment train a local model on a self-maintained item log and collaboratively train a global model by exchanging model parameters instead of personalized preferences. In this research, we proposed a federated learning-based privacy-preserving CF model for context-aware recommender systems that work with a user-defined collaboration protocol to ensure users’ privacy. Instead of crawling users’ personal information into a central server, the whole data are divided into two disjoint parts, i.e. user data and sharable item information. The inbuilt power of federated architecture ensures the users’ privacy concerns while providing considerably accurate recommendations. We evaluated the performance of the proposed algorithm with two publicly available datasets through both the prediction and ranking perspectives. Despite the federated cost and lack of open collaboration, the overall performance achieved through the proposed technique is comparable with popular recommendation models and satisfactory while providing significant privacy guarantees.
What type of physical exercise should be recommended for improving arterial stiffness on adult population? A network meta-analysis
Authors: Saz-Lara Alicia , Cavero-Redondo Iván , Álvarez-Bueno Celia , Notario-Pacheco Blanca , Reina-Gutiérrez Sara , Sequí-Domínguez Irene , Ruiz Jonatan R , Martínez-Vizcaíno Vicente
Published: March 2021

Aims

Physical exercise has been associated with a reduction in arterial stiffness, a subclinical process underlying cardiovascular disease. However, the effect of different types of exercise (aerobic, resistance, combined, interval training, stretching, or mind–body modalities) on arterial stiffness is unclear. This network meta-analysis aimed to examine the effectiveness of different types of exercise on arterial stiffness as measured by pulse wave velocity in adults.

Methods and results

We searched Cochrane Central Register of Controlled Trials, CINAHL, MEDLINE (via Pubmed), Embase, and Web of Science databases, for randomized clinical trials including at least a comparison group, from their inception to 30 June 2020. A frequentist network meta-analysis was performed to compare the effect of different types of physical exercise on arterial stiffness as measured by pulse wave velocity. Finally, 35 studies, with a total of 1125 participants for exercise intervention and 633 participants for the control group, were included. In the pairwise meta-analyses, the exercises that improved arterial stiffness were: interval training [effect size (ES) 0.37; 95% confidence interval (CI) 0.01–0.73], aerobic exercise (ES 0.30; 95% CI 0.13–0.48) and combined exercise (ES 0.22; 95% CI 0.04–0.40). Furthermore, the network meta-analysis showed that mind–body interventions were the most effective type of exercise to reduce the pulse wave velocity (ES 0.86; 95% CI 0.04–1.69). In addition, combined exercise (ES 0.35; 95% CI 0.08–0.62), aerobic exercise (ES 0.33; 95% CI 0.09–0.57), and interval training (ES 0.33; 95% CI 0.02–0.64) showed significant improvements.

Conclusion

Our findings showed that aerobic exercise, combined exercise, interval training, and mind–body exercises were the most effective exercise modalities for reducing arterial stiffness, assuming an important role in the prevention of cardiovascular diseases.
Predictors of unplanned 30-day readmissions after coronary artery bypass graft: a systematic review and meta-analysis of cohort studies
Authors: Son Youn-Jung , Lee Hyeon-Ju , Lim Sang-Hyun , Hong Joonhwa , Seo Eun Ji
Published: March 2021

Aims

Coronary artery bypass graft (CABG) is one of the most performed cardiac surgery globally. CABG is known to have a high rate of short-term readmissions. The 30-day unplanned readmission rate as a quality measure is associated with adverse health outcomes. This study aimed to identify and synthesize the perioperative risk factors for 30-day unplanned readmission after CABG.

Methods and results

We systematically searched seven databases and reviewed studies to identify all eligible English articles published from 1 October 1999 to 30 September 2019. Random-effect models were employed to perform pooled analyses. Odds ratio and 95% confidence interval were used to estimate the risk factors for 30-day unplanned readmission. The 30-day hospital readmission rates after CABG ranged from 9.2% to 18.9% in 14 cohort studies. Among preoperative characteristics, older adults, female, weight loss, high serum creatinine, anticoagulant use or dialysis, and comorbidities were found to be statistically significant. Postoperative complications, prolonged length of hospital stay, and mechanical ventilation were revealed as the postoperative risk factors for 30-day unplanned readmission. However, intraoperative risk factors were not found to be significant in this review.

