bluuebunny/crossref_metadata_2025_split huggingface dataset:
Single-cell metabolite detection and genomics reveals uncultivated talented producer
Authors: Kogawa Masato , Miyaoka Rimi , Hemmerling Franziska , Ando Masahiro , Yura Kei , Ide Keigo , Nishikawa Yohei , Hosokawa Masahito , Ise Yuji , Cahn Jackson K B , Takada Kentaro , Matsunaga Shigeki , Mori Tetsushi , Piel Jörn , Takeyama Haruko 
Published: March 2022

Abstract
The production of bioactive metabolites is increasingly recognized as an important function of host-associated bacteria. An example is defensive symbiosis that might account for much of the chemical richness of marine invertebrates including sponges (Porifera), 1 of the oldest metazoans. However, most bacterial members of sponge microbiomes have not been cultivated or sequenced, and therefore, remain unrecognized. Unequivocally linking metabolic functions to a cellular source in sponge microbiomes is, therefore, a challenge. Here, we report an analysis pipeline of microfluidic encapsulation, Raman microscopy, and integrated digital genomics (MERMAID) for an efficient identification of uncultivated producers. We applied this method to the chemically rich bacteriosponge (sponge that hosts a rich bacterial community) Theonella swinhoei, previously shown to contain ‘Entotheonella’ symbionts that produce most of the bioactive substances isolated from the sponge. As an exception, the antifungal aurantosides had remained unassigned to a source. Raman-guided single-bacterial analysis and sequencing revealed a cryptic, distinct multiproducer, ‘Candidatus Poriflexus aureus’ from a new Chloroflexi lineage as the aurantoside producer. Its exceptionally large genome contains numerous biosynthetic loci and suggested an even higher chemical richness of this sponge than previously appreciated. This study highlights the importance of complementary technologies to uncover microbiome functions, reveals remarkable parallels between distantly related symbionts of the same host, and adds functional support for diverse chemically prolific lineages being present in microbial dark matter.
Curvilinear Relationships Between Age and Job Performance and the Role of Job Complexity
Authors: Karanika-Murray Maria , Van Veldhoven Marc , Michaelides George , Baguley Thom , Gkiontsi Dimitra , Harrison Natalie 
Published: March 2022

Abstract
Despite suggestions that work performance varies with age, the empirical evidence is inconclusive and contradictory. Possible reasons for this are the lack of differentiation between different types of performance and a naive assumption of a negative linear relationship between age and task performance across the working lifespan. With this study we question and revisit these expectations. We take a lifespan perspective to explore differential and curvilinear relationships between age (measured as chronological age) and three types of task performance (task proficiency, proactivity, and adaptivity), moderated by job complexity (measured as cognitive demands). Using Bayesian polynomial regression on survey data from 903 employees, we tested the relationships between age and each performance type, with job complexity as a moderator. The data indicated a U-shaped age–adaptivity relationship (main effects for job complexity) and an S-shaped age–proactivity relationship that was more pronounced under low job complexity (interaction effect). We identify the turning points for these changes, which show midlife as a critical period for changes in performance where the job context itself shapes the gradient and direction of these changes. Our findings provide crucial evidence that different types of job performance vary by age and the role of perceived job complexity in explaining trajectories in proactivity and adaptivity. Implications for job design, organizational interventions, and human resource management are discussed.
Quadratus Lumborum Block Versus Transversus Abdominis Plane Block for Caesarean Delivery: A Systematic Review and Network Meta-Analysis
Authors: El-Boghdadly K. , Desai N. , Halpern S. , Blake L. , Odor P.M. , Bampoe S. , Carvalho B. , Sultan P. 
Published: March 2022

(Anaesthesia. 2021;76:393–403. doi: 10.1111/anae.15160. Epub July 4, 2020)
Cesarean deliveries (CD) are the most globally performed surgical operation, thus it is important to improve postoperative pain following CD. The typical approach for improved analgesia outcomes following CD is multimodal analgesia (including long-acting intrathecal and epidural opioid). When long-acting neuraxial opioid options are not available, other analgesia methods, including quadratus lumborum blocks (QLB) and transversus abdominis plane (TAP) blocks have shown to improve postoperative analgesia. This study aims to compare TAP blocks and QLB technique outcomes (eg, 24-h morphine equivalent consumption) following CD.
Postpartum-specific Vital Sign Reference Ranges
Authors: Green L.J. , Pullon R. , Mackillop L.H. , Gerry S. , Birks J. , Salvi D. , Davidson S. , Loerup L. , Tarassenko L. , Mossop J. , Edwards C. , Gauntlett R. , Harding K. , Chappell L.C. , Knight M. , Watkinson P.J. 
Published: March 2022

