bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perianal sepsis in neutropaenic patients with haematological malignancies: the role of magnetic resonance imaging and surgery
Authors: Ashkar Claudia , Britto Maneka , Carne Peter , Cheung Wa , Mirbagheri Naseem 
Published: February 2020

AbstractBackgroundPerianal sepsis occurs in up to 10% of neutropaenic patients with haematological malignancy and is associated with significant morbidity and mortality. The management of this condition is challenging in neutropaenic patients due to its atypical pathophysiology. The aim of this study is to assess the role of magnetic resonance imaging (MRI) and surgery in neutropaenic patients with perianal sepsis.MethodsA retrospective chart review was performed on all neutropenic patients with a haematological malignancy who had a diagnosis of perianal sepsis during the inpatient admission between 2008 and 2017. Patient characteristics, symptoms, haematological data, MRI result, surgical intervention, intraoperative findings and outcomes including recurrence and mortality were collected.ResultsNineteen neutropaenic patients with haematological malignancy were treated for perianal sepsis, eight (42%) patients were managed conservatively and 11 (58%) were managed surgically. Nine patients underwent MRI, which identified a collection in 88% of cases despite severe neutropaenia. In patients with a collection identified on MRI prior to surgery, 80% had a drainable collection confirmed intraoperatively. Post‐operative complications included two cases of sepsis from a presumed perianal source and one death. A total of 82% of patients experienced symptom resolution after surgery compared to 88% of patients managed conservatively.ConclusionThis study has demonstrated that MRI is a useful diagnostic tool in evaluating perianal sepsis in patients with haematological malignancy, even during periods of severe neutropenia. We found that both conservative and surgical management strategies lead to resolution of symptoms.
Meprin‐α (Mep1A) enhances TNF‐α secretion by mast cells and aggravates abdominal aortic aneurysms
Authors: Gao Ran , Liu Duan , Guo Wenjun , Ge Weipeng , Fan Tianfei , Li Bolun , Gao Pan , Liu Bin , Zheng Yuehong , Wang Jing 
Published: February 2020

Background and PurposeAbdominal aorticaneurysm (AAA) rupture is mainly due to elastic lamina degradation. As a metalloendopeptidase, meprin‐α (Mep1A) critically modulates the activity of proteins and inflammatory cytokines in various diseases. Here, we sought to investigate the functional role of Mep1A in AAA formation and rupture.Experimental ApproachAAA tissues were detected by using real‐time PCR (RT‐PCR), western blotting (WB), and immunohistochemistry. Further mechanistic studies used RT‐PCR, WB, and enzyme‐linked immunosorbent assays.Key ResultsMep1A mediated AAA formation by regulating the mast cell (MC) secretion of TNF‐α, which promoted matrix metalloproteinase (MMP) expression and apoptosis in smooth muscle cells (SMCs). Importantly, increased Mep1A expression was found in human AAA tissues and in angiotensin II‐induced mouse AAA tissues. Mep1A deficiency reduced AAA formation and increased the survival rate of AAA mice. Pathological analysis showed that Mep1A deletion decreased elastic lamina degradation and SMC apoptosis in AAA tissues. Furthermore, Mep1A was expressed mainly in MCs, wherein it mediated TNF‐α expression. Mep1A inhibitor actinonin significantly inhibited TNF‐α secretion in MCs. TNF‐α secreted by MCs enhanced MMP2 expression in SMCs and promoted SMC apoptosis.Conclusion and ImplicationsTaken together, these data suggest that Mep1A may be vital in AAA pathophysiology by regulating TNF‐α production by MCs. Knocking out Mep1A significantly decreased AAA diameter and improved AAA stability in mice. Therefore, Mep1A is a potential new therapeutic target in the development of AAA.
Transplantation of viral‐positive hepatitis C‐positive kidneys into uninfected recipients offers an opportunity to increase organ access
Authors: Graham Jay A. , Torabi Julia , Ajaimy Maria , Akalin Enver , Liriano Luz E. , Azzi Yorg , Pynadath Cindy , Greenstein Stuart M. , Goldstein Doctor Y. , Fox Amy S. , Weiss Jeffery M. , Powell Tia P. , Reinus John F. , Kinkhabwala Milan M. , Rocca Juan P. 
Published: February 2020

