bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barley to Barrel
Authors: Bamforth Charles W. 
Published: October 2023

Abstract
The production of beer is a highly complex process, but this chapter offers a description of the conversion of barley into beer that is readily intelligible to the layperson. The grain from the barley is hard and unpleasant in flavor. Malting converts the grain into a softer, tastier form that can be efficiently extracted in the brewhouse. The successive stages are as follows: milling of malt into extractable particles; mashing, in which milled malt is mixed with hot water, primarily to allow the enzymic breakdown of starch into fermentable sugars; lautering, in which the extracted sugars are separated from spent grains; boiling with hops to extract bitterness; clarification and cooling prior to fermentation, in which yeast converts the sugars into alcohol, carbon dioxide, and certain flavor compounds; followed by clarification and packaging.
Beer and the Body
Authors: Bamforth Charles W. 
Published: October 2023

Abstract
Brewers strive to ensure that their products do not contain damaging components, but increasingly realize that beer is not without nutritional value and has been associated with beneficial impacts on the body. However, it is not permissible to market beer on a platform of health, and responsible brewers preach moderate consumption. Beneficial components of beer include silicate, soluble fiber, antioxidants, most B vitamins, and prebiotics. Beer in moderation has been associated with decreased instances of coronary heart disease, strokes, gallstones, kidney stones, late-onset diabetes, and with improved cognitive function. The “beer belly” is a myth, though like any other alcoholic beverage, the main source of calories in beer is alcohol. Most beers contain some level of the protein material that people who are gluten-intolerant will react to, but there are diverse approaches to making beers that these people can enjoy. Brewers recognize that there continue to be anti-alcohol lobbies.
Environmental Matters
Authors: Bamforth Charles W. 
Published: October 2023

Abstract
The production of beer is a highly demanding operation in terms of resources and potential impacts on the environment. Brewers strive to be as efficient as possible in terms of water and energy needs and the generation of waste products. Many initiatives have been bought in, including less energy-demanding boiling systems, carbon dioxide capture, use of solar and other non-fossil fuel sources of energy, and aerobic and anaerobic water treatment with energy recovery. Brewing is associated with a range of eco-products, primarily the spent grains which have traditionally gone to animal feed, and surplus yeast, one of the uses for which is the production of spreads such as Marmite and Vegemite.
Reverence for Beer
Authors: Bamforth Charles W. 
Published: October 2023

Abstract
Everyone has an opinion on beer and seems to be adamant about what is and what is not a good beer. The author insists that a good beer is defined by the drinker: What do they want in a beer, and how consistently do they get it? A craft brewer, like any other craftsperson, is someone fully trained and adept at making products of excellence, irrespective of the size of the operation and the style and nature of the beer. Beer should be respected at least as highly as other alcoholic drinks and should be recognized for its merits, not least as an accompaniment to a wider range of foods than, say, wine. Beer deserves proper presentation in the appropriate glasses and should be consumed as an adjunct to a wholesome and convivial lifestyle. It should not be the focus of games such as beer pong!
To the Future
Authors: Bamforth Charles W. 
Published: October 2023

Abstract
The fundamental nature of the brewing process has not changed in millennia, and neither would it be expected to in the future. Through the application of science, it has become more consistent and reliable. There will continue to be a focus on efficiency and minimizing the environmental footprint. And there will continue to be interest in exploring a diversity of beverage opportunities, such as flavored alcoholic beverages. Driving forces will include those based on tax opportunities. There is a gradual emergence of interest in what opportunities may be afforded by the genetic modification of yeast and perhaps cereals, but brewers will always insist upon the wholesomeness of their raw materials, processes, and products.
DnaK2 Mediates a Negative Feedback Regulation of the Heat Shock Responsive Hik2-Rre1 Two-Component System in the Cyanobacterium Synechococcus Elongatus PCC 7942
Authors: Hasegawa Hazuki , Kobayashi Ikki , Bairagi Nachiketa , Watanabe Satoru , Tanaka Kan 
Published: October 2023