Conclusion

Our findings emphasize the importance of a comprehensive assessment during the perioperative period of CABG. Healthcare professionals can perform a readmission risk stratification and develop strategies to reduce readmission rates after CABG using the risk factors identified in this review. Future studies with prospective cohort samples are needed to identify the personal or psychosocial factors influencing readmission after CABG, including perioperative risk factors.
Probiotic capability of novel lactic acid bacteria isolated from worker honey bees gut microbiota
Authors: Elzeini Hoda Mahmoud , Ali Abdel Rahman Abdel Atti , Nasr Nasr Fawzy , Hassan Mariam , Hassan Ashwaa Abdel moneim , Elenany Yasser Essam
Published: March 2021

The study aimed to evaluate the probiotic and safety properties of lactic acid bacterial (LAB) strains isolated from the gut microbiota of honey bee Apis mellifera L., since this source remains a promising reservoir of microbial diversity. A total of five bacterial isolates were molecularly identified using 16S rRNA gene sequencing as Enterococcus faecalis-HBE1, Lactobacillus brevis-HBE2, Enterococcus faecalis-HBE3, Enterococcus faecalis-HBE4 and Lactobacillus casei-HBE5. Gut tolerance conditions (low pH and bile salt) were evaluated. Exopolysaccharides (EPS) production, hemolytic, antioxidant activity, resistance toward antibiotics and technological characteristics (starter activity, pH and proteolysis) were examined. The five isolates showed a high survival rate (>95%), under gastrointestinal tract conditions indicating excellent potential for application as probiotics. The isolates showed no hemolytic activities and good acidification rates in the range of pH 4.6–4.98 after incubation at 37°C for 24h. The isolates exhibited promising proteolytic activity as well as DPPH radical scavenging activity in the range of 16.52–59.39%. All the tested isolates had the capability to produce exopolysaccharides except Lactobacillus casei-HBE5. These results put forward that lactic acid bacterial strain isolated from honey bee workers can be considered as promising candidates for future applications as starter cultures and could constitute new potential probiotics for the production of functional dietary products promoting health benefits.
A natural association of a yeast with Aspergillus terreus and its impact on the host fungal biology
Authors: Arora Palak , Kumar Amit , A Vishwakarma Ram , Riyaz-Ul-Hassan Syed
Published: March 2021

Several fungi have been shown to harbor microorganisms that regulate the key components of fungal metabolism. We explored the symbiotic association of an endophyte, Aspergillus terreus, which led to the isolation of a yeast, Meyerozyma caribbica, as its symbiont. An axenic fungal culture, free of the symbiont, was developed to study the effect of this association on the endophytic fungus. The symbiotic yeast partner was found to play an important role in the adaptation of A. terreus to thermal as well as osmotic stress. Under these stress conditions, the symbiont enhanced the production of lovastatin and the growth of the host fungus. The symbiotic yeast was found to induce the expression of the global regulator gene, the key genes involved in the lovastatin biosynthetic pathway as well as those involved in general growth and development, under stress conditions, in the fungal partner. Analysis by PCR and fluorescent in situ hybridization microscopy indicated that the yeast may be present inside the hyphae of the fungus. However, a direct method like transmission electron microscopy may help to better understand the dynamics of this association, including the distribution of the yeast cells in/on the fungal hyphae and spores.
Monitoring of Some Chemical Contaminants Residue in Imported Wheat and Barley Grains Using QuEChERS Method and GC-MS/MS
Authors: Thabit Tamer M A M , El-Hefny Dalia E , Elgeddawy Dalia I H , El-Naggar Medhat A H , Serageldin Ferhad M
Published: March 2021

Background

Cereal grains are an important for the nutrition of both humans and animals, and contribute to the nutrition cycle in different ways. Chemical contaminants are important to be monitored in food due to their direct effects on human health.

Objective

This work aimed to monitor some of the hazardous chemical contaminants i.e., organochlorines (OCs), pyrethroids, polychlorinated biphenyls (PCBs), and polycyclic aromatic hydrocarbons (PAHs) in wheat and barley grains of European origin during 2019.

