bluuebunny/crossref_metadata_2025 huggingface dataset:
Intrahepatic cholestasis of pregnancy and maternal dyslipidemia: a systematic review and meta‐analysis
Authors: Zhan Yongchi , Xu Tingting , Chen Tiantian , Wang Xiaodong
Published: May 2022

Introduction

The association between intrahepatic cholestasis of pregnancy (ICP) and maternal lipid metabolism remains unknown. This systematic review and meta‐analysis aimed to evaluate the association between ICP and maternal lipid metabolism.

Material and methods

We systematically searched Medline, Embase and the Cochrane Library (up to December 11, 2021) to identify relevant studies that investigated ICP and maternal plasma lipid concentrations. The weighted mean difference (WMD) and 95% confidence intervals (CI) were calculated using random‐effects models. A subgroup analysis was conducted to identify the potential sources of heterogeneity. Potential publication bias was tested using funnel plots and the Egger's and Begg's tests. This meta‐analysis was registered with PROSPERO (CRD42021293783).

Results

Eleven studies were included in this qualitative analysis. A random‐effects meta‐analysis of data from the final included nine studies (n = 786 participants) showed a significant association between ICP and maternal dyslipidemia, with elevated levels of triglycerides (WMD, 0.67 mmol/L; 95% CI 0.39–0.95; P < 0.001), total cholesterol (WMD, 1.08 mmol/L; 95% CI 0.58–1.58; P < 0.001), low‐density lipoprotein cholesterol (WMD, 1.08 mmol/L; 95% CI 0.53–1.64; P < 0.001), and reduced high‐density lipoprotein cholesterol level (WMD, −0.38 mmol/L; 95% CI −0.53 to −0.23; P < 0.001) vs normal pregnancies.

Conclusions

The present study's findings support an association between ICP and maternal dyslipidemia. ICP pregnancies have dysregulated lipid metabolism vs normal pregnancies.
Correlation between retinal oxygen saturation and the haemodynamic parameters of the ophthalmic artery in healthy subjects
Authors: Král Michal , Svrčinová Tereza , Hok Pavel , Dorňák Tomáš , Rybáriková Martina , Mareš Jan , Kaňovský Petr , Šín Martin
Published: May 2022

Purpose

The aim of the study was to obtain the values of oxygen saturation in retinal vessels and ophthalmic blood flow parameters in a healthy Caucasian population and assess whether the oximetry parameters are affected by the flow rate or the vascular resistance.

Methods

The spectrophotometric retinal oximetry and colour Doppler imaging (CDI) of retinal vessels were successfully performed with 52 healthy subjects (average age 29.7 ± 5.6 years). The retinal oximeter simultaneously measures the wavelength difference of haemoglobin oxygen saturation in retinal arterioles and venules. The arteriolar and venular saturation in both eyes was measured. The peak systolic (PSV) end diastolic (EDV) velocities, resistive (RI) and pulsatility (PI) indices were obtained for both eyes using CDI in the ophthalmic artery. A paired t‐test and two sample t‐tests were used for statistical analyses. The correlation was assessed using the Pearson coefficient correlation.

Results

The mean oxygen saturation level was 96.9 ± 3.0% for the retinal arterioles and 65.0 ± 5.1% for the retinal venules. The A‐V difference was 31.8 ± 4.6%. The mean of the measured haemodynamic parameters was PSV 46.6 ± 9.4 cm/s, EDV 12.0 ± 3.5 cm/s, PI 1.68 ± 0.38 and RI 0.74 ± 0.05. No significant difference in oxygen saturation and haemodynamic parameters was found between the left and the right eyes or the dominant and non‐dominant eye. The oximetry and ultrasound values were sex independent. The Pearson correlation coefficient demonstrated a significant yet weak negative correlation between A‐V difference and RI (r = −0.321, p = 0.020).

Conclusions

A negative correlation between A‐V difference and resistance index was observed, suggesting that reduced oxygen consumption may reflect the increased vascular tone of the ophthalmic vessels, which is likely determined by autoregulatory mechanisms.
Plasma and breast milk pharmacokinetics of tenofovir alafenamide in mothers with chronic hepatitis B infection
Authors: Kayes Tahrima , Crane Harry , Symonds Allison , Dumond Julie , Cottrell Mackenzie , Di Girolamo Julia , Manandhar Sicha , Lim Tien Huey , Gane Edward , Kashuba Angela , Levy Miriam T.
Published: May 2022

Background

Antenatal antiviral therapy (AVT) is effective in preventing mother‐to‐child transmission (MTCT) in chronic hepatitis B (CHB); tenofovir disoproxil fumarate (TDF) is the preferred agent. Tenofovir alafenamide (TAF) is a prodrug of tenofovir (TFV) similar to TDF, with improved bone and renal safety. There are no data on TAF breast milk pharmacokinetics and exposure to breastfeeding infants in CHB.

Aim

To assess the pharmacokinetics of TAF/TFV in breastfeeding women with CHB on TAF monotherapy.

Methods

Pregnant women with CHB requiring AVT commenced TAF 25 mg daily at third trimester or postpartum. Sample collection occurred while breastfeeding and taking TAF for minimum 4 weeks. Maternal blood, breast milk and infant urine samples were collected. Drug concentrations were measured by LCMS/MS analyses using validated methods. Non‐compartmental analyses were performed to quantify the pharmacokinetic parameters.