Abstract
The two-component system (TCS) is a conserved signal transduction module in bacteria. The Hik2-Rre1 system is responsible for transcriptional activation upon high-temperature shift as well as plastoquinone-related redox stress in the cyanobacterium Synechococcus elongatus PCC 7942. As heat-induced de novo protein synthesis was previously shown to be required to quench the heat-activated response, we investigated the underlying mechanism in this study. We found that the heat-inducible transcription activation was alleviated by the overexpression of dnaK2, which is an essential homolog of the highly conserved HSP70 chaperone and whose expression is induced under the control of the Hik2-Rre1 TCS. Phosphorylation of Rre1 correlated with transcription of the regulatory target hspA. The redox stress response was found to be similarly repressed by dnaK2 overexpression. Considered together with the previous information, we propose a negative feedback mechanism of the Hik2-Rre1-dependent stress response that maintains the cellular homeostasis mediated by DnaK2.
A systematic review of diversity, equity, and inclusion and antiracism training studies: Findings and future directions
Authors: Wang Monica L , Gomes Alexis , Rosa Marielis , Copeland Phillipe , Santana Victor Jose 
Published: October 2023

Abstract
A growing number of organizations are prioritizing diversity, equity, and inclusion (DEI) and antiracism in the workplace, including investing resources in DEI or antiracism training. However, such trainings vary widely in curriculum, objectives, delivery, and evaluation, with little known about the efficacy of existing trainings. The aim of this systematic review is to evaluate training characteristics, measures, and results of peer-reviewed studies (published between 2000 and 2022) testing DEI or antiracism trainings. Studies were identified using Google Scholar, JSTOR, and a university library database. Key search terms included “diversity, equity, and inclusion training”; “antiracism training”; and “effect,” “impact,” “outcome,” or “evaluation.” The search yielded N = 15 DEI training studies and N = 8 antiracism training studies. The majority of studies (75% of antiracism training; 66.6% of DEI training) utilized a one-time training session. Content, objectives, measures, and impact varied widely across studies. Randomized designs were uncommon (13%), and over 70% of studies had majority female participants. Findings highlight several strategies to advance the field of DEI and antiracism training, such as shifting curriculum from targeting individual knowledge to supporting behavioral and organizational change, providing longitudinal training, standardizing outcomes of interest, and implementing rigorous evaluation methods.
Intraoperative Surgeon Assessment of Bone
Authors: Bernatz James T , Goh Brian C , Skjaerlund Jonathan D , Mikula Anthony L , Johnson Sarah E , Bydon Mohamad , Fogelson Jeremy , Elder Benjamin , Huddleston Paul , Karim Mohammed , Nassr Ahmad , Sebastian Arjun , Freedman Brett 
Published: October 2023

Study design.
Retrospective observational study of consecutive patients

Objective.
The purpose of the study is to determine if a surgeon’s qualitative assessment of bone intraoperatively correlates with radiologic parameters of bone strength.

Summary of Background Data.
Preoperative radiologic assessment of bone can include modalities such as CT Hounsfield Units (HUs), dual-energy x-ray absorptiometry bone mineral density (DXA BMD) with trabecular bone score (TBS) and MRI vertebral bone quality (VBQ). Quantitative analysis of bone with screw insertional torque and pull-out strength measurement has been performed in cadaveric models and has been correlated to these radiologic parameters. However, these quantitative measurements are not routinely available for use in surgery. Surgeons anecdotally judge bone strength, but the fidelity of the intraoperative judgement has not been investigated.

Methods.
All adult patients undergoing instrumented posterior thoracolumbar spine fusion by one of seven surgeons at a single center over a 3-month period were included. Surgeons evaluated the strength of bone based on intraoperative feedback and graded each patient’s bone on a 5-point Likert scale. Two independent reviewers measured preoperative CT HUs and MRI VBQ. BMD, lowest T-score and TBS were extracted from DXA within 2 years of surgery.

Results.
Eighty-nine patients were enrolled and 16, 28, 31, 13 and 1 patients had Likert grade 1 (strongest bone), 2, 3, 4, and 5 (weakest bone), respectively. The surgeon assessment of bone correlated with VBQ (τ=0.15, P=0.07), CT HU (τ=−0.31, P<0.01), lowest DXA T-score (τ=−0.47, P<0.01), and TBS (τ=−0.23, P=0.06).

Conclusion.
Spine surgeons’ qualitative intraoperative assessment of bone correlates with preoperative radiologic parameters, particularly in posterior thoracolumbar surgeries. This information is valuable to surgeons as this supports the idea that decisions based on feel in surgery have statistical foundation.
Identifying Patterns of Medical Intervention in Acute Respiratory Failure: A Retrospective Observational Study
Authors: Kruser Jacqueline M. , Sharma Kartikey , Holl Jane L. , Nohadani Omid 
Published: October 2023

IMPORTANCE:
Characterizing medical interventions delivered to ICU patients over time and their relationship to outcomes can help set expectations and inform decisions made by patients, clinicians, and health systems.

