bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prolonged neuromuscular block after rocuronium administration in laparoscopic pyloromyotomy patients: A retrospective bayesian regression analysis
Authors: Gilbertson Laura E. , Fiedorek Michael C. , Fiedorek Christopher S. , Trinh Tuan A. , Lam Humphrey , Austin Thomas M. 
Published: December 2020

AbstractBackgroundInfants undergoing pyloromyotomy are at a high risk of aspiration, making rapid sequence induction the preferred method of induction. Since succinylcholine use in infants can be associated with complications, rocuronium is frequently substituted despite its prolonged duration of action.AimsTo examine the likelihood of non‐reversibility to neostigmine at the end of surgery in laparoscopic pyloromyotomies and its correlation to both rocuronium dose and out of operating room time.MethodsPatients who underwent laparoscopic pyloromyotomy for infantile hypertrophic pyloric stenosis, received rocuronium, and were reversed with neostigmine were included. Bayesian multivariable logistic regression was utilized to determine the probability of non‐reversibility, and Bayesian multivariable median regression was performed to ascertain the correlation between out of operating room time and non‐reversibility.Results306 patients were analyzed with a median surgical duration of 19 min (interquartile range 16 to 23). 74% received succinylcholine for intubation followed by rocuronium, and the remaining received rocuronium alone. The median rocuronium dose was 0.41 mg/kg (interquartile range 0.27 – 0.56 mg/kg). Prolonged block occurred in 68 (22.2%) patients. There was a non‐trivial probability of prolonged block with low rocuronium doses, and each 0.1 mg/kg increase in total rocuronium dose was associated with an odds ratio of 1.36 (95% credible interval: 1.17–1.58) of neostigmine non‐reversibility at the end of surgery. Non‐reversibility was correlated with a substantial increase in median out of operating room time (13.4 min, 95% credible interval: 5.5–20.8 min), which was compounded by high rocuronium dosing (2.2 min increase per 0.1 mg/kg for doses greater than 0.5 mg/kg, 95% credible interval: 0.7–3.6 min).ConclusionProlonged blockade can occur from rocuronium administration in infants undergoing pyloromyotomy even at low doses. Therefore, consideration of appropriate rocuronium dosing or the use of sugammadex should be considered.
Clinical practice recommendations for recurrence of focal and segmental glomerulosclerosis/steroid‐resistant nephrotic syndrome
Authors: Weber Lutz T. , Tönshoff Burkhard , Grenda Ryszard , Bouts Antonia , Topaloglu Rezan , Gülhan Bora , Printza Nikoleta , Awan Atif , Battelino Nina , Ehren Rasmus , Hoyer Peter F. , Novljan Gregor , Marks Stephen D. , Oh Jun , Prytula Agnieszka , Seeman Tomas , Sweeney Clodagh , Dello Strologo Luca , Pape Lars 
Published: December 2020

AbstractRecurrence of primary disease is one of the major risks for allograft loss after pediatric RTx. The risk of recurrence of FSGS/SRNS after pediatric RTx in particular can be up to 86% in idiopathic cases. There is a need for consensus recommendations on its prevention and treatment. The CERTAIN study group has therefore performed a thorough literature search based on the PICO model of clinical questions to formulate educated statements to guide the clinician in the process of decision‐making. A set of educated statements on prevention and treatment of FSGS/SRNS after pediatric RTx has been generated after careful evaluation of available evidence and thorough panel discussion. We do not recommend routine nephrectomy prior to transplantation; neither do we recommend abstaining from living donation. Special attendance needs to be given to those patients who had already experienced graft loss due to FSGS/SRNS recurrence. Early PE or IA with or without high‐dose CsA and/or rituximab seems to be most promising to induce remission. The educated statements presented here acknowledge that FSGS/SRNS recurrence after pediatric RTx remains a major concern and is associated with shorter graft survival or even graft loss. The value of any recommendation needs to take into account that evidence is based on cohorts that differ in ethnicity, pre‐transplant history, immunosuppressive regimen, definition of recurrence (eg, clinical and/or histological diagnosis) and treatment modalities of recurrence.
Post‐transplant hepatic fibrosis in pediatric liver‐small bowel transplant recipients: A single‐center, retrospective, observational study
Authors: Vo Hanh D. , Radio Stanley J. , Reyes‐Santiago Emille M. , Mauch Teri J. 
Published: December 2020

