bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Frailty on Long‐Term Patient‐Oriented Outcomes after Emergency General Surgery: A Retrospective Cohort Study
Authors: Lee Katherine C. , Streid Jocelyn , Sturgeon Dan , Lipsitz Stuart , Weissman Joel S. , Rosenthal Ronnie A. , Kim Dae H. , Mitchell Susan L. , Cooper Zara 
Published: February 2020

OBJECTIVESFew studies examine the impact of frailty on long‐term patient‐oriented outcomes after emergency general surgery (EGS). We measured the prevalence of frailty among older EGS patients and examined the impact of frailty on 1‐year outcomes.DESIGNRetrospective cohort study using 2008 to 2014 Medicare claims.SETTINGAcute care hospitals.PARTICIPANTSPatients 65 years or older who received one of the five EGS procedures with the highest mortality burden (partial colectomy, small bowel resection, peptic ulcer disease repair, adhesiolysis, or laparotomy).MEASUREMENTSA validated claims‐based frailty index (CFI) identified patients who were not frail (CFI < .15), pre‐frail (.15 ≤ CFI < .25), mildly frail (.25 ≤ CFI < .35), and moderately to severely frail (CFI ≥ .35). Multivariable Cox regression compared 1‐year mortality. Multivariable Poisson regression compared rates of post‐discharge hospital encounters (hospitalizations, intensive care unit stay, emergency department visit) and home time over 1 year after discharge. All regression models adjusted for age, sex, race, admission from facility, procedure, sepsis, inpatient palliative care delivery, trauma center designation, hospital bed size, and teaching status, and they were clustered by patient and hospital referral region.RESULTSAmong 468 459 older EGS adults, 37.4% were pre‐frail, 12.4% were mildly frail, and 3.6% were moderately to severely frail. Patients with mild frailty experienced a higher risk of 1‐year mortality compared with non‐frail patients (hazard ratio = 1.97; confidence interval [CI] = 1.94‐2.01). In the year after discharge, patients with mild and moderate to severe frailty had more hospital encounters compared with non‐frail patients (7.8 and 11.5 vs 2.0 per person‐year; incidence rate ratio [IRR] = 4.01; CI = 3.93‐4.08 vs IRR = 5.89; CI = 5.70‐6.09, respectively). Patients with mild and moderate to severe frailty also had fewer days at home in the year after discharge compared with non‐frail patients (256 and 203 vs 302 mean days; IRR = .97; CI = .96‐.97 vs IRR = .95; CI = .94‐.95, respectively).CONCLUSIONOlder EGS patients with frailty are at increased risk for poor 1‐year outcomes and decreased home time. Targeted interventions for older EGS patients with frailty during the index EGS hospitalization are urgently needed to improve long‐term outcomes. J Am Geriatr Soc 68:1037–1043, 2020
Low damage lamella preparation of metallic materials by FIB processing with low acceleration voltage and a low incident angle Ar ion milling finish
Authors: SATO T. , AIZAWA Y. , MATSUMOTO H. , KIYOHARA M. , KAMIYA C. , VON CUBE F. 
Published: February 2020

SummaryMetallic materials are known to be very sensitive to Gallium (Ga) focused ion beam (FIB) processing. Crystal defects formed by FIB irradiation degrade the transmission electron microscope image quality, and it is difficult to distinguish original defects from FIB process‐induced damage. A solution to this problem is the low acceleration voltage and low incident angle (LVLA) Argon ion milling, which can be incorporated as an extensional countermeasure for FIB damage removal and eventually for preparation of high‐quality lamellae. The transmission electron microscope image quality of iron single crystal could be improved by removing crystal defects using the low acceleration voltage and low incident angle Argon ion milling finish. Lamella quality of the processing result was almost similar with that of the conventional electrolytic polishing.As a practical application of the process, low damage lamella of stainless cast steel could be prepared. Effectiveness of the FIB system equipped with the low acceleration voltage and low incident angle Argon ion milling function as a tool to make high‐quality metallic material lamellae is illustrated.
Mucinous borderline ovarian tumors with and without Intraepithelial Carcinoma: Differences in clinicopathologic features and fertility results
Authors: Chen Rui‐fang , Tao Xiang , Wu Bei‐bei , Li Jun , Wang Jie‐yu , Gu Wei‐yong , Lu Xin 
Published: February 2020