OBJECTIVES:
To determine whether distinct and clinically relevant pathways of medical intervention can be identified among adult ICU patients with acute respiratory failure.

DESIGN, SETTING, AND PARTICIPANTS:
Retrospective observational study using all-payer administrative claims data from 2012 to 2014. Patients were identified from the Healthcare Cost and Utilization Project State Inpatient Databases from Maryland, Massachusetts, Nevada, and Washington.

MAIN OUTCOMES AND MEASURES:
Patterns of cumulative medical intervention delivery, over time, using temporal k-means clustering of interventions delivered up to hospital days 0, 5, 10, 20, and up to discharge.

RESULTS:
A total of 12,175 admissions were identified and divided into training (75%; n = 9,130) and validation sets (25%; n = 3,045). Without applying a priori classification and using only medical interventions to cluster, we identified three distinct pathways of intervention accounting for 93.5% of training set admissions. We found 45.9% of admissions followed a “cardiac” intervention pathway (e.g., cardiac catheterization, cardioversion); 36.7% followed a “general” pathway (e.g., diagnostic interventions); and 17.4% followed a “prolonged” pathway (e.g., tracheostomy, gastrostomy). Prolonged pathway admissions had longer median hospital length of stay (13 d; interquartile range [IQR], 7.5–18.5 d) compared with cardiac (5; IQR, 2.5–7.5) and general (5; IQR, 3–7). In-hospital death occurred in 24.6% of prolonged pathway admissions compared with 17.9% of cardiac and 6.9% of general. Findings were confirmed in the validation set.

CONCLUSIONS AND RELEVANCE:
Most ICU admissions for acute respiratory failure follow one of three clinically relevant pathways of medical intervention which are associated with hospitalization outcomes. This study helps define the longitudinal nature of critical care delivery, which can inform efforts to predict patient outcomes, communicate with patients and their families, and organize critical care resources.
Diagnostic Accuracy of Procalcitonin in Bacterial Infections of the CNS: An Updated Systematic Review, Meta-Analysis, and Meta-Regression*
Authors: Biasucci Daniele Guerino , Sergi Paola Giuseppina , Bilotta Federico , Dauri Mario 
Published: October 2023

OBJECTIVES:
To evaluate diagnostic accuracy of serum and cerebrospinal fluid (CSF) procalcitonin for diagnosing CNS bacterial infections.

DATA SOURCES:
We searched MEDLINE, Cochrane Central Register of Controlled Trials, and International Web of Science databases from January 1, 2016, to September 30, 2022.

STUDY SELECTION:
Randomized controlled trials and observational studies, either prospective or retrospective, focusing on procalcitonin as a biomarker for CNS infections.

DATA EXTRACTION:
We screened and extracted studies independently and in duplicate. We assessed risk of bias using the revised Quality Assessment for Studies of Diagnostic Accuracy tool. Data for diagnostic sensitivity and specificity were pooled using the bivariate or hierarchical model, as appropriate.

DATA SYNTHESIS:
Of 5,347 citations identified, 23 studies were included. Overall, CSF procalcitonin showed slightly higher pooled sensitivity, specificity, and positive likelihood ratio compared with serum procalcitonin. In adults, pooled sensitivity of CSF procalcitonin was 0.89 (95% CI, 0.71–0.96), specificity 0.81 (95% CI, 0.66–0.91); pooled sensitivity of serum procalcitonin was 0.82 (95% CI, 0.58–0.94), specificity 0.77 (95% CI, 0.60–0.89). In children, pooled sensitivity of CSF procalcitonin was 0.96 (95% CI, 0.88–0.99), specificity 0.91 (95% CI, 0.72–0.97); pooled sensitivity of serum procalcitonin was 0.90 (95% CI, 0.75–0.97), specificity 0.83 (95% CI, 0.67–0.92). In post-neurosurgical patients, pooled sensitivity of CSF procalcitonin was 0.82 (95% CI, 0.53–0.95), specificity 0.81 (95% CI, 0.63–0.91); pooled sensitivity of serum procalcitonin was 0.65 (95% CI, 0.33–0.88), specificity 0.61 (95% CI, 0.41–0.78). Logistic regression revealed between-study heterogeneity higher for serum than CSF procalcitonin. For the latter, threshold variability was found as source of heterogeneity.