AbstractThe advent of direct‐acting antivirals (DAAs) has provided the impetus to transplant kidneys from hepatitis C virus‐positive donors into uninfected recipients (D+/R−). Thirty D+/R− patients received DAA treatment. Sustained virologic response (SVR12) was defined as an undetectable viral load in 12 weeks after treatment. An age‐matched cohort of uninfected donor and recipient pairs (D−/R−) transplanted during same time period was used for comparison. The median day of viral detection was postoperative day (POD) 2. The detection of viremia in D+/R− patients was 100%. The initial median viral load was 531 copies/μL (range: 10‐1 × 108 copies/μL) with a median peak viral load of 3.4 × 105 copies/μL (range: 804‐1.0 × 108 copies/μL). DAAs were initiated on median POD 9 (range: 5‐41 days). All 30 patients had confirmed SVR12. During a median follow‐up of 10 months, patient and graft survival was 100%, and acute rejection was 6.6% with no major adverse events related to DAA treatment. Delayed graft function was significantly decreased in D+/R− patients as compared to the age‐matched cohort (27% vs 60%; P = .01). D+/R− transplantation offers patients an alternative strategy to increase access.
The influence of ischemia and reperfusion time on outcome in heart transplantation
Authors: Jernryd Victoria , Metzsch Carsten , Andersson Bodil , Nilsson Johan 
Published: February 2020

AbstractIschemia/reperfusion may lead to graft dysfunction in heart transplantation (HT). The purpose of this study was to evaluate the influence of ischemic and reperfusion time on acute cellular rejection (ACR) within the first‐year post‐HT and on long‐term outcomes. Data were collected from 331 patients (mean age 49 ± 12 y, 28% females) who underwent HT 1988‐2016. Endomyocardial biopsies obtained within the first year after HT were graded according to the 2004‐ISHLT‐WF. We classified the patients by ischemic time </≥4 hours and further by reperfusion time </≥90 minutes. Primary endpoint was ACR ≥ 2R within one‐year post‐HT. A multiple logistic regression analysis was used to adjust for potential confounders. Secondary endpoint was long‐term survival. There were 56 (17%) patients who received donor hearts with ischemic time >4 hours, and of these, 31 (55%) patients had reperfusion with CPB ≥90 minutes. Ischemia >4 hours had an increased risk of ACR ≥ 2R during the first year (adjusted OR = 3.1, P = .016); however, an extended reperfusion ≥90 minutes reduced the risk (adjusted OR = 0.25, P = .024). The conditional probability of surviving 10 years post‐transplant, given that the patients already survived first year, was inferior for recipients with ischemia ≥ 4 hours and reperfusion <90 minutes, 59%, compared with the other groups 83%, P = .016. Prolonged reperfusion appears to reduce the risk for ACR ≥ 2R and improve long‐term survival.
Phenological shuffling of major marine phytoplankton groups over the last six decades
Authors: Chivers William J. , Edwards Martin , Hays Graeme C. 
Published: February 2020

