bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between chorionicity and preterm birth in twin pregnancies: a systematic review involving 29 864 twin pregnancies
Authors: Marleen S , Dias C , Nandasena R , MacGregor R , Allotey J , Aquilina J , Khalil A , Thangaratinam S 
Published: September 2020

BackgroundThe perinatal mortality and morbidity among twins vary by chorionicity. Although it is considered that monochorionicity is associated with an increased risk of preterm birth in twin pregnancies, no systematic review exists evaluating this association.ObjectivesThis systematic review was undertaken to assess the association between preterm birth and chorionicity in twin pregnancies.Search strategyWe searched the electronic databases from January 1990 to July 2019 without language restrictions.Selection criteriaAll studies on twin pregnancies where chorionicity and preterm birth were evaluated were included.Data collection and analysisFindings are reported as odds ratios with 95% confidence intervals. The estimates are pooled using random‐effects meta‐analysis.Main resultsFrom 13 156 citations, we included 39 studies (29 864 pregnancies). Monochorionicity was significantly associated with increased risk of preterm birth at ≤28, ≤32, ≤34 and <37 weeks in women asymptomatic and symptomatic for preterm labour (odds ratio [OR] 2.14, 95% CI 1.52–3.02, I2 = 46%, OR 1.55, 95% CI 1.27–1.89 I2 = 68%, OR 1.47, 95% CI 1.27–1.69, I2 = 60%, OR 1.66, 95% CI 1.43–1.93, I2 = 65%, respectively). Among those asymptomatic for preterm labour, significantly increased odds of preterm birth were seen for monochorionicity at gestations ≤34 weeks (OR 1.85, 95% CI 1.42–2.40, I2 = 25%) and <37 weeks (OR 1.75, 95% CI 1.22–2.53, I2 = 61%). Sensitivity analysis showed significantly increased odds of spontaneous preterm birth at ≤34 and <37 weeks for monochorionicity (OR 1.25, 95% CI 1.01–1.55, I2 = 0% and OR 1.41, 95% CI 1.13–1.78, I2 = 0%).ConclusionsMonochorionicity is significantly associated with preterm birth at all gestations.Tweetable abstractIn twin pregnancies, monochorionicity is associated with an increased risk of preterm birth at all gestations.
Impact of changes to national UK Guidance on testing for gestational diabetes screening during a pandemic: a single‐centre observational study
Authors: van‐de‐l’Isle Y , Steer PJ , Watt Coote I , Cauldwell M 
Published: September 2020

ObjectiveTo examine the differences in detection rate for gestational diabetes (GDM) comparing the methodology recommended by the National Institute for Health and Clinical Excellence (NICE) compared with testing described as appropriate during the Covid‐19 pandemic by the Royal College of Obstetricians and Gynaecologists (RCOG).DesignCohort study of women delivering between 1 January 2016 and 1 July 2020.SettingLondon Teaching Hospital.PopulationAll women delivering between 1 January 2016 and 13 May 2020 and follow up of women screening negative between 1 April 2020 and 13 May 2020.MethodsRetrospective study of prospectively collected data.Main outcome measuresDetection rate of gestational diabetes.ResultsUsing the RCOG guidance, the overall rate of women identified as having gestational diabetes fell from 7.7% (1853/24168) to 4.2% (35/831)(P = 0.0003). Of 230 women who tested negative according to the RCOG criteria from 1 April to 13 May but who subsequently had an oral glucose tolerance test, 47 (20.4%) were diagnosed as having gestational diabetes according to the NICE criteria.ConclusionsIn our setting, the RCOG Covid‐19 gestational diabetes screening regime failed to detect 47 of 82 (57%) women subsequently identified as gestational diabetics, and therefore cannot be recommended for general use.Tweetable abstractScreening for GDM using RCOG Covid criteria reduced detection rates.
Spatial Spillovers on Input‐specific Inefficiency of Dutch Arable Farms
Authors: Schneider Kevin , Skevas Ioannis , Oude Lansink Alfons 
Published: September 2020