CONCLUSIONS:
In children and critical post-neurosurgical patients, CSF procalcitonin gains superior sensitivity and specificity compared with serum procalcitonin. Overall, CSF procalcitonin appears to have a higher pooled positive likelihood ratio compared with serum procalcitonin.
The Utility of the Paramedian Forehead Flap in Lower Eyelid Reconstruction
Authors: Shope Chelsea , Gonzalez-Parrilla Leonardo , Atherton Kelly , Eiseman Andrew , Patel Krishna 
Published: October 2023

Background
Malignant cutaneous eyelid tumors account for approximately 10% of all cutaneous cancers. Like other cancerous skin lesions, treatment commonly involves excision with wide margins, requiring tissue reconstruction. The use of the paramedian forehead flap (PMFF) has been described for reconstruction of the medial and upper eyelid, but literature is lacking for its use in lower eyelid anterior lamella reconstruction. We present a case series of patients who underwent reconstruction of lower eyelid defects using the PMFF.

Case presentations
We present 2 patients who underwent reconstruction of lower eyelid defects using the PMFF surgical technique. The patients had previous history of lower lid repair with other reconstructive methods because of cancerous eyelid lesions. In addition, both received adjuvant radiation therapy, which led to development of ectropion. Postoperative signs, symptoms, and photographs were collected to monitor outcomes.

Management and Outcomes
Reconstructions were performed by the collaborative efforts of a facial plastic reconstructive surgeon and oculoplastic surgeon using a staged PMFF approach. Postoperatively, both patients had significant improvement in ophthalmologic symptoms, particularly ectropion and lagophthalmos. At their most recent follow-up visit, they were satisfied with their functional and aesthetic outcomes.

Conclusion
The PMFF may be safely used to reconstruct defects of the lower eyelid anterior lamella. In this study, the PMFF has proven to be an excellent option for patients with complications after previous lower eyelid reconstructions or history of radiation therapy. Overall, the PMFF should be considered as part of the surgeon's reconstructive ladder when addressing lower eyelid defects.
Costs of Care for Operative and Non-Operative Management of Emergency General Surgery Conditions
Authors: Kaufman Elinore J. , Wirtalla Christopher J. , Keele Luke J. , Neuman Mark D. , Rosen Claire B. , Syvyk Solomiya , Hatchimonji Justin , Ginzberg Sara , Friedman Ari , Roberts Sanford E. , Kelz Rachel R. 
Published: October 2023

Objective:
Many emergency general surgery (EGS) conditions can be managed operatively or non-operatively, with outcomes that vary by diagnosis. We hypothesized that operative management would lead to higher in-hospital costs but to cost savings over time.

Summary Background Data:
Emergency general surgery conditions account for $28 billion in healthcare costs in the US annually. Compared to scheduled surgery, patients who undergo emergency surgery are at increased risk of complications, readmissions, and death, with accompanying costs of care that are up to 50% higher than elective surgery. Our prior work demonstrated that operative management had variable impacts on clinical outcomes depending on EGS condition.

Methods:
This was a nationwide, retrospective study using fee-for-service Medicare claims data. We included patients ≥ 65.5 years of age with a principal diagnosis for an EGS condition, 7/1/2015-6/30/2018. EGS conditions were categorized as: colorectal, general abdominal, hepatopancreaticobiliary, intestinal obstruction, and upper gastrointestinal. We used near-far matching with a preference-based instrumental variable to adjust for confounding and selection bias. Outcomes included Medicare payments for the index hospitalization and at 30, 90, and 180 days.

Results:
Of 507,677 patients, 30.6% received an operation. For hepatopancreaticobiliary conditions, costs for operative management were initially higher but became equivalent at 90 and 180 days. For all others, operative management was associated with higher inpatient costs which persisted, though narrowed, over time. Out-of-pocket costs were nearly equivalent for operative and non-operative management.

