bluuebunny/crossref_metadata_2025_split huggingface dataset:
Provider perceptions on steroid dosing in AECOPD: Laying the groundwork for steroid stewardship
Authors: Cole Jennifer L. , Smith Sarah 
Published: August 2020

AbstractIntroductionSteroid overprescribing is well documented in acute exacerbations of COPD (AECOPD). Given the myriad of unwanted side effects of corticosteroids, facilities should implement steroid stewardship efforts. The objective of this project was to evaluate the prescribing habits of steroids in AECOPD for needs assessment and to tailor interventions in a single centre.MethodsA questionnaire was developed to evaluate practices and beliefs around steroid dosing in a simplified case of uncomplicated AECOPD. There were 31 total responders: 12 inpatient clinicians, 9 medical residents and 10 emergency department (ED) clinicians. All steroid dosing was converted to prednisone equivalents for reporting. Subgroup analysis was conducted between provider groups.ResultsInitial dosing ranged from 40 to 625 mg/day with only four responders (13%) selecting 40 mg/day. Dosing was not significantly different in newer providers ≤4 years’ experience: mean 215 mg versus >4 years’ experience: mean 312 mg (P = 0.23). Less experienced providers selected shorter treatment durations: median 5 days (IQR 5,6) versus 8.5 days (IQR 6,10.5) (P = 0.015). ED providers selected higher doses than non‐ED providers: 447 mg versus 208 mg (P = 0.003). Most responders (81%) selected IV agents over oral steroids. The majority (65%) stated dosing choices were based on prescribing habits/clinical experience, while 36% felt their selections were based on current evidence. Five (16%) of responders correctly identified consensus treatment guidelines and the majority (77%) reported being “very likely” or “somewhat likely” to prescribe lower doses.ConclusionBaseline knowledge was a significant barrier to guideline utilisation. Education will need to focus on the evidence behind using lower doses, oral agents and disease severity.
The COVID‐19 pandemic: A community approach
Authors: Cravedi Paolo , Schold Jesse D. , Safa Kassem , Kates Olivia S. , Elfadawy Nissreen , Mannon Roslyn B. , Shah Malay B. , Hammond Sarah P. , Avery Robin , Guerrero Miranda Cesar , Riella Leonardo V. , Jowsey‐Gregoire Sheila , Akalin Enver , Camirand Geoffrey , Alegre Maria‐Luisa , Azzi Jamil 
Published: August 2020

AbstractAn unprecedented global pandemic caused by a novel coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) has quickly overwhelmed the health care systems worldwide. While there is an absence of consensus among the community in how to manage solid organ transplant recipients and donors, a platform provided by the American Society of Transplantation online community “Outstanding Questions in Transplantation,” hosted a collaborative multicenter, multinational discussions to share knowledge in a rapidly evolving global situation. Here, we present a summary of the discussion in addition to the latest published literature.
Role of Wnt signaling in dermatofibroma induction phenomenon
Authors: Bennett Sabrina Lichon , Basko‐Plluska Juliana L. , Shea Christopher R. , Bolotin Diana 
Published: August 2020

AbstractBackgroundDermatofibroma (DF) is a common benign skin neoplasm. Induction above DF lesions, including follicular unit induction, is a frequently observed phenomenon. Wnt signaling is known to be critical in hair follicle morphogenesis. Our study assesses the role of Wnt signaling in DF induction by evaluating intracellular localization of β‐catenin in various types of DF induction.MethodsArchived tissue collected between 1 October 1980 and 1 October 2013 was stained per protocol using hematoxylin and eosin and anti‐β‐catenin monoclonal antibody. Specimens were grouped into categories based on the presence or absence and type of induction. All specimens were scored for nuclear β‐catenin localization.ResultsOf 62 specimens, 42 (68%) showed induction while 20 (32%) showed none. Nuclear β‐catenin staining was detected in 23 (55%) of the induction and in none of the no‐induction specimens (P‐value < 0.001). Types of induction included: 15 (24%) follicular induction, 31 (50%) acanthosis, and 4 (6%) sebaceous induction. For follicular induction, 13 (87%) showed positive nuclear β‐catenin staining compared to 11 (35%) for acanthosis and 1 (25%) for sebaceous induction (P‐value = 0.002).ConclusionOur findings support the hypothesis that DFs promote an ectopic activation of Wnt pathway signaling in follicular induction phenomenon.
Stress Echocardiography and Strain in Aortic Regurgitation (SESAR protocol): Left ventricular contractile reserve and myocardial work in asymptomatic patients with severe aortic regurgitation
Authors: D'Andrea Antonello , Sperlongano Simona , Formisano Tiziana , Tocci Giampaolo , Cameli Matteo , Tusa Maurizio , Novo Giuseppina , Corrado Giovanni , Ciampi Quirino , Citro Rodolfo , Bossone Eduardo , Galderisi Maurizio , Giallauria Francesco , Ambrosio Giuseppe , Picano Eugenio 
Published: August 2020