AbstractTraditional benchmarking implicitly assumes that decision making units operate in isolation from their peers. For arable production systems in particular, this assumption is unlikely to hold in reality. This paper quantifies spatial spillovers on input‐specific inefficiency using data envelopment analysis and a second‐stage bootstrap truncated regression model. The bootstrap algorithm is extended to allow for the estimation of the parameter of the spatial weight matrix, which captures the proximity between producers. The empirical application concerns Dutch arable farms for which latitudes and longitudes are available. The average inefficiency across years was 3.87% for productive inputs and 2.98% for damage abatement inputs under variable returns to scale. For productive inputs technical inefficiency, statistically significant spillover effects from neighbours’ age and their degree of specialisation depended on the type of the spatial weight matrix used (inverse distance or k‐nearest neighbours). Statistically significant spillover effects of subsidy payments were adverse while statistically significant spillover effects from insurance payments were beneficial. For damage abatement inputs technical inefficiency, statistically significant adverse effects were found for neighbours’ age and subsidy payments and beneficial effects from neighbours’ insurance payments and their degree of specialisation.
Emulsion structure design for improving the oxidative stability of polyunsaturated fatty acids
Authors: Wang Chenxi , Sun Cuixia , Lu Wei , Gul Khalid , Mata Analucia , Fang Yapeng 
Published: September 2020

AbstractPolyunsaturated fatty acids (PUFAs) play an important role in promoting brain development, decreasing the incidence of cardiovascular diseases, and reducing inflammation. However, PUFAs are inherently unstable and susceptible to oxidative deterioration due to two or more double bonds in their structure. Delivery systems have been developed to provide effective encapsulation and protection for PUFAs, and finally fulfill their health benefits. Emulsion‐based encapsulation is one of the most promising techniques for the delivery of PUFAs. The emulsion composition and structure, as well as the storage conditions are regarded as key factors to influence the stability of emulsions. To maximize the resistance of PUFAs in emulsions against oxidation, emulsion structure design has been particularly highlighted, and different methods for tailoring emulsion structure have been developed. The current work is focused on the careful design of emulsion structure to improve the oxidative stability of PUFAs. Different types of emulsions, including conventional emulsions, multilayer emulsions, gelled emulsions, and Pickering emulsions are introduced, and their protective effect for PUFAs are discussed. The major role of interfacial structure in emulsions is emphasized. The effects of emulsifiers and involved modification methods on the interfacial structure are presented to further improve the stability of PUFAs during storage.
Regulatory mechanisms of microbial homeostasis in insect gut
Authors: Bai Shuai , Yao Zhichao , Raza Muhammad Fahim , Cai Zhaohui , Zhang Hongyu 
Published: September 2020

AbstractInsects live in incredibly complex environments. The intestinal epithelium of insects is in constant contact with microorganisms, some of which are beneficial and some harmful to the host. Insect gut health and function are maintained through multidimensional mechanisms that can proficiently remove foreign pathogenic microorganisms while effectively maintaining local symbiotic microbial homeostasis. The basic immune mechanisms of the insect gut, such as the dual oxidase–reactive oxygen species (Duox‐ROS) system and the immune deficiency (Imd)‐signaling pathway, are involved in the maintenance of microbial homeostasis. This paper reviews the role of physical defenses, the Duox‐ROS and Imd signaling pathways, the Janus kinase/signal transducers and activators of transcription signaling pathway, and intestinal symbiotic flora in the homeostatic maintenance of the insect gut microbiome.
Influence of different extraction techniques on recovery, purity, antioxidant activities, and microstructure of flaxseed gum
Authors: Safdar Bushra , Zhihua Pang , Xinqi Liu , Jatoi Mushtaque Ahmad , Rashid Muhammad Tayyab 
Published: September 2020

