bluuebunny/crossref_metadata_2025_split huggingface dataset:
SynGAP splice variants display heterogeneous spatio‐temporal expression and subcellular distribution in the developing mammalian brain
Authors: Gou Gemma , Roca‐Fernandez Adriana , Kilinc Murat , Serrano Elena , Reig‐Viader Rita , Araki Yoichi , Huganir Richard L. , de Quintana‐Schmidt Cristian , Rumbaugh Gavin , Bayés Àlex 
Published: February 2020

AbstractThe SynGAP protein is a major regulator of synapse biology and neural circuit function. Genetic variants linked to epilepsy and intellectual disability disrupt synaptic function and neural excitability. SynGAP has been involved in multiple signaling pathways and can regulate small GTPases with very different roles. Yet, the molecular bases behind this pleiotropy are poorly understood. We hypothesize that different SynGAP isoforms will mediate different sets of functions and that deciphering their spatio‐temporal expression and subcellular localization will accelerate understanding their multiple functions. Using isoform‐specific antibodies recognizing SynGAP in mouse and human samples we found distinctive developmental expression patterns for all SynGAP isoforms in five mouse brain areas. Particularly noticeable was the delayed expression of SynGAP‐α1 isoforms, which directly bind to postsynaptic density‐95, in cortex and hippocampus during the first 2 weeks of postnatal development. Suggesting that during this period other isoforms would have a more prominent role. Furthermore, we observed subcellular localization differences between isoforms, particularly throughout postnatal development. Consistent with previous reports, SynGAP was enriched in the postsynaptic density in the mature forebrain. However, SynGAP was predominantly found in non‐synaptic locations in a period of early postnatal development highly sensitive to SynGAP levels. While, α1 isoforms were always found enriched in the postsynaptic density, α2 isoforms changed from a non‐synaptic to a mostly postsynaptic density localization with age and β isoforms were always found enriched in non‐synaptic locations. The differential expression and subcellular distribution of SynGAP isoforms may contribute to isoform‐specific regulation of small GTPases, explaining SynGAP pleiotropy.
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Living donor liver transplantation in situs inversus totalis with a patient‐specific three‐dimensional printed liver model
Authors: Ishii Takamichi , Fukumitsu Ken , Ogawa Eri , Okamoto Tatsuya , Uemoto Shinji 
Published: February 2020

AbstractWe utilized patient‐specific 3D liver models based on preoperative computed tomography images as intraoperative navigation and describe our experience. A 1‐year and 10‐month‐old girl with situs inversus totalis underwent living donor liver transplantation for biliary atresia. Information on the hepatic artery, portal vein, inferior vena cava, and liver parenchyma was extracted and segmented from computed tomography images using liver analysis software. Laser lithography produced each 3D part of the liver from these data. The 3D models of each part of the liver were molded from polyurethane resin using different colors for each part and combined together, resulting in a patient‐specific liver model. The industrial computed tomography scan of the patient‐specific 3D liver model revealed that the gaps between the liver model and the original data were <0.4 mm in the 90% area, <0.8 mm in the 98% area, and 1.53 mm at the maximum. The 3D liver model was brought into the operative field and used as intraoperative navigation for total liver resection. The procedure was finished successfully without any major intraoperative complications. In conclusion, the 3D model facilitates the identification of vessels during operations; it is possible to promptly share patients' anatomy with the operative team.
Prediction paradigm involving time series applied to total blood issues data from England
Authors: Nandi Anita K. , Roberts David J. , Nandi Asoke K. 
Published: February 2020