AbstractAimTo investigate the clinicopathologic characteristic and fertility results of patients with mucinous borderline ovarian tumors (MBOTs), and the effects of intraepithelial carcinoma (IECA) on them.MethodsFifty‐two patients treated for MBOTs with or without IECA were retrospectively analyzed.ResultsPatients with IECA were more frequently observed at stage Ic (3/12 vs 1/40, P = 0.034) and accompanied by microinvasive carcinoma (3/12 vs 1/40, P = 0.034). The detected rate of IECA by intraoperative frozen section (5/12, 41.7%) was much lower than that of MBOTs (82.5%, P = 0.010). About 61.5% patients in our study underwent fertility‐sparing surgery. Follow‐up information was retained completely in 41 patients. And all four tumor recurrences were observed (9.8%) in conservative surgery group in 66 months, though there was no statistical association (P = 0.280). There were three patients who recurred more than once, even one occurred tumor‐related death. Only one recurrent patient was in IECA group (P > 0.05). However, patients with IECA were more likely to receive adjuvant chemotherapy (3 of 12 vs 0 of 40, P = 0.010) and surgical staging (75% vs 52.5%, P = 0.200). As for fertility results, nine patients wished to be pregnant and seven of them (77.8%) were successful.ConclusionFor young patients with MBOTs, fertility results are satisfactory after conservative surgery. But patients should be fully informed about the relative high recurrent rate. And IECA has no statistical negative effects on MBOTs till now, but a long‐term follow‐up is required.
Increased risk of dizziness in human immunodeficiency virus-infected patients taking zidovudine and efavirenz combination: a Brazilian cohort study
Authors: Valeriano Josué Jeyzon de Lima Soares , Carvalho-Silva Wlisses Henrique Veloso , Coelho Antônio Victor Campos , Moura Ronald Rodrigues , Arraes Luiz Cláudio , Brandão Lucas André Cavalcanti , Crovella Sergio , Guimarães Rafael Lima 
Published: February 2020

Abstract

Objectives
Neuropsychiatric adverse effects (NPAE) related to efavirenz, mainly dizziness, is detrimental to human immunodeficiency virus (HIV) treatment. Our study aims at evaluating if zidovudine use potentiates the risk of dizziness related to efavirenz when used together and whether there are significant differences in over time distribution of this NPAE and others relatively frequents regarding efavirenz regimen without zidovudine.

Methods
Human immunodeficiency virus-infected patients under efavirenz-containing different therapy were enrolled. A retrospective analysis of official medical records was accomplished to collect clinical data regarding NPAE occurrence and severity. Univariate statistic and statistical model based on survival analyses were performed.

Key findings
One hundred sixty-two patients were included, of these seventy-seven (47.5%) had NPAE reported, such as dizziness (more frequent), depression and insomnia. Univariate statistical analysis demonstrated that the combined use of efavirenz with zidovudine increased the NPAE risk (OR: 2.5; P-value: 0.008), mainly dizziness risk (OR: 3.5; P-value: 0.009) and survival analysis showed that such combination is associated with dizziness occurrence faster (HR: 2.9; P-value: 0.02).

Conclusions
The results may contribute to clarify the dizziness occurrence dynamics in therapy with efavirenz and zidovudine by identifying susceptibilities and assisting in the choice of combined antiretroviral therapy.
The management and outcome of pediatric blunt chest‐abdominal injuries
Authors: Kurahachi Tomohiro , Hashizume Naoki , Asagiri Kimio , Asakawa Takahiro , Tanaka Hiroaki , Yoshida Motomu , Tsuru Tomomitsu , Yagi Minoru 
Published: February 2020