Method

Samples were collected consecutively during the season and the QuEChERS technique (quick, easy, cheap, effective, rugged, and safe) followed by GC-tandem mass spectrometry (GC-MS/MS) analysis was used in the extraction and cleaning up for all analyzed compounds. The method was verified, and a recovery study was performed at two spiking levels: 0.01 and 0.05 µg/g. RSD(%), LOD, and LOQ were calculated. Recovery ranged from 78.70–104.00% for all compounds at both levels at RSD 2.16–11.76%. Fat, moisture, protein, and specific weight contents of both grains of all studied origins were also recorded.

Results

Results revealed that all detected pesticides were lower than the estimated maximum residue limits (MRLs). Few congeners of PCBs and PAHs were detected in the most of origins with tiny amounts but no estimated MRLs for it in cereal grains to be compared.

Conclusions

None of the analyzed OCs were detected except endosulfan-I which was detected in some wheat samples from Ukraine and Poland, and some barley samples from Latvia, but still lower than the MRL.

Highlights

None of the OCs, highly toxic PCBs or the carcinogenic PAH benzo[a]pyrene were detected in any analyzed samples.
Determination of Lactose Concentration in Low-Lactose and Lactose-Free Milk, Milk Products, and Products Containing Dairy Ingredients, Enzymatic Method: Single-Laboratory Validation First Action Method 2020.08
Authors: Ivory Ruth , Delaney Elaine , Mangan David , McCleary Barry V
Published: March 2021

Background

The AOAC Stakeholder Panel on Strategic Food Analytical Methods issued a call for methods for the measurement of lactose in low-lactose and lactose-free products under Standard Method Performance Requirement (SMPR®) 2018.009. Megazyme’s Lactose Assay Kit (K-LOLAC) was developed specifically to address the need for accurate enzymatic testing in lactose-free samples.

Objective

K-LOLAC was validated for measurement of lactose in low-lactose and lactose-free milk, milk products, and products containing dairy ingredients. A single-laboratory validation (SLV) of the method is reported.

Method

K-LOLAC is an accurate and sensitive enzymatic method for the rapid measurement of lactose in low-lactose or lactose-free products. Validation analysis was performed on a sample set of 36 commercial food and beverage products and a set of 10 certified reference materials. Parameters examined during the validation included working range and linear range, selectivity, LOD, LOQ, trueness (bias), precision (repeatability and intermediate precision), robustness, and stability.

Results

For all samples tested within the lower range (10–100 mg/100 g or mL), recoveries varied from 93.21–114.10%. Recoveries obtained for samples in the higher range (>100 mg/100 g or mL) varied from 94.44–108.28%. All materials had repeatability relative standard deviations (RSDr and RSDir) of <9%.

Conclusions

The commercial K-LOLAC assay kit, as developed by Megazyme, meets the requirements set out under SMPR 2018.009.

Highlights

K-LOLAC is a robust, quick, and easy method for analysis of lactose in foodstuffs and beverages.
The Validation of the MEMP Salmonella Assay: AOAC Performance Tested MethodSM 042002
Authors: Lonczynski Thomas , Cowin Laura
Published: March 2021

Background

The Molecular Environmental Monitoring Program (MEMP) Salmonella Assay is a quick and reliable method for detecting Salmonella species in environmental samples. The assay incorporates a real-time PCR approach to identifying Salmonella cells expressed from the swab sample. The assay does not require an enrichment step, leading to much faster time to a negative result.

Objective

This report details the method validation study to validate the MEMP using environmental surface swabs for stainless steel, plastic, rubber, ceramic tile, and sealed concrete.

Method

Matrix studies, inclusivity/exclusivity, product consistency and stability, and robustness testing were conducted to assess the method’s performance. In the matrix studies, this method was compared to the US Food and Drug Administration (FDA) Bacteriological Analytical Manual (BAM) Chapter 5 for environmental surface sponges and swabs.

Results

Inclusivity/exclusivity testing showed that this assay was able to detect all 100 Salmonella strains tested while excluding the 30 non-Salmonella species. There were no statistically significant differences found between the candidate and reference methods. Small variations in critical test parameters (volume of extraction reagent and volume of extracted DNA sample) did not adversely affect the assay’s performance, and stability testing indicated consistent results for at least one year.

Conclusions

The data presented in this report show that the candidate method performed as well as the reference method; therefore, it can be used in place of the reference method for detecting Salmonella species.

