bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gut microbiome–immune system interaction in reptiles
Authors: Siddiqui Ruqaiyyah , Maciver Sutherland K. , Khan Naveed Ahmed 
Published: January 2022

AbstractReptiles are ectothermic amniotes in a world dominated by endotherms. Reptiles originated more than 300 million years ago and they often dwell in polluted environments which may expose them to pathogenic micro-organisms, radiation and/or heavy metals. Reptiles also possess greater longevity and may live much longer than similar-sized land mammals, for example, turtles, tortoises, crocodiles and tuatara are long-lived reptiles living up to 100 years or more. Many recent studies have emphasized the pivotal role of the gut microbiome on its host; thus, we postulated that reptilian gut microbiome and/or its metabolites and the interplay with their robust immune system may contribute to their longevity and overall hardiness. Herein, we discuss the composition of the reptilian gut microbiome, immune system–gut microbiome cross-talk, antimicrobial peptides, reptilian resistance to infectious diseases and cancer, ageing, as well the current knowledge of the genome and epigenome of these remarkable species. Preliminary studies have demonstrated that microbial gut flora of reptiles such as crocodiles, tortoises, water monitor lizard and python exhibit remarkable anticancer and antibacterial properties, as well as comprise novel gut bacterial metabolites and antimicrobial peptides. The underlying mechanisms between the gut microbiome and the immune system may hold clues to developing new therapies overall for health, and possible extrapolation to exploit the ancient defence systems of reptiles for Homo sapiens benefit.
Effectiveness of clown intervention for pain relief in children: A systematic review and meta‐analysis
Authors: Ding Yiwen , Yin Huiru , Wang Shuo , Meng Qiuyan , Yan Mingli , Zhang Yining , Chen Li 
Published: January 2022

AbstractBackgroundPain is common in children receiving medical procedures, and there is a lack of adequate awareness and management. In addition, children who undergo medical procedures involving pain may also experience stress, crying and prolonged hospitalisation. Clown intervention is a promising nonpharmacological intervention. However, studies on the effectiveness of clown intervention in pain management have reported conflicting findings.ObjectiveTo evaluate the effectiveness of clown intervention in relieving pain in children, as well as its effects on cortisol levels, crying duration and length of hospital stay.DesignSystematic review and meta‐analysis of randomised controlled studies.Data sourcesPubMed, Web of Science (SCI), Embase, PsycINFO, the Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), Weipu (VIP), Wanfang Data and SinoMed were systematically searched from inception date to December 31, 2020.Review methodsTwo reviewers independently used the Cochrane risk of bias tool to assess the risk of bias of the included studies. Meta‐analysis was conducted when data were available, otherwise, a narrative description was provided. Data were analysed using Review Manager 5.3. The review process is reported according to PRISMA.ResultsNine studies including 852 children met the inclusion criteria. The results showed that compared with standard care, clown intervention was beneficial for relieving pain. Further subgroup analysis showed that it was more effective with children aged 2–7 years. The duration of crying after the procedure and the length of stay were shortened, but there was no significant difference in cortisol levels.ConclusionClown intervention may be a promising way to relieve acute pain in children, especially those aged 2–7 years. It also seems to shorten the duration of crying and the length of hospital stays, but the effect on cortisol levels is still uncertain. More high‐quality randomised controlled trials are needed to confirm these results and take into account different age groups, cultural backgrounds and specific populations.
Rural and urban disparities in quality of home health care: A longitudinal cohort study (2014‐2018)
Authors: Ma Chenjuan , Devoti Andrea , O'Connor Melissa 
Published: January 2022

