bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Sepsis Mandates on Sepsis Care: Unintended Consequences
Authors: Swenson Kai E , Winslow Dean L 
Published: March 2020

Abstract
The creation of dedicated sepsis guidelines and their broad dissemination over the past 2 decades have contributed to significant improvements in sepsis care. These successes have spurred the creation of bundled care mandates by major healthcare payers, such as the Center for Medicare and Medicaid Services. However, despite the likely benefits of guideline-directed sepsis bundles, mandated treatments in sepsis may lead to unintended consequences as the standard of care in sepsis improves. In particular, the heterogeneous spectrum of presentation and disease severity in sepsis, as well as the complexity surrounding the benefits of specific interventions in sepsis, argues for an individualized and titrated approach to interventions: an approach generally not afforded by care mandates. In this review, we review the risks and benefits of mandated care for sepsis, with particular emphasis on the potential adverse consequences of common bundle components such as early empiric antibiotics, weight-based fluid administration, and serum lactate monitoring. Unlike guideline-directed care, mandated care in sepsis precludes providers from tailoring treatments to heterogeneous clinical scenarios and may lead to unintended harms for individual patients.
The Use of Dermal Substitute in Deep Burns of Functional/Mobile Anatomic Areas at Acute Phase After Early Excision and Subsequent Skin Autografting: Dermal Substitute Prevents Functional Limitations
Authors: Gurbuz Kayhan , Demir Mete , Das Koray 
Published: March 2020

Abstract
We aimed to evaluate the results of dermal substitute implantation after early excision in the acute phase of major burn cases within the scope of efforts to reduce contractions and scar formation in functional anatomic areas (face, neck, axilla, elbow, popliteal). Twelve patients with major burn who were treated in the burn center between September 2017 and September 2018 were included in the study. In these patients, Nevelia® dermal substitute was implanted into 24 functional areas with deep partial or full-thickness burns after surgical debridement of the wound. Autologous split-thickness skin graft was applied to these areas after 14 to 21 days. The patients were followed for 4 to 14 months (mean 6 months). Postoperative scar formation was assessed by the Vancouver Scar Scale at the end of the follow-up period. A simple qualitative staging system was used for aesthetic and functional evaluation. The time from burn injury to dermal substitute implantation was 3 to 21 days. Skin graft take was complete in 22 of 24 regions and partial in one of them, while graft loss developed in one region. In the implantation sites, the Vancouver Scar Scale ranged from 1 to 7. The aesthetic and functional evaluation showed excellent/good results in 21 of 24 anatomic regions, moderate results in 2 regions, and poor results in 1 region. The use of dermal substitute in deep burns of functional/mobile anatomic areas at the acute phase after early excision and subsequent skin autografting has opened a new alternative area in the burn surgery arena to prevent contractures and functional limitations.
Evaluation of Chilean Boldo Essential Oil as a Natural Insecticide Against Chrysomya megacephala (Diptera: Calliphoridae)
Authors: Viana Thais de S , Dias Rayane F , Vianna Ana Carolina da S , Moreira Ricardo F A , Aguiar Valéria M 
Published: March 2020

AbstractChrysomya megacephala (Fabricius, 1794) is a vector of enteric bacteria, protozoa, helminths, and viruses. These Diptera can also be responsible for secondary myiasis in several animal species. Therefore, it is easy to understand the relevance of studies focusing on C. megacephala dissemination control. The employment of essential oils as natural insecticides must be considered as a promising alternative for the replacement of synthetic insecticides. In this context, the essential oil obtained from Chilean boldo leaves should be highlighted. The aim of the present work was to assess the insecticidal activity of Chilean boldo essential oil against C. megacephala blowflies in different life stages (larva, pupa, and adult). The essential oils were extracted from commercial samples of Chilean boldo leaves by hydrodistillation and were mixed to produce a pool that was employed in the study. Gas chromatographic techniques were used to enable the identification and quantification of the pool’s components. Larvae, pupae, and adult insects of C. megacephala were exposed (topical application) to different concentrations of this essential oil pool. After that, the larvicidal, pupicidal, and insecticidal actions of the oil were tested. Its toxicity might be associated with compounds such as eucalyptol, linalool, α-pinene, limonene, and ascaridole, either acting alone or by synergic effects. Interestingly, the pupae appeared to be stronger than the larvae and adult insects, needing higher doses of essential oil to be killed. The oil’s toxic effects could be useful to control C. megacephala dissemination in all of its development phases.
Soluble CD14 Subtype in Peripheral Blood is a Biomarker for Early Diagnosis of Sepsis
Authors: Zhou Wuqiong , Rao Heping , Ding Qiuming , Lou Xiang , Shen Jianjiang , Ye Bin , Xiang Caixia 
Published: March 2020

Abstract

Objective
To study the value of serum soluble CD14 subtype (sCD14-ST) in early diagnosis of sepsis.

