bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying Clear Cell Renal Cell Carcinoma Coexpression Networks Associated with Opioid Signaling and Survival
Authors: Scarpa Joseph R. , DiNatale Renzo G. , Mano Roy , Silagy Andrew W. , Kuo Fengshen , Irie Takeshi , McCormick Patrick J. , Fischer Gregory W. , Hakimi A. Ari , Mincer Joshua S. 
Published: December 2020

Abstract

While opioids constitute the major component of perioperative analgesic regimens for surgery in general, a variety of evidence points to an association between perioperative opioid exposure and longer term oncologic outcomes. The mechanistic details underlying these effects are not well understood. In this study, we focused on clear cell renal cell carcinoma (ccRCC) and utilized RNA sequencing and outcome data from both The Cancer Genome Atlas, as well as a local patient cohort to identify survival-associated gene coexpression networks. We then projected drug-induced transcriptional profiles from in vitro cancer cells to predict drug effects on these networks and recurrence-free, cancer-specific, and overall survival. The opioid receptor agonist, leu-enkephalin, was predicted to have antisurvival effects in ccRCC, primarily through Th2 immune- and NRF2-dependent macrophage networks. Conversely, the antagonist, naloxone, was predicted to have prosurvival effects, primarily through angiogenesis, fatty acid metabolism, and hemopoesis pathways. Eight coexpression networks associated with survival endpoints in ccRCC were identified, and master regulators of the transition from the normal to disease state were inferred, a number of which are linked to opioid pathways. These results are the first to suggest a mechanism for opioid effects on cancer outcomes through modulation of survival-associated coexpression networks. While we focus on ccRCC, this methodology may be employed to predict opioid effects on other cancer types and to personalize analgesic regimens in patients with cancer for optimal outcomes.

Significance:
This study suggests a possible molecular mechanism for opioid effects on cancer outcomes generally, with implications for personalization of analgesic regimens.
Distribution and composition of Dragonfly and Damselfly species (Odonata) of the upper Rio das Velhas, Ouro Preto, Minas Gerais State, Brazil
Authors: Ávila Júnior Walter Francisco de , Machado Gustavo Lisboa Vieira , Lencioni Frederico Augusto de Atayde , Carneiro Marco Antônio Alves 
Published: December 2020

This paper describes the composition and distribution of Anisoptera and Zygoptera (Odonata) species of the upper Rio das Velhas in the municipality of Ouro Preto, Minas Gerais State, Brazil. A total of 727 specimens of 40 species were collected near water bodies over a period of 23 months between 2015 and 2017. The families with greatest species richness were Libellulidae (13 species), Coenagrionidae (12 species) and Heteragrionidae and Aeshnidae (4 species each). Notable among the species collected were Perilestes fragilis Hagen in Selys, 1862, inhabiting well-preserved forests, Minagrion waltheri Santos, 1965, pertaining a endemic genus of Brazil and the recently described Heteragrion cauei Ávila-Júnior et al., 2017, and three species recorded for the first time for the state: Elasmothemis alcebiadesi (Santos, 1945); Erythrodiplax melanica Borror, 1942 and Erythrodiplax acantha Borror, 1942, the latter is considered Critically Endangered (CR) by the International Union for Conservation of Nature's (IUCN) Red List.
The Rusty-spotted Cat Prionailurus rubiginosus (I. Geoffroy Saint-Hillaire, 1831) (Mammalia: Carnivora: Felidae) in Rajasthan, India – a compilation of two decades
Authors: Sharma Satish Kumar , Dhakad Meenu 
Published: December 2020

