bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reevaluation of the medical necessity of washed red blood cell transfusion in chronically transfused adults
Authors: Huso Tait , Buban Kristen , Van Denakker Tayler A. , Haddaway Kathy , Smetana Heather , Marshall Christi , Rai Herleen , Ness Paul M. , Bloch Evan M. , Tobian Aaron A. R. , Crowe Elizabeth P. 
Published: December 2023

AbstractBackgroundWashing red blood cell (RBC) units mitigates severe allergic transfusion reactions. However, washing reduces the time to expiration and the effective dose. Automated washing is time‐ and labor‐intensive. A shortage of cell processor tubing sets prompted review of medical necessity for washed RBC for patients previously thought to require washing.Study Design and MethodsA single‐center, retrospective study investigated discontinuing wash RBC protocols in chronically transfused adults. In select patients with prior requirements for washing, due to a history of allergic transfusion reactions, trials of unwashed transfusions were performed. Patient demographic, clinical, laboratory, and transfusion data were compiled. The per‐unit washing cost was the sum of the tubing set, saline, and technical labor costs.ResultsFifteen patients (median age 34 years interquartile range [IQR] 23–53 years, 46.7% female) were evaluated. These patients had been transfused with a median of 531 washed RBC units (IQR 244–1066) per patient over 12 years (IQR 5–18 years), most commonly for recurrent, non‐severe allergic reactions. There were no transfusion reactions with unwashed RBCs aside from one patient with one episode of pruritus and another with recurrent pruritus, which was typical even with washed RBC. We decreased the mean number of washed RBC units per month by 72.9% (104 ± 10 vs. 28.2 ± 25.2; p < .0001) and saved US $100.25 per RBC unit.ConclusionWashing of RBCs may be safely reconsidered in chronically transfused patients without a history of anaphylaxis. Washing should be implemented judiciously due to potential lack of necessity and logistical/operational challenges.
Computed tomographic findings in a canine ovarian teratoma
Authors: Radtke Alexandra V. , Jorge Kelsey M. , Townsend Adam M. , Hardie Robert J. , Jones Kaitlin , Yap Seng Wai 
Published: December 2023

AbstractA 2‐year‐old, intact female, Labrador Retriever was referred for progressive abdominal distension, assessed by emergency clinicians as being extrauterine in origin on AFAST. Abdominal radiographs and ultrasound identified a large, lobulated, partially mineralized, soft tissue, mid‐abdominal mass and gravid uterus. Contrast‐enhanced CT identified a mixed fat to soft tissue attenuating mass with a complex internal mineralized matrix, heterogeneous contrast enhancement, receiving blood from the left ovarian artery. Histology confirmed a left ovarian teratoma, diffuse endometrial hyperplasia, and fetal implantation. The patient had a good post‐operative outcome for 2 years, but was later diagnosed with primary cranial mediastinal neuroendocrine carcinoma.
Radiographic and CT features of metallosis in a lame dog after total hip replacement: the cloud sign
Authors: Lucaci Felix Daniel , Battiato Pierantonio , Bassi Jessica , Zani Davide Danilo , De Zani Donatella , Vezzoni Aldo , Stranieri Angelica , Longo Maurizio 
Published: December 2023

AbstractA 2‐year‐old female American Akita was referred for CT of the pelvis and hindlimbs due to a left hindlimb lameness after a left total hip replacement. Referral radiographs and CT images demonstrated amorphous soft‐tissue and mineral opacities surrounding the proximal femur and the prosthetic stem, consistent with the “cloud sign” reported as a characteristic of metallosis in humans. Dorsomedial displacement of the prosthetic head, multiple foci of geographic osteolysis alongside the “cloud sign”, presumed pseudotumor lesions, and medial iliac lymphadenopathy were also identified with CT. Metallosis was confirmed based on ultrasound‐guided cytology, revision surgery, and histopathology.
Key management practices to reduce the risk of the occurrence of Rumex obtusifolius in productive grasslands
Authors: Klötzli Julie , Suter Matthias , Beaumont Deborah , Kolmanič Aleš , Leskovšek Robert , Schaffner Urs , Storkey Jonathan , Lüscher Andreas 
Published: December 2023