Results

Eight women provided samples. In breast milk and plasma, median TAF half‐life was 0.81 and 0.94 h, respectively, and Cmax 1.69 and 120.5 ng/ml, respectively. Median maternal breast milk to plasma (M/P) ratio of TAF was 0.029; for and TFV it was 2.809. The relative infant dose of TAF was 0.005% of maternal dose, well below safety threshold of 5–10%. TFV was detectable in three out of seven infant urine samples with median steady‐state concentration of 5 ng/ml being 300–2500 times less than reported adult steady‐state urine concentrations in those taking TAF and TDF, respectively.

Conclusions

In this first pharmacokinetic study of TAF monotherapy in breastfeeding women with CHB, concentrations of TAF and TFV were low in breast milk with negligible infant exposure, supporting the use of TAF to prevent MTCT.
VAERS‐reported new‐onset seizures following use of COVID‐19 vaccinations as compared to influenza vaccinations
Authors: Avasarala Jagannadha , McLouth Christopher J. , Pettigrew Luther C. , Mathias Sally , Qaiser Sharoon , Zachariah Phenu
Published: May 2022

The incidence of new‐onset seizures, which we defined as de novo seizures occurring within 4 weeks of receiving any of the US Food and Drug Administration‐approved COVID‐19 vaccinations as reported in patient‐reported data compiled in the US Centers for Disease Control and Prevention Vaccine Adverse Events Reporting System Data (CDC VAERS), has not been explored. The VAERS database contains de‐identified patient‐reported adverse events following vaccination and represents post‐marketing surveillance and analysis of vaccine safety. After adjusting for time at risk, this resulted in estimated incidence rates of 3.19 seizures per 100 000 persons per year for the COVID‐19 vaccine and 0.090 seizures per 100 000 persons per year for the influenza vaccines. A data‐driven, individualized dataset that is comprehensive and coupled with a longitudinal follow‐up in larger numbers of vaccinated individuals is needed to expand on our preliminary findings of vaccine‐related seizures.
Medicines, environment and clinical pharmacology
Authors: Lapatto‐Reiniluoto Outi , Siven Mia , Backman Janne T. , Törrönen Anneli
Published: May 2022

Medical associations and other societies have announced their theses on protection of the climate and environmental aspects in medicine. The challenges with climate change and sustainability are complex, and no quick solutions are to be found. However, basic knowledge on these issues should be available to everyone, and environmental aspects of drugs are important to all healthcare professionals.

We present here a study with medical students who were introduced for the first time to environmental aspects of medicines. The results confirmed the suitability and feasibility of the approach to introduce this subject to students, and we propose that the same method can be used also when explaining the issue to medical professionals. We would like to encourage particularly clinical pharmacologists, pharmacologists and pharmacists to take a more apparent position in this field and to participate in the discussions where the strategies for the choice of medicines are considered.
Object representation: intersecting infant observation with observational documentary
Authors: Isserow Jonathan
Published: May 2022

Between 1947 and 1973 a handful of ocularcentric psychoanalysts turned to observational film to inscribe infant subjectivity. In doing so, they significantly informed the field of child development. In light of this history, this article interrogates the construction of infant subjectivity on screen. It does this by intersecting practices of looking in psychoanalytic infant observation with those of observational film, and explores their confluence in James Robertson's film, A Two‐Year‐Old Goes to Hospital (1952). Understanding is advanced by making evident that both domains draw on realist aesthetics and linear temporality in their representations of subjectivity. It argues that this increased awareness may inform the reappraisal of documentary film as a methodology in infant mental health research. Observational documentary may integrate diverse ways of looking in the field and develop greater reflexivity around the construction of subjectivity inherent in all infant observational practices.
Sulking as a declaration of dependence
Authors: Wrottesley Catriona
Published: May 2022

Adult sulking is an emotional state and behaviour, characterized by misery and sometimes hostility, that occurs within intimate relationships. A remnant of unmet needs in infancy, it is enacted when omnipotence, grandiosity and feelings of entitlement are threatened. Sulking signals the sulker's feelings of dependency and powerlessness in relation to a significant other while defending against feared consequences of self‐assertion. As protest, appeal or coercion, sulking may be the recourse of any individual when words fail or are refused. This paper examines sulking in couple relationships because sulking is intrinsically interpersonal: a sulker requires someone to sulk at or to. While the sulker overtly cold‐shoulders the other, emotionally he is far from indifferent to the other's response. Sulking sits on a narcissistic continuum, with relatively benign moodiness at one end and coercive control at the other. Section 1 of this paper explores sulking firstly in childhood and then in adult relationships, together with the way spatial metaphors – the cave and tent – may assist the clinician's understanding of the sulker's self‐positioning in relation to his object. Sulking's purposive aspects are also considered. In Section 2, psychic agony is discussed to demonstrate how some people may become prisoners of their own or the other's sulking.
The Knitting Knows: On Learning How to Work With the Countertransference
Authors: Innocente Kylie
Published: May 2022