Methods
Seventy-two patients were diagnosed with systemic inflammatory response syndrome, sepsis, or septic shock. Peripheral blood was collected at 0, 12, 24, and 48 hours after admission to the hospital. Levels of sCD14-ST, procalcitonin (PCT), hypersensitive C-reactive protein (CRP), and white blood cells (WBC) were determined.

Results
Levels of sCD14-ST in the patients with septic shock were higher than those in the other patients (P &lt; .01) and peaked at 48 h. PCT and CRP levels were similar in the patients at admission but increased by 5 times to 10 times in the next 48 h, especially in the patients with septic shock. WBC levels remained high and did not change dramatically. Receiver operating characteristic analysis revealed that the area under the curve, sensitivity, and specificity values of sCD14-ST to diagnose sepsis were much higher than those of the other markers.

Conclusion
Compared with PCT, CRP, and WBC, sCD14-ST is a better biomarker for the early diagnosis of sepsis.
The effect of ram-pressure stripping on dwarf galaxies
Authors: Steyrleithner P , Hensler G , Boselli A 
Published: March 2020

ABSTRACT
Ram-pressure stripping (RPS) is a well observed phenomenon of massive spiral galaxies passing through the hot intracluster medium (ICM) of galaxy clusters. For dwarf galaxies (DGs) within a cluster, the transformation from gaseous to gas-poor systems by RPS is not easily observed and must happen in the outskirts of clusters. In a few objects in close by galaxy clusters and the field, RPS has been observed. Since cluster early-type DGs also show a large variety of internal structures (unexpected central gas reservoirs, blue stellar cores, composite radial stellar profiles), we aim in this study to investigate how ram pressure (RP) affects the interstellar gas content and therefore the star formation (SF) activity. Using a series of numerical simulations, we quantify the dependence of the stripped-off gas on the velocity of the infalling DGs and on the ambient ICM density. We demonstrated that SF can be either suppressed or triggered by RP depending on the ICM density and the DGs mass. Under some conditions, RP can compress the gas, so that it is unexpectedly retained in the central DG region and forms stars. When gas clouds are still bound against stripping but lifted from a thin disc and fall back, their new stars form an ellipsoidal (young) stellar population already with a larger velocity dispersion without the necessity of harassment. Most spectacularly, star clusters can form downstream in stripped-off massive gas clouds in the case of strong RP. We compare our results to observations.
Deep spectroscopy in nearby galaxy clusters – V. The Perseus cluster
Authors: Aguerri J A L , Girardi M , Agulli I , Negri A , Dalla Vecchia C , Domínguez Palmero L 
Published: March 2020

ABSTRACT
Dwarfs are the largest population of galaxies in number in the nearby Universe. Deep spectroscopic data are still missing to obtain a better understanding of their formation and evolution processes. This study shows the results obtained from a spectroscopic campaign in the Perseus cluster. We have obtained 963 new galaxy spectra. We have measured the recessional velocity of the galaxies by using a cross-correlation technique. These data have been used to obtain the cluster membership, the dynamics of the galaxies, and the spectroscopic luminosity function (LF) of the cluster. The cluster membership was obtained by using the peak + gap technique, reporting a total of 403 galaxies as cluster members within 1.4r200. The mean velocity and velocity dispersion of the cluster galaxies are Vc = 5258 km s−1 and σc = 1040 km s−1, respectively. We obtained M200 = 1.2 × 1015 M⊙ and r200 = 2.2 Mpc for this cluster. The clusters members were classified blue and red according to their g − r stellar colour. The velocity dispersion of these two families of galaxies is different, indicating that the blue galaxies can be classified as recently accreted into the cluster. We present the spectroscopic galaxy LF of the cluster. This function turned to be flat: α = 0.99 ± 0.06. In addition, blue and red galaxies show similar densities in the faint end of the LF. This indicates that Perseus does not have a population of red dwarf galaxias as large as other nearby clusters. We have compared the LF of the Perseus cluster with other spectroscopic LFs of nearby clusters and those from cosmological simulations. This comparison shows that the spectroscopic LF of nearby galaxy cluster is far from universal.
On the orbital evolution of meteoroid 2020 CD3, a temporarily captured orbiter of the Earth–Moon system
Authors: de la Fuente Marcos C , de la Fuente Marcos R 
Published: March 2020

