bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is breast milk iodine concentration an influential factor in growth‐ and obesity‐related hormones and infants' growth parameters?
Authors: Nazeri Pantea , Tahmasebinejad Zhale , Hedayati Mehdi , Mirmiran Parvin , Azizi Fereidoun 
Published: September 2020

AbstractIodine, a key constituent of thyroid hormones, plays an indirect role in prenatal and postnatal growth. This study aimed to investigate whether breast milk iodine concentration (BMIC) is associated with growth‐ and obesity‐related hormones and subsequently the infants' anthropometric measures. In present study conducted in Tehran (Iran), 94 lactating mothers and healthy infants who were exclusively breastfed were included. Concentrations of iodine, insulin‐like growth factor‐1 (IGF‐1), adiponectin (AD) and leptin (LP) were measured in breast milk samples collected during 3‐ to 5‐day postpartum. Anthropometric measures of infants were assessed at 6 months of life, and age‐ and sex‐specific z‐score values were calculated using the World Health Organization growth standards. The median (interquartile range) iodine, IGF‐1, AD and LP concentrations were 232.5 (157.5–296.0) μg L−1, 15.7 (11.9–21.1) ng ml−1, 13.2 (5.1–29.8) mg L−1 and 1.16 (0.86–1.70) ng ml−1 in breast milk, respectively. No significant correlations were found between BMIC and IGF‐1, AD and LP concentrations during the first few days postpartum. In adjusted regression model, BMIC was positively associated with weight‐for‐length z score of infants. In the presence of IGF‐1, AD or LP, the coefficients of BMIC for weight‐for‐length z score of infants were β = .003 (P = .021), β = .002 (P = .028) or β = .003 (P = .013), respectively. No other anthropometric measurements were associated with iodine or growth‐ and obesity‐related hormones in breast milk. Our findings indicate that BMIC is a potential contributor to infants' growth status, independent of IGF‐1, AD or LP concentrations in breast milk. The underlying mechanisms remain to be elucidated.
Catheter ablation for atrial tachycardias: How to interpret the unclear activation map?
Authors: Ma Wei , Qiu Jiuchun , Lu Fengmin , Shehata Michael , Wang Xunzhang , Wu Dongyan , He Le , Xu Jing 
Published: September 2020

AbstractBackgroundPost‐ablation atrial tachycardias (ATs) are characterized by low‐voltage signals that challenge current mapping methods. In this study, we analyzed common mistakes during activation mapping and delineated a mapping strategy for correct interpretation of tachycardia mechanisms in patients with challenging underlying substrate.Methods and resultsThirty‐one patients referred for AT ablation were selected for the study. Three types of incorrect activation patterns were identified, which were referred to as unrecognized block line (pseudo‐macroreentry and pseudo‐fig‐8 reentry), incorrect activation timing window of interest (WOI) (chaotic activation), and mis‐annotation of complex signals (multiple sites of “early meets late”). Pseudo‐macroreentry and chaotic activation occur in focal or localized reentry AT with the error related to the WOI selection (four cases), incorrect annotation of local activation time (six cases), or a previous line of atrial block in (seven cases). Pseudo‐fig‐8 reentry (five cases) and multiple sites of “early meets late” (nine cases) occur in macroreentrant AT with blocked areas and low‐voltage atrial substrate. All ATs were successfully eliminated at the origin site.ConclusionsWe delineated a series of ATs in the setting of a disordered pattern of activation mapping encountered in patients after previous extensive ablation or atriotomy. The algorithm proposed rapidly corrects the activation map and identifies the mechanism of the AT.
Long‐term respiratory outcomes of post‐op congenital lung malformations
Authors: Dincel Alican , Yilmaz Yegit Cansu , Ergenekon Almala Pinar , Erdem Eralp Ela , Gokdemir Yasemin , Kiyan Gursu , Karadag Bulent 
Published: September 2020