BACKGROUNDBlood products are essential for modern medicine, but managing their collection and supply in the face of fluctuating demands represents a major challenge. As deterministic models based on predicted changes in population have been problematic, there remains a need for more precise and reliable prediction of demands. Here, we propose a paradigm incorporating four different time‐series methods to predict red blood cell (RBC) issues 4 to 24 weeks ahead.STUDY DESIGN AND METHODSWe used daily aggregates of RBC units issued from 2005 to 2011 from the National Health Service Blood and Transplant. We generated a new set of nonoverlapping weekly data by summing the daily data over 7 days and derived the average blood issues per week over 4‐week periods. We used four methods for linear prediction of blood demand by computing the coefficients with the minimum mean squared error and weighted least squares error algorithms.RESULTSWe optimized the time‐window size, order of the prediction, and order of the polynomial fit for our data set. The four time‐series methods, essentially using different weightings to data points, gave very similar results and predicted mean RBC issues with a standard deviation of the percentage error of 3.0% for 4 weeks ahead and 4.0% for 24 weeks ahead.CONCLUSIONThis paradigm allows prediction of demand for RBCs and could be developed to provide reliable and precise prediction up to 24 weeks ahead to improve the efficiency of blood services and sufficiency of blood supply with reduced costs.
Multi-Objective Optimization of Combined Heat and Power Industrial Microgrid
Authors: Mehrabadi Elham Sheikhi , Sathiakumar Swamidoss 
Published: February 2020

Abstract
Microgrids play a critical role in the transition from conventional centralized power systems to the smart distributed networks of the future. To achieve the greatest outputs from microgrids, a comprehensive multi-objective optimization plan is necessary. Among various conflicting planning objectives, emissions and cost are primary concerns in microgrid optimization. In this work, two novel procedures, i.e., non-dominated sorting genetic algorithm-II (NSGA-II) and multi-objective particle swarm optimization (MOPSO), were developed to minimize emissions and cost in combined heat- and power-based (CHP) industrial microgrids (IMGs) simultaneously, by applying the most practical constraints and considering the variable loads. Two different scenarios, the presence and absence of photovoltaics (PV) and PV storage systems, were analyzed. The results concluded that when considering PVs and PV storage systems, the NSGA-II algorithm provides the most optimized solution in minimizing economic and environmental objectives.
Does breast reduction surgery improve health-related quality of life? A prospective cohort study in Australian women
Authors: Crittenden Tamara , Watson David I , Ratcliffe Julie , Griffin Philip A , Dean Nicola R 
Published: February 2020

ObjectivesTo assess the health burden of breast hypertrophy and the comparative effectiveness of breast reduction surgery in improving health-related quality of life.DesignProspective cohort study.SettingA major public tertiary care hospital in Australia.ParticipantsWomen with symptomatic breast hypertrophy who underwent breast reduction surgery were followed for 12 months. A comparison control cohort comprised women with breast hypertrophy who did not undergo surgery.InterventionsBilateral breast reduction surgery for women in the surgical cohort.Main outcome measuresThe primary outcome measure was health-related quality of life measured preoperatively and at 3, 6 and 12 months postoperatively using the Short Form-36 (SF-36) questionnaire. Secondary outcome measures included post-surgical complications.Results209 patients in the surgical cohort completed questionnaires before and after surgery. 124 patients in the control hypertrophy cohort completed baseline and 12-month follow-up questionnaires. At baseline, both groups had significantly lower scores compared with population norms across all scales (p<0.001). In the surgical cohort significant improvements were seen across all eight SF-36 scales (p<0.001) following surgery. Within 3 months of surgery scores were equivalent to those of the normal population and this improvement was sustained at 12 months. SF-36 physical and mental component scores both significantly improved following surgery, with a mean change of 10.2 and 9.2 points, respectively (p<0.001). In contrast, SF-36 scores for breast hypertrophy controls remained at baseline across 12 months. The improvement in quality of life was independent of breast resection weight and body mass index.ConclusionBreast reduction significantly improved quality of life in women with breast hypertrophy. This increase was most pronounced within 3 months of surgery and sustained at 12-month follow-up. This improvement in quality of life is comparable to other widely accepted surgical procedures. Furthermore, women benefit from surgery regardless of factors including body mass index and resection weight.
Using Facebook to tell stories of premature ageing and sexual and reproductive healthcare across the life course for women with cerebral palsy in the UK and USA
Authors: Shah Sonali , Bradbury-Jones C , Taylor Julie 
Published: February 2020