Learning how to identify and work with the countertransference is a cornerstone of any psychoanalytic training, yet it can't be taught solely through books or in the classroom. Experience of the countertransference and having it pointed out through supervision or a peer group is an essential component of this learning process. Nonetheless, countertransference can be missed as it's often an unconscious form of communication. This article explores, through the example of an infant observation, how an intense countertransference penetrated unchecked and unnoticed but was enacted through the creative act of knitting. The emergence of this countertransference is examined and is then considered through the lens of a ‘creative block’. This idea gives a different way to think about unconscious processes and enriches the understanding of what is being communicated.
“We're entitled to be parents just like normal people”: A multiperspective interpretative phenomenological analysis of a mother with a learning disability's experience of parenting following the removal of her older children
Authors: MacLeod Alison M. , Smart Cordet , Keohane Peter , Dallos Rudi , Cox Kathy J.
Published: May 2022

Background

Despite a growing body of literature about parents with learning disabilities; there is a paucity of research about experiences of parenting after the removal of a child/children. This study aimed to fill this gap, examining the experiences of that parenting in this context.

Method

A multiperspective interpretative phenomenological analysis approach was used. Semistructured interviews were conducted with a parent with a learning disability and three professionals who worked alongside her.

Findings

Multiple factors were identified as key changes which enabled the parent to maintain care of her son. The effort from the parent and professionals, understanding of the parent's past experiences and learning disability, and offering her opportunities to develop and illustrate parenting skills were all key to successful parenting after a removal; underpinned by the connection between the parent and professionals.

Conclusion

Findings highlighted the complex, systemic, and relational nature of these experiences. A formulation‐based approach is needed to support parents with learning disabilities in this context.
Prevalence of diabetic retinopathy in women with pregestational diabetes during pregnancy and the postpartum
Authors: Widyaputri Felicia , Rogers Sophie L. , Khong Edmund W. C. , Nankervis Alison J. , Conn Jennifer J. , Sasongko Muhammad B. , Shub Alexis , Fagan Xavier J. , Guest Daryl , Symons Robert C. A. , Lim Lyndell L.
Published: May 2022

Background

Diabetic retinopathy (DR) may be affected by pregnancy. The majority of prevalence data regarding DR in pregnancy predate the advent of contemporary guidelines for diabetes management during pregnancy. This study reports DR prevalence and associated risk factors in women with pregestational diabetes during pregnancy and the postpartum in Australia.

Methods

A total of 172 pregnant women with type 1 (T1DM) or type 2 diabetes diagnosed pre‐pregnancy were prospectively recruited from two obstetrics hospitals in Melbourne (November 2017–March 2020). Eye examinations were scheduled in each trimester, at 3‐, 6‐, and 12‐months postpartum. DR severity was graded from two‐field fundus photographs by an independent grader utilising the Airlie House Classification. Sight‐threatening DR (STDR) was defined as the presence of diabetic macular oedema or proliferative DR.

Results

Overall, 146 (84.9%) women had at least one eye examination during pregnancy. The mean age was 33.8 years (range 19–51), median diabetes duration was 7.0 years (IQR 3.0–17.0), 71 women (48.6%) had T1DM. DR and STDR prevalence during pregnancy per 100 eyes was 24.3 (95% CI 19.7–29.6) and 9.0 (95% CI 6.1–12.9); while prevalence in the postpartum was 22.2 (95% CI 16.5–29.3) and 10.0 (95% CI 5.4–17.9), respectively. T1DM, longer diabetes duration, higher HbA1c in early pregnancy, and pre‐existing nephropathy were significant risk factors.

Conclusions

The prevalence of DR in pregnant women was similar to the non‐pregnant diabetic population in Australia. One in nine participants had STDR during pregnancy and the postpartum, highlighting the need to optimise DR management guidelines in pregnancy given the significant risk of vision loss.
Day‐case discharge criteria and safety of children undergoing adenoidectomy and tonsillectomy for obstructive symptoms—A systematic review
Authors: Gowda Siri , Leong Wei S. , Edafe Ovie
Published: May 2022

Objectives

Obstructive sleep apnoea (OSA) is a common indication for adenoidectomy and tonsillectomy in children. Traditional practice involves overnight admission to monitor for respiratory complications. However, there is a shift towards same‐day discharge in selected patients. This systematic review aims to critically evaluate day‐case criteria and safety in children with OSA undergoing adenotonsillectomy.

Design

We performed a systematic search of EMBASE, Medline and the Cochrane library. All data collected were independently validated for accuracy. Quality assessment of included articles was performed. The protocol was registered with PROSPERO.

Results

A total of 15 studies were included (10 731 patients). There was heterogeneity in methods used to ascertain OSA, day‐case discharge criteria and lack of prospective discharge protocol. The proportion of children considered for planned day‐case surgery ranged from 28.7%–100% based on individual criteria, with an average rate of successful same‐day discharge of 96.1% in these patients. The reported rates of post‐operative respiratory adverse events and need for airway intervention were 0%–27.3% and 0.4%–6.8%, respectively. There was no reported mortality. The studies were considered low to medium on quality assessment.