AbstractRumex obtusifolius (broad‐leaved dock) is a problematic weed that reduces yield and nutritional value of forage in grasslands of temperate regions worldwide. We conducted an on‐farm study to identify management practices and environmental factors that influence the risk of the occurrence of R. obtusifolius in high densities in permanent, productive grasslands used for forage production. Following a common protocol, a paired case–control design was implemented in Switzerland (CH), Slovenia (SI), and United Kingdom (UK) to compare parcels with high densities of R. obtusifolius (cases, ≥1 plant m−2) with nearby parcels free of or with very low densities of the species (controls, ≤4 plants 100 m−2). A total of 40, 20, and 18 pairs were recorded in CH, SI, and UK respectively. Parameters measured included data about management practices and history, vegetation cover and composition, and soil nutrients and texture. Across countries, increased vegetation cover reduced the relative risk of R. obtusifolius occurrence. By contrast, increased soil phosphorus and potassium and high soil bulk density raised the relative risk. These effects were consistent across countries, as no interactions between country and any of the factors were observed. The two indicator species for case parcels, Plantago major and Poa annua, were typical species of disturbed areas and fertile soils, while indicators for control parcels were characteristic of grasslands under medium to high management intensity (e.g., Festuca rubra, Cynosorus cristatus, Anthoxantum odoratum). We conclude that the risk for grassland infestation with R. obtusifolius can be significantly affected by management practices. Prevention measures should target phosphorus and potassium fertilisation to the forage plants' requirements, minimise soil compaction, and maintain dense swards.
Patterns and Correlates of Participation in a Weekly Mass Participation Physical Activity Event, parkrun, in Australia, 2011–2020
Authors: Grunseit Anne C. , Huang Bo-Huei , Merom Dafna , Bauman Adrian , Cranney Leonie , Rogers Kris 
Published: December 2023

Background: Studying effective interventions already operating at scale is critical to improving physical activity intervention research translation. The free, weekly, timed 5-km run or walk parkrun represents a unique opportunity to examine successful organic dissemination. We conducted an ecological analysis to identify patterns of growth in Australian parkrun participation and their correlates from 2011 to 2020. Method: Outcome variables were (1) weekly counts of walkers/runners and (2) monthly number of new parkrun registrants. We used latent class analysis to characterize growth trajectories followed by logistic regression on class membership. Covariates included parkrun course characteristics (eg, surface type and route), site-level aggregate participant profile (eg, proportion women and mean age), and surrounding area characteristics (eg, population density and physical activity norm). Results: Three hundred and sixty-three parkruns were included (n = 8,388,695 participation instances). Sixty-nine percent followed a low-growth and 31% a high-growth participation pattern. High growth was associated with greater participation by women, concrete/bitumen surface type, lower area socioeconomic status, and greater volunteer heterogeneity. Odds of being in the slow-growth class were higher if the course contained >1 km of repetition, higher average age of participants, better average parkrun performance, and higher running group membership. Two patterns of new registration were identified: high start followed by steep decline; and low start, slow decline with similar correlates to participation. Conclusions: Parkruns with a less competitive social milieu may have more rapid dissemination. As a free and regular event, parkruns in low socioeconomic areas have the potential to improve the activity levels of those with fewer resources.
Omadacycline pharmacokinetics/pharmacodynamics and efficacy against multidrug-resistant
Mycobacterium tuberculosis
in the hollow fiber system model
Authors: Singh Sanjay , Gumbo Tawanda , Boorgula Gunavanthi D. , Thomas Tania A. , Philley Julie V. , Srivastava Shashikant 
Published: December 2023

ABSTRACT

Seventy-five years ago, first-generation tetracyclines demonstrated limited efficacy in the treatment of tuberculosis but were more toxic than efficacious. We performed a series of pharmacokinetic/pharmacodynamic (PK/PD) experiments with a potentially safer third-generation tetracycline, omadacycline, for the treatment of multidrug-resistant tuberculosis (MDR-TB).
Mycobacterium tuberculosis
(
Mtb
) H37Rv and an MDR-TB clinical strain (16D) were used in the minimum inhibitory concentration (MIC) and static concentration-response studies in test tubes, followed by a PK/PD study using the hollow fiber system model of TB (HFS-TB) that examined six human-like omadacycline doses. The inhibitory sigmoid maximal effect (
E
max
) model and Monte Carlo experiments (MCEs) were used for data analysis and clinical dose-finding, respectively. The omadacycline MIC for both
Mtb
H37Rv and MDR-TB clinical strain was 16 mg/L but dropped to 4 mg/L with daily drug supplementation to account for omadacycline degradation. The Mycobacteria Growth Indicator Tube MIC was 2 mg/L. In the test tubes, omadacycline killed 4.39 log
10
CFU/mL in 7 days. On Day 28 of the HFS-TB study, the
E
max
was 4.64 log
10
CFU/mL, while exposure mediating 50% of
E
max
(EC
50
) was an area under the concentration-time curve to MIC (AUC
0–24
/MIC) ratio of 22.86. This translates to PK/PD optimal exposure or EC
80
as AUC
0–24
/MIC of 26.93. The target attainment probability of the 300-mg daily oral dose was 90% but fell at MIC ≧4 mg/L. Omadacycline demonstrated efficacy and potency against both drug-susceptible and MDR-TB. Further studies are needed to identify the omadacycline effect in combination therapy for the treatment of both drug-susceptible and MDR-TB.
Metabolic engineering of
Caldicellulosiruptor bescii
for 2,3-butanediol production from unpretreated lignocellulosic biomass and metabolic strategies for improving yields and titers
Authors: Tanwee Tania N. N. , Lipscomb Gina L. , Vailionis Jason L. , Zhang Ke , Bing Ryan G. , O'Quinn Hailey C. , Poole Farris L. , Zhang Ying , Kelly Robert M. , Adams Michael W. W. 
Published: December 2023