ObjectiveTo enhance understanding of the bodily and lifestyle effects of ageing with cerebral palsy (CP) for women, with a particular focus on experiences with sexual and reproductive healthcare (SRH) services in the UK and North America.DesignA qualitative study underpinned by feminist disability theory and drawing on digital ethnographies to capture health and healthcare experiences for women with CP.SettingA global community of 140 women with CP, who are members of the closed international Facebook group,Women Ageing with Cerebral Palsy(WACP).ParticipantsForty-five members of WACP who were based in the UK and North America. The women were aged between 21 and 75.MethodsMessages posted on WACP between January 2018 and October 2018 were collated and underwent thematic analysis to identify themes relating to effects of ageing and experiences of SRH for women with CP at different points over the female life course.ResultsThe breadth of experiences in relation to the effects of ageing and access to reproductive and sexual healthcare for women with CP can be divided into three themes: (1) bodily effects of ageing; (2) lifestyle effects of ageing; (3) experiences of reproductive and sexual healthcare.ConclusionsGiving women with CP a platform to ‘speak for themselves’ in relation to effects of ageing and SRH provides health professionals with an informed knowledge base on which to draw. This might improve treatment for this growing adult patient community whose experiences have not received attention in health discourse or services. Including these experiences in public medical and social discourse can also bring a new knowledge to girls with CP about what ageing could mean for them so plans can be put in place for their future.
Factors influencing the utilisation of free-standing and alongside midwifery units in England: a qualitative research study
Authors: Walsh Denis , Spiby Helen , McCourt Christine , Grigg Celia , Coleby Dawn , Bishop Simon , Scanlon Miranda , Culley Lorraine , Wilkinson Jane , Pacanowski Lynne , Thornton Jim 
Published: February 2020

ObjectiveTo identify factors influencing the provision, utilisation and sustainability of midwifery units (MUs) in England.DesignCase studies, using individual interviews and focus groups, in six National Health Service (NHS) Trust maternity services in England.Setting and participantsNHS maternity services in different geographical areas of England Maternity care staff and service users from six NHS Trusts: two Trusts where more than 20% of all women gave birth in MUs, two Trusts where less than 10% of all women gave birth in MUs and two Trusts without MUs. Obstetric, midwifery and neonatal clinical leaders, managers, service user representatives and commissioners were individually interviewed (n=57). Twenty-six focus groups were undertaken with midwives (n=60) and service users (n=52).Main outcome measuresFactors influencing MU use.FindingsThe study findings identify several barriers to the uptake of MUs. Within a context of a history of obstetric-led provision and lack of decision-maker awareness of the clinical and economic evidence, most Trust managers and clinicians do not regard their MU provision as being as important as their obstetric unit (OU) provision. Therefore, it does not get embedded as an equal and parallel component in the Trust’s overall maternity package of care. The analysis illuminates how implementation of complex interventions in health services is influenced by a range of factors including the medicalisation of childbirth, perceived financial constraints, adequate leadership and institutional norms protecting the status quo.ConclusionsThere are significant obstacles to MUs reaching their full potential, especially free-standing midwifery units. These include the lack of commitment by providers to embed MUs as an essential service provision alongside their OUs, an absence of leadership to drive through these changes and the capacity and willingness of providers to address women’s information needs. If these remain unaddressed, childbearing women’s access to MUs will continue to be restricted.
Implementation of a strategy involving a multidisciplinary mobile unit team to prevent hospital admission in nursing home residents: protocol of a quasi-experimental study (MMU-1 study)
Authors: Nouvenne Antonio , Caminiti Caterina , Diodati Francesca , Iezzi Elisa , Prati Beatrice , Lucertini Stefano , Schianchi Paolo , Pascale Federica , Starcich Bruno , Manotti Pietro , Brianti Ettore , Fabi Massimo , Ticinesi Andrea , Meschi Tiziana 
Published: February 2020