Conclusion

There is a lack of prospective data on day‐case criteria and systematic assessment of post‐operative complications in children with OSA undergoing adenoidectomy and tonsillectomy. However, current literature suggests that day‐case surgery is safe in carefully selected patients. Better characterisation of patient‐specific risk factors is needed to develop an optimal criteria‐based timeline for safe discharge. This has the potential to improve confidence and uptake across units.
Achieving hemostasis during endoscopic necrosectomy for walled‐off pancreatic necrosis using gel immersion technique
Authors: Iwano Kosuke , Toyonaga Haruka , Katanuma Akio
Published: May 2022

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The missing heritability in type 1 diabetes
Authors: Pang Haipeng , Lin Jian , Luo Shuoming , Huang Gan , Li Xia , Xie Zhiguo , Zhou Zhiguang
Published: May 2022

Type 1 diabetes (T1D) is a complex autoimmune disease characterized by an absolute deficiency of insulin. It affects more than 20 million people worldwide and imposes an enormous financial burden on patients. The underlying pathogenic mechanisms of T1D are still obscure, but it is widely accepted that both genetics and the environment play an important role in its onset and development. Previous studies have identified more than 60 susceptible loci associated with T1D, explaining approximately 80%‐85% of the heritability. However, most identified variants confer only small increases in risk, which restricts their potential clinical application. In addition, there is still a so‐called ‘missing heritability’ phenomenon. While the gap between known heritability and true heritability in T1D is small compared with that in other complex traits and disorders, further elucidation of T1D genetics has the potential to bring novel insights into its aetiology and provide new therapeutic targets. Many hypotheses have been proposed to explain the missing heritability, including variants remaining to be found (variants with small effect sizes, rare variants and structural variants) and interactions (gene–gene and gene–environment interactions; e.g. epigenetic effects). In the following review, we introduce the possible sources of missing heritability and discuss the existing related knowledge in the context of T1D.
Tooth resorption—Part 2: A clinical classification
Authors: Abbott Paul V. , Lin Shaul
Published: May 2022

Tooth resorption is either a physiological or a pathological process resulting in loss of dentin and/or cementum. It may also be associated with bone loss. Currently there is no universal classification for the different types of tooth resorption. This lack of a universal classification leads to both confusion amongst practitioners and poor understanding of the resorptive processes occurring in teeth which can result in incorrect/inappropriate diagnoses and mis‐management. When developing a classification of diseases and/or conditions that occur within the body, several criteria should be followed to ensure a useful classification. The classification should not only include pathological conditions but also physiological conditions. Since tooth resorption can be either pathological or physiological, a classification of tooth resorption should include both of these categories. Any classification of diseases should be possible to use clinically, meaningful, useful, clear and universal. It should enable easy storage, retrieval and analysis of health information for evidenced‐based decision‐making. It should also be possible to share and compare data and information between different institutions, settings and countries. A classification of tooth resorption should be developed by combining anatomical, physiological and pathological approaches. For some types of resorption, the aetiological approach should also be incorporated. A classification of tooth resorption that uses simple, relevant and appropriate terminology based on the nature and location of the resorptive process occurring in teeth is proposed. There are two broad categories of internal and external tooth resorption which are sub‐divided into three types of internal tooth resorption (surface, inflammatory, replacement) and eight types of external tooth resorption (surface, inflammatory, replacement, invasive, pressure, orthodontic, physiological, idiopathic). The clinician's understanding, diagnosis and management of tooth resorption can be facilitated by using this simple classification which should ideally be used universally by the entire dental profession to ensure clarity and to avoid confusion.
Predictive biomarkers of response to bacillus Calmette‐Guérin immunotherapy and bacillus Calmette‐Guérin failure for non‐muscle invasive bladder cancer
Authors: Wang Ziting , So Wei Zheng , Loh Kep Yong , Lim Yew Koon , Mahendran Ratha , Wu Qing Hui , Chiong Edmund
Published: May 2022

Within the heterogeneous population of patients with bacillus Calmette‐Guérin failure, there are clear differences in prognosis and therapy with regard to the timeline when bacillus Calmette‐Guérin failure occurred. There are a variety of classifications which include bacillus Calmette‐Guérin refractory disease, relapsing, unresponsive, and intolerant. Further profiling of these patients may help to shed light on other forms of therapy that are less radical. We hereby summarize the different biomarkers that predicts for response to bacillus Calmette‐Guérin immunotherapy and bacillus Calmette‐Guérin failure for non‐muscle invasive bladder cancer.
Impact of a pharmacist‐led thiopurine monitoring service in outpatients with inflammatory bowel disease
Authors: Rodda Sheridan E. , Fildes Karina J. , Shelton Edward , Goldberg Rimma , Moore Gregory T.
Published: May 2022

Background

Thiopurines are effective therapies for inflammatory bowel disease (IBD); however, treatment comes with safety concerns and adverse effects. Knowledge of the impact of pharmacists performing thiopurine monitoring is limited.

Aims

To determine the impact of a pharmacist‐led monitoring service in patients with IBD commencing thiopurine therapy managed in the ambulatory care setting.

Methods

Patients commencing thiopurine therapy for IBD pre‐ and post‐introduction of a pharmacist‐led monitoring intervention were assessed. Pre‐intervention patients received standard of care, while the post‐intervention cohort was managed by the pharmacist. Data were acquired via retrospective audit of hospital medical records. The primary end‐point was the proportion of patients with documented review for thiopurine adverse effects within the initial 3 weeks. Secondary end‐points included achievement of therapeutic drug levels, persistence with thiopurine therapy, IBD‐related episodes of care and number of outpatient medical reviews.