AbstractBackgroundThe aim of this study was to determine the frequency and nature of pediatric blunt chest–abdominal injuries (BCAIs) and to summarize their management, ranging from non‐operative management (NOM), with or without angioembolization (AE), to surgical treatment.MethodsThis retrospective study included patients admitted to our hospital for BCAIs from January 1996 to December 2017. The age, injury pattern, organs of injury, outcome, and treatment were summarized.ResultsOne hundred and thirty‐two patients (98 males, 34 females, mean age 7.68 years ± 3.58, range 1–15 years) were included in the study. Their injuries resulted from motor‐vehicle traffic incidents (n = 60), single‐bicycle injuries (n = 16), falls (n = 33), sports (n = 10), assault (n = 6), abuse (n = 3), and others (n = 4). There were no injured organs in 31 cases, while there were 130 injured organs in 101 cases, including the liver (n = 42), spleen (n = 35), lung (n = 23), kidney (n = 13), intestine (n = 10), pancreas (n = 5), and adrenal gland (n = 2). Angiography (AG) was performed in 20 cases, and NOM with AE was performed in 16 cases, including 17 organs (liver injury [n = 9], splenic injury [n = 5], and kidney injury [n = 4]). Surgical treatment was performed in eight cases (splenic injury in one, pancreas injury in one, and intestinal injury in six). NOM without AE was performed in the other cases.ConclusionsThe management of organ injury must take into consideration the management of integrated bleeding. It is recommended that children with severe organ injury are treated in dedicated trauma centers in which AE is available.
Providers’ perspectives on substance use among solid organ transplant candidates in a pediatric hospital
Authors: Steinberg Christofferson Elizabeth , Burgers Darcy E. , Buchanan Cindy , Suplee Amanda F. , Upshaw Naadira , Ariefdjohan Merlin 
Published: February 2020

AbstractIntroductionSubstance use is prevalent among youth and often leads to impairment in multiple domains. Additionally, substance use may pose adverse health issues post‐transplant. Yet, practices related to substance use among pediatric patients who require organ transplant remain inconsistent. In this study, providers were surveyed for their perspectives on substance use among solid organ transplant candidates within a pediatric hospital.MethodsAn online survey was administered to providers on the heart, kidney, and liver transplant teams at one tertiary pediatric care center located in the intermountain region of the United States (N = 50, 42% response rate). Providers answered questions about the need for a hospital‐wide policy across heart, liver, and kidney transplant teams within this transplant center, timing of substance use evaluation, types of substances eliciting concerns based on organ, and recommended interventions. Data were analyzed using descriptive statistics.ResultsProviders felt strongly about the need for a policy to guide recommendations for substance use among transplant candidates. Providers wanted a hospital‐wide substance use policy (84%) and a standardized measure for assessing substance use (98%). Respondents (98%) indicated that substance use should be assessed during the pretransplant evaluation. Respondents expressed varied concerns based on substance and organ type, and recommended interventions for patients to cease substance use prior to transplant listing.ConclusionsThis study highlights the need for a clear, directive, hospital‐wide policy and standardized procedure for evaluating substance use among adolescent solid organ transplant candidates nationally across pediatric transplant centers.
The Sum of its Parts: How Supreme Court Justices Disparately Shape Attention to Their Opinions
Authors: Masood Ali S. , Kassow Benjamin J. 
Published: February 2020

ObjectiveWhile studies frequently examine the impact of the U.S. Supreme Court as an institution, little is known about how individual justices influence attention to their opinions. We investigate whether inherent differences in the majority opinions of individual justices result in certain justices being systematically more influential than their peers.MethodsWe advance a theory in which Supreme Court adoption of prior opinions is influenced by factors that relate to the identity of the authoring justice. To test these propositions, we explore the universe of the Supreme Court's signed majority opinions from 1986 to 2000.ResultsWe find that intricate tendencies in opinion writing vary systematically by justice in key dimensions relating to their opinions. We also discover that differences among the justices exert an asymmetric impact on citation and adherence to precedent.ConclusionThe findings offer important theoretical and normative implications toward a better understanding of the impact of Supreme Court justices on attentiveness to precedent and doctrinal development.
Neuropsychological and neurophysiological aspects of brain‐computer‐interface (BCI) control in paralysis
Authors: Chaudhary Ujwal , Mrachacz‐Kersting Natalie , Birbaumer Niels 
Published: February 2020

AbstractBrain‐computer interfaces (BCIs) aim to help paralysed patients to interact with their environment by controlling external devices using brain activity, thereby bypassing the dysfunctional motor system. Some neuronal disorders, such as amyotrophic lateral sclerosis (ALS), severely impair the communication capacity of patients. Several invasive and non‐invasive brain‐computer interfaces (BCIs), most notably using electroencephalography (EEG), have been developed to provide a means of communication to paralysed patients. However, except for a few reports, all available BCI literature for the paralysed (mostly ALS patients) describes patients with intact eye movement control, i.e. patients in a locked‐in state (LIS) but not a completely locked‐in state (CLIS). In this article we will discuss: (1) the fundamental neuropsychological learning factors and neurophysiological factors determining BCI performance in clinical applications; (2) the difference between LIS and CLIS; (3) recent development in BCIs for communication with patients in the completely locked‐in state; (4) the effect of BCI‐based communication on emotional well‐being and quality of life; and (5) the outlook and the methodology needed to provide a means of communication for patients who have none. Thus, we present an overview of available studies and recent results and try to anticipate future developments which may open new doors for BCI communication with the completely paralysed.
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Oxidative ATP synthesis in human quadriceps declines during 4 minutes of maximal contractions
Authors: Bartlett Miles F. , Fitzgerald Liam F. , Nagarajan Rajakumar , Hiroi Yeun , Kent Jane A. 
Published: February 2020