AbstractPurposeHome health care is one of the fastest growing health care sectors in the United States. However, little is known of differences in trends in quality performance between rural and urban home health agencies over time. This study aimed to examine disparities in quality performance between rural and urban home health agencies between 2014 and 2018.MethodsThis is a cohort study using 2014‐2018 national Home Health Compare data and Providers of Service Profile data, including 7,908 home health agencies, of which 1,537 were rural agencies. Quality performance measures included timely initiation of care, hospitalization, and emergency department (ED) visits. Two‐level hierarchical regression models were used to identify rural‐urban differences in these quality indicators over time when controlling organizational characteristics.FindingsRural agencies were less likely to be for‐profit and accredited, and more likely to be hospital‐based, serve both Medicare and Medicaid beneficiaries, and have hospice programs. Rural agencies consistently outperformed on timely initiation of care over time, and urban agencies consistently outperformed on hospitalization and ED visits over time. These gaps between rural and urban agencies were steady over time except the gap in hospitalization, which slightly narrowed over time (Coef. = 0.11, P = .001 for urban and year interaction term).ConclusionsSignificant differences exist in quality of care between rural and urban home health agencies and such differences have not been significantly narrowed over time. To reduce rural‐urban disparities, policy makers should take into account unique challenges faced by urban and rural agencies when making policy decisions.
Origen’s Theology of Fire and the Early Monks of Egypt
Authors: Stang Charles M. 
Published: January 2022

AbstractOrigen’s Peri archôn includes a description of the soul of Christ as an iron in God’s fire. Christ’s mind, “becoming wholly fire” (et tota ignis effecta) is the origin and the destiny of all minds, all those minds who “cooled” (psychesthai) into souls (psychai) and eventually became angels, humans, and demons. The iron in the fire of God is the defining figure for the divinized mind, an illustration of what all minds were in the beginning and will be again in the end. God’s fire, however, is not only divinizing, but also purifying, and perhaps also punishing. These three aspects are braided together in Origen’s surviving works into a distinctive theology of fire. This essay attempts to explain Origen’s theology of fire, and then to ask what becomes of it. We find evidence of it among the early monks of Egypt, including in Antony the Great. We find further evidence of it in the sayings collections of early Egyptian monasticism—the so‐called Apophthegmata patrum. Throughout the collections, but especially in the Alphabetical collection, we find monks bursting into flames: a worthy disciple of Arsenius sees him “as though he were all fire”; Joseph stretches his hands to heaven and his ten fingers become “like ten lamps of fire” —he enjoins another monk to “become altogether like fire,” insisting that it is a monk’s only proper pursuit. These stories come into sharper relief when we see them against the backdrop of Origen’s theology of fire.
Diversification dynamics of cheilostome bryozoans based on a Bayesian analysis of the fossil record
Authors: Moharrek Farideh , Taylor Paul D. , Silvestro Daniele , Jenkins Helen L. , Gordon Dennis P. , Waeschenbach Andrea 
Published: January 2022

AbstractCheilostomata is the most diverse and ecologically dominant order of bryozoans living today. We apply a Bayesian framework to estimate macroevolutionary rates of cheilostomes since the Late Jurassic across four datasets: (I) manually curated genus ranges; (II) published text‐mined genus ranges; (III) non‐revised Paleobiology Database (PBDB) records; (IV) revised and augmented PBDB records. All datasets revealed increased origination rates in the Albian, and a twin K–Pg and Danian extinction rate peak. High origination rates in the Late Selandian–Ypresian in Dataset I indicate the onset of an ascophoran‐grade radiation. Lineage‐through‐time plots confirm the macroevolutionary lag preceding the radiation of cheilostomes in the middle Cretaceous, and their renewed diversification in the late Paleocene and Eocene. A multivariate birth–death model indicates that origination rates are shaped by diversity‐dependent dynamics coupled with a positive correlation with sea surface temperature, while extinction rates negatively correlate with sea level. Text‐mined data provide broadly similar rate dynamics as manually curated data, although discrepancies could be attributed to the omission of key literature in Dataset II, and the inclusion of new published and unpublished data, and revised ranges in Dataset I. Revision and augmentation of PBDB occurrences were necessary to generate rate profiles akin to those of Datasets I and II and highlight the risks of using unedited occurrence data. Our results support the widely held assumption that diversification dynamics are controlled by both biotic and abiotic factors, and pave the way for integrating fossils with molecular phylogenies to study these processes in more detail.
Preferential freezing avoidance localised in anthers and embryo sacs in winteringDaphne kamtschaticavar.jezoensisflower buds visualised by magnetic resonance imaging
Authors: Ishikawa Masaya , Ide Hiroyuki , Tsujii Tetsuya , Stait‐Gardner Timothy , Kubo Hikaru , Matsushita Norihisa , Fukuda Kenji , Price William S. , Arata Yoji 
Published: January 2022