Results

Pre‐ and post‐intervention cohorts comprised of 37 and 33 patients respectively. Pharmacist intervention increased the proportion of patients with documented monitoring within 3 weeks from 8.1% to 84.8% (P < 0.01). No difference in thiopurine dose optimisation was seen (27% vs 27.3%). Persistence with thiopurine therapy increased from 65.7% to 87.9% (P < 0.03) at 6 months. IBD‐related emergency department presentations were not significantly decreased (8.1% vs 3%; P = 0.62). No significant change was observed in hospital admissions (16.2% vs 12.1%; P = 0.74) or outpatient medical reviews.

Conclusions

Pharmacist monitoring of thiopurine therapy initiation in IBD outpatients improves adverse effect monitoring and increases medication persistence.
Rain events at maturity severely impact the seed quality of psyllium (Plantago ovata Forssk.)
Authors: Cowley James M. , McNeil David L. , Lui King Yin , Barsby Jacqueline P. , Ciani Silvano , Cerne Virna , Burton Rachel A.
Published: May 2022

Plantago ovata Forssk. is an emerging crop yielding psyllium husk, a material comprised of hydrophilic polysaccharides that form mucilage upon wetting. Psyllium husk has important industrial uses including as a dietary fibre supplement and a textural alternative in gluten‐free bread production. Industrial applications require high‐quality and purity psyllium husk, but consistent supply of uniform quality material is often limited by climatic constraints, especially unseasonable rainfall at crop maturity. Here we compared the seed quality of four P. ovata varieties harvested before and after 26 mm of rain and validated our key findings in the following season. Colourimetry showed that the rain event caused the seeds to be darker and greener, possibly from pigment oxidation and microbial growth. Sugar profiling, water absorption assays and microscopy showed that premature hydration of the husk in rain‐damaged samples caused loss of the most soluble mucilage components and an increase in non‐mucilage contaminants, leading to a reduction in seed water absorption capacity, which is a key indicator of psyllium husk functionality. Germination was also diminished in rain‐affected seeds. In this study we show for the first time the extent that unseasonable rain at maturity has on P. ovata seed quality. We suggest that rain‐damaged seeds are unsuitable for husk production and resowing and outline potential screening methods to identify rain‐damaged seeds before purchase. Additionally, the extensive quality impacts described here may make P. ovata a suitable model or indicator species for studying acute climate effects on seed quality, especially from rain.
Effectiveness of compost inoculated with phosphate solubilizing bacteria
Authors: Ahmad Areesha , Zafar Urooj , Khan Adnan , Haq Tooba , Mujahid Talat , Wali Mahreen
Published: May 2022

Aims

The present study was carried out to design a phosphate solubilizing bacterial (PSB)-based biofertilizer using locally produced fruit waste.

Method and results

Two PSB strains Pseudomonas aeruginosa CMG4 and AAC1 were inoculated into compost. Six compost piles were prepared with carbon:nitrogen (C:N) ratio 30:1. Four piles were inoculated with PSB and two piles served as a control. After 125 days, composts were considered mature at 29–31°C in the pH range of 7.1–7.3 and 32%–35% moisture content (MC). Accessible calcium (Ca) content increased up to 50 g kg−1. Microbial analysis showed the survival of P. aeruginosa species in the maturing compost even at higher temperature (~53°C). Native bacterial load was retrieved in the range of 109–1011 CFUg−1. Heavy metal concentrations including copper (Cu), lead (Pb), chromium (Cr) and cadmium (Cd) were found to occur below critical thresholds. Seed germination index for compost toxicity was found to be >80%, significantly higher than animal manure and chemical fertilizer, that is, 78% and 31%, respectively, suggesting non-toxicity.

Conclusions

The evaluation of prepared compost by physicochemical parameters revealed that inoculation of P. aeruginosa does not affect the temperature, MC, carbon to nitrogen ratio, organic matter and Mg content but significantly increased the accessible Ca content, suggesting the solubilization of inorganic Ca bound phosphate. Compost was safe in terms of heavy metal concentration and seed germination.

Significance and impact of study

This study encourages that the PSB-rich tailored compost can be utilized as a phosphatic biofertilizer to fulfil the demand for phosphorus which would improve and sustain soil fertility.
Antimicrobial potential of culturable actinobacteria isolated from the Pacific oyster Crassostrea gigas (Bivalvia, Ostreidae)
Authors: Cera Guillermo , Risdian Chandra , Pira Hani , Wink Joachim
Published: May 2022

Aims

Explore the diversity of culturable actinobacteria isolated from the Pacific oyster Crassostrea gigas with special emphasis on their antimicrobial activity.

Methods and Results

For the characterization of the isolated actinobacteria, a polyphasic approach was adopted and thereby phenotypic descriptions, phylogenetic analysis, evaluations of antimicrobial activities and chemical analyses of crude extracts through HPLC and LC-HRESIMS were performed. Five strains were isolated from C. gigas. The 16S rRNA gene analysis revealed that three of them were taxonomically affiliated to the genus Streptomyces and the other two strains were related to Micromonospora. High inhibition was detected against different test microorganisms such as Candida albicans, Staphylococcus aureus, Bacillus subtilis and Mycobacterium smegmatis. On the basis of the chemical analysis, 11 compounds from the active fractions of the crude extracts were determined, and 8 were related putatively to previously reported compounds.