AbstractBackgroundLittle is known about the prevalence of hepatic graft fibrosis in combined LSBT children. We aimed to determine the prevalence of and identify potential predictors for hepatic graft fibrosis in LSBT children and to compare them with those in LT children.MethodsWe retrospectively included children younger than 19 years who had received a primary LT/LSBT between 2000 and 2018 and had a liver biopsy performed at least 6 months post‐transplant. A Cox proportional hazards regression model was used to determine predictors associated with significant hepatic graft fibrosis (≥F2) in LSBT vs LT children.ResultsNinety‐six children (47 LSBT, 54 females) were included. The median post‐transplant follow‐up (years) was 12.8 in LT vs 10.5 in LSBT patients (P = .06). Hepatic graft fibrosis was found in 81.6% of LT vs 70.2% of LSBT children (P = .19), after a median time of 2.5 years and 2.6 years, respectively. On multivariate analyses, having post‐transplant biliary complications was found to be associated with significant graft fibrosis in LT children, whereas AST/ALT ratio was found to predict significant hepatic graft fibrosis in LSBT children. The use of parenteral nutrition after transplant was not associated with significant hepatic graft fibrosis.ConclusionsThe prevalence of hepatic graft fibrosis in LSBT children did not significantly differ from that in LT children, but the predictors may differ. Future studies should investigate the role of post‐transplant autoimmune antibodies and donor‐specific antibodies in the development and progression of hepatic graft fibrosis in LSBT children.
Politics and Corporate‐Sector Environmentally Significant Actions: The Effects of Political Partisanship on U.S. Utilities Energy Efficiency Policies
Authors: Adua Lazarus , Clark Brett 
Published: December 2020

AbstractThis study assesses the direct, indirect, and total impacts of political partisanship on state‐level utilities' investment in energy efficiency. This subject is of utmost importance because energy efficiency improvement has become a linchpin in worldwide efforts to combat climate change and other environmental challenges. Analysis of data on 51 electric utilities nested within 31 U.S. states indicates that political partisanship influences utilities' energy efficiency policies. There is strong evidence that electric utilities in states dominated by the Republican Party are less likely to invest in energy efficiency than those in states governed by the Democratic Party. This finding suggests that political partisanship may be shaping the policy and regulatory frameworks put in place by state governments to incentivize or compel the participation of private‐sector entities' in environmental management and/or resource conservation.
An evaluation of the geriatric dental curricula within Advanced Education in General Dentistry and General Practice Residency programs in the United States
Authors: Mueldener Emma J. , McQuistan Michelle R. , Qian Fang , Hartshorn Jennifer E. , Oishi Matthew M. 
Published: December 2020

AbstractAimTo compare the geriatric dentistry curricula between Advanced Education in General Dentistry (AEGD) and General Practice Residency (GPR) programs.MethodsA 108‐item survey was developed to assess residents’ didactic and clinical experiences pertaining to geriatric patients. Surveys were mailed in 2018 to all AEGD (N = 89) and GPR (N = 180) program directors. Statistical analysis consisted of descriptive and bivariate analyses with the chi‐square test, Fisher's exact test, and the Wilcoxon rank sum test (alpha = .05).ResultsTwenty‐four AEGD and fifty‐eight GPR directors completed surveys (response rate = 30%). Seventy‐one percent of responding programs reported mandatory didactic training pertaining to frail and functionally dependent geriatric adults. Ninety‐nine percent of respondents reported that residents provided treatment to geriatric patients; however, they were less likely to perform procedures on frail and functionally dependent patients. Only 15% of respondents provided nursing home care. Considering all patient encounters, responding GPR programs were more likely than AEGD programs to treat patients using IV bisphosphonates (63% vs 25%; P < .01), undergoing chemotherapy (48% vs 16%; P = .02), and undergoing head and neck radiation therapy (55% vs 25%; P = .02).ConclusionA majority of responding AEGD and GPR programs reported providing educational experiences pertaining to geriatric patients; however, GPR programs reported treating more medically complex patients than AEGD programs.
Metabolic rejuvenation upgrades circulatory functions of red blood cells stored under blood bank conditions
Authors: Marin Mickaël , Roussel Camille , Dussiot Michael , Ndour Papa A. , Hermine Olivier , Colin Yves , Gray Alan , Landrigan Matt , Le Van Kim Caroline , Buffet Pierre A. , Amireault Pascal 
Published: December 2020