Highlights

The MEMP Salmonella Assay is the first and only AOAC Performance Tested MethodSM approved for detecting Salmonella on surfaces without enrichment.
A computational simulation model for assessing social performance of BIM implementations in construction projects
Authors: Zoghi Milad , Lee Donghoon , Kim Sungjin
Published: March 2021

The construction industry has been adopting building information modeling (BIM) to enhance project and social performance. However, it is difficult to address and assess how integrating BIM into construction can support improving social performance. Thus, this study developed a system dynamics (SD) model to evaluate the social performance of BIM-integrated construction management. The proposed model aims to demonstrate the dynamic behavior of social indicators in construction and their interrelationships. The developed model was simulated under the different scenarios by different levels of BIM implementations. As a result, levels 2 and 3 of BIM implementation can enhance social performance by 26% and 45%, respectively. This study is limited to develop the SD model and assessing the performance without the vaildation through case study. However, this study can contribute to developing the simulation model to address how the BIM can affect the social performance in the construction industry.
Microbial engineering to produce fatty alcohols and alkanes
Authors: Sharma Ashima , Yazdani Syed Shams
Published: March 2021

Owing to their high energy density and composition, fatty acid-derived chemicals possess a wide range of applications such as biofuels, biomaterials, and other biochemical, and as a consequence, the global annual demand for products has surpassed 2 million tons. With the exhausting petroleum reservoirs and emerging environmental concerns on using petroleum feedstock, it has become indispensable to shift to a renewable-based industry. With the advancement in the field of synthetic biology and metabolic engineering, the use of microbes as factories for the production of fatty acid-derived chemicals is becoming a promising alternative approach for the production of these derivatives. Numerous metabolic approaches have been developed for conditioning the microbes to improve existing or develop new methodologies capable of efficient oleochemical production. However, there still exist several limitations that need to be addressed for the commercial viability of the microbial cell factory production. Though substantial advancement has been made toward successfully producing these fatty acids derived chemicals, a considerable amount of work needs to be done for improving the titers. In the present review, we aim to address the roadblocks impeding the heterologous production, the engineering pathway strategies implemented across the range of microbes in a detailed manner, and the commercial readiness of these molecules of immense application.
Proton pump inhibitor use and appropriateness analysis: a snapshot from a secondary care hospital
Authors: Damji Sukaina Salim , Rabbani Syed Arman , Rao Padma G M , Butt Ain-ur Rashid
Published: March 2021

Objectives

Proton pump inhibitors (PPIs) have become one of the most frequently prescribed drugs since their introduction 30 years ago. Effectiveness and safety profile of PPIs has led to their overutilization and has exposed patients to a number of potential risks. The objective of this study was to evaluate the use of PPIs in a secondary care hospital in the United Arab Emirates.

Methods

This prospective observational drug-utilization study was conducted in patients receiving treatment with PPIs and admitted to internal medicine wards of the study site. Electronic patient case records were reviewed and data on PPI prescribing was collected and analysed. Appropriateness of PPI use was assessed as per international guidelines.

Key findings

Out of 172 patients enrolled, 53.5% were females with median age of 57 years (34.3, 71.0). Four different PPIs were prescribed to study patients, pantoprazole (86.6%), esomeprazole (5.8%), rabeprazole (4.1%) and omeprazole (3.5%). Ninety-two (53.5%) patients were prescribed intravenous PPI, whereas 80 (46.5%) patients were given PPI in oral form. Overall, 103 (59.9%) patients had inappropriate PPI prescriptions. Of these inappropriate prescriptions, 22 patients had no clear indication for PPI use and for 16 patients; PPIs were indicated for stress ulcer prophylaxis in low-risk category. Corticosteroid use [odds ratio (OR): 4.34, 95% confidence interval (CI): 1.22–15.46; P = 0.023] was significantly associated with greater odds of inappropriate PPI use.

Conclusions

We report a high prevalence of inappropriate PPI prescribing among the hospitalized patients in our study. Inappropriate PPI prescribing is a concerning issue and collective efforts should be made to check and minimize the same.
Perceived Stress, Personality Traits, and State of Victim’s Consciousness: Impact on Tourniquet Application Time and Effectiveness
Authors: Mulet Marin , Vuillemin Quentin , Lachaux Jordan , Trousselard Marion , Ferrer Marie-Hélène
Published: March 2021

Introduction

One of the main avoidable causes of combat-related injury death is extremity hemorrhage. Even with regular training, failure to properly apply a tourniquet is common. In this study, we sought to assess if rescuer’s stress and personality traits, along with victim’s state of consciousness, had a role to explain tourniquet application failure.