ABSTRACT
Any near-Earth object (NEO) following an Earth-like orbit may eventually be captured by Earth’s gravity during low-velocity encounters. This theoretical possibility was first attested during the fly-by of 1991 VG in 1991–1992 with the confirmation of a brief capture episode – for about a month in February 1992. Further evidence was obtained when 2006 RH120 was temporarily captured into a geocentric orbit from July 2006 to July 2007. Here, we perform a numerical assessment of the orbital evolution of 2020 CD3, a small NEO found recently that could be the third instance of a meteoroid temporarily captured by Earth’s gravity. We confirm that 2020 CD3 is currently following a geocentric trajectory although it will escape into a heliocentric path by early May 2020. Our calculations indicate that it was captured by the Earth in 2016$_{-4}^{+2}$, median and 16th and 84th percentiles. This episode is longer (4$_{-2}^{+4}$ yr) than that of 2006 RH120. Prior to its capture as a minimoon, 2020 CD3 was probably a NEO of the Aten type, but an Apollo type cannot be excluded; in both cases, the orbit was very Earth-like, with low eccentricity and low inclination, typical of an Arjuna-type meteoroid. A few clone orbits remained geocentric for nearly a century, opening the door to the existence of yet-to-be-detected minimoons that are relatively stable for time-scales comparable to those of unbound quasi-satellites such as (469219) Kamo‘oalewa 2016 HO3. In addition, nearly 10 per cent of the experiments led to brief moon–moon episodes in which the value of the selenocentric energy of 2020 CD3 became negative.
Electronic Consults for Infectious Diseases in a United States Multisite Academic Health System
Authors: Wood Brian R , Bender Jessica A , Jackson Sara , Rosengaus Leah , Pottinger Paul S , Gottlieb Geoffrey S , Dhanireddy Shireesha , Harrington Robert D , Pruzhanskaya Yuliya , Chew Lisa D , Scott John D 
Published: March 2020

Abstract
We launched Infectious Disease electronic consultations (eConsults) in 2018. During the first 15.5 months, primary care practitioners submitted 328 eConsults; the most frequent reasons were a positive culture or polymerase chain reaction (PCR) result, syphilis, and latent tuberculosis. Practitioners commonly requested advice on antimicrobial choice, clinical evaluation, and indications for treatment. Internal phone consultations decreased after eConsult implementation.
High-Dose Intravenous Immunoglobulin as a Therapeutic Option for Deteriorating Patients With Coronavirus Disease 2019
Authors: Cao Wei , Liu Xiaosheng , Bai Tao , Fan Hongwei , Hong Ke , Song Hui , Han Yang , Lin Ling , Ruan Lianguo , Li Taisheng 
Published: March 2020

AbstractThe outbreak of coronavirus disease 2019 (COVID-19) has spread rapidly in China. Until now, no definite effective treatment has been identified. We reported on 3 patients with severe COVID-19 who received high-dose intravenous immunoglobulin (IVIg) with satisfactory recovery. Based on these observations, randomized studies of high-dose IVIg should be considered in deteriorating patients infected with COVID-19.
Building a COVID-19 Vulnerability Index
Authors: DeCapprio Dave , Gartner Joseph , McCall Carol J. , Burgess Thadeus , Kothari Sarthak , Sayed Shaayaan 
Published: March 2020

AbstractCOVID-19 is an acute respiratory disease that has been classified as a pandemic by the World Health Organization. Characterization of this disease is still in its early stages; however, it is known to have high mortality rates, particularly among individuals with preexisting medical conditions. Creating models to identify individuals who are at the greatest risk for severe complications due to COVID-19 will be useful for outreach campaigns to help mitigate the disease’s worst effects. While information specific to COVID-19 is limited, a model using complications due to other upper respiratory infections can be used as a proxy to help identify those individuals who are at the greatest risk. We present the results for three models predicting such complications, with each model increasing predictive effectiveness at the expense of ease of implementation.
Protocol for a mixed methods process evaluation of the Smoking Treatment Optimisation in Pharmacies (STOP) trial
Authors: Jumbe Sandra , Madurasinghe Vichithranie , Houlihan Colin , Jumbe Samantha L , James Wai-Yee , Taylor Stephanie JC , Walton Robert 
Published: March 2020