AbstractBackgroundCongenital lung malformations (CLM) are rare disorders and surgical intervention is the definitive treatment. Our aim is to evaluate the long‐term lung function of patients with CLM after surgery compared to healthy children.MethodsSixteen children with CLM (M/F: 9/7) and 30 age‐matched, healthy controls (M/F: 13/17) were included in the study. Demographic data were recorded and both groups were compared by spirometry and the nitrogen‐based Lung Clearance Index (LCI).ResultsMean ± SD age of the patients was 12.0 ± 5.4 years. The mean forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, and forced expiratory flow between 25% and 75% of force expiration (FEF25‐75) predicted was, 86.68 ± 16.65, 88.00 ± 14.58, 97.44 ± 9.89, and 79.00 ± 26.41, respectively in the patient group. Patients with CLM had significantly lower values in FEV1, FVC, FEF25‐75 than healthy controls (P = 0.002, P 0.007, P 0.045). While the mean LCI2,5% value in patients' group was 8.33 ± 1.52, it was 7.28 ± 0.80 in healthy controls (P = 0.023). Strong inverse correlation between LCI and FEV1, FEV1/FVC was detected in the patient group (P = 0.023; r: −0.581, P 0.017; r: −0.606 respectively).ConclusionThis study revealed that, in long‐term follow‐up, patients who had surgery because of CLM have impairment in the pulmonary function compared to healthy children and LCI may be more accurate in detecting airway diseases early than spirometry.
Fluorimetric ex vivo quantification of protease debriding efficacy on natural substrate
Authors: Vootukuri Reddy Sreekanth , Philpott Mike P. , Trigiante Giuseppe 
Published: September 2020

AbstractDebridement is the process of removal of necrotic and infected tissue to clean a wound or burn and expedite healing. Proteases such as papain, bromelain, and collagenase that promote debridement by degrading proteins in the dead tissue are in use today. However, the only method to measure debriding efficacy in vitro is the fluorescent monitoring of the digestion of an Artificial Wound Eschar (AWE) substrate. This AWE substrate contains a pellet of only three eschar matrix proteins collagen, elastin, and fibrin which do not account for the complexity and the composition of necrotic tissue. Here, we describe an ex vivo method using dry necrotic full thickness human skin and ortho‐phthalaldehyde (OPA), a molecule commonly used for sensitive fluorimetric protein detection to monitor debridement activity. We advocate this simple yet sensitive approach to detect debridement efficacy that can readily be used commercially to benchmark products prior to in vivo testing.
A chloride channel blocker prevents the suppression by inorganic phosphate of the cytosolic calcium signals that control muscle contraction
Authors: Ferreira Juan J. , Pequera Germán , Launikonis Bradley S. , Ríos Eduardo , Brum Gustavo 
Published: September 2020

Key points
Accumulation of inorganic phosphate (Pi) may contribute to muscle fatigue by precipitating calcium salts inside the sarcoplasmic reticulum (SR). Neither direct demonstration of this process nor definition of the entry pathway of Pi into SR are fully established.
We showed that Pi promoted Ca2+ release at concentrations below 10 mm and decreased it at higher concentrations. This decrease correlated well with that of [Ca2+]SR.
Pre‐treatment of permeabilized myofibres with 2 mm Cl− channel blocker 9‐anthracenecarboxylic acid (9AC) inhibited both effects of Pi.
The biphasic dependence of Ca2+ release on [Pi] is explained by a direct effect of Pi acting on the SR Ca2+ release channel, combined with the intra‐SR precipitation of Ca2+ salts. The effects of 9AC demonstrate that Pi enters the SR via a Cl− pathway of an as‐yet‐undefined molecular nature.
AbstractFatiguing exercise causes hydrolysis of phosphocreatine, increasing the intracellular concentration of inorganic phosphate (Pi). Pi diffuses into the sarcoplasmic reticulum (SR) where it is believed to form insoluble Ca2+ salts, thus contributing to the impairment of Ca2+ release. Information on the Pi entrance pathway is still lacking. In amphibian muscles endowed with isoform 3 of the RyR channel, Ca2+ spark frequency is correlated with the Ca2+ load of the SR and can be used to monitor this variable. We studied the effects of Pi on Ca2+ sparks in permeabilized fibres of the frog. Relative event frequency (f/fref) rose with increasing [Pi], reaching 2.54 ± 1.6 at 5 mm, and then decreased monotonically, reaching 0.09 ± 0.03 at [Pi] = 80 mm. Measurement of [Ca2+]SR confirmed a decrease correlated with spark frequency at high [Pi]. A large [Ca2+]SR surge was observed upon Pi removal. Anion channels are a putative path for Pi into the SR. We tested the effect of the chloride channel blocker 9‐anthracenecarboxylic acid (9AC) on Pi entrance. 9AC (400 µm) applied to the cytoplasm produced a non‐significant increase in spark frequency and reduced the Pi effects on this parameter. Fibre treatment with 2 mm 9AC in the presence of high cytoplasmic Mg2+ suppressed the effects of Pi on [Ca2+]SR and spark frequency up to 55 mm [Pi]. These results suggest that chloride channels (or transporters) provide the main pathway of inorganic phosphate into the SR and confirm that Pi impairs Ca2+ release by accumulating and precipitating with Ca2+ inside the SR, thus contributing to myogenic fatigue.
Investigation of Chemical Kinetic Model for Hypergolic Propellant of Monomethylhydrazine and Nitrogen Tetroxide
Authors: Hong-bo Hu , Hong-yu Chen , Yu Yan , Feng Zhang , Ji-Hui Yin , Dong Zheng 
Published: September 2020