AbstractTo explore diversity in cold hardiness mechanisms, high resolution magnetic resonance imaging (MRI) was used to visualise freezing behaviours in winteringDaphne kamtschaticavar.jezoensisflower buds, which have naked florets and no bud scales. MRI images showed that anthers remained stably supercooled to the range from −14 to −21°C or lower while most other tissues froze by −7°C. Freezing of some anthers detected in MRI images between −14 and −21°C corresponded with numerous low temperature exotherms and also with the ‘all‐or‐nothing’ type of anther injuries. In ovules/pistils, only embryo sacs remained supercooled at −7°C or lower, but slowly dehydrated during further cooling. Cryomicroscopic observation revealed ice formation in the cavities of calyx tubes and pistils but detected no ice in embryo sacs or in anthers. The distribution of ice nucleation activity in floral tissues corroborated the tissue freezing behaviours. Filaments likely work as the ice blocking barrier that prevents ice intrusion from extracellularly frozen calyx tubes to connecting unfrozen anthers. Unique freezing behaviours were demonstrated inDaphneflower buds: preferential freezing avoidance in male and female gametophytes and their surrounding tissues (by stable supercooling in anthers and by supercooling with slow dehydration in embryo sacs) while the remaining tissues tolerate extracellular freezing.
Cardiac allograft vasculopathy: A review
Authors: Laks Jessica A. , Dipchand Anne I. 
Published: January 2022

AbstractBackgroundHeart transplantation has become the standard of care for pediatric patients with end‐stage heart disease, and outcomes have consistently improved over the last few decades. CAV, however, remains a leading cause of morbidity and mortality in heart transplantation and is the leading cause of death beyond 3 years post‐transplantation. We sought out to provide an in‐depth overview of CAV in the pediatric heart transplant population.MethodsDatabase searches were conducted in both Medline and Embase on the topic of cardiac vasculopathy in pediatric heart transplant recipients. The search used five broad concept terms: heart transplant; pediatric; CAV; diagnosis, prognosis, and risk factors; and guidelines and reviews. References were captured if there was at least one term in each of the concepts. The search was limited to articles in the English language.ResultsA total of 148 articles were identified via the literature search with further articles identified via review of references. Pediatric data regarding the etiology and development of CAV remain limited although knowledge about the immune and non‐immune factors playing a role are increasing. CAV continues to be difficult to detect with many invasive and non‐invasive methods available, yet their effectiveness in the detection of CAV remains suboptimal. There remains no proven medical intervention to treat or reverse established CAV disease, and CAV is associated with high rates of graft loss once detected. However, several medications are used in hopes of preventing, slowing progression, or modifying the outcomes.ConclusionThis review provides a comprehensive overview of CAV, discusses its clinical presentation, risk factors, diagnostic tools used to identify CAV in the pediatric population, and highlights the current therapeutic options and the need for ongoing research.
Laparoscopic salpingectomy in Papio hamadryas for birth control in captivity
Authors: Lacitignola Luca , Laricchiuta Pietro , Imperante Annarita , Acquafredda Claudia , Stabile Marzia , Staffieri Francesco 
Published: January 2022

AbstractObjectiveTo evaluate the feasibility of laparoscopic salpingectomy in baboons (Papio hamadryas). We hypothesized that laparoscopic salpingectomy could be performed in baboon species within a reasonable amount of surgical time, with minor complications occurring at low rates.Study designCase series and technique description.AnimalsSixteen baboons (n = 16).MethodsThe surgical procedures were performed using the 3‐port technique, with 5 mm instruments and a telescope placed at the umbilical and hypogastric regions. A salpinx dissection was performed, using a radiofrequency bipolar vessel sealing device, from the fimbriae to the uterine attachments. We evaluated the surgical duration, learning curve, and intraoperative and early postoperative complications.ResultsTen adult and 6 subadult baboons with a mean weight of 9.32 kg, a range of 4‐14.2 kg, and a standard deviation (SD) of 3.09 kg were included in the study. The total duration of surgery was 28.75 min (range, 16‐50 min; SD, 9.60 min). The installation phase was completed in a mean time of 7.68 min (range, 3‐15 min; SD, 3.43 min), and the time to complete the salpingectomy of both salpinges was 9.68 min (range, 4‐20 min; SD, 3.97 min). No complications were observed in the postoperative period.ConclusionLaparoscopic salpingectomy in Papio hamadryas was feasible, with an acceptable surgical time, low invasiveness, and only minor technical perioperative complications.Clinical significanceLaparoscopic salpingectomy could be a viable and safe therapeutic option in nonhuman primate birth‐control programs.
Correlates of cardiorespiratory fitness among overweight or obese individuals with type 2 diabetes
Authors: Kaze Arnaud D , Agoons Dayawa Da , Santhanam Prasanna , Erqou Sebhat , Ahima Rexford S , Echouffo-Tcheugui Justin B 
Published: January 2022