AbstractFour extraction techniques (that is, hot water extraction [HWE], alkaline–acidic extraction [AAE], ultrasound assisted extraction [UAE], and microwave assisted extraction [MAE]) were compared for flaxseed gum extraction and their influence on the yield, purity, structural characterization (monosaccharide composition, molecular weight distribution, and microstructure by transmission electron microscope), and antioxidant activity (in terms of scavenging ability of 2,2‐diphenyl‐1‐picrylhydrazyl [DPPH], 2,2'‐azino‐bis(3‐ethylbenzothiazoline‐6‐sulphonic acid [ABTS], and reducing power) was investigated. The HWE achieved higher yield (8.96%) than UAE (7.84%) followed by MAE (7.01%) and AAE (6.44%). Moreover, the four flaxseed gum (FSG) samples exhibited the identical monosaccharide composition, but slight difference was observed in the content, whereas the molecular weight ratios exhibited significant difference. All samples displayed concentration‐dependent manner for all antioxidant assays. UAE‐FSG showed significant higher scavenging ability on DPPH free radical, ABTS free radical, reducing power, and β‐carotene bleaching assay followed by HWE‐FSG, MAE‐FSG, and AAE‐FSG. Overall results showed that UAE was favorable to the purity of FSG, whereas HWE was more advantageous to improve the extraction yield and facile as it requires no special equipment.Practical ApplicationExtraction methods directly affect the recovery and purity of the extracted compound. Thus, this study could help in selection of appropriate extraction method for FSG. The results suggested that FSG possesses potential healthcare application in food industry because of their nutrition composition and antioxidant activities, and thus, it can be used for formulation of functional food as a natural antioxidant agent.
Feasibility of rapid piperine quantification in whole and black pepper using near infrared spectroscopy and chemometrics
Authors: Park Jong‐Rak , Kang Hyun‐Hee , Cho Jong‐Ku , Moon Kwang‐Deog , Kim Young‐Jun 
Published: September 2020

AbstractPiperine is a bioactive alkaloid that possesses various health benefits and is responsible for the pungent aroma of pepper. Piperine content in whole and ground black pepper (n= 132) was analyzed by near‐infrared spectroscopy (NIRS) in the 950 to 1650 nm wavelength window. Chemometric modeling using partial least square regression was performed, and outliers were checked and removed during the preparation of the calibration curve by considering sample residual variance and sample leverage. Model accuracy was evaluated with a low root‐mean‐square error of cross‐validation (RMSECV) and a high ratio performance to deviation (RPD). The optimal model had a coefficient of determination (R2) of 0.726, RMSECV of 0.289 g/100 g, and RPD of 1.744 for the whole black pepper. The results ofR2, RMSECV, and RPD for the ground black pepper were 0.850, 0.231 g/100 g, and 2.424, respectively. Therefore, based on the perspective of onsite process, the proposed NIRS method can be employed for selecting abnormal samples during the inspection of black pepper raw material and for quantifying piperine contents of final black pepper product.Practical ApplicationGenerally, the quality indicators of black pepper are graded solely based on their external appearance, quality, and size. This study discloses the development of a near‐infrared spectroscopy‐based fast and accurate nondestructive analytical method for the detection of piperine, a bioactive constituent of pepper, as a tool for the quality control of whole and ground black pepper.
Spray drying encapsulation of stevia extract with maltodextrin and evaluation of the physicochemical and functional properties of produced powders
Authors: Zorzenon Maria Rosa T. , Formigoni Maysa , da Silva Sandra B. , Hodas Fabiane , Piovan Silvano , Ciotta Simone R. , Jansen Cler A. , Dacome Antonio S. , Pilau Eduardo J. , Mareze‐Costa Cecília E. , Milani Paula G. , Costa Silvio C. 
Published: September 2020

AbstractThis work aimed to formulate and perform physicochemical and functional characterization of maltodextrin microcapsules containing ethanolic extract of stevia, rich in antioxidant compounds, encapsulated by a spray‐drying process with two maltodextrins (DE10 and DE19). The powders were named M10 and M19, respectively. We analyzed the physicochemical parameters, antidiabetic activity, cytotoxicity, bioaccessibility of the compounds by in vitro digestion, as well as the structure of the microcapsules by scanning electron microscopy. Microcapsules showed higher solubility (∼35%), lower moisture content (∼29%), and the maltodextrin DE10 had higher efficiency as an encapsulating agent (87%) when compared to DE19 (76%) and showed well‐defined spherical structures. The microencapsulation preserved the content of phenolic compounds and antioxidant activity present in the extract (7.2% and 87.5%, respectively). The bioaccessibility of these microencapsulated compounds and antioxidant activity were higher under different conditions of in vitro digestion (mouth, gastric, and intestinal conditions) and showed no cytotoxic effects. We identified 41 compounds (by UHPLC‐MS/MS‐Qtof) related to the nutritional benefits offered by stevia and the microencapsulation technique can be recommended to preserve bioactive compounds.Practical ApplicationEthanol extract from stevia leaves contains antioxidant phytochemicals related to the nutritional benefits of stevia. However, this extract presents low solubility and consequently low bioaccessibility under in vitro digestion. The microencapsulation process protects the bioactive compounds of the different pH from digestion and improves the physical‐chemical parameters of the extract, increasing its applicability as a possible food additive.
The quest for absolute abundance: The use of internal standards for DNA‐based community ecology
Authors: Harrison Joshua G. , John Calder W. , Shuman Bryan , Alex Buerkle C. 
Published: September 2020