Abstract
Hypergolic bipropellant of monomethylhydrazine (MMH) and nitrogen tetroxide (NTO) is extensively used in spacecraft propulsion applications and rocket engines. But studies on the chemical kinetic mechanism of MMH/NTO are limited. So, in this study by integrating the submechanisms of MMH decomposition, NTO thermal decomposition, MMH/NTO and intermediates, and small hydrocarbons, the comprehensive chemical mechanism of MMH/NTO bipropellant is proposed. The present chemical mechanism consists of 72 species and 406 elementary reactions. In two respects of ignition delay times and combustion flame temperatures, the present model has been validated against the theoretical calculation results and also compared with other kinetic models in the literature. The validations show that the predicted ignition delay times by the present kinetic model are highly consistent with the theoretical data and well describe the pressure-dependent characteristic. For combustion flame temperature, the present model also exhibits better predictions to the theoretical calculation results, which are also the same as the predictions by the MMH-RFNA model. Furthermore, the influences of initial temperature, chamber pressure, and NTO/HHM mass ratio (O/F) on the ignition delay time and combustion flame temperature are investigated. The auto-ignition behavior of MMH/NTO propellant is sensitive to initial temperature and chamber pressure, and the combustion flame temperature is more sensitive to the O/F. This study provides a detail chemical kinetics model for further mechanism simplification and combustion numerical simulation.
Safety and efficacy of dual versus triple antithrombotic therapy (DAT vs TAT) in patients with atrial fibrillation following a PCI: a systematic review and network meta-analysis
Authors: Altoukhi Renad M , Alshouimi Reema A , Al Rammah Shahad M , Alzahrani Mohammed Y , Almutairi Abdulaali R , Alshehri Abdulmajeed M , Alfayez Osamah M , Al Yami Majed S , Almohammed Omar A 
Published: September 2020

ObjectiveCreating an appropriate antithrombotic therapy for patients with atrial fibrillation (AF) who have undergone percutaneous coronary intervention (PCI) remains a dilemma. Several clinical trials compared the use of a dual antithrombotic therapy (DAT) regimen with a direct oral anticoagulants including (apixaban, dabigatran, edoxaban or rivaroxaban) and a P2Y12inhibitor versus a triple antithrombotic therapy (TAT) that includes a vitamin K antagonist plus aspirin and a P2Y12inhibitor in patients with AF who have undergone PCI. However, there are no head-to-head trials comparing the DAT regimens to each other. We aimed to compare the efficacy and safety of DAT regimens using a network meta-analysis (NMA) approach.DesignA systematic review and NMA of randomised clinical trials.MethodsWe conducted a systematic literature review to identify relevant randomised clinical trials and performed a Bayesian NMA for International Society on Thrombosis and Haemostasis (ISTH) major or clinically relevant non-major (CRNM) bleeding, all-cause mortality, stroke, myocardial infarction (MI) and stent thrombosis outcomes. We used NetMetaXL V.1.6.1 and WinBUGS V.1.4.3 for the NMA and estimated the probability of ranking the treatments based on the surface under the cumulative ranking curve.ResultsThe comparison between DAT regimens showed no significant difference in the safety or efficacy outcomes. Apixaban regimen was ranked first as the preferred therapy in terms of ISTH major or CRNM bleeding and stroke, with a probability of 52% and 54%, respectively. Rivaroxaban regimen was the preferred therapy in terms of MI and stent thrombosis, with a probability of 34% and 27%, respectively. Dabigatran regimen was ranked first in terms of all-cause mortality, with a probability of 28%.ConclusionThe DAT regimens are as safe and effective as TAT regimens. However, ranking probabilities for the best option in the selected outcomes can be used to guide the selection among these agents based on different patients’ conditions.
Psychosocial volunteer support for older adults with cognitive impairment: development of MyCare Ageing using a codesign approach via action research
Authors: Ayton Darshini , O'Donnell Renée , Vicary Dave , Bateman Catherine , Moran Chris , Srikanth Velandai K , Lustig Julie , Banaszak-Holl Jane , Hunter Peter , Pritchard Elizabeth , Morris Heather , Savaglio Melissa , Parikh Seema , Skouteris Helen 
Published: September 2020