IntroductionMechanistic studies suggest that type 2 diabetes is independently associated with low cardiorespiratory fitness (CRF). Little is known about the CRF profile in type 2 diabetes; we assessed the correlates of low CRF among overweight/obese adults with type 2 diabetes.Research design and methodsA total of 4215 participants with type 2 diabetes and without cardiovascular disease underwent maximal exercise testing in the Look AHEAD (Action for Health in Diabetes) study. Low CRF was defined based on the Aerobics Center Longitudinal Study reference standards. Calorie intake and physical activity were assessed using questionnaires. Body fat composition was assessed using dual-energy X-ray absorptiometry.ResultsWaist circumference, systolic blood pressure, glycemic measures, whole body fat, caloric intake, and fat-free mass were inversely associated with fitness across sex (all p<0.001). Comparing with moderate or high CRF groups, the low CRF group was associated with higher adjusted odds of obesity (OR 3.19 (95% CI 1.95 to 5.20) in men, 3.86 (95% CI 2.55 to 5.84)) in women), abdominal obesity (OR 3.99 (95% CI 2.00 to 7.96) in men, 2.28 (95% CI 1.08 to 4.79) in women), hypertension (OR 1.74 (95% CI 1.09 to 2.77) in men, 1.44 (95% CI 1.02 to 2.05) in women), metabolic syndrome (OR 5.52 (95% CI 2.51 to 12.14) in men, 2.25 (95% CI 1.35 to 3.76) in women), use of beta-blocker (1.22 (95% CI 0.86 to 1.73) in men, 1.33 (95% CI 1.03 to 1.73) in women), and ACE inhibitor/angiotensin-receptor blocker (1.86 (95% CI 1.39 to 2.50) in men, 1.07 (95% CI 0.86 to 1.32) in women). Women with low CRF had higher odds of current smoking (2.02 (95% CI 1.25 to 3.28)).ConclusionsLow CRF was associated with increased odds of cardiometabolic correlates in a large cohort of adults with type 2 diabetes.
Effect of maternal height on the risk of caesarean section in singleton births: evidence from a large-scale survey in India
Authors: Marbaniang Strong P , Lhungdim Hemkhothang , Chaurasia Himanshu 
Published: January 2022

ObjectiveThis study examines the association of maternal height with caesarean section (CS) in India. It is hypothesised that maternal height has no significant effect on the risk of undergoing caesarean section.DesignA cross-sectional study based on a nationally representative large-scale survey data (National Family Health Survey-4), conducted in 2015–2016.Setting and participantsAnalysis is based on 125 936 women age 15–49 years, having singleton live births. Logistic regression has been performed to determine the contribution of maternal height to the ORs of CS birth, adjusting for other exposures. Restricted cubic spline was used as a smooth function to model the non-linear relationship between height and CS. Height data were decomposed using the restricted cubic spline with five knots located at the 5th, 27.5th, 50th, 72.5th and 95th, percentiles.Primary and secondary outcome measuresThe main outcome variable of interest in the study is CS. Maternal height is the key explanatory variable. Other explanatory variables are age, parity, sex of child, birth weight, wealth index, place of residence, place of child delivery and household health insurance status.ResultsThe results reveal that the odds of undergoing CS significantly decrease with increase in maternal heights. Mothers with a height of 120 cm (adjusted OR (AOR): 5.08; 95% CI 3.83 to 6.74) were five times more likely, while mothers with height of 180 cm were 23% less likely (AOR: 0.77; 95% CI 0.62 to 0.95) to undergo CS as compared with mothers with height of 150 cm.ConclusionsShorter maternal height is linked to a higher risk of CS. Our findings could be used to argue for policies that target stunting in infant girls and avoid unnecessary CS, as there is potential effect on growth during adolescence and early adulthood, with the goal to increase their adult heights, thereby lowering their risk of CS and adverse delivery outcomes.
Does performance at the intercollegiate Membership of the Royal Colleges of Surgeons (MRCS) examination vary according to UK medical school and course type? A retrospective cohort study
Authors: Ellis Ricky , Brennan Peter A , Scrimgeour Duncan S G , Lee Amanda J , Cleland Jennifer 
Published: January 2022

