bluuebunny/crossref_metadata_2025_split huggingface dataset:
Synthesis of iron-loaded MFI-type (Fe/ZSM-5) zeolite using Philippine natural zeolites (PNZ) for potential adsorption and catalytic applications
Authors: Dumrigue Apraile Hope P. , Cosiñero Hannah Shamina O. , Potato Don Nelson C. , Tamargo Ramuel John I. 
Published: November 2024

Abstract
Philippine natural zeolites (PNZ) are locally abundant aluminosilicates used in different applications such as filtration and purification. However, the presence of impurities limits their usability. Structure modification of PNZ into a new framework was conducted in the study to address this issue. This study used PNZ as a precursor in the sustainable synthesis of iron-loaded MFI-type (Fe/ZSM-5) zeolite, a synthetic zeolite extensively studied for its excellent catalytic activity and high adsorption capacity. PNZ was depolymerized into active silica and alumina, then recrystallized via hydrothermal synthesis. Ammonium iron citrate (AIC) and TPAOH were used as the iron source and structure-directing agent, respectively. The disappearance and appearance of FTIR peaks in the depolymerized PNZ spectra deduced the successful destruction of the initial zeolite framework of the PNZ. The synthesized material was characterized using FTIR, XRD, SEM-EDS, TGA, and BET analyses. FTIR showed the crystallinity peak of MFI-type zeolite, while XRD confirmed its successful synthesis. SEM images show hierarchical aggregated particles suggesting the presence of intercrystalline and intracrystalline mesopores. The BET surface area of the synthesized zeolite increased by 168% compared to the raw PNZ, and TGA results show its high thermal stability. EDS analysis confirmed the presence of iron in the sample.
Identifying critical periods of susceptibility for maternal exposure to biothermal stress and the risks of stillbirth and spontaneous preterm birth in Western Australia
Authors: Nyadanu Sylvester Dodzi , Tessema Gizachew A , Mullins Ben , Gasparrini Antonio , Pereira Gavin 
Published: November 2024

Abstract
A few studies investigated critical periods of temperature and the risks of stillbirth and preterm birth. This study aimed to identify critical periods of composite biothermal stress (Universal Thermal Climate Index, UTCI) for stillbirth and spontaneous preterm birth (sPTB). From the Midwives Notification System, 415,271 singleton births between 1st January 2000 and 31st December 2015 were linked to spatiotemporal UTCI in Western Australia. Covariate-adjusted weekly and monthly distributed lag non-linear Cox regression from twelve weeks before conception to birth were performed. Relative to median exposure (14.2 °C), extreme UTCI levels (1st–10th and 90th–99th centiles) were associated with higher hazards of stillbirth and sPTB, especially stronger at lower than higher exposures. Critical susceptible periods at 1st centile (10.2°C) exposure were found during gestational weeks 21–42 with the strongest hazard of 1.14 (95% CI 1.03, 1.27) in the 42nd week for stillbirth and during gestational weeks 26–36 with the strongest hazard of 1.09 (95% CI 1.06, 1.12) in the 36th week for sPTB. Monthly exposure showed a similar pattern but with greater magnitude. Mid to late gestation showed critical susceptible periods of biothermal stress on the birth outcomes, suggesting further studies and timely climate-related healthcare interventions.
Associations between community social capital and posttraumatic growth among older survivors 11 years after a natural disaster
Authors: Hikichi Hiroyuki , Kondo Katsunari , Kawachi Ichiro 
Published: November 2024

Abstract
We prospectively examined whether community-level social capital plays a significant role in developing Posttraumatic Growth (PTG) among older survivors of the 2011 Japan Earthquake and Tsunami. The baseline survey was conducted 7 months before the disaster among residents of a city located 80km west of the earthquake epicenter. The survey inquired about participants’ health status and social capital (informal socializing and social participation, and social cohesion). Approximately 2.5 years after the disaster, we surveyed older survivors to assess their disaster experiences. A follow-up survey in 2022 inquired about PTG in the 11 years following experiences of the disaster (n = 1,819). Multilevel linear regression analysis showed that pre-disaster community-level informal socializing and social participation was associated with higher PTG scores (coefficient = 0.25, 95% CI: 0.02, 0.47). In cross-classified multilevel regression, maintenance of higher community-level informal socializing and social participation during the post-disaster period was associated with higher scores of PTG (coefficient = 0.22, 95% CI: 0.07, 0.37). Pre-disaster community-level informal socializing and social participation was associated with higher PTG scores among older survivors. Interventions encouraging social interactions among neighbors may be effective in promoting PTG of survivors after natural disasters.
Investigating the service utilization and pathways of patients with alcohol use disorders
Authors: Zhang Jingxiang , Qian Siyu , Su Guoxin , Deng Chao , Reid David , Sinclair Barbara , Yu Ping 
Published: November 2024