Background and objectivesOlder adults with cognitive impairment are vulnerable to frequent hospital admissions and emergency department presentations. The aim of this study was to use a codesign approach to develop MyCare Ageing, a programme that will train volunteers to provide psychosocial support to older people with dementia and/or delirium in hospital and at home when discharged from hospital.SettingMelbourne, Victoria, Australia.Research designThis study adopts an action research methodology. We report on two co-design workshops with keystakeholders: Workshop 1: identification of components from three existing programmes to inform the development of the MyCare Ageing program logic and, Workshop 2: identification of implementation strategies.ParticipantsThe key stakeholders and workshop participants included clinicians (geriatricians, nurses and allied health), hospital staff (volunteer coordinators and hospital executives), Baptcare staff, a consumer, researchers and implementation experts and project staff.ResultsWorkshop 1 identified the components from three existing programmes—the Volunteer Dementia and Delirium Care programme, Home-Start and MyCare for inclusion in MyCare Ageing. In workshop 2, the p implementation plan was developed taking into consideration hospital-specific processes, training and support needs of volunteers and safety and risk management processes.Discussion and conclusionThe codesign process was successfully applied to develop the MyCare Ageing programme to provide volunteer support to patients with dementia and/or delirium in hospital and their transition home. MyCare Ageing is an innovative programme that meets an identified need from hospitals and consumers to support patients with dementia and/or delirium to improve psychosocial outcomes on discharge from hospital.
Impact of physician’s sex/gender on processes of care, and clinical outcomes in cardiac operative care: a systematic review
Authors: Etherington Cole , Deng Mimi , Boet Sylvain , Johnston Amy , Mansour Fadi , Said Hussein , Zheng Katina , Sun Louise Y 
Published: September 2020

ObjectivesThis systematic review aimed to assess the role of physician’s sex and gender in relation to processes of care and/or clinical outcomes within the context of cardiac operative care.DesignA systematic review.Data sourcesSearches were conducted in PsycINFO, Embase and Medline from inception to 6 September 2018. The reference lists of relevant systematic reviews and included studies were also searched.Eligibility criteria for selecting studiesQuantitative studies of any design were included if they were published in English or French, involved patients of any age undergoing a cardiac surgical procedure and specifically assessed differences in processes of care or clinical patient outcomes by physician’s sex or gender. Studies were screened in duplicate by two pairs of independent reviewers.Outcome measuresProcesses of care, patient morbidity and patient mortality.ResultsThe search yielded 2095 publications after duplicate removal, of which two were ultimately included. These studies involved various types of surgery, including cardiac. One study found that patients treated by female surgeons compared with male surgeons had a lower 30-day mortality. The other study, however, found no differences in patient outcomes by surgeon’s sex. There were no studies that investigated anaesthesiologist’s sex/gender. There were also no studies investing physician’s sex or gender exclusively in the cardiac operating room.ConclusionsThe limited data surrounding the impact of physician’s sex/gender on the outcomes of cardiac surgery inhibits drawing a robust conclusion at this time. Results highlight the need for primary research to determine how these factors may influence cardiac operative practice, in order to optimise provider’s performance and improve outcomes in this high-risk patient group.
Strategies to Promote ResiliencY (SPRY): a randomised embedded multifactorial adaptative platform (REMAP) clinical trial protocol to study interventions to improve recovery after surgery in high-risk patients
Authors: Reitz Katherine Moll , Seymour Christopher W , Vates Jennifer , Quintana Melanie , Viele Kert , Detry Michelle , Morowitz Michael , Morris Alison , Methe Barbara , Kennedy Jason , Zuckerbraun Brian , Girard Timothy D , Marroquin Oscar C , Esper Stephen , Holder-Murray Jennifer , Newman Anne B , Berry Scott , Angus Derek C , Neal Matthew 
Published: September 2020