In Rajasthan, the presence of the Rusty-spotted Cat Prionailurus rubiginosus was first reported in 1994 in Udaipur District, the southernmost district of Rajasthan. Since then, it was also recorded in four more districts scattered over an area of about 86,205km2. We compiled information about the occurrence of the Rusty-spotted Cat in Rajasthan based on direct sightings, road kills, rescued kittens, and camera trap images. Our data set shows that the Rusty-spotted Cat is also present in eight more districts of Rajasthan that form part of the Aravalli Hills and Vindhyan Hills in the semi-arid zone of eastern Rajasthan. The area encompassed by these records amounts to 71,586km2. Kittens were rescued in six instances. Adult cats were recorded in 45 instances including 41 live cats and four roadkills. Ten adult live Rusty-spotted Cats were sighted in the mornings, and 31 were recorded after dark between late evenings and early mornings. They were recorded in eight habitat types including foremost thorny and dry deciduous forests, but also ravines and agricultural fields adjacent to forests, and in forest patches in the vicinity of human settlements. The preservation of forests is of utmost importance for the long-term viability of the Rusty-spotted Cat. We strongly recommend surveys outside protected areas to determine the connectivity between Rusty-spotted Cat population units in Rajasthan.
Updating records of a threatened felid species of the Argentinian Patagonia: the Guigna Leopardus guigna (Molina, 1782) (Mammalia: Carnivora: Felidae) in Los Alerces National Park
Authors: Guerisoli Maria de las Mercedes , Schiaffini Mauro Ignacio , Bauer Gabriel 
Published: December 2020

The Guigna Leopardus guigna is an endemic felid of the Valdivian Temperate Forests in Argentina and Chile, and of the Chilean Matorral ecoregion. It is a small-sized felid (1.6–2.5 kg), one of the least known wild felids, and categorized as Vulnerable to extinction. Here, we present two new reliable records in Los Alerces National Park, Chubut Province, Argentina, the southernmost protected area, in which the species is present. The first record is an individual found dead on 6 June 2019 on the bank of Frey River near Amutui Quimei Lake. The second record was an individual casually captured in an American Mink Neovison vison cage on 7 December 2019 near Menéndez Lake. Both records were in forested Nothofagus sites very nearby to watercourses. In order to maintain viable long-term Guigna populations, corridors between protected areas should be established, particularly in habitat dominated by human presence and activities. We strongly recommend further fieldwork in protected areas and between them to increase the knowledge about the distribution, habitat use, and ecology of the Guigna.
Utilization of Percentage of Predicted Forced Vital Capacity to Stratify Rib Fracture Patients: An Updated Clinical Practice Guideline
Authors: Khan Abid D. , Marlor Derek R. , Billings Joshua D. , Rodriguez Joe , Leininger Brian E. , Douville Alyssa A. , Clement Lesley Paige , Schroeppel Thomas J. 
Published: December 2020

Background Rib fractures are the most common injuries diagnosed after blunt thoracic trauma and are a source of significant morbidity and mortality. Early identification of at-risk patients and initiation of effective analgesia are keys to mitigating complications from these injuries. Multiple tools exist to predict pulmonary decompensation after rib fractures; however, none has found a widespread acceptance. A clinical practice guideline (CPG) utilizing Forced vital capacity (FVC) has been in place at a single institution. The goal of this study is to update the CPG to use percentage of predicted FVC (FVC%) instead of FVC to triage patients with rib fractures. Materials and Methods A retrospective study of 266 patients with rib fractures was conducted. Patients were divided into 3 groups based on FVC of <1000 mL, 1001-1500 mL, or >1500 mL for analysis. Data were analyzed with analysis of variance, and Youden’s J Index was used to identify inflection points. Results Patients in the high-risk category were more likely to be women, older than 65 years, admitted to the intensive care unit (ICU), transferred to the ICU, require intubation, and have overall longer hospital and ICU stays. The updated CPG triage cutoffs for admission to ICU, stepdown, and floor were redefined as FVC% values of <25%, 25-45%, and >45%, respectively. Discussion The updated CPG using FVC% may more accurately identify patients with compromised physiology and be a better tool to help predict patients who are at risk for decompensation following rib fractures. A validation study for the updated CPG is in progress.
Palliative Care in Emergency General Surgery Patients: Reduced Inpatient Mortality And Increased Discharge to Hospice
Authors: Baimas-George Maria , Yelverton Sam , Ross Samuel W. , Rozario Nigel , Matthews Brent D. , Reinke Caroline E. 
Published: December 2020