AbstractBackgroundRed blood cells (RBC) change upon hypothermic conservation, and storage for 6 weeks is associated with the short‐term clearance of 15% to 20% of transfused RBCs. Metabolic rejuvenation applied to RBCs before transfusion replenishes energetic sources and reverses most storage‐related alterations, but how it impacts RBC circulatory functions has not been fully elucidated.Study Design and MethodsSix RBC units stored under blood bank conditions were analyzed weekly for 6 weeks and rejuvenated on Day 42 with an adenine‐inosine–rich solution. Impact of storage and rejuvenation on adenosine triphosphate (ATP) levels, morphology, accumulation of storage‐induced microerythrocytes (SMEs), elongation under an osmotic gradient (by LORRCA), hemolysis, and phosphatidylserine (PS) exposure was evaluated. The impact of rejuvenation on filterability and adhesive properties of stored RBCs was also assessed.ResultsRejuvenation of RBCs restored intracellular ATP to almost normal levels and decreased the PS exposure from 2.78% to 0.41%. Upon rejuvenation, the proportion of SME dropped from 28.2% to 9.5%, while the proportion of normal‐shaped RBCs (discocytes and echinocytes 1) increased from 47.7% to 67.1%. In LORCCA experiments, rejuvenation did not modify the capacity of RBCs to elongate and induced a reduction in cell volume. In functional tests, rejuvenation increased RBC filterability in a biomimetic splenic filter (+16%) and prevented their adhesion to endothelial cells (−87%).ConclusionRejuvenation reduces the proportion of morphologically altered and adhesive RBCs that accumulate during storage. Along with the improvement in their filterability, these data show that rejuvenation improves RBC properties related to their capacity to persist in circulation after transfusion.
History of indigenous Trypanosomacruzi infection in humans, animals and triatomines in California, USA
Authors: Dye‐Braumuller Kyndall C. , Lynn Mary K. , Nolan Melissa S. 
Published: December 2020

AbstractThis historical review highlights previously undescribed potential foci for sylvatic and domestic locally acquired Chagas disease in California. The review starts in the 1910s, when Trypanosoma cruzi was first discovered through scientific triatomine investigations. Next, the natural transition around the mid‐1900s into clinical investigations of the domestic and peridomestic environments and their epidemiologic profiles is detailed. The review closes with the shift to applied genetic, diagnostic and scientific applications surrounding Chagas disease infected individuals in the state. Throughout the course of the review, transmission foci and their unique clinical and epidemiologic characteristics are described. This in‐depth review has merit for clinicians, veterinarians and public health officials working with vector‐borne diseases in the southwestern USA.
Effect of preoperative nutritional supplementation on postoperative outcomes for patients undergoing pancreaticoduodenectomy for cancer: a systematic review protocol
Authors: Dangen Jordyn , Porritt Kylie , Abbas Saleh 
Published: December 2020

ABSTRACT

Objective:
This review aims to present the best available evidence related to the effect of preoperative nutritional supplementation on postoperative outcomes for patients undergoing pancreaticoduodenectomy for cancer.

Introduction:
Pancreaticoduodenectomy surgery is the only curative option for early head of pancreas and periampullary cancers. This complex, high-risk procedure is associated with significant morbidity, making opportunities to improve outcomes paramount. Nutritional supplementation in the preoperative period may enhance the body's ability to withstand the stress of major surgery and reduce postoperative complications.

Inclusion criteria:
This review will consider studies of patients undergoing pancreaticoduodenectomy for cancer who are provided preoperative nutritional supplementation in any form for a minimum of 48 hours. Randomized and quasi-randomized trials that compare any form of preoperative nutritional supplementation to standard care in these patients will be included. Outcome data will include hospital length of stay, mortality, infections, delayed gastric emptying, pancreatic fistula, anastomotic leak, hemorrhage, weight loss, body mass index, serum albumin, lymphocyte levels, and nutrition risk index score.

Methods:
Electronic databases (PubMed, Scopus, CINAHL, and Cochrane Library) and trial registers will be searched for published and unpublished articles. All articles from database inception to present, published in any language will be included. One reviewer will perform the literature search, screen texts for inclusion, and extract data. Two authors will assess methodological quality of the literature using the JBI critical appraisal tool. Authors will be contacted where additional data or clarification is required. Statistical meta-analysis through synthesis and pooling of data for each intervention will be completed where meaningful.