Abstract

Background
Process mining was widely used in healthcare settings to analyse patient pathways, providing insights about patient care and resource allocation. This study aimed to apply process mining to explore service utilization and pathways of patients with alcohol use disorders in receiving the community-based Drug and Alcohol Service to establish a baseline for evaluating improvement initiatives.

Methods
Patients’ encounters with the Drug and Alcohol Service and their direct care activities (i.e. Intake, Assessment, and treatment service activities) that occurred in these encounters were analysed to depict the actual pathways. Patterns were uncovered from these actual pathways using a process mining tool Disco. Patients with alcohol use disorders were divided into two groups—patients who use polysubstance and those who do not—to compare their service utilization and pathway patterns.

Results
Five hundred seventy-one patients with alcohol use disorders incurred 1447 encounters, comprising 13,974 activities. The top three actual pathways with at least three activities were: (i) pathway ‘Intake-&gt; Withdrawal Management-&gt; Withdrawal Management’ (170 (11.7%) encounters and 130 (22.8%) patients); (ii) pathway ‘Intake-&gt; Adult Counselling-&gt; Adult Counselling’ (161 (11.1%) encounters and 126 (22.1%) patients); and (iii) pathway ‘Intake-&gt; Assessment-&gt; Withdrawal Management’ (155 (10.7%) encounters and 129 (22.6%) patients). However, 313 (21.6%) encounters did not proceed beyond the Intake stage. When the patients started their pathways from Intake, their immediate next activities were frequently Withdrawal Management, Assessment or Adult Counselling. Compared to those who do not use polysubstance, patients who use polysubstance had a higher proportion of Intake (19.3% vs 11.8%, P &lt; .001), Involuntary Treatment (4.0% vs 1.0%, P &lt; .001) and Magistrate Early Referral into Treatment (6.4% vs .3%, P &lt; .001), but a lower proportion of Withdrawal Management (31.2% vs 39.0%, P &lt; .001) and Adult Counselling (27.8% vs 37.6%, P &lt; .001).

Conclusion
This study contributes to an in-depth understanding of service utilization and pathways of patients with alcohol use disorders within the community-based Drug and Alcohol Service. Future studies should investigate their reasons for dropping out after Intake.
Structural insights into the inhibition mechanism of glucosidase inhibitors toward kojibiose hydrolase belonging to glycoside hydrolase family 65
Authors: Nakamura Shuntaro , Miyazaki Takatsugu 
Published: November 2024

Abstract
Glycoside hydrolase family 65 (GH65) includes glycoside hydrolases active on various α-glucosides. We previously demonstrated that the GH65 enzyme from Flavobacterium johnsoniae (FjGH65A) is a kojibiose hydrolase and determined its 3-dimensional structure. In this study, the effects of glucosidase inhibitors on FjGH65A and their complex structures were analyzed to elucidate their inhibition mechanism. FjGH65A was competitively inhibited by 1-deoxynojirimycin (DNJ) and noncompetitively inhibited by castanospermine (CSP) with Ki values of 2.95 and 3.69 µm, respectively. The crystal structures of FjGH65A complexed with the inhibitors indicated that DNJ was bound to subsite −1 of FjGH65A, while CSP was bound to subsites −1 and +1 of FjGH65A. Compared with the glucose complex structure, the conformation of Tyr337 was changed in the CSP complex structure. These results provide new structural insights into the mechanism of inhibition against GH65 α-glucoside hydrolases.
Development of a protein production system using Ogataea minuta alcohol oxidase-deficient strain under reduced-methanol-consumption conditions
Authors: Tsuda Masashi , Nakatani Yuki , Satoshi Baba , Nonaka Koichi 
Published: November 2024