Key points

During maximal exercise, skeletal muscle metabolism and oxygen consumption remain elevated despite precipitous declines in power. Presently, it is unclear whether these responses are caused by an increased ATP cost of force generation (ATPCOST) or mitochondrial uncoupling; a process that reduces the efficiency of oxidative ATP synthesis (ATPOX).
To address this gap, we used 31‐phosphorus magnetic resonance spectroscopy to measure changes in ATPCOST and ATPOX in human quadriceps during repeated trials of maximal intensity knee extensions lasting up to 4 min.
ATPCOST remained unchanged. In contrast, ATPOX plateaued by ∼2 min and then declined (∼15%) over the final 2 min. The maximal capacity for ATPOX (Vmax), as well as ADP‐specific rates of ATPOX, were also significantly diminished.
Collectively, these results suggest that mitochondrial uncoupling, and not increased ATPCOST, is responsible for altering the regulation of skeletal muscle metabolism and oxygen consumption during maximal exercise.AbstractThe relationship between skeletal muscle oxygen consumption and power output is augmented during exercise at workloads above the lactate threshold. Potential mechanisms for this response have been hypothesized, including increased ATP cost of force generation (ATPCOST) and mitochondrial uncoupling, a process that reduces the efficiency of oxidative ATP synthesis (ATPOX). To test these hypotheses, we used phosphorus magnetic resonance spectroscopy to non‐invasively measure changes in phosphate concentrations and pH in the vastus lateralis muscle of nine young adults during repeated trials of maximal, all‐out dynamic knee extensions (120°s−1, 1 every 2 s) lasting 24, 60, 120, and 240 s. ATPOX was measured at each time point from the initial velocity of PCr resynthesis, and ATPCOST was calculated as the sum of ATP synthesized by the creatine and adenylate kinase reactions, non‐oxidative glycolysis, ATPOX and net changes in [ATP]. Power output declined in a reproducible manner for all four trials. ATPCOST did not change over time (main effect P = 0.45). ATPOX plateaued from 60 to 120 s and then decreased over the final 120 s (main effect P = 0.001). The maximal capacity for oxidative ATP synthesis (Vmax), as well as ADP‐specific rates of ATPOX, also decreased over time (main effect P = 0.001, both). Collectively, these results demonstrate that prolonged maximal contraction protocols impair oxidative energetics and implicate mitochondrial uncoupling as the mechanism for this response. The causes of mitochondrial uncoupling are presently unknown but may offer a potential explanation for the dissociation between skeletal muscle power output and oxygen consumption during maximal, all‐out exercise protocols.
Predicting patient engagement in IAPT services: a statistical analysis of electronic health records
Authors: Davis Alice , Smith Theresa , Talbot Jenny , Eldridge Chris , Betts David 
Published: February 2020

BackgroundAcross England, 12% of all improving access to psychological therapy (IAPT) appointments are missed, and on average around 40% of first appointments are not attended, varying significantly around the country. In order to intervene effectively, it is important to target the patients who are most likely to miss their appointments.ObjectiveThis research aims to develop and test a model to predict whether an IAPT patient will attend their first appointment.MethodsData from 19 adult IAPT services were analysed in this research. A multiple logistic regression was used at an individual service level to identify which patient, appointment and referral characteristics are associated with attendance. These variables were then used in a generalised linear mixed effects model (GLMM). We allow random effects in the GLMM for variables where we observe high service to service heterogeneity in the estimated effects from service specific logistic regressions.FindingsWe find that patients who self-refer are more likely to attend their appointments with an OR of 1.04. The older a patient is, the fewer the number of previous referrals and consenting to receiving a reminder short message service are also found to increase the likelihood of attendance with ORs of 1.02, 1.10, 1.04, respectively.ConclusionsOur model is expected to help IAPT services identify which patients are not likely to attend their appointments by highlighting key characteristics that affect attendance.Clinical implicationsThis analysis will help to identify methods IAPT services could use to increase their attendance rates.
Rapid climate-driven evolution of the invasive species Mytilus galloprovincialis over the past century
Authors: Han Guo-Dong , Dong Yun-Wei 
Published: February 2020