Systematic review registration number:
PROSPERO CRD42020215307
SAFE, a new therapeutic intervention for families of children with autism: a randomised controlled feasibility trial
Authors: McKenzie Rebecca , Dallos Rudi , Stedmon Jacqui , Hancocks Helen , Vickery Patricia Jane , Barton Andy , Vassallo Tara , Myhill Craig , Chynoweth Jade , Ewings Paul 
Published: December 2020

ObjectivesTo establish the feasibility of a definitive randomised controlled trial of Systemic Autism-related Family Enabling (SAFE), an intervention for families of children with autism.DesignA randomised, controlled, multicentred feasibility study.SettingParticipants were identified from three National Health Service (NHS) diagnosing centres in Plymouth and Cornwall and a community pathway.Participants34 families of a child with a diagnosis of autism severity level 1 or 2 between 3 and 16 years. Four families were lost to follow-up.InterventionsSAFE is a manualised five-session family therapy-based intervention delivered over 16 weeks and designed for families of children with autism. SAFE involves families attending five 3-hour sessions led by systemic practitioners.Primary and secondary outcome measuresThe proposed primary outcome measure was the Systemic CORE 15 (SCORE-15). Proposed secondary outcome measures: Patient Health Questionnaire-Somatic Anxiety Depressive Symptoms, the Coding of Attachment-Related Parenting for use with children with Autism, the Child Behaviour Checklist (CBCL), the Reflective Functioning Questionnaire (RFQ) and the Caregiving Helplessness Questionnaire. Outcome measures were collected at baseline and 24 weeks post randomisation.ResultsAll primary caregivers retained in the study completed the SCORE-15 at both time points. 34 of the target of 36 families were recruited and 88% of families were retained. Training for therapists was effective. Feedback revealed willingness to undergo randomisation. There was 100% attendance at appropriate sessions for core family members. The SCORE-15 showed reduction in scores for families receiving SAFE compared with controls suggesting positive change. Qualitative data also revealed that families found the study acceptable and families receiving SAFE experienced positive change. Feedback indicated that the SCORE-15 should be retained as a primary measure in a future trial, but secondary measures should be reduced.ConclusionsThis study indicates that a larger trial of SAFE is feasible. Findings suggest that SAFE can address current gaps in recommended care, can be confidently delivered by NHS staff and has potential as a beneficial treatment.Trial registration numbersISCTRN83964946 and IRAS213527.
Why some women who attend focused antenatal care fail to deliver in health facilities: a qualitative study of women’s perspectives from slums of Addis Ababa, Ethiopia
Authors: Sendo Endalew G , Chauke M E , Ganga-Limando M 
Published: December 2020

ObjectiveThe purpose of this study was to explore why some women who attend focused antenatal care (FANC) fail to deliver in health facilities from slums of Addis Ababa, Ethiopia.SettingPublic health facilities (three health centres and one district hospital).Study designA qualitative exploratory and descriptive research design was used.Study participantsStudy participants comprised women of reproductive age (18–49 years) living in slum areas of Addis Ababa, Ethiopia. We used 20 in-depth audio-recorded interviews. Data were analysed concurrently with data collection. Thematic analysis was done for the study. A multilevel life-course framework of facility-based delivery in low-income and middle-income countries developed by Bohren et al was used to frame the current study and link the findings of the study to the body of knowledge.ResultsFrom the analysis of in-depth interview data, four themes emerged, namely, perceived benefits of home delivery, knowledge deficit about health facility-based delivery, poor access to healthcare facilities and inadequate (demand side) resources. These themes were identified as rich and detailed accounts of the perspectives of facility-based and home delivery among attendees of FANC in Addis Ababa, Ethiopia.ConclusionThe findings of this qualitative study revealed that perceived benefits of home delivery, knowledge deficit about health facility-based delivery, poor access to healthcare facilities and inadequate (demand side) resources were related to low uptake of facility-based delivery services. Use of ANC visits to advise women about birth preparedness and complication readiness, the use of facility deliveries to reduce risks of home delivery to the mother and the newborn should be stressed.
Risk of colectomy after conservative treatment of diverticulitis of the left hemicolon complicated by abdominal or pelvic abscess: protocol of a systematic review and meta-analysis
Authors: Sohn Maximilian , Agha Ayman , Iesalnieks Igors , Tiefes Anna , Hochrein Alfred , Friess Helmut , Wilhelm Dirk , Schorn Stephan 
Published: December 2020