AbstractTo characterize microbiomes and other ecological assemblages, ecologists routinely sequence and compare loci that differ among focal taxa. Counts of these sequences convey information regarding the occurrence and relative abundances of taxa, but provide no direct measure of their absolute abundances, due to the technical limitations of the sequencing process. The relative abundances in compositional data are inherently constrained and difficult to interpret. The incorporation of internal standards (ISDs; colloquially referred to as ‘spike‐ins’) into DNA pools can ameliorate the problems posed by relative abundance data and allow absolute abundances to be approximated. Unfortunately, many laboratory and sampling biases cause ISDs to underperform or fail. Here, we discuss how careful deployment of ISDs can avoid these complications and be an integral component of well‐designed studies seeking to characterize ecological assemblages via sequencing of DNA.
The 90% effective dose of intranasal dexmedetomidine for procedural sedation in children with congenital heart disease before and after surgery: A biased‐coin design up‐and‐down sequential allocation trial
Authors: Zhang Jing , Chen YuJiao , Li ShangYingYing , Liu Hui , Tu ShengFen 
Published: September 2020

BackgroundIntranasal dexmedetomidine can provide adequate sedation during short procedures. However, there are few reports investigating the effective dose of intranasal dexmedetomidine for sedation in children with congenital heart disease (CHD) before and after surgery.MethodsChildren aged 13‐36 months with acyanotic CHD requiring trans‐thoracic echocardiography before cardiac surgery were recruited for this study. One month after the cardiac surgery, the same children were studied again. The 90% effective dose was established using a biased‐coin design up‐and‐down sequential method. Onset time, examination time, wake‐up time and adverse effects were measured. Safety was evaluated in terms of changes in vital signs.ResultsA total of fifty‐eight subjects were recruited for this study. The 90% effective dose of intranasal dexmedetomidine for sedation was 2.13 μg/kg (95% CI, 1.73‐2.34 μg/kg) in children with CHD before cardiac surgery and 3.51 μg/kg (95% CI, 2.99‐3.63 μg/kg) after cardiac surgery (P < .01). There were no differences between the groups in terms of demographic variables, onset time, examination time, wake‐up time or adverse effects.ConclusionsThe 90% effective dose of intranasal dexmedetomidine for sedation in children with CHD was 2.13 μg/kg before cardiac surgery and 3.51 μg/kg after cardiac surgery.
Prevalence and impact of chronic dysglycemia in intensive care unit patients—A retrospective cohort study
Authors: Balintescu Anca , Palmgren Ida , Lipcsey Miklós , Oldner Anders , Larsson Anders , Cronhjort Maria , Lind Marcus , Wernerman Jan , Mårtensson Johan 
Published: September 2020

BackgroundThe prevalence of chronic dysglycemia (diabetes and prediabetes) in patients admitted to Swedish intensive care units (ICUs) is unknown. We aimed to determine the prevalence of such chronic dysglycemia and asses its impact on blood glucose control and patient‐centered outcomes in critically ill patients.MethodsIn this retrospective observational cohort study, we obtained glycated hemoglobin A1c (HbA1c) in patients admitted to four tertiary ICUs in Sweden between March and August 2016. Based on previous diabetes history and HbA1c we determined the prevalence of chronic dysglycemia. We used multivariable regression analyses to study the association of chronic dysglycemia with the time‐weighted average blood glucose concentration, glycemic lability index (GLI), and development of hypoglycemia (co‐primary outcomes), and with ICU length of stay, mechanical ventilation duration, renal replacement therapy (RRT) use, vasopressor use, ICU‐acquired infections, and mortality (exploratory clinical outcomes).ResultsOf 943 patients, 312 (33%) had chronic dysglycemia. Of these 312 patients, 84 (27%) had prediabetes, 43 (14%) had undiagnosed diabetes and 185 (59%) had known diabetes. Chronic dysglycemia was independently associated with higher time‐weighted average blood glucose concentration (P < .001), higher GLI (P < .001), and hypoglycemia (P < .001). Chronic dysglycemia was independently associated with RRT use (adjusted odds ratio 1.97, 95% CI 1.24‐3.13, P = .004) but not with other exploratory clinical outcomes.ConclusionsIn four tertiary Swedish ICUs, measurement of HbA1c showed that one‐third of patients had chronic dysglycemia. Chronic dysglycemia was associated with marked derangements in glycemic control, and a greater need for renal replacement therapy.
Anesthesiologists’ airway management expertise: Identifying subjective and objective knowledge gaps
Authors: Bessmann Ebbe L. , Rasmussen Lars S. , Konge Lars , Kristensen Michael S. , Rewers Mikael , Kotinis Alexandros , Rosenstock Charlotte V. , Graeser Karin , Pfeiffer Peter , Lauritsen Torsten , Østergaard Doris ,   Adaptive E‐learning Airway Study Group
Published: September 2020