Abstract
Methylotrophic yeast is a useful host for producing heterologous proteins using the unique and strong alcohol oxidase 1 (AOX1) promoter, which is induced by methanol and repressed by various carbon sources. However, methanol is preferably avoided in industrial-scale fermentation given its toxicity, flammability, and explosiveness. To develop a protein production system under reduced methanol supply conditions, we attempted to characterize the AOX1 promoter induction activity by comparing derepression conditions with methanol induction conditions. This comparison is important because decreasing methanol consumption would enhance the industrial value of Ogataea minuta for heterologous protein production. For such a comparison, an alcohol oxidase-deficient (Δaox) strain was generated, with methanol only being used for AOX1 promoter induction. We also developed a culture process in a jar fermentor using the O. minuta Δaox strain under mixed feed conditions to achieve heterologous protein production comparable to that of the wild-type strain under low-methanol conditions.
d-limonene suppresses RANKL-induced osteoclast differentiation and promotes osteoblast activity in vitro
Authors: McCallum Lynn , Fox Simon W 
Published: November 2024

Abstract
Treatments for osteoporosis are typically given postfracture. Therefore, identifying safe prophylactic interventions to reduce fracture risk would be beneficial. One approach is to utilize the bioactive properties of natural compounds to modify osteoclast and osteoblast activity. d-limonene a well-tolerated, anti-inflammatory monoterpene found in citrus fruits holds promise due to its suppressive effect on NFκB, a key regulator of bone cell activity. We found that limonene promoted osteoblast differentiation and bone nodule formation and inhibited RANKL-induced osteoclast formation and bone resorption in vitro. Limonene also reduced the proresorptive signal provided by osteoblast, augmenting markers of osteoblast differentiation (alkaline phosphatase, osterix, and osteocalcin) and significantly decreasing osteoclastogenic cytokine production (PTHrP, IL-1β, and TNF-α). Therefore, limonene supplementation represents a potential route in combination with current interventions to optimize bone cell activity to maintain or enhance bone mass.
BS O06 - Management of Leaks post Bariatric Surgery: Recent Experience from a Tertiary Bariatric Surgery Referral Unit
Authors: Intrator Christina , Al Aaraj Mahmoud , Alkhaffaf Bilal , Techache Roukia , Alwani Omneya , Nimeh Bara Abu , Alabdellat Osama 
Published: November 2024

Abstract

Background
Bariatric surgery has been consistently demonstrated to provide effective long-term sustained weight loss and remission of several life-threatening conditions. The most common bariatric procedures undertaken globally include laparoscopic sleeve gastrectomy (SG) and gastric bypass2. These procedures are safe and have low associated mortality rates [0.05% SG, 0.09% single anastomosis gastric bypass (SAGB) and Roux-en-Y (RNYGB)]3. However, complications including staple line and anastomotic leaks can occur in up to 3% of patients and are associated with significant morbidity, thus requiring prompt identification and treatment4. Our study aims to analyse management of these leaks and establish an algorithm for our centre.

Method
This was a retrospective study of consecutive patients who experienced post-bariatric surgery leak between 2018 to 2024, in a regional tertiary bariatric surgery referral unit in the UK, serving a population of 5 million. The study included patients who underwent bariatric surgery in the UK or abroad (SG, RNYGB and SAGB), both primary and revision cases, and were subsequently diagnosed with post-operative leak. Patients were initially managed in our facility or referred to our centre for ongoing management of leak from other centres. Demographics, time to presentation, hospital length of stay (LOS), diagnostic investigations performed, and management approaches were analysed.

Results
22 patients (8 bypasses, 14 sleeves) were included. Mean time to presentation from index surgery was 19.6 days and mean LOS was 43.6 days. Initial management included conservative (3), endo-vacuum therapy (EVT) (4), stent (1), surgical (14) [9 laparoscopy and 5 laparotomy]. Surgical management comprised 7 T-tube insertions, 1 Foley catheter, 2 primary repairs, 2 EVTs, 1 washout and drain, and 1 stoma formation. Three patients required no further intervention, six needed different management approaches and three required re-operations. 7 patients were readmitted following discharge. Resolution of leak was achieved in all cases. There was no 90-day mortality.