(Obstet Gynecol. 2021;137:295–304. doi: 10.1097/AOG.0000000000004239)
Though the majority of maternal deaths occur in the postpartum period (57% in the United States), compared with the antenatal and intrapartum periods, the postpartum period doesn’t receive as much focus. Abnormal vital signs such as venous thromboembolism, hemorrhage, sepsis, and gestational hypertensive disorders are the leading cause of death during the postpartum period. Little data exists for postpartum vital signs. This study aims to estimate maternal postpartum vital sign ranges.
Efficacy of Resuscitative Infusion With Hemoglobin Vesicles in Rabbits With Massive Obstetric Hemorrhage
Authors: Yuki Y. , Hagisawa K. , Kinoshita M. , Ishibashi H. , Kaneko K. , Ishida O. , Saitoh D. , Sakai H. , Terui K. 
Published: March 2022

(Am J Obstet Gynecol. 2021;224:398.e1–398.e11. doi: 10.1016/j.ajog.2020.09.010. Epub September 12, 2020)
Massive transfusion protocol (MTP) is a management strategy for massive obstetric hemorrhage (MOH), an unpredictable birth complication, yet small maternity clinics and birth centers don’t always have access to MTP. Red blood cell (RBC) transfusion is optimally administered to patients requiring resuscitative infusion following MOH, but there are logistical limitations to providing small maternity clinics and birth centers with the supplies required for treatment. Thus, hemoglobin vesicles (HbVs) have been developed and tested as an RBC transfusion substitute with a much more practical and stable shelf life, making it much more affordable for small hospitals to have on hand. Though HbVs are logistically beneficial, there are questions around its efficacy and safety, so animal models have been developed to address these. This study used a rabbit model to substitute RBC transfusion with MOH to show efficacy of HbVs in rabbits with MOH.
The Association Between Labor Epidural Analgesia and Postpartum Depressive Symptoms: A Longitudinal Cohort Study
Authors: Munro A. , George R.B. , Mackinnon S.P. , Rosen N.O. 
Published: March 2022

(Can J Anaesth. 2021;68:485–495. doi: 10.1007/s12630-020-01900-4. Epub January 6, 2021)
An estimated 17% of mothers have postpartum depression (PPD) even without a prior history of depression. Several factors are associated with PPD, including pain. This study aimed to find associations between labor epidural analgesia (LEA) and reduced PPD occurrence in women up to 12 months postpartum.
Continued Versus Discontinued Oxytocin Stimulation in the Active Phase of Labour (CONDISOX): Double Blind Randomized Controlled Trial
Authors: Boie S. , Glavind J. , Uldbjerg N. , Steer P.J. , Bor P. 
Published: March 2022

(BMJ. 2021;372:n716)
Oxytocin is commonly used to stimulate the uterus and induce labor. Hyperstimulation carries risks to mother and fetus and may increase the likelihood of cesarean delivery (CD). Recent studies suggest that discontinuing oxytocin augmentation will not interrupt labor but may help avoid hyperstimulation. It is unclear if discontinuing oxytocin has an effect on the cesarean rate. This study aims to determine whether discontinuing oxytocin once labor is established reduces the cesarean rate.
Immunogenicity of COVID-19 mRNA Vaccines in Pregnant and Lactating Women
Authors: Collier A.Y. , McMahan K. , Yu J. , Tostanoski L.H. , Aguayo R. , Ansel J. , Chandrashekar A. , Patel S. , Apraku Bondzie E. , Sellers D. , Barrett J. , Sanborn O. , Wan H. , Chang A. , Anioke T. , Nkolola J. , Bradshaw C. , Jacob-Dolan C. , Feldman J. , Gebre M. , Borducchi E.N. , Liu J. , Schmidt A.G. , Suscovich T. , Linde C. , Alter G. , Hacker M.R. , Barouch D.H. 
Published: March 2022