Conclusions:
Compared to non-operative management, costs were higher or equivalent for operative management of EGS conditions through 180 days, which could impact decision-making for clinicians, patients, and health systems in situations where clinical outcomes are similar.
Monitoring the battleground: Exploring Antimicrobial Resistance and Virulence Factors in Wound Bacterial Isolates
Authors: Awuor Silas Onyango , Omwenga Eric O. , Mariita Richard M. , Musila Jonathan , Musyoki Stanslaus 
Published: October 2023

There is an alarming increase in antibiotic resistance especially on common bacterial infections that could be attributed to extensive unregulated use of antibiotics. Continuous strategic monitoring of antibiotic use and AMR trends becomes imperative. This serves as a motivation to a thorough evaluation of wound isolates for relevant bacteria and assessing their drug susceptibility patterns, which we report herein. This cross-sectional study aimed to decipher antibacterial resistance by examining samples collected from patients with chronic wounds seeking medication at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH). Standard microbiological methods were employed to identify and characterize the bacterial pathogens. Analysis of the wound isolates revealed a significant presence of microbial growth, with a higher prevalence of59% isolates in male patients. Staphylococcus aureus 20.7%emerged as the most predominant pathogen, followed by Klebsiella spp.14.8%, P. aeruginosa spp. 14.8%, and E. coli 4.4% in the wound samples. Notably, Cotrimoxazole exhibited the highest antibacterial resistance 48.1%, followed by Clindamycin 25.9% and Erythromycin 25.9%, affecting both Gram-positive and Gram-negative bacteria. Furthermore, among the isolates, 75% were capable of producing haemolysin and protease, while 50% produced lipase and phospholipase, factors that enhance virulence and survival. These findings provide crucial insights into antimicrobial resistance in chronic wounds, emphasizing the importance of responsible antibacterial use in wound management. Additionally, they shed light on the need for developing more potent antibiotics for effectively treating chronic wounds.
Precise immunofluorescence canceling for highly multiplexed imaging capturing specific cell state
Authors: Tomimatsu Kosuke , Fujii Takeru , Bise Ryoma , Hosoda Kazufumi , Taniguchi Yosuke , Ochiai Hiroshi , Ohishi Hiroaki , Ando Kanta , Minami Ryoma , Tanaka Kaori , Tachibana Taro , Mori Seiichi , Harada Akihito , Maehara Kazumitsu , Nagasaki Masao , Uchida Seiichi , Kimura Hiroshi , Narita Masashi , Ohkawa Yasuyuki 
Published: October 2023

AbstractCell states are regulated by the response of signaling pathways to receptor ligand-binding and inter-cellular interactions. High-resolution imaging has been attempted to explore the dynamics of these processes and, recently, multiplexed imaging has profiled cell states by achieving a comprehensive acquisition of spatial protein information from cells. However, the specificity of antibodies is still compromised when visualizing activated signals. Here, we developed Precise Emission Canceling Antibodies (PECAbs) that have cleavable fluorescent labeling. PECAbs enable high-specificity sequential imaging using hundreds of antibodies, allowing for reconstruction of the spatiotemporal dynamics of signaling pathways. Additionally, combining this approach with seq-smFISH can effectively classify cells and identify their signal activation states in human tissue. Overall, the PECAb system can serve as a comprehensive platform for analyzing complex cell processes.
Membrane Lipids Augment Cell Envelope Stress Signaling and Resistance to Antibiotics and Antimicrobial Peptides inEnterococcus faecalis
Authors: Miller William R , Nguyen April , Singh Kavindra V , Rizvi Samie , Khan Ayesha , Erickson Sam G , Egge Stephanie L , Cruz Melissa , Dinh An Q , Diaz Lorena , Zhang Rutan , Xu Libin , Garsin Danielle A , Shamoo Yousif , Arias Cesar A 
Published: October 2023

AbstractEnterococci have evolved resistance mechanisms to protect their cell envelopes against bacteriocins and host cationic antimicrobial peptides (CAMPs) produced in the gastrointestinal environment. Activation of the membrane stress response has also been tied to resistance to the lipopeptide antibiotic daptomycin. However, the actual effectors mediating resistance have not been elucidated. Here, we show that the MadRS (formerly YxdJK) membrane antimicrobial peptide defense system controls a network of genes, including a previously uncharacterized three gene operon (madEFG) that protects theE. faecaliscell envelope from antimicrobial peptides. Constitutive activation of the system confers protection against CAMPs and daptomycin in the absence of a functional LiaFSR system and leads to persistence of cardiac microlesionsin vivo. Moreover, changes in the lipid cell membrane environment alter CAMP susceptibility and expression of the MadRS system. Thus, we provide a framework supporting a multilayered envelope defense mechanism for resistance and survival coupled to virulence.