Conclusion
Management of postoperative leak following bariatric surgery is a complex issue, requiring early identification, adequate drainage and control of sepsis, and maintenance of nutrition. Successful management requires a proactive and aggressive approach, including early clinical suspicion. Access to a range of interventions to support a dynamic approach to management is critical. The sequence and choice of management of leaks should be individualised according to each patient’s clinical presentation and investigation findings. A combination of different management approaches is often required for successful treatment of leak. Multicentre studies are needed to move closer to a consensus on managing bariatric leaks.
OGC O03 - Clinical Outcomes of Routine Jejunostomy Feeding Following Oesophagectomy
Authors: Ng Jessica Yan-Seen , Yi Cheang Catherine Jenn , Phillips Alexander 
Published: November 2024

Abstract

Background
Malnutrition negatively affects treatment outcomes of patients with oesophageal cancer post-oesophagectomy. Chemo(radio)therapy exacerbates nutritional deficits, and thus strategies to ensure adequate nutritional intake are necessary. Feeding jejunostomies are commonly used for nutritional support to maintain nutrition and reduce the effect of complications but may be associated with increased morbidity.
This study examines the impact of routine post-operative jejunostomy feeding on postoperative weight loss in patients who have undergone oesophagectomy.

Method
A retrospective review of patients undergoing oesophagectomy between January 2012-December 2014 and January 2016-December 2019 at a single oesophagogastric unit was performed. Routine post operative feeding with overnight feeding on discharge was introduced in 2015. 507 patients were identified and separated into two groups (245 without routine post operative jejunostomy feeding, 262 with routine feeding). Primary outcomes measured included post operative weight loss (2 weeks, 6 weeks, 3 months and 6 months). Secondary outcomes investigated included length of hospital stay, complications and long-term survival. Subgroup analyses were performed on patients who have experienced complications and those receiving different treatments.

Results
Weight loss was less in patients discharged with jejunostomy feeding at 2 weeks, 6 weeks, 3 months, 6 months (2.92kg vs 5.49kg, 3.39kg vs 6.37kg, 4.81kg vs 7.96kg, 7.25kg vs 9.285kg, p&lt;0.05). In those with complications, routine feeding resulted in less weight loss up to 3 months (p&lt;0.05). Jejunostomy feeding experienced less weight loss in subgroups surgery alone (7.99kg vs 8.72kg, p&lt;0.001), neoadjuvant therapy with surgery (8.02kg vs 9.90kg, p&lt;0.05), and neoadjuvant therapy, surgery with adjuvant therapy (6.29kg vs 9.14kg, p&lt;0.05). Average hospital stay was 16 days with feeding, 19 days without. Long-term survival was greater with jejunostomy feeding (P=0.04).

Conclusion
Post-operative jejunal feeding is associated with significantly reduced post operative weight loss. This is reflected in patients who received surgery alone, neoadjuvant therapy with surgery and neoadjuvant therapy with surgery and adjuvant therapy. Patients with complications who had routine jejunostomy feeding also experienced significantly less weight loss than those without routine jejunostomy feeding. Routine jejunostomy feeding is associated with a shorter length of hospital stay and is associated with a greater long-term survival.
BN O05 - Physiological Transit Assessment of the Oesophagus In Patients With Anti-Reflux Surgery
Authors: Miah Ismail , Wong Terry , Gossage James , Zeki Sebastian , Jafari Jafar 
Published: November 2024

Abstract

Background
High-resolution manometry (HRM) is the gold-standard investigation for oesophageal motility in patients with dysphagia. The HRM findings may influence surgical decision for myotomy or anti-reflux surgery (ARS). However, HRM pitfall is the inability to measure oesophageal transit in parallel to the motility during physiology testing. Both transit and motility are complementary that offer insights in the pathophysiology and aetiology of the dysphagia symptoms.
This research evaluates the multichannel intraoesophageal impedance transit (MIIT) concept [1] to assess the oesophageal transit in symptomatic patients who undertook the postoperative oesophageal physiology testing between January 2020 and June 2024.