(JAMA. 2021;325:2370–2380. doi-10.1001/jama2021.7563)
Pregnant women are at a greater risk of severe complications from symptomatic COVID-19, including ICU admission, needing mechanical ventilation, and death compared with their nonpregnant peers. Similarly, women who contract influenza and other viruses during pregnancy often have more severe illnesses as pregnancy reduces immune system effectiveness to prevent an immune system response to foreign DNA in a fetus. Women are encouraged to receive influenza and pertussis vaccines during pregnancy. In addition to protecting the mother from complications from these viruses while pregnant, studies have shown the baby also carries antibodies to prevent these viral infections after birth while it is too young to yet receive these vaccinations. A patient biorepository study from Beth Isreal Deaconess Medical Center investigated if babies of pregnant or lactating mothers who received a COVID-19 vaccine also carried antibodies to prevent this new virus. In addition the number of antibodies in babies born to women who had contracted COVID-19 while pregnant was compared to antibodies of babies whose mothers had only received a vaccine.
Comparison of Perinatal Outcomes for All Modes of Second Stage Delivery in Obstetric Theaters: A Retrospective Observational Study
Authors: Gurney L. , Wattar B.H.A.I. , Sher A. , Echevarria C. , Simpson H. 
Published: March 2022

(BJOG. 2021;128:1248–1255)
The World Health Organization recommend techniques to encourage vaginal delivery to mitigate unnecessary cesarean deliveries and the associated complications. These techniques include Keilland’s rotational forceps delivery, direct forceps delivery, manual rotation followed by forceps delivery, or ventouse delivery. Although this study demonstrated that Keilland’s rotational forceps delivery may be associated with successful vaginal delivery, some clinicians currently avoid instrumental delivery to evade maternal or neonatal harm, which ultimately leads to less skilled instrumental delivery and therefore, a riskier alternative. This study evaluated the effectiveness and safety of instrumental vaginal delivery techniques. In addition, it compared adverse perinatal outcomes between instrumental delivery and primary emergency cesarean section at full dilation (pEmCS).
Maternal Body Mass Index and Risk of Obstetric, Maternal and Neonatal Outcomes: A Cohort Study of Nulliparous Women With Spontaneous Onset of Labor
Authors: Dalbye R. , Gunnes N. , Blix E. , Zhang J. , Eggebø T. , Nistov Tokheim L. , Øian P. , Bernitz S. 
Published: March 2022

(Acta Obstet Gynecol Scand. 2021;100:521–530. doi: 10.1111/aogs.14017. Epub November 27, 2020)
Worldwide obesity and body mass index (BMI) have dramatically increased in the past few decades. As obesity can increase risk for serious health problems, understanding its impact on pregnancy and delivery is essential to improve patient care, labor outcomes, and health outcomes. Despite past work, there is still a need for studies examining impact of BMI on nulliparous women versus multiparous women and on induced and spontaneous onset of labor. This study focuses on nulliparous women with a singleton fetus in cephalic presentation with spontaneous onset of labor at term within the Ten-Group Classification System (TGCS) group 1. The aim of this study was to analyze those within TGCS group 1 and investigate the relational effect of early-pregnancy maternal BMI and obstetric, maternal, and neonatal outcomes.
Randomized Trial of Fetal Surgery for Severe Left Diaphragmatic Hernia
Authors: Deprest J.A. , Nicolaides J.H. , Benachi A. , Gratacos E. , Ryan G. , Persico N. , Sago H. , Johnson A. , Wielgoś M. , Berg C. , Van Calster B. , Russo F.M. ,   for the TOTAL Trial for Severe Hypoplasia Investigators
Published: March 2022

(Engl J Med. 2021;385:107–118)
Congenital diaphragmatic hernia (CDH) can lead to serious lifelong complications, but may be treated if diagnosed before birth. In fetoscopic endoluminal tracheal occlusion (FETO), a balloon is inserted into the fetal trachea in utero to stimulate fetal lung growth and is removed prior to birth. One study of 210 fetuses undergoing FETO for severe lung hypoplasia due to isolated CDH found a nearly doubled survival rate among fetuses who received FETO compared with controls (49% vs. 24%). This current study, Tracheal Occlusion to Accelerate Lung Growth (TOTAL), aimed to test whether fetuses with surgical treatment of severe left CDH had superior survival rates compared with fetuses who received expectant prenatal care.
Fetal Tracheal Occlusion for Congenital Diaphragmatic Hernia
Authors: Cole F. 
Published: March 2022