AbstractAimPhytoplankton form the basis of the marine food web and are responsible for approximately 50% of the world's photosynthesis. Changes to their ecology are, therefore, important: here, we examined seasonal patterns in ocean phytoplankton abundance for 45 taxa over 59 years collected from circa 410,000 km of line‐transect sampling at temperate latitudes.LocationThe North Sea.MethodsFor our analysis we used plankton abundance data from the Continuous Plankton Recorder (CPR) survey, sea surface temperature measurements from the Hadley Centre, UK Meteorological Office and wind speed data from the International Comprehensive Ocean–Atmosphere Data Set, NOAA.ResultsWe found large differences in changes in the timing of peak abundance between the major phytoplankton groups. Late‐summer blooming dinoflagellates (n = 10 taxa) tended to show a large seasonal advancement, the timing of peak abundance for dinoflagellates as group advancing 39 days over these six decades. By contrast diatoms (n = 35) did not show any change as a group in their timing of peak abundance over the time series. Granger causality testing suggested a major driver of these phenological changes has been ocean warming in general but more specifically the rate of spring temperature rise as the most important factor. We also found differences in the timing of peak abundance of harmful algal bloom taxa, with some showing peak abundance earlier while others have moved later.Main conclusionsThere has been a fundamental transformation of the classic seasonal progression from blooms of diatoms to dinoflagellates, which lies at the heart of temperate marine food chains, as the classic bimodal diatom and dinoflagellate seasonal peaks are eroded to a more continuous, single, longer‐lasting phytoplankton peak. This phenological shuffling within and between major taxonomic groups is likely to have profound implications for the transfer of energy to higher trophic levels.
Endocytoscopic intramucosal capillary network changes and crypt architecture abnormalities can predict relapse in patients with an ulcerative colitis Mayo endoscopic score of 1
Authors: Maeda Yasuharu , Kudo Shin‐ei , Ogata Noriyuki , Mori Yuichi , Misawa Masashi , Homma Mayumi , Nemoto Tetsuo , Ogawa Masataka , Sasanuma Seiko , Sato Yuta , Kataoka Shinichi , Kouyama Yuta , Sakurai Tatsuya , Igarashi Kenta , Ogawa Yushi , Kato Kazuki , Ichimasa Katsuro , Nakamura Hiroki , Kudo Toyoki , Hayashi Takemasa , Wakamura Kunihiko , Baba Toshiyuki , Inoue Haruhiro , Ohtsuka Kazuo 
Published: February 2020

ObjectivesRecent studies have suggested the necessity of therapeutic intervention for patients with ulcerative colitis at high risk of clinical relapse with a Mayo endoscopic score (MES) of 1. The aim of this retrospective cohort study was to demonstrate the impact of intramucosal capillary network changes and crypt architecture abnormalities to stratify the risk of relapse in patients with an MES of 1.MethodsAll included patients had an MES of ≤1 and confirmed sustained clinical remission between October 2016 and April 2019. We classified patients with an MES of 1 as “intramucosal capillary/crypt (ICC)‐active” or “ICC‐inactive” using endocytoscopic evaluation. We followed patients until October 2019 or until relapse; the main outcome measure was the difference in clinical relapse‐free rates between ICC‐active and ICC‐inactive patients with an MES of 1.ResultsWe included 224 patients and analyzed data for 218 (82 ICC‐active and 54 ICC‐active with an MES of 1 and 82 with an MES of 0). During follow‐up, among the patients with an MES of 1, 30.5% (95% confidence interval 20.8–41.6; 25/82) of the patients relapsed in the ICC‐active group and 5.6% (95% confidence interval 1.2–15.4; 3/54) of the patients relapsed in the ICC‐inactive group. The ICC‐inactive group had a significantly higher clinical relapse‐free rate compared with the ICC‐active group (P < 0.01).ConclusionsIn vivo intramucosal capillary network and crypt architecture patterns stratified the risk of clinical relapse in patients with an MES of 1 (UMIN 000032580; UMIN 000036359).
Sleep and obesity among children: A systematic review of multiple sleep dimensions
Authors: Morrissey Bridget , Taveras Elsie , Allender Steven , Strugnell Claudia 
Published: February 2020

SummaryThe objectives were to systematically investigate the multiple dimensions of sleep and their association with overweight or obesity among primary school‐aged children. CINHAL, PsycINFO, SPORTDiscus, Medline, Cochrane, Embase, and PubMed databases were searched for papers reporting on an association between children's sleep and weight status. Studies on clinical populations, published in languages other than English, without objectively measured weight status, or where weight status was reported outside the outlined age bracket (5‐13 years) were excluded. A total of 34  248 citations were extracted from our systematic search protocol, of which 112 were included for detailed review. Compared with sleep duration, of which 86/103 articles found a significant inverse association between sleep duration and measured weight status, few studies examined other dimensions of sleep, such as quality, efficiency and bed/wake times, and relationship with weight status. Where studies existed, variation in defining and measurement of these dimensions restricted comparison and potentially influenced discrepancies across results. Overall, the findings of this review warrant the need for further research of the outlined dimensions of sleep. Future research would benefit from clarity on definitions across the different dimensions, along with the use of valid and reliable tools.
Caring for a family member with intellectual disability into old age: Applying the sociocultural stress and coping model to Italian and Greek migrants in Australia
Authors: Walker Ruth , Belperio Irene , Gordon Sally , Hutchinson Claire , Rillotta Fiona 
Published: February 2020