ABSTRACT

The platform chemical 2,3-butanediol (2,3-BDO) is used to derive products, such as 1,3-butadiene and methyl ethyl ketone, for the chemical and fuel production industries. Efficient microbial 2,3-BDO production at industrial scales has not been achieved yet for various reasons, including product inhibition to host organisms, mixed stereospecificity in product formation, and dependence on expensive substrates (i.e., glucose). In this study, we explore engineering of a 2,3-BDO pathway in
Caldicellulosiruptor bescii
, an extremely thermophilic (optimal growth temperature = 78°C) and anaerobic bacterium that can break down crystalline cellulose and hemicellulose into fermentable C
5
and C
6
sugars. In addition
, C. bescii
grows on unpretreated plant biomass, such as switchgrass. Biosynthesis of 2,3-BDO involves three steps: two molecules of pyruvate are condensed into acetolactate; acetolactate is decarboxylated to acetoin, and finally, acetoin is reduced to 2,3-BDO.
C. bescii
natively produces acetoin; therefore, in order to complete the 2,3-BDO biosynthetic pathway,
C. bescii
was engineered to produce a secondary alcohol dehydrogenase (sADH) to catalyze the final step. Two previously characterized, thermostable sADH enzymes with high affinity for acetoin, one from a bacterium and one from an archaeon, were tested independently. When either sADH was present in
C. bescii,
the recombinant strains were able to produce up to 2.5-mM 2,3-BDO from crystalline cellulose and xylan and 0.2-mM 2,3-BDO directly from unpretreated switchgrass. This serves as the basis for higher yields and productivities, and to this end, limiting factors and potential genetic targets for further optimization were assessed using the genome-scale metabolic model of
C. bescii
.

IMPORTANCE

Lignocellulosic plant biomass as the substrate for microbial synthesis of 2,3-butanediol is one of the major keys toward cost-effective bio-based production of this chemical at an industrial scale. However, deconstruction of biomass to release the sugars for microbial growth currently requires expensive thermochemical and enzymatic pretreatments. In this study, the thermo-cellulolytic bacterium
Caldicellulosiruptor bescii
was successfully engineered to produce 2,3-butanediol from cellulose, xylan, and directly from unpretreated switchgrass. Genome-scale metabolic modeling of
C. bescii
was applied to adjust carbon and redox fluxes to maximize productivity of 2,3-butanediol, thereby revealing bottlenecks that require genetic modifications.
Research on phage λ: a lucky choice
Authors: Lewis Dale E. A. , Adhya Sankar 
Published: December 2023

ABSTRACT

Bacteriophage λ is a paradigm in the field of gene regulation and one of the best-understood systems in genetic regulatory biology. A so-called Genetic Switch determines the mechanisms by which λ transitions to its dual lifestyles—lytic or lysogenic. When λ initiates the lysogenic lifestyle, the phage-encoded CI repressor binds cooperatively to multi-partite operators in a defined pattern that autoregulates repression of phage lytic promoters as well as activation of the lysogenic promoter. The study of this genetic switch and related earlier research on phage λ revealed the main principles of gene expression and regulation in molecular biology. This article describes the underlying molecular details of λ lysogeny, as it is currently understood.
Early and exclusive enteral nutrition in infants born very preterm
Authors: Razzaghy Jacqueline , Shukla Vivek V , Gunawan Emily , Reeves Audrey , Nguyen Kelly , Salas Ariel A 
Published: December 2023