Background Admissions due to emergency general surgery (EGS) are on the rise, and patients who undergo emergency surgery are at increased risk of mortality. We hypothesized that utilization of palliative care and discharge to hospice in the EGS population have increased over time and that this is associated with a decrease in inpatient mortality. Methods Using the 2002-2011 nationwide inpatient sample and American Association for the Surgery of Trauma-defined EGS diagnosis codes, we identified patients ≥18 years old with an EGS admission. Demographics, hospitalization characteristics, mortality, use of palliative care services, and discharge to hospice were queried. All Patient Refined-Diagnosis Related Group risk of mortality was used to categorize those with an extreme likelihood of dying (ELD). Multivariable logistic regression was used to investigate the association between palliative care consult and discharge to hospice. Results Of the included patients, 0.3% received palliative care and 0.2% were discharged to hospice. Over time, rates of palliative care and hospice discharge increased while inpatient mortality decreased. In the 4% of patients with ELD, 3% received palliative care, 5% were transitioned to hospice care, and 22% suffered inpatient mortality. Controlling for patient characteristics, utilization of palliative care services was associated with increased odds of discharge to hospice compared to inpatient mortality (OR = 1.78 all patients and OR = 2.04 for ELD). Conclusions Despite the known increased risks associated with emergency surgical diagnoses, palliative care services remain infrequently utilized in the EGS population. This may be an opportunity for lessening suffering, improving patient-concordant care and outcomes, and reducing nonbeneficial and unwanted care.
National Health Burden of Aspiration Pneumonia on Clinical and Operational Outcomes in Patients With Small Bowel Obstruction Requiring Nasogastric Decompression
Authors: Mehta Amit , Martin Tracey , Demiralp Berna , Steele-Adjognon Marie , Agarwal Aishwarya , Mahadev Srihari , Sharaiha Reem Z. 
Published: December 2020

Background Nasogastric tubes (NGTs) are used for decompression in patients with acute small bowel obstruction (SBO); however, their role remains controversial. There is evidence that NGT use is still associated with high incidence of aspiration pneumonia. The aims of this study were to define the prevalence of aspiration pneumonia in patients with SBO managed with an NGT and estimate the association of aspiration pneumonia with 30-day mortality rates, length of stay (LOS), and hospital costs. Materials and Methods A retrospective cohort study was done using Medicare Inpatient Standard Analytic Files from 2016 to 2018. Patients hospitalized with SBO and managed with NGT were identified using an algorithm of ICD-10-CM codes. The key exposure was aspiration pneumonia. Outcome measures included 30-day mortality rates, LOS, and hospital costs. Results 53 715 patients hospitalized with SBO and managed with an NGT were identified and included in the analysis. We observed a prevalence of aspiration pneumonia of 7.3%. The 30-day mortality rate was 31% for those who developed aspiration pneumonia vs. 10% for those without pneumonia ( P < .001). Those with aspiration pneumonia, on average, were hospitalized 7.0 days longer ( P < .001) and accrued $20,543 greater hospitalization costs ( P < .001) than those without pneumonia. Controlling for hospital size and hospital teaching status, we noted a significant association between aspiration pneumonia and increased mortality ( P < .001), longer length of stay ( P < .001), and higher hospital costs ( P < .001). Discussion Among patients hospitalized for SBO who required an NGT, aspiration pneumonia was associated with a higher mortality rate, longer hospital LOS, and higher total hospital costs. vv
Between Violence, Racism and Reform: São Tomé e Príncipe in the Great Depression Years, 1930–7
Authors: Valverde Contreras Beatriz , Keese Alexander 
Published: December 2020

The effects of the Great Depression on the important cocoa plantation sector of the archipelago of São Tomé e Príncipe – a Portuguese colonial laboratory for social change in plantation agriculture shifting between coercive practices and attempts at accommodation – were drastic: initially backed by a right-wing authoritarian government, plantation managements lowered workers’ wages and made already repressive conditions of worker exploitation worse. This article highlights the processes of degradation in plantation workers' life. However, in ways that might seem paradox at first glance, the crisis years of the 1930s also opened the ways to changes in social experiences in the plantations. Labour inspectors were increasingly called upon to scrutinize existing abuses on the plantations, and although this might have been in the first phase simply lip service to certain international debates on good standards in colonialism, inspectors internalized the need for reform and turned out to be critical observers. At the same time, the workers expanded their repertoire of responses – from individual resistance to ever better-organized escape strategies and the manipulation of offers of settlement schemes for small groups of workers. By 1937, these trends were important precursors to changes that would achieve their full impact in the 1950s.
The Teacher Behavior Checklist: The Mediation Role of Teacher Behaviors in the Relationship Between the Students’ Importance of Teacher Behaviors and Students’ Effort
Authors: Geier Michael T. 
Published: December 2020