(N Engl J Med. 2021;385:177–178)
Studies on prenatal surgical interventions have historically been limited due to rarity and potential maternal complications. In 2011, the Management of Myelomeningocele Study (MOMS) found neonatal benefits associated with fetal surgery, including reduced need for cerebrospinal fluid shunting and improved infant motor outcomes at 30 months of age, but also found an increased risk of premature birth and maternal complications. This study provided an important framework for studies on fetal surgery: the inclusion of short- and long-term neonatal outcomes, attention to maternal complications, careful patient selection, and the use of multiple care centers.
Predictability of Preoperative Carotid Artery-corrected Flow Time for Hypotension After Spinal Anaesthesia in Patients Undergoing Caesarean Section: A Prospective Observational Study
Authors: Kim H.J. , Choi Y.S. , Kim S.H. , Lee W. , Kwon J.-Y. , Kim D.H. 
Published: March 2022

(Eur J Anaesthesiol. 2021;38:394–401)
Hypotension affects more than 50% of cesarean delivery (CD) patients receiving spinal anesthesia (SA). Fluid administration (preload and co-load), as well as prophylactic use of phenylephrine, noradrenaline, and ondansetron are all used to prevent hypotension. There are a number of reasons for hypotension following SA, and predicting the pathway leading to hypotension by monitoring hemodynamics may help inform the best prevention and treatment. Corrected blood flow time (FTc) in the carotid artery is affected by left ventricular preload and associated with myocardial afterload. This study aimed to evaluate preanesthetic FTc as a predictor of hypotension in CD patients receiving spinal anesthesia.
PROSPECT Guideline for Elective Cesarean Section: Updated Systematic Review and Procedure-specific Postoperative Pain Management Recommendations
Authors: Roofthooft E , Joshi GP , Rawal N , Van de Velde M ,   PROSPECT Working Group* of the European Society of Regional Anaesthesia and Pain Therapy and supported by the Obstetric Anaesthetists’ Association
Published: March 2022

(Anaesthesia. 2021;76:665–680. doi: 10.1111/anae.15339. Epub December 28, 2020)
Although postoperative pain from cesarean delivery (CD) can be severe and cause adverse maternal outcomes, it is often underestimated and undertreated. The PROSPECT working group is a multidisciplinary team of surgeons and anesthetists that collaborated to systematically review the current literature and provide evidence-based guidelines to optimize post-delivery analgesia for elective CDs. The PROSPECT group deemed an update from the last systematic review necessary to incorporate more recent approaches, including quadratus lumborum blocks.
Reliability of Uncertainty Tolerance Scales Implemented Among Physicians and Medical Students: A Systematic Review and Meta-Analysis
Authors: Stephens Georgina C. , Karim M. Nazmul , Sarkar Mahbub , Wilson Adam B. , Lazarus Michelle D. 
Published: March 2022

Purpose
Uncertainty tolerance (UT) is a construct describing individuals’ perceptions of, and responses to, uncertainty across their cognition, emotion, and behavior. Various UT scales have been designed for physician and medical student populations. However, links between UT and other variables (e.g., training stages) are inconsistent, raising concerns about scale reliability and validity. As reliability is a precondition for validity, a necessary first step in assessing UT scales’ efficacy is evaluating their reliability. Accordingly, the authors conducted a meta-analysis of the reliability of UT scales designed for, and implemented among, physician and medical student populations.

Method
In 2020, the authors searched 4 electronic databases alongside a citation search of previously identified UT scales. They included English-language, peer-reviewed studies that implemented UT scales in physician and/or medical student populations and reported reliability evidence. A meta-analysis of studies’ Cronbach’s alphas evaluated aggregated internal consistency across studies; subgroup analyses evaluated UT scales by named scale, population, and item characteristics.

Results
Among 4,124 records screened, 35 studies met the inclusion criteria, reporting 75 Cronbach’s alphas. Four UT scales appeared in at least 3 included studies: Physicians’ Reactions to Uncertainty scale 1990 (PRU1990) and 1995 (PRU1995) versions, Tolerance for Ambiguity scale (TFA), and Tolerance of Ambiguity in Medical Students and Doctors scale (TAMSAD). The scores from these scales ranged in reliability from very good (PRU1990: 0.832, PRU1995: 0.818) to respectable (TFA: 0.761, TAMSAD: 0.711). Aggregated internal consistency was significantly higher (P < .001) among physicians (0.797) than medical students (0.711).