AbstractObjectivesTo analyze left ventricular (LV) myocardial deformation and contractile reserve (CR) in asymptomatic patients with severe aortic regurgitation (AR) at rest and during exercise, and their correlation with functional capacity.BackgroundThe natural history of chronic AR is characterized by a prolonged silent phase before onset of symptoms and overt LV dysfunction. Assessment of LV systolic function and contractile reserve has an important role in the decision‐making of AR asymptomatic patients.MethodsStandard echo, lung ultrasound, and LV 2D speckle tracking strain were performed at rest and during exercise in asymptomatic patients with severe AR and in age‐ and sex‐comparable healthy controls.Results115 AR patients (male sex 58.2%; 52.3 ± 18.3 years) and 55 controls were enrolled. Baseline LV ejection fraction was comparable between the groups. Resting LV global longitudinal strain (GLS) and myocardial work efficiency (MWE) were significantly reduced in AR (GLS‐15.8 ± 2.8 vs −21.4 ± 4.4; P < .001). Patients with AR and CR− showed reduced resting LV GLS and MWE and increased B‐lines. MWE was closely related to peak effort watts, VO2, LV E/e′, and B‐lines, at a multivariable analysis. Both GLS and MWE were strong independent predictors of CR. A resting LV GLS cutoff of −12% differentiated CR+ and CR− (78% sensitivity and 84% specificity).ConclusionsThe lower resting values of LV GLS and MWE in severe AR asymptomatic patients suggest an early subclinical myocardial damage that seems to be closely associated with lower exercise capacity, greater pulmonary congestion, and blunted LV contractile reserve during stress.
Antiepileptic combination therapy with Stevens‐Johnson syndrome and toxic epidermal necrolysis: Analysis of a Japanese pharmacovigilance database
Authors: Noguchi Yoshihiro , Takaoka Mirai , Hayashi Tsuyoshi , Tachi Tomoya , Teramachi Hitomi 
Published: August 2020

AbstractObjectiveStevens‐Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are immune‐mediated diseases characterized by an extensive loss of the epidermal skin layer, often resulting in death. SJS and TEN are often triggered by certain drugs, including antiepileptic drugs (AEDs). Epilepsy is very difficult to treat and often involves the combination of two or more AEDs. In this study, we quantified not only the risk of SJS or TEN associated with single‐AED therapy but also the risk related to concomitant AED treatment using reporting‐derived signals.MethodsAn analysis of the Japanese Adverse Drug Event Report (JADER) database was performed from the first quarter of 2004 to the fourth quarter of 2018. The single‐AED signals were evaluated using the proportional reporting ratio (PRR), and the combination therapy signals were evaluated using Ω shrinkage measure and combination risk ratio (CRR).ResultsSJS signals were associated with 11 AEDs, and TEN signals were related to 12 AEDs. Moreover, the following AED combinations were associated with SJS signals: carbamazepine‐lorazepam (Ω025: 0.33, CRR: 2.18) and fosphenytoin‐lorazepam (Ω025: 0.99, CRR: 39.20). The TEN signals were related to the following combinations: clobazam‐gabapentin (Ω025: 0.35, CRR: 3.14), phenytoin‐gabapentin (Ω025: 0.03, CRR: 2.18), valproic acid–gabapentin (Ω025: 0.15, CRR: 2.25), clobazam‐clonazepam (Ω025: 0.03, CRR: 2.93), clobazam–valproic acid (Ω025: 0.29, CRR: 1.55), fosphenytoin‐lamotrigine (Ω025: 0.05, CRR: 7.37), and lacosamide‐levetiracetam (Ω025: 0.74, CRR: 1.85).SignificanceThis study identified two AED combinations that increased the SJS signals and seven combinations that increased the TEN signals. Although AED monotherapies require attention for SJS and TEN, some AED combinations require extra caution.
In vivo quantitative analysis of advanced glycation end products in atopic dermatitis—Possible culprit for the comorbidities?
Authors: Hong Ji Yeon , Kim Min Jeong , Hong Jun Ki , Noh Hyun Ha , Park Kui Young , Lee Mi Kyung , Seo Seong Jun 
Published: August 2020