Materials and Methods

Eighty-seven soldiers completed a sociodemographic and personality questionnaire (perceived stress, active altruism, mindfulness, and empathy) during a forward combat casualty care course. Then, they underwent a leg hemorrhage simulation on a randomly conscious or unconscious victim. Tourniquet application time and effectiveness (using popliteal artery Doppler) were recorded.

Results

Tourniquet application effective rate was 37% and soldiers with higher levels of perceived stress were at greater risk of failure, especially on a conscious victim. Participants who deployed overseas and those who have undergone combat rescue training were significantly quicker to apply a tourniquet. Altruist and empathetic caregivers were slower to apply the tourniquet while mindful ones were faster.

Conclusions

Combat-related injuries, even simulated, not only involve the rescuer’s technical skills but also their ability to deal with stressful external stimuli. Tourniquet application speed seems to be influenced by perceived stress and personality traits of the rescuers. Frequent failures justify repeated training, and one way to pursue improvement could be to develop a personalized pedagogy adapting to the needs of the students according to their current skillset but also their perceived stress and personality determinants. In the pedagogical process (planning, goal setting, teaching, and evaluating), the state of consciousness of the victim seems to be a parameter that needs to be accounted for, but further studies are required to accurately describe its influence.
Using Shell models to investigate clumping in the wind of the O7Iaf + supergiant AzV83
Authors: Flores Brian L , Hillier D John
Published: March 2021

Hot massive stars exhibit strong stellar winds that enrich the surrounding interstellar medium and affect the stars’ evolution. However, the winds are inhomogeneous (clumped) and are difficult to model in radiative transfer codes. To produce more realistic spectra, many codes use a volume-filling factor (VFF) approach to incorporate the effects of clumping. While this approach is convenient, it is simplistic. We introduce an alternative approach to incorporate clumping by assuming the wind is composed of dense spherical shells. Using this approach in the radiative transfer code cmfgen, we produce synthetic spectra for AzV83, an O7Iaf + supergiant located in the Small Magellanic Cloud. The spectrum of AzV83 is rich in both photospheric and wind features, making it an ideal candidate with which to investigate the physical characteristics of stellar winds. Synthetic spectra are compared to the star’s observed spectrum to better characterize the influence of clumped winds on spectral features, and to better understand the limitations of the VFF approach. The approach using spherical shells yields similar wind parameters to those obtained using the VFF approach although a slightly higher mass-loss rate is required to fit Hα. As expected, the interclump medium in the model with shells allows the high ionization resonance transitions of N v and O vi to be fitted using LX-ray/LBol ≈ 10−7, which is typically observed for O stars, and which is a factor of 10 lower than needed with the VFF approach.
Chemical analysis of the bulge globular cluster NGC 6553
Authors: Montecinos Carolina , Villanova S , Muñoz C , Cortés C C
Published: March 2021

Globular clusters are among the oldest objects in the Galaxy, thus their researchers are key to understanding the processes of evolution and formation that the galaxy has experienced in early stages. Spectroscopic studies allow us to carry out detailed analysis on the chemical composition of globular clusters. The aim of our research is to perform a detailed analysis of chemical abundances to a sample of stars of the bulge globular cluster NGC 6553, in order to determine chemical patterns that allow us to appreciate the phenomenon of Multiple Population in one of the most metal-rich Globular Clusters in the Galaxy. This analysis is being carried out with data obtained by FLAMES/GIRAFFE spectrograph, VVV survey and DR2 of Gaia mission. We analysed 20 red horizontal branch stars, being the first extensive spectroscopic abundance analysis for this cluster and measured 8 chemical elements (O, Na, Mg, Si, Ca, Ti, Cr, and Ni), deriving a mean iron content of [Fe/H] = −0.10 ± 0.01 and a mean of [α/Fe] = 0.21 ± 0.02, considering Mg, Si, Ca, and Ti (errors on the mean). We found a significant spread in the content of Na but a small or negligible in O. We did not find an intrinsic variation in the content of α and iron-peak elements, showing a good agreement with the trend of the bulge field stars, suggesting a similar origin and evolution.
The evolution of the galaxy stellar-mass function over the last 12 billion years from a combination of ground-based and HST surveys
Authors: McLeod D J , McLure R J , Dunlop J S , Cullen F , Carnall A C , Duncan K
Published: March 2021