IntroductionNursing home residents represent a particularly vulnerable population experiencing high risk of unplanned hospital admissions, but few interventions have proved effective in reducing this risk. The aim of this research will be to verify the effects of a hospital-based multidisciplinary mobile unit (MMU) team intervention delivering urgent care to nursing home residents directly at their bedside.Methods and analysisFour nursing homes based in the Parma province, in Northern Italy, will be involved in this prospective, pragmatic, multicentre, 18-month quasiexperimental study (sequential design with two cohorts). The residents of two nursing homes will receive the MMU team care intervention. In case of urgent care needs, the nursing home physician will contact the hospital physician responsible for the MMU team by phone. The case will be triaged as (a) manageable by phone advice, (b) requiring urgent assessment by the MMU team or (c) requiring immediate emergency department (ED) referral. MMU team is composed of one senior physician and one emergency-medicine resident chosen within the staff of Internal Medicine and Critical Subacute Care Unit of Parma University-Hospital, usually with different specialty background, and equipped with portable ultrasound, set of drugs and devices useful in urgency. The MMU visits patients in nursing homes, with the mission to stabilise clinical conditions and avoid hospital admission. Residents of the other two nursing homes will receive usual care, that is, ED referral in every case of urgency. Study endpoints include unplanned hospital admissions (primary), crude all-cause mortality, hospital mortality, length of stay and healthcare-related costs (secondary).Ethics and disseminationThe study protocol was approved by the Ethics Committee of Area Vasta Emilia Nord (Emilia-Romagna region). Informed consent will be collected from patients or legal representatives. The results will be actively disseminated through peer-reviewed journals and conference presentations, in compliance with the Italian law.Trial registration numberClinicalTrials.gov Registry (NCT 04085679); Pre-results.
Outcomes of transcatheter aortic valve implantations in high-volume or low-volume centres in Germany
Authors: Oettinger Vera , Kaier Klaus , Heidt Timo , Hortmann Markus , Wolf Dennis , Zirlik Andreas , Zehender Manfred , Bode Christoph , von zur Mühlen Constantin , Stachon Peter 
Published: February 2020

ObjectiveTranscatheter aortic valve implantation (TAVI) is the most common aortic valve replacement in Germany. Since 2015, to ensure high-quality procedures, hospitals in Germany and other countries that meet the minimum requirement of 50 interventions per centre are being certified to perform TAVI. This study analyses the impact of these requirements on case number and in-hospital outcomes.MethodsAll isolated TAVI procedures and in-hospital outcomes between 2008 and 2016 were identified by International Classification of Diseases (ICD) and the German Operation and Procedure Classification codes.Results73 467 isolated transfemoral and transapical TAVI procedures were performed in Germany between 2008 and 2016. During this period, the number of TAVI procedures per year rose steeply, whereas the overall rates of hospital mortality and complications declined. In 2008, the majority of procedures were performed in hospitals with fewer than 50 cases per year (54.63%). Until 2014, the share of patients treated in low-volume centres constantly decreased to 5.35%. After the revision of recommendations, it further declined to 1.99%. In the 2 years after the introduction of the minimum requirements on case numbers, patients were at decreased risk for in-hospital mortality when treated in a high-volume centre (risk-adjusted OR 0.62, p=0.012). The risk for other in-hospital outcomes (stroke, permanent pacemaker implantation and bleeding events) did not differ after risk adjustment (p=0.346, p=0.142 and p=0.633).ConclusionA minimum volume of 50 procedures per centre and year appears suitable to allow for sufficient routine and thus better in-hospital outcomes, while ensuring nationwide coverage of TAVI procedures.
Impact of Change in 2010 American Heart Association Cardiopulmonary Resuscitation Guidelines on Survival After Out-of-Hospital Cardiac Arrest in the United States
Authors: Pasupula Deepak Kumar , Bhat Anusha , Siddappa Malleshappa Sudeep K. , Munir Muhammad Bilal , Barakat Amr , Jain Sandeep , Wang Norman C. , Saba Samir , Bhonsale Aditya 
Published: February 2020

Background:
In October 2010, the American Heart Association/Emergency Cardiovascular Care updated cardiopulmonary resuscitation guidelines. Its impact on the survival rate among out-of-hospital cardiac arrest patients (OHCA) is not well studied. We sought to assess the survival trends in OHCA patients before and after the introduction of the 2010 American Heart Association cardiopulmonary resuscitation guidelines in the United States.