AbstractAdvanced glycation end products (AGEs) interact with the membrane‐bound receptor for AGEs (RAGE), consequently amplifying the inflammatory response. Soluble receptor for AGE (sRAGE) and endogenous secretory RAGE (esRAGE) act as decoys for AGE and competitively sequester RAGE ligands, thereby serving a cytoprotective role. Our objective was to investigate AGE expression and their receptors in the serum and skin of patients with atopic dermatitis (AD). In this case‐control study, the levels of AGE, sRAGE and esRAGE were measured in the blood samples and corneocytes of 29 adult patients with AD and 12 healthy controls by ELISA. Corneocyte AGE levels increased in the AD group (P = .002). Higher corneocyte AGE levels were observed in the severe AD than in the milder form of AD. No significant difference in serum AGE level was observed in patients with AD and healthy controls. Serum sRAGE markedly decreased in patients with AD (P = .007) and serum esRAGE followed a similar trend. In conclusion, dermal accumulation of AGE in AD may have a role in fuelling skin inflammation. The potential after‐effects of reduced neutralizer on systemic risk need further evaluation.
Decreases in cardiac catheter laboratory workload during the COVID‐19 level 4 lockdown in New Zealand
Authors: Elliott John M. , Crozier Ian G. 
Published: August 2020

AbstractAn increase in coronavirus disease (COVID‐19) infections prompted Level 4 lockdown throughout New Zealand from 25 March 2020. We have investigated trends in coronary and electrophysiology (EP) procedures before and during this lockdown. The number of acute procedures for ST elevation myocardial infarction remained stable. In contrast, the number of in‐patient angiograms and percutaneous intervention procedures fell by 53% compared with the previous 4 weeks in 2020 and by 56% compared with the corresponding period in 2019. Further study is required to determine the reasons for these trends.
Collusive equilibria with switching costs: The effect of consumer concentration
Authors: Roig Guillem 
Published: August 2020

AbstractI study the ability of two competing firms to set collusive prices in markets where consumers have switching costs. In consumer markets (with a small number of consumers), I find an antifolk result in which collusion, in the presence of switching costs, does not arise with patient firms. Patient firms compete aggressively and consumers expect a large utility. A collusive equilibrium is unstable because a deviating firm incorporates the future consumer utility in its deviating price. Also, consumers have a strategic impact so, with the prospects of large utility, they decide to switch to destabilize the firms' collusive agreement. These results do not eventuate in markets with a large number of consumers. In mass markets (a continuum of consumers), a single consumer lacks a strategic impact to destabilize a collusive agreement and a deviating firm cannot appropriate the consumer utility when deviating from collusion. Collusion, then, becomes straightforward to achieve. We show that for any number of consumers, switching costs make collusion easy to sustain.
Taiwanese Nurses’ Attitudes Towards and Knowledge About Sexual Minorities and Their Behavior of Providing Care to Sexual Minority Patients: Results of an Online Survey
Authors: Wang Ya‐Ching , Chang Shiow‐Ru , Miao Nae‐Fang 
Published: August 2020

AbstractPurposeTo assess Taiwanese nurses’ attitudes toward and knowledge about sexual minorities, and their awareness and behavior of providing care to sexual minority patients.DesignA cross‐sectional descriptive design was employed.MethodsA total of 323 Taiwanese nurses 20 years of age or older completed an online questionnaire between September and November 2019. It included five sections: demographics, the Attitudes Toward Lesbians and Gay Men Scale, Knowledge About Homosexuality Questionnaire, Gay Affirmative Practice Scale, and nurses’ needs for promoting culturally competent care.ResultsTaiwanese nurses held positive attitudes, and demonstrated high levels of awareness and behaviors of providing care to sexual minority patients. However, they had limited knowledge regarding homosexuality. More so, nurses who were older, self‐identified as heterosexuals, were married, had more than 10 years’ work experience, and were Buddhists had poor knowledge about homosexuality. Nurses reported that for providing culturally competent care they required knowledge about sexual minorities’ physical and mental health issues; the populations’ social and welfare resources; communication skills training; privacy; and safe space.ConclusionsInformation on homosexuality and health issues among sexual minority populations, communication skills training, privacy, and safe space should be provided to Taiwanese nurses to improve their abilities to provide culturally competent care and to reduce health inequalities among sexual minorities.Clinical RelevanceThis study’s results could be used as evidence for designing and providing training programs for nurses regarding culturally competent care, and thus promote quality nursing care and decrease difficulties of accessing healthcare services among sexual minority patients.
The Effect of the Medicaid Expansion on Dropout Rates
Authors: Yeung Ryan 
Published: August 2020