IntroductionAs the population ages, there is interest in strategies to promote resiliency, especially for frail patients at risk of its complications. The physiological stress of surgery in high-risk individuals has been proposed both as an important cause of accelerated age-related decline in health and as a model testing the effectiveness of strategies to improve resiliency to age-related health decline. We describe a randomised, embedded, multifactorial, adaptative platform (REMAP) trial to investigate multiple perioperative interventions, the first of which is metformin and selected for its anti-inflammatory and anti-ageing properties beyond its traditional blood glucose control features.Methods and analysisWithin a multihospital, single healthcare system, the Core Protocol for Strategies to Promote ResiliencY (SPRY) will be embedded within both the electronic health record (EHR) and the healthcare culture generating a continuously self-learning healthcare system. Embedding reduces the administrative burden of a traditional trial while accessing and rapidly analysing routine patient care EHR data. SPRY-Metformin is a placebo-controlled trial and is the first SPRY domain evaluating the effectiveness of three metformin dosages across three preoperative durations within a heterogeneous set of major surgical procedures. The primary outcome is 90-day hospital-free days. Bayesian posterior probabilities guide interim decision-making with predefined rules to determine stopping for futility or superior dosing selection. Using response adaptative randomisation, a maximum of 2500 patients allows 77%–92% power, detecting >15% primary outcome improvement. Secondary outcomes include mortality, readmission and postoperative complications. A subset of patients will be selected for substudies evaluating the microbiome, cognition, postoperative delirium and strength.Ethics and disseminationThe Core Protocol of SPRY REMAP and associated SPRY-Metformin Domain-Specific Appendix have been ethically approved by the Institutional Review Board and are publicly registered. Results will be publicly available to healthcare providers, patients and trial participants following achieving predetermined platform conclusions.Trial registration numberNCT03861767.
How do users of a ‘digital-only’ contraceptive service provide biometric measurements and what does this teach us about safe and effective online care? A qualitative interview study
Authors: Baraitser Paula , McCulloch Hannah , Morelli Alessandra , Free Caroline 
Published: September 2020

ObjectivesTo describe user experience of obtaining and uploading biometric measurements to a ‘digital-only’ contraceptive service prior to a prescription for the combined oral contraceptive (COC). To analyse this experience to inform the design of safe and acceptable ‘digital-only’ online contraceptive services.SettingAn online contraceptive service available free of charge to women in South East London, UK.ParticipantsTwenty participants who had ordered the combined oral contraceptive (COC) online. Our purposive sampling strategy ensured that we included participants from a wide range of ages and those who were and were not prescribed the COC.InterventionA ‘digital-only’ contraceptive service that prescribes the COCafter an online medical history and self-reported height, weight and blood pressure (BP) with pills prescribed by a GMC registered doctor, dispensed by an online pharmacy and posted to the user.DesignSemistructured interviews with a purposive sample of 20 participants who were already enrolled in a larger study of this service.AnalysisInductive, thematic analysis of the interviews assisted by NVivo qualitative analysis software.ResultsUsers valued the convenience of ‘digital-only care’ but experienced measuring BP but not height or weight as a significant barrier to service use. They actively engaged in work to understand and measure BP through a combination of recent/past measurements, borrowed machines, health service visits and online research. They negotiated tensions around maintaining a trusting relationship with the service, meeting its demands for accurate information while also obtaining the contraception that they needed.ConclusionDigital strategies to build trusting clinical relationships despite a lack of face-to-face contact are needed in ‘digital-only’ health services. This includes acknowledgement of work required, evidence of credible human support and a digital interface that communicates the health benefits of collaborating with an engaged clinical team.