ObjectiveTo characterise the effects of early and exclusive enteral nutrition with either maternal or donor milk in infants born very preterm (280/7–326/7weeks of gestation).DesignParallel-group, unmasked randomised controlled trial.SettingRegional, tertiary neonatal intensive care unit.Participants102 infants born very preterm between 2021 and 2022 (51 in each group).InterventionInfants randomised to the intervention group received 60–80 mL/kg/day within the first 36 hours after birth. Infants randomised to the control group received 20–30 mL/kg/day (standard trophic feeding volumes).Main outcome measuresThe primary outcome was the number of full enteral feeding days (>150 mL/kg/day) in the first 28 days after birth. Secondary outcomes included growth and body composition at the end of the first two postnatal weeks, and length of hospitalisation.ResultsThe mean birth weight was 1477 g (SD: 334). Half of the infants were male, and 44% were black. Early and exclusive enteral nutrition increased the number of full enteral feeding days (+2; 0–2 days; p=0.004), the fat-free mass-for-age z-scores at postnatal day 14 (+0.5; 0.1–1.0; p=0.02) and the length-for-age z-scores at the time of hospital discharge (+0.6; 0.2–1.0; p=0.002). Hospitalisation costs differed between groups (mean difference favouring the intervention group: −$28 754; −$647 to −$56 861; p=0.04).ConclusionsIn infants born very preterm, early and exclusive enteral nutrition increases the number of full enteral feeding days. This feeding practice may also improve fat-free mass accretion, increase length and reduce hospitalisation costs.Trial registration numberNCT04337710.
Relationship of close contact settings with transmission and infection during the SARS-CoV-2 Omicron BA.2 epidemic in Shanghai
Authors: Zhu Wenlong , Yuan Shiying , Mao Shenghua , Chen Jian , Zheng Yaxu , Jiang Xianjin , Yu Xiao , Jiang Chenyan , Fang Qiwen , Wang Weibing , Yuan Zheng'an , Yao Ye 
Published: December 2023

IntroductionWe analysed case-contact clusters during the Omicron BA.2 epidemic in Shanghai to assess the risk of infection of contacts in different settings and to evaluate the effect of demographic factors on the association of infectivity and susceptibility to the Omicron variant.MethodsData on the settings and frequency of contact, demographic characteristics and comorbidities of index cases, contacts and secondary cases were analysed. Independent effect of multiple variables on the risk for transmission and infection was evaluated using generalised estimating equations.ResultsFrom 1 March to 1 June 2022, we identified 450 770 close contacts of 90 885 index cases. The risk for infection was greater for contacts in farmers’ markets (fixed locations where farmers gather to sell products, adjusted OR (aOR): 3.62; 95% CI 2.87 to 4.55) and households (aOR: 2.68; 95% CI 2.15 to 3.35). Children (0–4 years) and elderly adults (60 years and above) had higher risk for infection and transmission. During the course of the epidemic, the risk for infection and transmission in different age groups initially increased, and then decreased on about 21 April (17th day of citywide home quarantine). Compared with medical workers (reference, aOR: 1.00), unemployed contacts (aOR: 1.77; 95% CI 1.53 to 2.04) and preschoolers (aOR: 1.61; 95% CI 1.26 to 2.05) had the highest risk for infection; delivery workers (aOR: 1.90, 95% CI 1.51 to 2.40) and public service workers (aOR: 1.85; 95% CI 1.64 to 2.10) had the highest risk for transmission. Contacts who had comorbidities (aOR: 1.10; 95% CI 1.09 to 1.12) had a higher risk for infection, particularly those with lung diseases or immune deficiency.ConclusionFarmers’ markets and households were the main setting for transmission of Omicron. Children, the elderly, delivery workers and public service workers had the highest risk for transmission and infection. These findings should be considered when implementing targeted interventions.
Real-world evaluation of smartphone-based artificial intelligence to screen for diabetic retinopathy in Dominica: a clinical validation study
Authors: Kemp Oliver , Bascaran Covadonga , Cartwright Edyta , McQuillan Lauren , Matthew Nanda , Shillingford-Ricketts Hazel , Zondervan Marcia , Foster Allen , Burton Matthew 
Published: December 2023