Conclusions

Actinobacteria isolated from C. gigas represent an interesting reservoir of antimicrobial compounds, and further study to uncover the full capacity of this source is encouraged.

Significance and Impact

At present, the study of actinobacteria and their antimicrobial potential from uncommon sources as C. gigas is vital to the development of new therapeutic agents to cope with the widespread resistance of human pathogens.
Towards automatic annotation of collaborative problem‐solving skills in technology‐enhanced environments
Authors: Flor Michael , Andrews‐Todd Jessica
Published: May 2022

Background

Collaborative problem solving (CPS) is important for success in the 21st century, especially for teamwork and communication in technology‐enhanced environments. Measurement of CPS skills has emerged as an essential aspect in educational assessment. Modern research in CPS relies on theory‐driven measurements that are usually carried out as manual annotations over recorded logs of collaborative activities. However, manual annotation has limited scalability and is not conductive towards CPS assessments at scale.

Objective

We explore possibilities for automated annotation of actions in collaborative‐teams, especially chat messages. We evaluate two approaches that employ machine learning for automated classification of CPS events.

Method

Data were collected from engineering, physics and electronics students' participation in a simulation‐based task on electronics concepts, in which participants communicated via text‐chat messages. All task activities were logged and time stamped. Data have been manually classified for the CPS skills, using an ontology that includes both social and cognitive dimensions. In this article, we describe computational linguistic methods for automatically classifying the CPS skills from logged data, with a view towards automating CPS assessments.

Results

We applied two machine learning methods to our data. A Naïve Bayes classifier has been previously used in CPS research, but it is only moderately successful on our data. We also present a k‐nearest‐neighbours (kNN) classifier that uses distributional semantic models for measuring text similarity. This classifier shows strong agreement between automated and human annotations. The study also demonstrates that automatic spelling correction and slang normalization of chat texts are useful for accurate automated annotation.

Implications

Our results suggest that a kNN classifier can be very effective for accurate annotation of CPS events. It achieves reasonably strong results even when trained on only half of the available data. This shows a promise towards reduction of manual data annotation for CPS measurement.
Stigma, epistemic injustice, and “looked after children”: The need for a new language
Authors: Fieller Danielle , Loughlin Michael
Published: May 2022

This article examines the processes that contribute to the stigmatization of a group of people typically identified as “children in care” or “looked after children.” In particular, we will look at the ways that we (adults, professionals, and carers) interact with these children, based on their status as both children and members of a socially marginalized and disadvantaged group, and how these modes of interaction can inhibit dialogue—a dialogue that is needed if we are to base our conceptions regarding the needs of these children on a more accurate understanding of their experiences and perspective. The problem is particularly challenging because the very terminology we use in the care community to identify this group is a product of the damaging preconceptions that have affected our interactions with its members and, we argue, it serves to reinforce those preconceptions. Using Fricker's work on epistemic injustice, in conjunction with evidence regarding how accusations of abuse and neglect of these children have been addressed in numerous cases, we illustrate the problems we have in hearing the voices of members of this group and the harmful effects this has on their own ability to understand and articulate their experiences. These problems represent “barriers to disclosure” that need to be surmounted if we are to establish a more inclusive dialogue. Currently, dialogue between these children and those of us charged to “look after” them is too often characterized by a lack of trust: not only in terms of the children feeling that their word is not taken seriously, that their claims are not likely to be believed, but also in their feeling that they cannot trust those to whom they might disclose abuse or neglect. The goals of the paper are modest in that we aim simply to open up the debate on how to meet this epistemic challenge, noting that there are specific problems that extend beyond those already identified for hearing the voices of other victims of epistemic injustice. Explicitly recognizing the nature and extent of the problem still leaves us a long way from its solution, but it is a crucial start.
Comparative pan‐genomic analysis of 51 Renibacterium salmoninarum indicates heterogeneity in the principal virulence factor, the 57 kDa protein
Authors: Saldarriaga‐Córdoba Mónica , Avendaño‐Herrera Ruben
Published: May 2022

Renibacterium salmoninarum, a Gram‐positive intracellular pathogen, is the causative agent of bacterial kidney disease (BKD), the impacts of which are high mortalities and economic losses for the salmon industry. This study provides novel analyses for the whole‐genome sequences of 50 R. salmoninarum isolates and the reference strain ATCC 33209 using a pan‐genomic approach to elucidate phylogenomic relationships and identify unique and shared genes associated with pathogenicity and infection mechanisms. Genome size varied from 3,061,638 to 3,155,332 bp; gene count from 3452 to 3580; and predicted coding sequences from 3402 to 3527. Comparative analyses revealed an open, but approaching closed, pan‐genome. The pan‐genome analysis recovered 4064 genes, with a core genome containing 3306 genes. Phylogenetic analysis of R. salmoninarum showed high genomic homogeneity, apart from one isolate obtained from Salmo trutta in Norway. All genomes presented the 57‐kDa protein (p57). Strain ATCC 33209 and the Chilean isolates H‐2 and DJ2R presented two copies of the msa gene, while the remaining isolates had one copy. The pan‐genome analysis further identified differences in the number of copies and length of the signalling peptide for p57, the principal virulence factor reported for this bacterium. This heterogeneity could be associated with the secretion levels of p57, potentially influencing virulence. Additionally identified were numerous common genes related to iron uptake, the stress response and regulation, and cell signalling—all of which constitute the pathogenic repertoire of R. salmoninarum. This investigation provides information that is applicable in future studies for identifying therapeutic targets and/or for designing new strategies (e.g., vaccines) to prevent BKD infections in salmon farming.
Bovine meat, authoritarian populism, and state contradictions in Modi's India
Authors: Jakobsen Jostein , Nielsen Kenneth Bo
Published: May 2022