AbstractIntroductionAssessing the fidelity of complex behavioural interventions and examining the contextual reasons why such interventions succeed, or fail are important activities but challenging and rarely reported. The Smoking Treatment Optimisation in Pharmacies (STOP) trial is a cluster randomised trial evaluating the effectiveness of a complex intervention to optimise the National Health Service (NHS) Stop Smoking Service delivered in community pharmacies. This complex intervention comprises a training package for pharmacy staff involving motivational interviewing and communication skills aimed at increasing smoking cessation knowledge and proactive client engagement. We report on a process evaluation which was planned alongside the trial to offer findings that will assist in the interpretation of the main trial results and help inform potential implementation in community pharmacy settings on a wider scale.Methods and analysisQuantitative data on recruitment and retention process of pharmacies, pharmacy staff and service users has been collected during the trial along with data on dose and fidelity of the intervention delivery from participating intervention arm pharmacies to identify potential implementation issues. Simulated client data on behaviour change skills and display of intervention materials from both control and intervention pharmacies is being assessed. These data will be combined with qualitative data; including adviser-smoker consultation recordings that provide a snapshot of behaviour skills delivery by stop smoking advisers and semi-structured interviews with pharmacy staff and services users from the intervention arm.DiscussionPublished protocols for process evaluations of complex health interventions are still rare despite increasing funding for this work to facilitate understanding of trial outcomes from an implementation perspective. This mixed methods protocol will contribute to the developing literature around the conduct of process evaluation and the value they add to health services research.Trial registration numberISRCTN16351033.Strengths and limitations of this studyA planned mixed methods process evaluation that draws together data from different sources to help explain the trial results and establish the feasibility of scaling this complex intervention up in community pharmacy settings.A strength is the use of a previously tested mystery shopping method to assess fidelity of skills performance at the pharmacy counterThe process evaluation relies on willing pharmacy staff and service users involved in the trial to collect some of the data, which may introduce bias.This paper also provides a detailed example of how to use the MRC framework for process evaluation of complex interventions to design an extensive process evaluation within trial settings.
More than stoichiometry: the molecular composition of inorganic and organic substrates controls ammonium regeneration by bacteria
Authors: Guo J. , Cherif M. 
Published: March 2020

AbstractThe mineralization of nitrogen (N) and especially the regeneration of ammonium are critical processes performed by bacteria in aquatic ecosystems. Quantifying these processes is complicated because bacteria simultaneously consume and produce ammonium. Here we use experimental data on the effects of the molecular composition of the supplied substrates, combined with a classical stoichiometric model of ammonium regeneration, to demonstrate how the quantification of these processes can be improved. We manipulated a batch culture experiment with an isolated bacterial community by adding three different types of N substrates: dissolved inorganic nitrogen (DIN, nitrate), dissolved organic nitrogen (DON, amino acid) and a mixture of DIN and DON. With such experiment set-up, the ammonium regeneration per se could be easily tracked without using complicated methods (e.g. isotope dilution). We compared the experimental data with the predictions of Goldmanet al’ model (1987) as well as with a revised version, using the measured consumption carbon:nitrogen ratio (C:N ratio), rather than an estimated consumption ratio. We found that, for all substrates, and in particular, mixed substrates where C and N are partially dissociated between different molecules, estimates of ammonium regeneration rates can be improved by measuring the actual consumption C: N ratio.ImportanceMeasuring bacterial ammonium regeneration in natural aquatic ecosystem is difficult because bacteria in the field simultaneously consume and produce ammonium. In our experimental design, we used nitrate as the inorganic nitrogen substrate. This way, we could measure separately the uptake and excretion of inorganic nitrogen by bacteria without incorporating cumbersome methods such as isotope dilution. Our experiment allowed us to evaluate the accuracy of various stoichiometric models for the estimation of net bacterial nitrogen regeneration. We found that:The exact distribution of C and N among the various molecules that make the bulk of DOM is a crucial factor to consider for bacterial net nitrogen regeneration.For all substrates, and in particular, mixed substrates where C and N are partially dissociated between different molecules, estimates of net nitrogen regeneration rates can be improved by measuring the actual C: N ratio of bacterial consumption.
A comparison of ThinPrep-PreservCyt against four non-volatile transport media for HPV testing at or near the point of care
Authors: Badman S.G. , Vallely A.J. , Pardo C. , Mhango L.P. , Cornall A.M. , Kaldor J.M. , Whiley D. 
Published: March 2020