Method
This cross-sectional retrospective study selected patients with intact Nissen fundoplication (NF) wrap on gastroscopy or with known LINX implant in-situ. HRM with Chicago Classification (version 4.0)[2] compared the ARS cases with augmented antireflux barrier [AARB] from the surgery to healthy treatment naïve controls. The multichannel impedance-pH studies assessed both reflux and the MIIT [1]. MIIT &gt;0.76 minutes were considered positive and comparable to GOJ outflow obstruction [1].
This project was approved by the NHS institution and the local research ethics committee (REC 18/NW/0120)(IRAS 333800).

Results
60 patients were found (NF 54, LINX implant 6)(females 30, mean age 51.3 years). 11 patients(18.3%) had pathological reflux despite ARS(DeMeester scores &gt;14.72); 2 patients (18.2%) demonstrated hypotensive AARB. Conversely, 6 patients(10%) showed poor relaxation from the AARB and were compatible to outflow obstruction (5 patients [83.3%] showed conformation with MIIT &gt;0.76 minutes). Patients with ineffective oesophagus (20%) and absent contractility(11.7%) showed MIIT &gt;0.76 minutes in respectively two-thirds with ineffective oesophagus and in all patients with absent contractility. Normal HRM study was observed in 35 patients (58.3%) with 27 patients (77.1%) demonstrating MIIT &gt;0.76 minutes.

Conclusion
MIIT was able to explain the post-surgical dysphagia in majority of patients from the equivalent transit to outflow obstruction (n=52 patients, 86.7%). Half of these cases had a normal HRM study and would have been perceived as having functional dysphagia. We would recommend performing MIIT adjunctive testing as part of postoperative oesophageal physiology assessment in symptomatic patients.
Incidentally, we observed 16 patients (26.7%) having hypotensive AARB post ARS comparing to healthy treatment naïve controls with 2 patients (12.5%) having persistent pathological reflux who may still benefit from surgical revision.
References
[1] https://doi.org/10.1136/gutjnl-2020-bsgcampus.41
[2] https://onlinelibrary.wiley.com/doi/10.1111/nmo.14058
MS O02 - OGC An audit of waiting times of the oesophagogastric cancer diagnostic pathway at a high-volume, tertiary centre
Authors: Velayudham Ganesh , Fox Sebastian , Griffiths Ewen 
Published: November 2024

Abstract

Background
The oesophagogastric cancer (OGC) staging pathway is extensive, contributing to prolonged waiting times from referral to treatment. NHS England guidance details the ideal timeframe from referral to finalisation of the patient’s treatment plan and stipulates a time of 21 days from OGD to communication of the treatment plan to the patient. This audit aims to compare pathway times at a tertiary cancer centre, which accepts referrals from seven different hospitals, to the current NHS target and further stratify pathway times according to patient characteristics and referring hospitals.

Method
Data was collected using a prospectively collected database of OGC patients who underwent staging investigations at the tertiary centre between October 2022 and October 2023. The primary outcome was OGD to communication of the treatment plan. Secondary outcomes included time from OGD to first staging investigation and the proportion of patients that had a next-day computed tomography (CT) scan. Outcomes were stratified to investigate inter-hospital variation and the effect of curative status and tumour location. Data was expressed as median and interquartile range (IQR) for continuous data or n (%) if categorical.

Results
263 patients were included in this audit with a median age of 69.0 (IQR 61.5-77.0). 13.8% of patients satisfied the target time of 21 days from OGD to communication of treatment plan. Curative patients had a longer median pathway time than palliative patients (49.0 vs 35.0 days), whereas oesophageal and gastric cancer patients had similar pathway times (44.0 vs 44.5 days). Patients diagnosed at the tertiary centre had a faster time from OGD to first staging investigation than patients diagnosed at non-specialist centres. Only 13.3% of patients had a next-day CT scan following their OGD (median time 5.0 days).

Conclusion
The OGC staging pathway is considerably slower than the target. Faster pathway times in palliative patients can be attributed to many of these patients not requiring further staging post-CT. Potentially, targets should be re-evaluated to distinguish between palliative and curative patients. The faster staging process at the central hospital may be explained by more regular clinics run by specialist clinicians and the prompt requesting of staging investigations without awaiting MDT discussions. Alongside increasing the proportion of next-day CT scans, these factors must be addressed to streamline the entire pathway.