We present a new determination of the galaxy stellar-mass function (GSMF) over the redshift interval 0.25 ≤ z ≤ 3.75, derived from a combination of ground-based and Hubble Space Telescope (HST) imaging surveys. Based on a near-IR-selected galaxy sample selected over a raw survey area of 3 deg2 and spanning ≥4 dex in stellar mass, we fit the GSMF with both single and double Schechter functions, carefully accounting for Eddington bias to derive both observed and intrinsic parameter values. We find that a double Schechter function is a better fit to the GSMF at all redshifts, although the single and double Schechter function fits are statistically indistinguishable by z = 3.25. We find no evidence for significant evolution in M⋆, with the intrinsic value consistent with $\log _{10}(M^{\star }/\hbox{$\rm \, M_{\odot }$})=10.55\pm {0.1}$ over the full redshift range. Overall, our determination of the GSMF is in good agreement with recent simulation results, although differences persist at the highest stellar masses. Splitting our sample according to location on the UVJ plane, we find that the star-forming GSMF can be adequately described by a single Schechter function over the full redshift range, and has not evolved significantly since z ≃ 2.5. In contrast, both the normalization and the functional form of the passive GSMF evolve dramatically with redshift, switching from a single to a double Schechter function at z ≤ 1.5. As a result, we find that while passive galaxies dominate the integrated stellar-mass density at z ≤ 0.75, they only contribute ≲10 per cent by z ≃ 3. Finally, we provide a simple parametrization that provides an accurate estimate of the GSMF, both observed and intrinsic, at any redshift within the range 0 ≤ z ≤ 4.
Discovery of Novel Herpes Simplexviruses in Wild Gorillas, Bonobos, and Chimpanzees Supports Zoonotic Origin of HSV-2
Authors: Wertheim Joel O. , Hostager Reilly , Ryu Diane , Merkel Kevin , Angedakin Samuel , Arandjelovic Mimi , Ayimisin Emmanuel Ayuk , Babweteera Fred , Bessone Mattia , Brun-Jeffery Kathryn J. , Dieguez Paula , Eckardt Winnie , Fruth Barbara , Herbinger Ilka , Jones Sorrel , Kuehl Hjalmar , Langergraber Kevin E. , Lee Kevin , Madinda Nadege F. , Metzger Sonja , Ormsby Lucy Jayne , Robbins Martha M. , Sommer Volker , Stoinski Tara , Wessling Erin G. , Wittig Roman M. , Yuh Yisa Ginath , Leendertz Fabian H. , Calvignac-Spencer Sébastien
Published: March 2021

Viruses closely related to human pathogens can reveal the origins of human infectious diseases. Human herpes simplexvirus type 1 (HSV-1) and type 2 (HSV-2) are hypothesized to have arisen via host-virus codivergence and cross-species transmission. We report the discovery of novel herpes simplexviruses during a large-scale screening of fecal samples from wild gorillas, bonobos, and chimpanzees. Phylogenetic analysis indicates that, contrary to expectation, simplexviruses from these African apes are all more closely related to HSV-2 than to HSV-1. Molecular clock-based hypothesis testing suggests the divergence between HSV-1 and the African great ape simplexviruses likely represents a codivergence event between humans and gorillas. The simplexviruses infecting African great apes subsequently experienced multiple cross-species transmission events over the past 3 My, the most recent of which occurred between humans and bonobos around 1 Ma. These findings revise our understanding of the origins of human herpes simplexviruses and suggest that HSV-2 is one of the earliest zoonotic pathogens.
Experimental Resurrection of Ancestral Mammalian CPEB3 Ribozymes Reveals Deep Functional Conservation
Authors: Bendixsen Devin P. , Pollock Tanner B. , Peri Gianluca , Hayden Eric J.
Published: March 2021