IntroductionAcute diverticulitis of the sigmoid colon is increasingly treated by a non-operative approach. The need for colectomy after recovery from a flare of acute diverticulitis of the left colon, complicated diverticular abscess is still controversial. The primary aim of this study is to assess the risk of interval emergency surgery by systematic review and meta-analysis.Methods and analysisThe systematic review and meta-analysis will be conducted in accordance to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols statement. PubMed/MEDLINE, Cochrane Central Register of Controlled Trials and EMBASE will be screened for the predefined searching term: (Diverticulitis OR Diverticulum) AND (Abscess OR pelvic abscess OR pericolic abscess OR intraabdominal abscess) AND (surgery OR operation OR sigmoidectomy OR drainage OR percutaneous drainage OR conservative therapy OR watchful waiting). All studies published in an English or German-speaking peer-reviewed journal will be suitable for this analysis. Case reports, case series of less than five patients, studies without follow-up information, systematic and non-systematic reviews and meta-analyses will be excluded. Primary endpoint is the rate of interval emergency surgery. Using the Review Manager Software (Review Manager/RevMan, V.5.3, Copenhagen, The Nordic Cochrane Centre, The Cochrane Collaboration, 2012) meta-analysis will be pooled using the Mantel-Haenszel method for random effects. The Risk of Bias in Non-randomized Studies of Interventions tool will be used to assess methodological quality of non-randomised studies. Risk of bias in randomised studies will be assessed using the Cochrane developed RoB 2-tool.Ethics and disseminationAs no new data are being collected, ethical approval is exempt for this study. This systematic review is to provide a new insight on the need for surgical treatment after a first attack of acute diverticulitis, complicated by intra-abdominal or pelvic abscesses. The results of this study will be presented at national and international meetings and published in a peer-reviewed journal.PROSPERO registration numberCRD42020164813.
Fine-grained Complexity Analysis of Two Classic TSP Variants
Authors: Berg Mark de , Buchin Kevin , Jansen Bart M. P. , Woeginger Gerhard 
Published: December 2020

We analyze two classic variants of the T
RAVELING
S
ALESMAN
P
ROBLEM
(
TSP
) using the toolkit of fine-grained complexity.

Our first set of results is motivated by the B
ITONIC TSP
problem: given a set of
n
points in the plane, compute a shortest tour consisting of two monotone chains. It is a classic dynamic-programming exercise to solve this problem in
O
(
n
2
) time. While the near-quadratic dependency of similar dynamic programs for L
ONGEST
C
OMMON
S
UBSEQUENCE
and D
ISCRETE
F
réchet
D
istance
has recently been proven to be essentially optimal under the Strong Exponential Time Hypothesis, we show that bitonic tours can be found in subquadratic time. More precisely, we present an algorithm that solves bitonic TSP in
O
(
n
log
2
n
) time and its bottleneck version in
O
(
n
log
3
n
) time. In the more general pyramidal TSP problem, the points to be visited are labeled 1,… ,
n
and the sequence of labels in the solution is required to have at most one local maximum. Our algorithms for the bitonic (bottleneck) TSP problem also work for the pyramidal TSP problem in the plane.

Our second set of results concerns the popular
k
-
OPT
heuristic for TSP in the graph setting. More precisely, we study the
k
-
OPT
decision problem, which asks whether a given tour can be improved by a
k
-
OPT
move that replaces
k
edges in the tour by
k
new edges. A simple algorithm solves
k
-
OPT
in
O
(
n

k

) time for fixed
k
. For 2-
OPT
, this is easily seen to be optimal. For
k
=3, we prove that an algorithm with a runtime of the form Õ(
n
3−ɛ
) exists if and only if A
LL
-P
AIRS
S
HORTEST
P
ATHS
in weighted digraphs has such an algorithm. For general
k
-
OPT
, it is known that a runtime of
f
(
k
) ·
n

o
(
k
/ log
k
)

would contradict the Exponential Time Hypothesis. The results for
k
=2,3 may suggest that the actual time complexity of
k
-
OPT
is Θ (
n

k

). We show that this is not the case, by presenting an algorithm that finds the best
k
-move in
O
(
n

⌊ 2
k
/3 ⌋+1

) time for fixed
k
≥ 3. This implies that 4-
OPT
can be solved in
O
(
n
3
) time, matching the best-known algorithm for 3-
OPT
. Finally, we show how to beat the quadratic barrier for
k
=2 in two important settings, namely, for points in the plane and when we want to solve 2-
OPT
repeatedly.