Conclusions
UT scales generally demonstrated respectable internal consistency when administered among physicians and medical students, yet the reliability among medical students was significantly lower. The authors caution against using UT scores for decision-making purposes (e.g., applicant selection, program evaluation), especially among medical student populations. Future research should explore the reasons underlying these observed population differences.
Unreamed Intramedullary Nailing Versus External Fixation for the Treatment of Open Tibial Shaft Fractures in Uganda: A Randomized Clinical Trial
Authors: Kisitu Daniel K. , O'Hara Nathan N. , Slobogean Gerard P. , Howe Andrea L. , Blachut Piotr A. , O'Brien Peter J. , Stockton David J. 
Published: March 2022

Objective:
To compare unreamed intramedullary nailing versus external fixation for the treatment of Gustilo–Anderson type II and IIIA open tibial fractures admitted to a hospital in rural Uganda.

Design:
Randomized clinical trial.

Setting:
Regional referral hospital in Uganda.

Patients:
Fifty-five skeletally mature patients with a Gustilo–Anderson type II or IIIA open tibia shaft fracture treated within 24 hours of injury between May 2016 and December 2019.

Intervention:
Unreamed intramedullary nailing (n = 31) versus external fixation (n = 24).

Main Outcome Measurements:
The primary outcome was function within 12 months of injury, measured using the Function IndeX for Trauma (FIX-IT) score. Secondary outcomes included health-related quality of life (HRQoL) using the 3-level version of the 5-dimension EuroQol instrument (EQ-5D-3L), radiographic healing using the Radiographic Union Scale for Tibia (RUST) fractures score, and clinical complications.

Results:
Treatment with an intramedullary nail resulted in a 1.0-point higher [95% credible intervals (CrI), 0.1 to 1.9] FIX-IT score compared with external fixation. Results were similar for the secondary patient-reported outcomes, EQ-5D-3L and the visual analog scale component of the EuroQol instrument (EQ-VAS). RUST scores were not different between groups at any time point. Treatment with an intramedullary nail was associated with a 22.1% (95% CrI, −42.6% to 1.7%) lower rate of malunion and a 20.8% (95% CrI, −44.0% to 2.9%) lower rate of superficial infection.

Conclusion:
In rural Uganda, treatment of open tibial shaft fractures with an unreamed intramedullary nail results in marginal clinically important improvements in functional outcomes, although there is likely an important reduction in malunion and superficial infection.

Level of Evidence:
Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
Validation of an Electronic Phenotyping Algorithm for Patients With Acute Respiratory Failure
Authors: Essay Patrick , Fisher Julia M. , Mosier Jarrod M. , Subbian Vignesh 
Published: March 2022

OBJECTIVES:
Acute respiratory failure is a common reason for ICU admission and imposes significant strain on patients and the healthcare system. Noninvasive positive-pressure ventilation and high-flow nasal oxygen are increasingly used as an alternative to invasive mechanical ventilation to treat acute respiratory failure. As such, there is a need to accurately cohort patients using large, routinely collected, clinical data to better understand utilization patterns and patient outcomes. The primary objective of this retrospective observational study was to externally validate our computable phenotyping algorithm for patients with acute respiratory failure requiring various sequences of respiratory support in real-world data from a large healthcare delivery network.

DESIGN:
This is a cross-sectional observational study to validate our algorithm for phenotyping acute respiratory patients by method of respiratory support. We randomly selected 5% (n = 4,319) from each phenotype for manual validation. We calculated the algorithm performance and generated summary statistics for each phenotype and a priori defined clinical subgroups.

SETTING:
Data were extracted from a clinical data warehouse containing electronic health record data from 46 ICUs in the southwest United States.

PATIENTS:
All adult (≥ 18 yr) patient records requiring any type of oxygen therapy or mechanical ventilation between November 1, 2013, and September 30, 2020, were extracted for the study.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Micro- and macroaveraged multiclass specificities of the algorithm were 0.902 and 0.896, respectively. Sensitivity and specificity of phenotypes individually were greater than 0.90 for all phenotypes except for those patients extubated from invasive to noninvasive ventilation. We successfully created clinical subgroups of common illnesses requiring ventilatory support and provide high-level comparison of outcomes.

CONCLUSIONS:
The electronic phenotyping algorithm is robust and provides a necessary tool for retrospective research for characterizing patients with acute respiratory failure across modalities of respiratory support.