Background: Previous research suggests a relationship between teacher behaviors and students’ effort. However, it is not clear what role the students’ expectations (i.e., importance of teacher behaviors) play in this relationship. Objective: Utilizing the teacher behavior checklist, this study sought to investigate whether teacher behaviors mediate the relationship between the importance students set on teacher behaviors and students’ effort. Further, the study explored which specific behaviors influence students’ effort. Method: Cross-sectional survey data were analyzed ( N = 159) using mediation analysis and stepwise multiple linear regression. Results: There was evidence that teacher behaviors mediate the relationship between the importance students set on teacher behaviors and students’ effort. Four of the 28 teacher behaviors had a significant relationship to students’ effort: creative and interesting, enthusiastic about teaching, happy/positive/humorous, and promotes critical thinking. Conclusion: Knowing students’ expectations (i.e., the importance of teacher behaviors) is essential to increasing students’ effort. Teaching Implications: Happy/positive/humorous had a negative relationship with students’ effort, while creative and interesting, enthusiastic about teaching, and promotes critical thinking showed a positive relationship with students’ effort.
Long-Term Follow-Up After Fat Graft Myringoplasty: Do Size and Location Matter?
Authors: Diaz Alfonso Rodriguez , Reina Carlos O’Connor , Plaza Guillermo , Posadas Elena Rodriguez , Arevalo Francisco Valdeon , Iriarte Maria Teresa Garcia 
Published: December 2020

Objective: To assess clinical and functional outcomes of a fat graft myringoplasty under local in an office setting. Study Design: Prospective case series. Setting: Tertiary care facility. Patients: Patients with a tympanic membrane (TM) perforation presenting between December 2005 and June 2019. Inclusion criteria included perforation size >25% of the surface of the pars tensa of the TM, entire perforation margins visualized through a transcanal view, and lack of spontaneous closure at the 6-month follow-up. The exclusion criteria were the presence of cholesteatoma, wet appearance of the mucosa in the tympanic cavity, ear discharge in the 3 months before surgery, or signs of ossicular inconsistency. Intervention: In-office fat graft myringoplasty technique under local anesthesia. Main outcome Measures: Complete perforation closure rate and audiometric outcomes. Results: A total of 121 patients underwent the procedure, of whom 21 had bilateral sequential procedures (total 142 ears). Average age was 51.1 ± 18.4 years (range, 3-78 years). The size of perforation was <25% of TM in 39 (27.5%) ears, 25% to 50% of TM in 49 (34.55%) ears, 50% to 75% of TM in 34 (23.91%) ears, and 75% to 100% of TM in 20 (14.10%) ears. Complete perforation closure was evident in 130 (91.55%) of the 142 ears. Preoperative mean air conduction threshold was 59.3 dB (17-95 dB) and significantly improved into 35.6 dB (10-85 dB; P < .0004) after surgery. Preoperative air–bone gap was 30.2 dB (5-70 dB) and also significantly improved into 10.2 dB (5-65 dB; P < .0001) after surgery. Conclusion: In office fat graft myringoplasty, in adult and pediatric patients with variable perforation sizes, is a well-tolerated procedure with very satisfactory clinical results.
Use of GlideScope in Patients Undergoing NIM Thyroidectomy
Authors: Casano Kelsey , Cannon C Ron , Didlake Ralph , Replogle William R. , Cannon Robert 
Published: December 2020