ABSTRACTBACKGROUNDThis study investigates how the Medicaid Expansion of the Affordable Care Act affected state high school dropout rates.METHODSThis study relies on a differences‐in‐differences estimation strategy that is common in program evaluation, especially in education. This method replicates in a regression framework a classic pre‐test post‐test comparison group quasi‐experimental design. The analysis is conducted at the state level, which reduces the precision of the estimates.RESULTSStates that adopted the Medicaid Expansion had a 0.658 percentage point greater reduction in dropout rates than non‐Expansion states in the year of Medicaid implementation. A back‐of‐the‐envelope calculation suggests that if all the remaining non‐Expansion states adopted Medicaid, there would be a decrease of over 92,500 youths who drop out of high school, representing a drop of 11.2% in the number of dropouts in these states.CONCLUSIONThe Medicaid Expansion of the Affordable Care Act is more than just a health insurance program; it is a dropout prevention program.
Period prevalence and mortality rates associated with hypocholesterolaemia in dogs and cats: 1,375 cases
Authors: Tan A. W. K. , Epstein S. E. , Hopper K. 
Published: August 2020

ObjectivesTo determine the period prevalence of hypocholesterolaemia and the associated mortality rates in dogs and cats at a university teaching hospital. The secondary aim was to identify disease processes associated with hypocholesterolaemia.Materials and MethodsMedical records over a 5‐year period were reviewed to determine the severity of hypocholesterolaemia and its associated mortality rate. Medical records of animals with moderate to severe hypocholesterolaemia (<2.59 mmol/L in dogs, <1.81 mmol/L in cats) were analysed further. Animals with hospital‐acquired hypocholesterolaemia were identified.ResultsAmong 16,977 dogs and 3,788 cats that had at least one cholesterol measurement, the period prevalence of hypocholesterolaemia was 7.0% in dogs and 4.7% in cats. The mortality rate of hypocholesteraemic dogs and cats was 12% in both species which was significantly higher than that of animals with normal serum cholesterol. The degree of hypocholesterolaemia was significantly associated with mortality. Dogs, but not cats, with hospital‐acquired hypocholesterolaemia had a higher mortality rate than those presenting with hypocholesterolaemia. Disease of hepatic, gastrointestinal and lymphoreticular systems were most commonly associated with hypocholesterolaemia, and infectious and neoplastic disease were the most commonly associated pathophysiologic processes in both species. Lymphoma was over‐represented in dogs with neoplasia.Clinical SignificanceHypocholesterolaemia is not a frequent abnormality but was associated with mortality in this study and may be a negative prognostic indicator. It is not known if hypocholesterolaemia is simply a marker for disease severity, or if it is has active physiologic effects contributing to poor outcomes.
Spatial patterning of soil microbial communities created by fungus‐farming termites
Authors: Baker Christopher C. M. , Castillo Vardaro Jessica A. , Doak Daniel F. , Pansu Johan , Puissant Jérémy , Pringle Robert M. , Tarnita Corina E. 
Published: August 2020

AbstractSpatially overdispersed mounds of fungus‐farming termites (Macrotermitinae) are hotspots of nutrient availability and primary productivity in tropical savannas, creating spatial heterogeneity in communities and ecosystem functions. These termites influence the local availability of nutrients in part by redistributing nutrients across the landscape, but the links between termite ecosystem engineering and the soil microbes that are the metabolic agents of nutrient cycling are little understood. We used DNA metabarcoding of soils from Odontotermes montanus mounds to examine the influence of termites on soil microbial communities in a semi‐arid Kenyan savanna. We found that bacterial and fungal communities were compositionally distinct in termite‐mound topsoils relative to the surrounding savanna, and that bacterial communities were more diverse on mounds. The higher microbial alpha and beta diversity associated with mounds created striking spatial patterning in microbial community composition, and boosted landscape‐scale microbial richness and diversity. Selected enzyme assays revealed consistent differences in potential enzymatic activity, suggesting links between termite‐induced heterogeneity in microbial community composition and the spatial distribution of ecosystem functions. We conducted a large‐scale field experiment in which we attempted to simulate termites’ effects on microbes by fertilizing mound‐sized patches; this altered both bacterial and fungal communities, but in a different way than natural mounds. Elevated levels of inorganic nitrogen, phosphorus and potassium may help to explain the distinctive fungal communities in termite‐mound soils, but cannot account for the distinctive bacterial communities associated with mounds.
Comparison of versioning methods to improve the information flow in the planning and building processes
Authors: Eriksson Helen , Sun Jing , Tarandi Väino , Harrie Lars 
Published: August 2020