Self-cleaving ribozymes are genetic elements found in all domains of life, but their evolution remains poorly understood. A ribozyme located in the second intron of the cytoplasmic polyadenylation binding protein 3 gene (CPEB3) shows high sequence conservation in mammals, but little is known about the functional conservation of self-cleaving ribozyme activity across the mammalian tree of life or during the course of mammalian evolution. Here, we use a phylogenetic approach to design a mutational library and a deep sequencing assay to evaluate the in vitro self-cleavage activity of numerous extant and resurrected CPEB3 ribozymes that span over 100 My of mammalian evolution. We found that the predicted sequence at the divergence of placentals and marsupials is highly active, and this activity has been conserved in most lineages. A reduction in ribozyme activity appears to have occurred multiple different times throughout the mammalian tree of life. The in vitro activity data allow an evaluation of the predicted mutational pathways leading to extant ribozyme as well as the mutational landscape surrounding these ribozymes. The results demonstrate that in addition to sequence conservation, the self-cleavage activity of the CPEB3 ribozyme has persisted over millions of years of mammalian evolution.
MRI-based radiomics for prognosis of pediatric diffuse intrinsic pontine glioma: an international study
Authors: Tam Lydia T , Yeom Kristen W , Wright Jason N , Jaju Alok , Radmanesh Alireza , Han Michelle , Toescu Sebastian , Maleki Maryam , Chen Eric , Campion Andrew , Lai Hollie A , Eghbal Azam A , Oztekin Ozgur , Mankad Kshitij , Hargrave Darren , Jacques Thomas S , Goetti Robert , Lober Robert M , Cheshier Samuel H , Napel Sandy , Said Mourad , Aquilina Kristian , Ho Chang Y , Monje Michelle , Vitanza Nicholas A , Mattonen Sarah A
Published: March 2021

Background

Diffuse intrinsic pontine gliomas (DIPGs) are lethal pediatric brain tumors. Presently, MRI is the mainstay of disease diagnosis and surveillance. We identify clinically significant computational features from MRI and create a prognostic machine learning model.

Methods

We isolated tumor volumes of T1-post-contrast (T1) and T2-weighted (T2) MRIs from 177 treatment-naïve DIPG patients from an international cohort for model training and testing. The Quantitative Image Feature Pipeline and PyRadiomics was used for feature extraction. Ten-fold cross-validation of least absolute shrinkage and selection operator Cox regression selected optimal features to predict overall survival in the training dataset and tested in the independent testing dataset. We analyzed model performance using clinical variables (age at diagnosis and sex) only, radiomics only, and radiomics plus clinical variables.

Results

All selected features were intensity and texture-based on the wavelet-filtered images (3 T1 gray-level co-occurrence matrix (GLCM) texture features, T2 GLCM texture feature, and T2 first-order mean). This multivariable Cox model demonstrated a concordance of 0.68 (95% CI: 0.61–0.74) in the training dataset, significantly outperforming the clinical-only model (C = 0.57 [95% CI: 0.49–0.64]). Adding clinical features to radiomics slightly improved performance (C = 0.70 [95% CI: 0.64–0.77]). The combined radiomics and clinical model was validated in the independent testing dataset (C = 0.59 [95% CI: 0.51–0.67], Noether’s test P = .02).

Conclusions

In this international study, we demonstrate the use of radiomic signatures to create a machine learning model for DIPG prognostication. Standardized, quantitative approaches that objectively measure DIPG changes, including computational MRI evaluation, could offer new approaches to assessing tumor phenotype and serve a future role for optimizing clinical trial eligibility and tumor surveillance.
The Japanese Constitution
Authors: McElwain Kenneth Mori
Published: March 2021

The Constitution of Japan is the oldest unamended supreme law in the world. This chapter examines the determinants of constitutional stability and its implications for Japanese politics. First, cross-national constitutional data shows that the COJ is uncommonly short, leaving many details regarding political institutions to be determined by law. This makes it possible to alter institutional rules through regular legislation, lessening the structural need for constitutional amendments. Second, strong disagreements among elites and citizens have insulated the COJ from polarizing reforms. While a supermajority of legislators support amendments in principle, there is no consensus on which provisions to amend or whether to prioritize them above bread-and-butter socioeconomic issues. Public opinion is similarly divided, but the most consistent support is for progressive priorities, such as adding new rights to privacy and the environment, rather than for conservative targets desired by the LDP, particularly Article 9.