Abstract
Climate-driven adaptive genetic variation is one of the most important ways for organisms to tolerate environmental change and succeed in altered environments. To understand rapid climate-driven evolution, and how this evolution might shift biogeographic distributions in response to global change, we measured the adaptive genetic variation to the local environment of a marine invasive species Mytilus galloprovincialis. The genetic structure of eight populations from the Mediterranean Sea, northeastern Atlantic, northeastern Pacific, and northwestern Pacific were determined using genome-wide screens for single nucleotide polymorphisms. The relationships of genetic variation to environmental (seawater and air) temperature were analyzed using redundancy analysis and BayeScEnv analysis to evaluate the impacts of temperature on the genetic divergences among these eight populations. We found that the genetic compositions were significantly different among populations and the adaptive genetic variation was associated with temperature variables. Further, we identified some genetic markers exhibiting signatures of divergent selection in association with environmental features that can be used in the future to closely monitor adaptive variation in this species. Our results suggest that divergent climatic factors have driven adaptive genetic variation in M. galloprovincialis over the past century. The rapid evolutionary adaptation has played a pivotal role in enabling this species to invade a wide range of thermal habitats successfully. Species like M. galloprovincialis that possess high levels of genetic variation may not only be especially capable of invading new habitats with different environmental conditions, but also poised to cope rapidly and successfully with rising global temperatures.
Kdm6a Deficiency Activates Inflammatory Pathways, Promotes M2 Macrophage Polarization, and Causes Bladder Cancer in Cooperation with p53 Dysfunction
Authors: Kobatake Kohei , Ikeda Ken-ichiro , Nakata Yuichiro , Yamasaki Norimasa , Ueda Takeshi , Kanai Akinori , Sentani Kazuhiro , Sera Yasuyuki , Hayashi Tetsutaro , Koizumi Miho , Miyakawa Yoshihiko , Inaba Toshiya , Sotomaru Yusuke , Kaminuma Osamu , Ichinohe Tatsuo , Honda Zen-ichiro , Yasui Wataru , Horie Shigeo , Black Peter C. , Matsubara Akio , Honda Hiroaki 
Published: February 2020

Abstract

Purpose:
Epigenetic deregulation is deeply implicated in the pathogenesis of bladder cancer. KDM6A (Lysine (K)-specific demethylase 6A) is a histone modifier frequently mutated in bladder cancer. However, the molecular mechanisms of how KDM6A deficiency contributes to bladder cancer development remains largely unknown. We hypothesized that clarification of the pathogenic mechanisms underlying KDM6A-mutated bladder cancer can help in designing new anticancer therapies.

Experimental Design:
We generated mice lacking Kdm6a in the urothelium and crossed them with mice heterozygous for p53, whose mutation/deletion significantly overlaps with the KDM6A mutation in muscle-invasive bladder cancer (MIBC). In addition, BBN (N-butyl-N-(4-hydroxybutyl) nitrosamine), a cigarette smoke-like mutagen, was used as a tumor-promoting agent. Isolated urothelia were subjected to phenotypic, pathologic, molecular, and cellular analyses. The clinical relevance of our findings was further analyzed using genomic and clinical data of patients with MIBC.

Results:
We found that Kdm6a deficiency activated cytokine and chemokine pathways, promoted M2 macrophage polarization, increased cancer stem cells and caused bladder cancer in cooperation with p53 haploinsufficiency. We also found that BBN treatment significantly enhanced the expression of proinflammatory molecules and accelerated disease development. Human bladder cancer samples with decreased KDM6A expression also showed activated proinflammatory pathways. Notably, dual inhibition of IL6 and chemokine (C-C motif) ligand 2, upregulated in response to Kdm6a deficiency, efficiently suppressed Kdm6a-deficient bladder cancer cell growth.

Conclusions:
Our findings provide insights into multistep carcinogenic processes of bladder cancer and suggest molecular targeted therapeutic approaches for patients with bladder cancer with KDM6A dysfunction.