AbstractBackgroundLittle is known about how older parent caregivers from culturally and linguistically diverse (CALD) backgrounds experience caring for their family member with intellectual disability into late life.MethodIn‐depth semi‐structured interviews were carried out with N = 19 family caregivers aged 50–91 from ten Italian and four Greek families. The Sociocultural Stress and Coping Model was used as a framework to interpret their experiences.ResultsA number of stressors including the need to make sacrifices, physical and emotional demands, uncertain futures and challenges associated with “the system” were identified. While family members play a key role in providing support, changing values around filial responsibility were evident.DiscussionFurther attention needs to be given to CALD families to address challenges associated with caring for their family member with intellectual disabilities as they age. This study also challenges assumptions that CALD families prefer to keep caring within the family long‐term.
Perceived healthiness of food items and the traffic light front of pack nutrition labelling: choice‐based conjoint analysis and cross‐sectional survey
Authors: Anabtawi O. , Swift J. A. , Hemmings S. , Gertson L. , Raaff C. 
Published: February 2020

AbstractBackgroundAlthough traffic light labelling (TLL) is designed to aid the selection of healthier choices, consumers often have to make trade‐offs between (un)desirable attributes. With the current emphasis of public health on sugar reduction, the present study aimed to investigate the relative influence of sugar on the perceived healthiness of products.MethodsA choice‐based conjoint analysis (CBC) survey was designed to assess the relative importance of the macronutrients commonly used in TLL, as well as the rescaled utilities of three attribute levels (red, amber and green), which involved 858 participants aged ≥18 years, who were recruited from the general population of Nottingham. An additional cross‐sectional online survey was completed by another 901 participants to assess public knowledge about the intake recommendations underpinning the TLL.ResultsUsable data for CBC analysis showed that, when deciding upon the healthiness of items, sugar was significantly the most important macronutrient (mean 0.34, 95% confidence interval = 0.32–0.35) among the 641 participants. Red labelling was significantly more influential than green across macronutrients. In the substudy, 13.3% of participants correctly identify the maximum recommended intake of free sugars. Moreover, 42.8% of the total sample could not identify whether the sugar information on TLL refers to the total or free sugar content.ConclusionsDespite a lack of knowledge about the recommendations underpinning the TLL criteria, decisions made by participants concerning the healthfulness of food products were significantly influenced by sugar content. TLL appears to guide consumer beliefs in the absence of deep knowledge. The dominance of sugar in decision making is unsurprising in the current public health climate.
Improving assessment of child development: Results of a quality improvement intervention in general practice
Authors: Alexander Karyn E. , Mazza Danielle 
Published: February 2020

AimsParents' Evaluation of Developmental Status (PEDS) is a validated tool used to assess child development that has not previously been tested in Australian general practice. We examined the effect of a Quality‐Improvement intervention in a single general practice in Melbourne, Australia, that aimed to use this tool to improve the documented assessment of child developmental surveillance during vaccination visits.MethodsMixed methods incorporated audits of clinical records of children aged 1–5 years, before and after intervention, written questionnaires and a focus group (informed by the theoretical domains framework and Capability, Opportunity, Motivation‐Behaviour (COM‐B model)) with clinical and non‐clinical staff.ResultsAfter 6 months, developmental surveillance more than doubled and was documented in more than one in three visits (34.1%). Almost one in five (18.6%) vaccination visits included the PEDS tool. Overall, the tool was positively received with staff expressing high levels of comfort asking parents to complete it (92.8%), increasing development of professional skills (71.4% staff) and confidence (55% clinicians) detecting developmental delays. Thematic analysis of the focus group transcript revealed underlying barriers arising from the practice environment, staff capabilities and motivation.ConclusionsIn a whole of practice Quality‐Improvement intervention that applied PEDS training and implementation, including the receptionist in the medical team more than doubled documented rates of child developmental surveillance during vaccination visits. Solutions to underlying barriers could be incorporated into a revised training module. Future studies need to test the tool in more methodologically robust studies that include analysis of the outcomes of developmental surveillance.
After an end‐of‐life decision: Parents' reflections on living with an end‐of‐life decision for their child
Authors: Sullivan Jane E , Gillam Lynn H , Monagle Paul T 
Published: February 2020