While authoritarian populism and its relationship to the rural world have gained analytical prominence recently, few have attempted a systematic exploration of how various authoritarian populisms emerge from, and are embedded within, dynamics of capital accumulation, state, and class struggle. Drawing on Poulantzas' approach to “state contradictions,” we focus on the ways by which bovine meat figures in Narendra Modi's authoritarian populist project in contemporary India. On the one hand, violent authoritarianism in the country uses beef eating as a powerful tool for subjugating subaltern groups to Hindutva rule. On the other hand, the country houses a rapidly expanding beef meat agro‐industry, accounting for as much as 20% of global exports and based on corporate concentration around dominant class interests. We argue that this points to state contradictions in Modi's India witnessing strained accumulation patterns. These contradictions, we emphasize, have distinct ramifications for India's classes of labour in the countryside, as certain groups experience what we describe as a process of “double victimization.”
Exploring the clinical efficacy of a self‐made acne prescription based on high‐throughput sequencing
Authors: Wang Liangyi , Wu Jingdong , Zhang Xiaoqing , Gu Wei , Han Xiaoqing
Published: May 2022

Background

We used high‐throughput sequencing on skin microbial flora to assess the effectiveness of an acne prescription to formulate evidence for clinical decision‐making.

Methods

We randomized 20 outpatients into two groups. The treatment group was given the acne formula orally. The control group took capsules of the Chinese patent medicine Qingre Anchuang. Both groups used a chloramphenicol tincture externally. After 14 days of treatment, we collected their skin samples and extracted the deoxyribonucleic acid for analysis.

Results

Forty samples were sequenced in this experiment, and of these, 1865 operational taxonomic units were obtained, belonging to 736 genera and 853 strains of 34 phyla. By alpha and beta diversity analysis, the abundance of microbial species in both the experimental and control groups before treatment was higher than after treatment, indicating the intervention drugs in this experiment had a bacteriostatic effect. Through the analysis of variance, we found that Subdoligranulum, Bifidobacterium, Bacteroides, and Akkermansia displayed large changes during the treatment. According to the linear discriminant analysis effect size, we discovered the bacteria groups with the greatest changes in the control group after treatment were Firmicutes, Clostridia, Proteobacteria, and Gammaproteobacteria. The flora of the experimental group before and after treatment were Corynebacteriaceae, Corynebacteriales, Cutibacterium, Propionibacteriales, Propionibacteriaceae, and Actinobacteria.

Conclusion

The acne prescription had a reliable intervention effect on some epidermal microbial flora of patients with acne vulgaris and could inhibit the growth of acne‐related microbial flora, such as Propionibacterium.
Prediction model of persistent ovulatory dysfunction in Korean women with polycystic ovary syndrome
Authors: Han Soo Jin , Kim Hoon , Hong Yun Soo , Kim Sung Woo , Ku Seung‐Yup , Suh Chang Suk
Published: May 2022

Aim

There is no validated tool to predict persistent ovulatory dysfunction after medication with oral contraceptives in women with polycystic ovary syndrome (PCOS), which is the most severe subtype of PCOS. We aimed to build a model to predict persistent ovulatory dysfunction after medication of oral contraceptives in women with PCOS.

Methods

A total of 286 patients with PCOS were treated with and without oral contraceptives at a tertiary academic medical center. Data were obtained from the electronic medical record system between January 2016 and March 2019. A risk prediction model was developed using multivariable logistic regression. Model 1 was based on age and chief complaints and Model 2 further included predictors evaluated during a clinic visit. Model 3 additionally included laboratory findings.

Results

Of the study population, ovulatory dysfunction was persistent in 117 patients (40.9%). Compared with the simple model (Models 1 and 2), the full prediction model (Model 3) had better Akaike's information criterion (286, 244 vs. 225) and the area under the curve (AUC) increased from 0.74 and 0.79 to 0.84. The full model included 7 covariates measured during the evaluation of PCOS, and two covariates were significant predictors of persistent ovulatory dysfunction in PCOS: age (OR 0.91; 95% CI 0.84–0.97), and anti‐Müllerian hormone (OR 1.17; 95% CI 1.09–1.26). This model demonstrated good discrimination (AUC, 0.84) and calibration (Hosmer–Lemeshow goodness of fit test, p = 0.74).

Conclusions

This prediction model was shown to be a useful method for predicting persistent ovulatory dysfunction after oral contraceptive medication in patients with PCOS.
A randomized comparison of hemodynamic changes in response to a heart rate‐dependent phenylephrine/ephedrine protocol versus ephedrine‐only for spinal hypotension during elective cesarean section
Authors: Uerpairojkit Ketchada , Thongthaweeporn Nutnicha , Anusorntanawat Ratikorn , Pipanmekaporn Tanyong , Hinthong Thanoo , Bunchungmongkol Nutchanart , Simarangsan Nawaporn
Published: May 2022

Aim

To compare incidences of abnormal heart rate (HR) between the phenylephrine/ephedrine protocol (P/E protocol) against the ephedrine‐only (C) protocol, conventionally used for treating predelivery hypotension following spinal anesthesia for cesarean section.