Objectives: Thyroidectomy and parathyroidectomy using the nerve integrity monitor (NIM) require proper placement of the endotracheal tube with electrodes aligned correctly within the larynx. The purpose of this study is to determine the percentage of patients who require positional adjustments of the endotracheal tube prior to beginning surgery and to understand the value of using the GlideScope to assure proper NIM tube placement within the larynx. Methods: This prospective study examines operative data from 297 patients who underwent NIM thyroidectomy and parathyroidectomy. After routine orotracheal intubation by an anesthesiologist and positioning of the patient for surgery, a GlideScope was used to check the position of the tube in 2 planes: depth of tube placement and rotation of the tube within the larynx assuring proper placement of the electromyogram electrodes within the glottis. Results: Tube adjustment was required for 66.5% of patients. In 48.1% of cases, tube retraction or advancement to a proper depth was needed. Tube rotation was required for 30.1% of patients, and 11.8% of patients required both adjustment of tube depth and tube rotation to properly align electrodes. Conclusions: After the anesthesiologist places the NIM endotracheal tube, and the patient is positioned for surgery, additional tube adjustment is often needed prior to the start of surgery. The GlideScope is readily available in the operating suite, its use adds little time to the procedure, and assures proper NIM tube placement. The use of the GlideScope is recommended.
The Research Protocol of SENIOR Project—Psychiatric Services and Support System for Serious Mental Illness in Old Age, Kerala, India
Authors: Thavody Jayakrishnan , Shibu Kumar TM  , Sujina CM  , Tharayil Harish M , Chandran Priya , George Biju , Neethu Mohan VM  , Prabakaran Anusha 
Published: December 2020

Background: India has the second-largest population of elderly in the world. Serious mental illness (SMI) is a subset of the mental disorders that result in significant functional impairment and is usually long term. Persons with SMI face several challenges in their old age that are different from the issues faced by younger people with SMI. Understanding the problems faced by elderly individuals suffering from SMI is fundamental for planning programs to address them. The SENIOR (Support Systems Evaluation of Neuropsychiatric Illness in Old age) project is a study aimed at evaluating the problems faced in obtaining mental health care by elderly persons having SMI in the Kerala state of India. Aim: To describe the scientific methodology of the SENIOR project. Methods: This study employs mixed-methods cross-sectional design among a minimum sample of 768 SMI patients identified through cluster sampling from three districts, and Focus Group Discussion among mental health program officials. Discussion: This paper presents a methodological model to assist researchers in future field epidemiological studies on mental illness. Assessing service needs and barriers to access for the most vulnerable among the mentally ill will help the policymakers make evidence-based decisions to improve their quality of life.
Inferior vena cava filters utilization in patients with venous thromboembolism: Analysis of a database of a tertiary hospital
Authors: Arslanbekov Magomed M , Efremova Oksana I , Lebedev Igor S , Kirienko Aleksandr I , Zolotukhin Igor A 
Published: December 2020

Purpose The aim of the study was to assess the inferior vena cava filter (IVCF) utilization in patients with venous thromboembolism (VTE) in tertiary care. Methods We performed a retrospective analysis of database of a tertiary hospital in 2016–2017. All the records of patients admitted for VTE or diagnosed with VTE being hospitalized for other reasons were extracted. The data collected were number of patients, who received IVCF, indications to filter insertion, PE and death rate after procedure, frequency of IVCF occlusion. Results 2399 patients with VTE were admitted to hospital. 442 (18,4%) of them received IVCF (239 in 2016 and 203 in 2017). Retrievable models were used in most cases (98,8%). In 119 (5,0%) patients cava filters were used due to contraindications for anticoagulation, while in 184 (7,7%) patients’ anticoagulation was not effective and thrombosis progression was registered. 101 (4,2%) patients received IVCF due to high PE risk (length of floating thrombus ≥7 cm, in proximal location), high pulmonary hypertension was indication to IVCF insertion in 38 (1,6%) patients with deep vein thrombosis (DVT) in combination with pulmonary embolism (PE). Overall mortality rate after IVCF insertion was 5 (0,2%). No fatal PE was registered. IVCF occlusion during hospitalization occurred in 116 (4,8%) cases. Only 29 (1,2%) of patients were admitted back for IVCF removal. Conclusions Every one in five patients with proximal DVT and/or PE receives IVCF in a routine practice in tertiary hospital. The most common indications for IVCF implantation were inability for anticoagulation or anticoagulation failure. Removal rate of retrievable cava filters is low.