Methods:
A retrospective observational study from the National Emergency Department (ED) Sample was designed to identify patients presenting to the ED primarily after an OHCA in the United States between January 1, 2006, and December 31, 2015. The main outcome studied was the change in trends of ED survival and survival-to-discharge rates before and after guideline modification.

Results:

Among 1 282 520 patients presenting to the ED after OHCA (mean [SD] age, 65.8 [17.2] years; 62% men), ED survival rate (23%) and survival-to-discharge rate (16%) trends showed significant improvement after implementation of the 2010 American Heart Association cardiopulmonary resuscitation guidelines, 1.25% ([95% CI, 0.72%–1.78%]
P
=0.001) and 0.89% ([95% CI, 0.35%–1.43%]
P
=0.006), respectively. Notably, among patients with nonshockable rhythm (change in ED survival rate trend, 1.3% [95% CI, 0.89%–1.74%];
P
<0.001 and survival-to-discharge trend, 0.94% [95% CI, 0.42%–1.47%];
P
=0.004). Among patients admitted to the presenting hospital (n=145 592), 46% were discharged alive, of which 49% were discharged home. Significant decrease in discharge to home was noted (−1.7% [95% CI, −3.18% to −0.22%];
P
=0.03), while a significant increase in neurological complication (0.17% [95% CI, 0.06%–0.28%];
P
=0.007) was noted with the guideline modification.

Conclusions:
The change in 2010 American Heart Association cardiopulmonary resuscitation guidelines was associated with only slight improvement in ED survival and survival-to-discharge trends among US OHCA patients and only 1 in 6 OHCA patients survival to discharge.
Pupillary Light Reflex Is Not Abolished by Epinephrine and Atropine Given During Advanced Cardiac Life Support in Patients Who Achieve Return of Spontaneous Circulation
Authors: Achamallah Natalie , Fried Jeffrey , Love Rebecca , Matusov Yuri , Sharma Rohit 
Published: February 2020

Introduction: Absence of pupillary light reflex (PLR) is a well-studied indicator of poor neurologic recovery after cardiac arrest. Interpretation of absent PLR is difficult in patients with hypothermia or hypotension, or who have electrolyte or acid-base disturbances. Additionally, many studies exclude patients who receive epinephrine or atropine from their analysis on the basis that these drugs are thought to abolish the PLR. This observational cohort study assessed for presence or absence of PLR in in-hospital cardiac arrest patients who received epinephrine with or without atropine during advanced cardiac life support and achieved return of spontaneous circulation (ROSC). Methods: Pupil size and reactivity were assessed in adult patients who had an in-hospital cardiac arrest, received epinephrine with or without atropine, and achieved ROSC. Measurements were taken using a NeurOptics NPi-200 infrared pupillometer. Results: Forty patients had pupillometry performed within 1 hour (median: 6 minutes) after ROSC. Of these only 1 (2.5%) patient had nonreactive pupils at first measurement after ROSC. The remaining 39 (97.5%) had reactive pupils. Of the 19 patients who had pupils checked within 3 minutes of ROSC, 100% had reactive pupils. Degree of pupil responsiveness was not correlated with cumulative dose of epinephrine. Ten patients received atropine in addition to epinephrine, including the sole patient with nonreactive pupils. The remaining 9 (90%) had reactive pupils. Conclusion: Epinephrine and atropine do not abolish the PLR in patients who achieve ROSC after in-hospital cardiac arrest. Lack of pupillary response in the post-arrest patient should not be attributed to these drugs.