ObjectiveSeveral artificial intelligence (AI) systems for diabetic retinopathy screening have been validated but there is limited evidence on their performance in real-world settings. This study aimed to assess the performance of an AI software deployed within the diabetic retinopathy screening programme in Dominica.Methods and analysisWe conducted a prospective, cross-sectional clinical validation study. Patients with diabetes aged 18 years and above attending the diabetic retinopathy screening in primary care facilities in Dominica from 5 June to 3 July 2021 were enrolled.Grading was done at the point of care by the field grader, followed by counselling and referral to the eye clinic. Images were then graded by an AI system. Sensitivity, specificity with 95% CIs and area under the curve (AUC) were calculated for comparing the AI to field grader as gold standard.ResultsA total of 587 participants were screened. The AI had a sensitivity and specificity for detecting referable diabetic retinopathy of 77.5% and 91.5% compared with the grader, for all participants, including ungradable images. The AUC was 0.8455. Excluding 52 participants deemed ungradable by the grader, the AI had a sensitivity and specificity of 81.4% and 91.5%, with an AUC of 0.9648.ConclusionThis study provides evidence that AI has the potential to be deployed to assist a diabetic screening programme in a middle-income real-world setting and perform with reasonable accuracy compared with a specialist grader.
Incident glaucoma and ocular hypertension after periocular and intravitreal steroid injections: a claims-based analysis
Authors: Polski Ashley , Liu Katy C , Gupta Divakar , Grewal Dilraj S , Horns Joshua , Wirostko Barbara M , Stagg Brian C 
Published: December 2023

Background/aimsThis study aims to determine the incidence and risk of open-angle glaucoma or ocular hypertension (OHT) following ocular steroid injections using healthcare claims data.MethodsWe retrospectively reviewed deidentified insurance claims data from the IBM MarketScan Database to identify 19 156 adult patients with no prior history of glaucoma who received ocular steroid injections between 2011 and 2020. Patient demographics and steroid treatment characteristics were collected. Postinjection glaucoma/OHT development was defined as a new diagnosis of glaucoma/OHT, initiation of glaucoma drops, and/or surgical or laser glaucoma treatment. Cox proportional hazards models were used to determine the risk of glaucoma/OHT development within 5 years after first steroid injection.ResultsOverall, 3932 (20.5%) patients were diagnosed with new glaucoma/OHT, 3345 (17.5%) started glaucoma drops and 435 (2.27%) required a laser or surgical glaucoma procedure within 5 years of first steroid injection. Triamcinolone subconjunctival injections were associated with a lower risk of glaucoma/OHT development than retrobulbar or intravitreal steroid injections (p<0.001, HR 0.68, 95% CI 0.59 to 0.79), whereas the 0.59 mg fluocinolone acetonide intravitreal implant had the highest risk of glaucoma/OHT development (p=0.001, HR 2.01, 95% CI 1.34 to 3.02). The risk of glaucoma/OHT development was also higher for patients receiving multiple steroid injections (p<0.001), with the largest increase in risk occurring after three total steroid injections.ConclusionPatients receiving ocular steroid injections are at risk of developing glaucoma/OHT, even with no prior glaucoma/OHT diagnosis or treatment. Patients should be closely monitored for the development of glaucoma following ocular steroid injections, particularly in the setting of intravitreal and/or repeated steroid administration.
Examining adaptive models of care implemented in hospital ICUs during the COVID-19 pandemic: a qualitative study
Authors: McGillis Hall Linda , Reali Vanessa , Canzian Sonya , Johnston Linda , Hatcher Carol , Hayward-Murray Kathryn , Layton Mikki , Merkley Jane , Richards Joy , Taggar Ru , Woollard Susan 
Published: December 2023

BackgroundThe emergence of the COVID-19 pandemic led to an increased demand for hospital beds, which in turn led to unique changes to both the organisation and delivery of patient care, including the adoption of adaptive models of care. Our objective was to understand staff perspectives on adaptive models of care employed in intensive care units (ICUs) during the pandemic.MethodsWe interviewed 77 participants representing direct care staff (registered nurses) and members of the nursing management team (nurse managers, clinical educators and nurse practitioners) from 12 different ICUs. Thematic analysis was used to code and analyse the data.ResultsOur findings highlight effective elements of adaptive models of care, including appreciation for redeployed staff, organising aspects of team-based models and ICU culture. Challenges experienced with the pandemic models of care were heightened workload, the influence of experience, the disparity between model and practice and missed care. Finally, debriefing, advanced planning and preparation, the redeployment process and management support and communication were important areas to consider in implementing future adaptive care models.ConclusionThe implementation of adaptive models of care in ICUs during the COVID-19 pandemic provided a rapid solution for staffing during the surge in critical care patients. Findings from this study highlight some of the challenges of implementing redeployment as a staffing strategy, including how role clarity and accountability can influence the adoption of care delivery models, lead to workarounds and contribute to adverse patient and nurse outcomes.