AbstractVersion management is a prerequisite for digital information flow between phases in the planning and building processes. Information evolves over time and many parties retrieve information from the various phases. The aim of this article is to evaluate versioning methods, focusing on geodata buildings in the 3D cadastre process. The main attention in the evaluation is on the comprehensive ISO standard Product Lifecycle Support (PLCS). PLCS is evaluated against two simpler versioning methods, the versioning in CityGML 3.0 and a modified Git versioning method implemented in CityJSON. CityGML 3.0 fulfils all but one requirement and PLCS meets all. The methods vary in complexity; the Git proposal is a simple solution, easy to implement and maintain, while PLCS includes all functionalities and is complex to implement. There is a trade‐off between number of functionalities and complexity, it is therefore important that the intended purpose determines the choice of versioning method.
Development and Simulation of a Magnetohydrodynamic Solar Generator Operated With NaCl Electrolyte Solution
Authors: Jiménez-Flores Steffanie , Pérez-Luna J. Guillermo , Alvarado-Pulido J. Joaquín , Jiménez-González Antonio E. 
Published: August 2020

Abstract
A magnetohydrodynamic (MHD) generator is a device that generates electrical energy through the interaction between a conductive fluid and a magnetic field. This method of direct energy conversion allows the use of a renewable energy source such as solar energy and represents an alternative to tackle the greenhouse effect. This paper presents the development of an MHD solar generator, which is constituted by a solar thermal system and an MHD cell. The solar thermal system consists of a set of tubes with copper fins, connected in parallel and placed inside of a 1 m2 panel. In which, an electrolytic mixture of H2O and NaCl at 20% vol. was introduced as a working fluid. In order to increase the kinetic energy of the fluid, the panel was exposed to solar radiation, where it reached temperatures above 373 K and pressures above 96 kPa. This solar thermal system operates in closed cycle conditions by including a check valve in its inlet–outlet junction; in this way, the fluid travels through the MHD generator. The MHD cell was composed of a block of polytetrafluoroethylene, two cylindrical stainless-steel electrodes, and four neodymium magnets. For simulation purposes, comsol multiphysics was used to reproduce the current density produced by the MHD solar generator. Pressure and temperature quantities obtained experimentally in the MHD cell were employed as boundary conditions. The experimental maximal current density obtained corresponds to 4.30 mA/m2, and the comparison between theoretical and experimental results shows that the model fits fairly well.
Numerical Modeling of CO2 Splitting in High-Temperature Solar-Driven Oxygen Permeation Membrane Reactors
Authors: Pan Heng , Lu Youjun , Zhu Liya 
Published: August 2020

Abstract
H2/CO production via H2O/CO2 splitting powered by concentrated solar energy is a promising pathway for energy conversion/storage. Oxygen permeable membrane reactor serves as an alternative reactor concept for realizing this chemical path with the advantages of continuous production, easy integration, and high product selectivity. In this paper, a mathematical model of steady-state mass and heat transfer coupled with reaction kinetics in the oxygen permeation membrane reactor was established. CO2 splitting in the ceria membrane reactor was simulated and the effects of various factors, including inert/CO2 flow configurations, reaction conditions, and geometric parameters of the membrane, on the CO2 conversion process, were studied. The increase of operating temperature could effectively improve the CO2 conversion ratio, and the effect of decreasing the oxygen pressure of the inert gas is very limited. The oxygen accumulation in the inert gas could lead to considerably high inert demand. Furthermore, conversion-limiting factors were studied under different conditions and there are two critical rate constants of reactions signifying a transition from a chemical kinetics limited conversion to oxygen diffusion limited conversion. This work helps guide reactor design and operate toward achieving the maximum CO2 conversion ratio.