BackgroundFailure in airway management continues to cause preventable patient harm, and the recommended continuing education is challenged by anesthesiologists’ unknown knowledge gaps. This study aimed to identify anesthesiologists’ subjective and objective knowledge gaps as well as areas where anesthesiologists are incorrect and unaware.MethodsAn adaptive E‐learning program with 103 questions on adult airway management was used for subjective and objective assessment of anesthesiologists’ knowledge. All anesthesiologists in the Capital Region of Denmark were invited to participate.ResultsThe response rate was 67% (191/285). For preoperative planning, participants stated low confidence (subjective assessment) regarding predictors of difficult airway management in particular (69.1%‐79.1%). Test scores (objective assessment) were lowest for obstructive sleep apnea as a predictor of difficult airway management (28.8% correct), with participants being incorrect and unaware in 33.5% of the answers. For optimization of basic techniques, the lowest confidence ratings related to patient positioning and prediction of difficulties (57.4%‐83.2%), which agreed with the lowest test scores. Concerning advanced techniques, videolaryngoscopy prompted the lowest confidence (72.4%‐85.9%), while emergency cricothyrotomy resulted in the lowest test scores (47.4%‐67.8%). Subjective and objective assessments correlated and lower confidence was associated with lower test scores: preoperative planning [r = −.58, P < .001], optimization of basic techniques [r = −.58, P = .002], and advanced techniques [r = −.71, P < .001].ConclusionWe identified knowledge gaps in important areas of adult airway management with differing findings from the subjective and objective assessments. This underlines the importance of objective assessment to guide continuing education.
Continuous intravenous infusion of enoxaparin controls thrombin formation more than standard subcutaneous administration in critically ill patients. A sub‐study of the ENOKSI thromboprophylaxis RCT
Authors: Vahtera Annukka , Szanto Timea , Lassila Riitta , Valkonen Miia , Sivula Mirka , Huhtala Heini , Pettilä Ville , Kuitunen Anne 
Published: September 2020

IntroductionStandard subcutaneous low‐molecular‐weight heparin (LMWH) thromboprophylaxis yields low anti‐factor Xa activity in patients in the intensive care unit (ICU). The aim of the study was to assess coagulation status in ICU patients randomized to receive enoxaparin thromboprophylaxis either as a standard subcutaneous bolus (SCB) or continuous intravenous infusion (CII) for 3 consecutive days after the initiation of LMWH thromboprophylaxis.Materials and MethodsThirty‐eight patients were studied by conventional coagulation variables: prothrombin fragment F 1+2 (F 1+2) representing FXa inhibition and antithrombin (AT). Additionally, 18 patients were analyzed by the thrombin generation assay‐calibrated automated thrombogram (TGA‐CAT). Blood samples were collected before the initiation of the LMWH thromboprophylaxis (ie, baseline), at 51 h, and at 72 h.ResultsAt beginning, no differences in coagulation biomarkers were observed. The levels of F 1+2 were significantly lower at 51 and 72 h in the CII group than in the SCB group. AT levels increased during the follow‐up in the CII group, unlike in the SCB group.TGA‐CAT was poor in some patients overall. In a subset of patients at 51 h lag time (4.3 vs 7.5 min, respectively, P < 0.05) and time to peak (7.7 vs 14.3 min, respectively, P < 0.05) were prolonged in the SCB group. At 72 h, however, peak thrombin was lower in the CII than in the SCB group: 271 vs 356 nM, respectively (P < 0.05).ConclusionsEnoxaparin thromboprophylaxis administered by CII inhibited more prominently FXa and preserved better the AT level, compared with standard subcutaneous care.