AbstractIntroductionThe Xpert HPV Test (Cepheid, Sunnyvale, CA) is used at point-of-care for cervical screening in a number of low-and middle-income countries (LMIC). It is validated for use with ThinPrep-PreservCyt (Hologic, Marlborough, MA) transport medium which has a high methanol content and is therefore classified as a dangerous good for shipping; making cost, transportation and use challenging within LMIC. Therefore, we compared the performance of ThinPrep against four non-volatile commercially available media for HPV point-of-care testing.MethodsTen-fold serial dilutions were prepared using three HPV cell lines each positive for 16, 18 or 31 and with each suspended in five different media types. The media types consisted of Phosphate Buffered Saline (Thermo Fischer Scientific, Waltham, MA, USA), Sigma Virocult (Medical Wire & Equipment, Wiltshire, England), MSwab (Copan, Brescia BS, Italy) Xpert Transport Media (Cepheid, Sunnyvale, USA) and ThinPrep-PreservCyt (Hologic Inc., Marlborough, MA).ResultsA total of 105 HPV Xpert tests were conducted in a laboratory setting, with 7 ten-fold dilutions of each of the 3 HPV genotypes tested in all 5 media types. The lowest HPV ten-fold dilution detected for any media, or cell line was the fifth dilution. Mswab was the only media to detect HPV to the 5thdilution across all three cell types.DiscussionMswab transport media may be a suitable alternative to ThinPrep for Xpert HPV point of care testing and increase HPV detection. A field-based, head to head comparison of both media types using the Xpert HPV assay is warranted to confirm these laboratory-based findings.
Evaluating signals generated in a large-scale sequence symmetry analyses: macrolides and heart failure; and NSAIDs and pneumonia
Authors: Sinnott SJ , Lin KJ , Wang S , Hallas J , Desai R , Schneeweiss S , Gagne JJ 
Published: March 2020

AbstractObjectiveUsing US claims data and the most up-to-date pharmacoepidemiological study design tools we aimed to investigate two safety signals for (1) macrolides and heart failure; and (2) non-steroidal anti-inflammatory drugs (NSAIDs) and pneumonia generated from a large-scale screening analysis using a self-controlled sequence symmetry design in Danish data.MethodsWe used IBM Marketscan data to conduct two new-user, active-comparator cohort studies. In the macrolides example, the exposure was clarithromycin or azithromycin and the comparator was amoxicillin/clavulanate, in patients with sinusitis. In the NSAIDs example, the exposure was oral NSAIDs and the comparator was topical diclofenac, in patients with osteoarthritis. We used Cox proportional hazards regression to estimate hazard ratios (HR) and 95% confidence intervals (CI) to adjust for approximately 50 investigator-specified confounders in a propensity score (PS) matched analysis. In a secondary analysis, we used high-dimensional PS (hd-PS) to adjust for 200 additional proxy confounders.ResultsWe had 1,012,364 propensity score matched patients exposed to clarithromycin or azithromycin versus amoxicillin/clavulanate. With 162 outcomes among clarithromycin or azithromycin exposed patients and 134 among amoxicillin/clavulanate, the HR for overall heart failure was 1.14 (95% CI 0.90 – 1.43). In the NSAIDs example, we included 94,490 patients after propensity score matching. With 794 pneumonia outcomes among oral NSAID patients and 700 among topical diclofenac, we found HR 0.98 (95% CI 0.89 – 1.09). Some upward bias was suspected as larger HRs were observed in the days immediately following exposure for both the macrolides and NSAIDs examples. We found similar results in the hd-PS matched analyses for both examples.ConclusionOur findings for NSAIDs and pneumonia suggest the original signal may have been due to protopathic or detection bias. Our analyses for macrolides and heart failure with short-term follow-up also suggest bias, although we encourage further research.