Methods

Two hundred and sixty‐eight parturients with pre‐delivery hypotension after spinal anesthesia were equally randomized to (1) Group P/E (n = 134), phenylephrine 100 mcg in 10 mL intravenously if HR ≥ 60 beats/min (bpm), or ephedrine 6 mg intravenously if HR < 60 bpm, and 2) Group C (n = 134). The primary outcome was the incidence of the parturients with abnormal HR after vasopressor administration. The secondary outcome was the mean differences of HR and hypotensive periods during the pre‐delivery period.

Results

There was no significant difference of between‐group incidences of bradycardia (12.0% in Group P/E vs 6.7% in Group C, p = 0.136) and tachycardia (26.9% vs 35.8%, p = 0.114). Mean HR was 81.9 bpm (95% confidence interval [CI] 79.9, 84.3) in Group P/E, and 88.8 bpm (86.8, 90.6) in Group C (p < 0.001). The duration of hypotension in relation to the time interval from spinal anesthesia to delivery was 20.9% (95% CI 18.4–23.2) in Group P/E, and 26.5% (23.9–29.3) in Group C (p < 0.01). The calculated area under the curve (AUC) of abnormal HR in relation to time was significantly reduced only in Group P/E (p < 0.010).

Conclusions

The incidences of out‐of‐range HR were comparable, but the P/E protocol resulted in a lower mean HR and better control of systolic blood pressure than the ephedrine‐only protocol.
Intrauterine fetal death during COVID‐19 pregnancy: Typical fetal heart rate changes, coagulopathy, and placentitis
Authors: Kato Maya , Yamaguchi Kyohei , Maegawa Yuka , Komine‐Aizawa Shihoko , Kondo Eiji , Ikeda Tomoaki
Published: May 2022

Although various perinatal outcomes in coronavirus disease 2019 (COVID‐19) pregnancies have been reported, the fetal and neonatal consequences of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection remain unclear. Several reports of miscarriages and stillbirths have been recorded, but vertical transmission by SARS‐CoV‐2 is considered very rare, and the cause remains unknown. We report a case of a 22‐year‐old uncomplicated Japanese woman infected with SARS‐CoV‐2 during the second trimester, resulting in intrauterine fetal death due to placental insufficiency associated with COVID‐19 placentitis. This report emphasizes the importance of longitudinal assessment of fetal well‐being by fetal heart rate monitoring and early detection of maternal coagulation dysfunction representing SARS‐CoV‐2 inflammation to manage COVID‐19 in pregnancy.
Assessment of safety and quality aspects of boiling treatment of quail eggs
Authors: Saad M.F. , Fadel M.A. , Abd El-Hafeez M.S. , Abdel-Salam A.B.
Published: May 2022

A total of 300 quail eggs were collected randomly from different markets in Cairo and Giza Governorates. Five eggs were represented as one egg sample. Shell and content of each egg were examined for their microbiological contents, sensory evaluation and study of Escherichia coli O157 survival in artificially contaminated eggs. Moreover, qualitative detection of antimicrobial residues by seven plates microbiologically bioassay and confirmed by validated high-performance liquid chromatography (HPLC) methods for positively reacted antimicrobials in raw and boiled samples. There was a significant difference (P < 0·05) between the grading score of eggs after the boiling at 2-, 4-, 5- and 7-min. Based on the survival results, the refrigeration storage and boiling for 5 min of quail eggs was confirmed that such eggs are without E. coli O157. After the boil, the concentrations of oxytetracycline (OTC) and 4-Epi-OTC residues were significantly reduced, and there was no effect on the concentration of sulphadimidine (SDD), amoxicillin (AMO) and Diketo residues. Samples that exceeded the maximum residual limits (MRLs) were 17·0%, 12·0%, 10·0%, 16·0% and 14·0% for SDD, OTC, 4-Epi-OTC, AMO and Diketo, respectively. After boiling, no significant change was noted for SDD, AMO and Diketo, but all OTC and 4-Epi-OTC were completely below MRLs. Therefore, SDD and AMO with their metabolite (Diketo) are heat-stable antimicrobial residues with multiple human health hazards.
Promoting cultural diversity in Buenos Aires throughcolectividades: The case of Buenos Aires Celebra
Authors: Natolo Michelle , Natolo Stephanie
Published: May 2022

Rising unemployment, poverty, and xenophobic discourse in politics and the media led the Buenos Aires City Government to distance itself from Argentine migration policies that have historically favored Europeans. This article discusses how the Buenos Aires City Government has recreated intercultural policies and cultural tourism entrepreneurism that recognizes and emphasizes cultural diversity and pluralism under the framework of human rights. It shows how since 2009, the city government under former President Mauricio Macri has applied the rhetoric of “pluralism” to establish the business ofcolectividadwith the year‐long festival,Buenos Aires Celebra. This intercultural branding program pays tribute to more than 50colectividadesin Argentina, increasing the visibility of non‐European communities. Various stakeholders take part in theBuenos Aires Celebraseries, which projects an image of inclusivity and diversity. Meanwhile, at a state level, the city government with its minimal financial input benefits economically and politically.