AimParents' role as end‐of‐life decision‐makers for their child has become largely accepted Western health‐care practice. How parents subsequently view and live with the end‐of‐life decision (ELD) they made has not been extensively examined. To help extend understanding of this phenomenon and contribute to care, as a part of a study on end‐of‐life decision‐making, bereaved parents were asked about the aftermath of their decision‐making.MethodsA qualitative methodology was used. Semi‐structured interviews were conducted with parents who had discussed ELDs for their child who had a life‐limiting condition and had died. Data were thematically analysed.ResultsTwenty‐five bereaved parents participated. Results indicate that parents hold multi‐faceted views about their decision‐making experiences. An ELD was viewed as weighty in nature, with decisions judged against the circumstances that the child and parents found themselves in. Despite the weightiness, parents reflected positively on their decisions, regarding themselves as making the right decision. Consequently, parents' comments demonstrated being able to live with their decision. When expressed, regret related to needing an ELD, rather than the actual decision. The few parents who did not perceive themselves as their child's decision‐maker subsequently articulated negative reactions. Enduring concerns held by some parents mostly related to non‐decisional matters, such as the child's suffering or not knowing the cause of death.ConclusionResults suggest that parents can live well with the ELDs they made for their child. End‐of‐life decision‐making knowledge is confirmed and extended, and clinical support for parents informed.
Understanding teenage fertility in Peru: An analysis using longitudinal data
Authors: Favara Marta , Lavado Pablo , Sánchez Alan 
Published: February 2020

AbstractReducing the prevalence of teenage pregnancy remains an elusive goal for public policy in Peru. We use longitudinal data from the Young Lives Study in Peru to investigate on an extensive set of early circumstances and life changes that might be the risk factors for teenage childbearing—about one out of five girls in the sample was a teenage mother. The use of longitudinal data allows us to reduce the methodological concerns common to this type of analysis. According to our results, growing up in a poor household, being raised in a single‐parent household, leaving school at or before age 15, performing badly in school at age 12, and having the first sexual relation at or under age 16 are the key risk factors for early childbearing. From a time‐varying perspective, we uncover the importance of changes in the characteristics of a child and household that occurred prior to childbearing. Among other factors, we find that improvements in self‐efficacy and education aspirations during adolescence are associated with a decrease in the probability of early childbearing. Risk factors identified are considerably more relevant—in most cases, only relevant—for girls. From a policy perspective, our results suggest that initiatives aimed at improving school attendance, sexual education, and socioemotional competencies among adolescents might be effective tools to reduce the high rates of teenage pregnancy in Peru.
Effects of Rooftop Photovoltaics on Building Cooling Demand and Sensible Heat Flux Into the Environment for an Installation on a White Roof
Authors: Brown Kyle E. , Baniassadi Amir , Pham Julie V. , Sailor David J. , Phelan Patrick E. 
Published: February 2020

Abstract
Photovoltaic (PV) panels are commonly used for on-site generation of electricity in urban environments, specifically on rooftops. However, their implementation on rooftops poses potential (positive and negative) impacts on the heating and cooling energy demand of buildings, and on the surrounding urban climate. The adverse consequences can be compounded if PV is installed on top of an otherwise highly reflective (“white”) rooftop. This study investigates these impacts on a test building in Tempe, AZ, by directly measuring the temperature of all involved surfaces. These measurements are supplemented by whole-building energy simulations to model the energy implications for archetypical residential and retail buildings. This includes calculations of the ratio of the energy demand penalty to electricity generation as well as the net sensible heat flux to the ambient environment. Results indicate that the summertime cooling energy penalty due to blockage of outgoing longwave radiation can be 4.9—11.2% of the PV electricity generation. The addition of PV to the white roof resulted in a small decrease in the computed sensible heat flux at night, but a daytime increase in sensible flux by more than a factor of 10 (from less than 25 W/m2 for the white roof alone, to more than 250 W/m2 when PV is added to the roof). This study highlights the potential unintended consequences of rooftop PV under certain conditions and provides a broader perspective for building designers and urban planners.