ObjectivesThe knowledge, skills and behaviours required of new UK medical graduates are the same but how these are achieved differs given medical schools vary in their mission, curricula and pedagogy. Medical school differences seem to influence performance on postgraduate assessments. To date, the relationship between medical schools, course types and performance at the Membership of the Royal Colleges of Surgeons examination (MRCS) has not been investigated. Understanding this relationship is vital to achieving alignment across undergraduate and postgraduate training, learning and assessment values.Design and participantsA retrospective longitudinal cohort study of UK medical graduates who attempted MRCS Part A (n=9730) and MRCS Part B (n=4645) between 2007 and 2017, using individual-level linked sociodemographic and prior academic attainment data from the UK Medical Education Database.MethodsWe studied MRCS performance across all UK medical schools and examined relationships between potential predictors and MRCS performance using χ2analysis. Multivariate logistic regression models identified independent predictors of MRCS success at first attempt.ResultsMRCS pass rates differed significantly between individual medical schools (p<0.001) but not after adjusting for prior A-Level performance. Candidates from courses other than those described as problem-based learning (PBL) were 53% more likely to pass MRCS Part A (OR 1.53 (95% CI 1.25 to 1.87) and 54% more likely to pass Part B (OR 1.54 (1.05 to 2.25)) at first attempt after adjusting for prior academic performance. Attending a Standard-Entry 5-year medicine programme, having no prior degree and attending a Russell Group university were independent predictors of MRCS success in regression models (p<0.05).ConclusionsThere are significant differences in MRCS performance between medical schools. However, this variation is largely due to individual factors such as academic ability, rather than medical school factors. This study also highlights group level attainment differences that warrant further investigation to ensure equity within medical training.
Do consultants do what they say they do? Observational study of the extent to which clinicians involve their patients in the decision-making process
Authors: Driever Ellen M , Stiggelbout Anne M , Brand Paul L P 
Published: January 2022

ObjectivesTo assess whether consultants do what they say they do in reaching decisions with their patients.DesignCross-sectional analysis of hospital outpatient encounters, comparing consultants’ self-reported usual decision-making style to their actual observed decision-making behaviour in video-recorded encounters.SettingLarge secondary care teaching hospital in the Netherlands.Participants41 consultants from 18 disciplines and 781 patients.Primary and secondary outcome measureWith the Control Preference Scale, the self-reported usual decision-making style was assessed (paternalistic, informative or shared decision making). Two independent raters assessed decision-making behaviour for each decision using the Observing Patient Involvement (OPTION)5 instrument ranging from 0 (no shared decision making (SDM)) to 100 (optimal SDM).ResultsConsultants reported their usual decision-making style as informative (n=11), shared (n=16) and paternalistic (n=14). Overall, patient involvement was low, with mean (SD) OPTION5 scores of 16.8 (17.1). In an unadjusted multilevel analysis, the reported usual decision-making style was not related to the OPTION5 score (p>0.156). After adjusting for patient, consultant and consultation characteristics, higher OPTION5 scores were only significantly related to the category of decisions (treatment vs the other categories) and to longer consultation duration (p<0.001).ConclusionsThe limited patient involvement that we observed was not associated with the consultants’ self-reported usual decision-making style. Consultants appear to be unconsciously incompetent in shared decision making. This can hinder the transfer of this crucial communication skill to students and junior doctors.