bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multiproxy strategy for determining palaeoclimate parameters in the Ruby Ranch Member of the Cedar Mountain Formation
Authors: Suarez M. B. , Knight J. A. , Godet A. , Ludvigson G. A. , Snell K. E. , Murphy L. , Kirkland J. I. 
Published: August 2020

Abstract

A multiproxy approach for evaluating palaeoclimate parameters in deep-time can result in improvements to inter-related factors affecting palaeohydrology. Here we utilize diverse geochemical tools to improve palaeoclimate estimates for the Cedar Mountain Formation (CMF). Prior research utilized stable carbon and oxygen isotopes to develop chemostratigraphic correlations to the late Aptian–early Albian, hypothesized aridity during a positive carbon isotope excursion (CIE) and estimated
p
CO
2
through this event. This study refines estimates using petrographical analyses, bulk geochemical proxies for mean annual precipitation (MAP) and clumped isotope palaeothermometry. MAP rates range from 736 to 1042 mm a
−1
with a slight decrease during the hypothesized aridity event. We interpret warm-biased temperatures (with an average of 32.9°C) that do not vary significantly through the study section. Carbonate nodules are likely to have precipitated in highly evaporative conditions as indicated by the presence of dolomite. Utilizing a simple Rayleigh fractionation model and two estimates of
δ
18
O of water, we suggest that evaporation of 2–57% is necessary to result in an enriched end member
δ
18
O
w
. These data suggest that an increase in aridity is a result of lower MAP rates and greater evaporation during seasonal extremes. Lastly, revised
p
CO
2
calculations suggest overestimates but indicate a shift towards greater concentrations during the positive CIE.
Designing Evolutionary-based Interception Strategies to Block the Transition from Precursor Phases to Multiple Myeloma
Authors: Maura Francesco , Landgren Ola , Morgan Gareth J. 
Published: August 2020

Abstract
The development of next-generation sequencing technology has dramatically improved our understanding of the genetic landscape of multiple myeloma. Several new drivers and recurrent events have been reported and linked to a potential driver role. This complex landscape is enhanced by intraclonal mutational heterogeneity and variability introduced through the dimensions of time and space. The evolutionary history of multiple myeloma is driven by both the accumulation of different genomic drivers and by the activity of different mutational processes active overtime. In this review, we describe how these new findings and sequencing technologies have been progressively allowed to understand and reshape our knowledge of the complexity of multiple myeloma at each of its developmental stages: premalignant, at diagnosis, and in relapsed/refractory states. We discuss how these evolutionary concepts can be utilized in the clinic to alter evolutionary trajectories providing a framework for therapeutic intervention at early-disease stages.
Hair Loss in Patients Treated with Vismodegib: A Single-Center Retrospective Study
Authors: Villani Alessia , Fabbrocini Gabriella , Costa Claudia , Scalvenzi Massimiliano 
Published: August 2020

Locally advanced basal cell carcinoma had always represented a form of skin cancer which had been difficult to treat until the hedgehog inhibitor vismodegib was approved. This small molecule acts by inhibiting the hedgehog signaling pathway that plays a critical role in the process of tumorigenesis. Although several trials have demonstrated the high efficacy of this drug, different adverse events have been described. Muscle spasms, dysgeusia, weight loss, and alopecia are the adverse events most frequently reported. The objective of this study was to report the incidence of alopecia arising in patients treated with vismodegib, assessing its characteristics, grade of severity, and time of onset.
The acute effects of cannabidiol on the neural correlates of reward anticipation and feedback in healthy volunteers
Authors: Lawn Will , Hill James , Hindocha Chandni , Yim Jocelyn , Yamamori Yumeya , Jones Gus , Walker Hannah , Green Sebastian F , Wall Matthew B , Howes Oliver D , Curran H Valerie , Freeman Tom P , Bloomfield Michael AP 
Published: August 2020

Background: Cannabidiol has potential therapeutic benefits for people with psychiatric disorders characterised by reward function impairment. There is existing evidence that cannabidiol may influence some aspects of reward processing. However, it is unknown whether cannabidiol acutely affects brain function underpinning reward anticipation and feedback. Hypotheses: We predicted that cannabidiol would augment brain activity associated with reward anticipation and feedback. Methods: We administered a single 600 mg oral dose of cannabidiol and matched placebo to 23 healthy participants in a double-blind, placebo-controlled, repeated-measures design. We employed the monetary incentive delay task during functional magnetic resonance imaging to assay the neural correlates of reward anticipation and feedback. We conducted whole brain analyses and region-of-interest analyses in pre-specified reward-related brain regions. Results: The monetary incentive delay task elicited expected brain activity during reward anticipation and feedback, including in the insula, caudate, nucleus accumbens, anterior cingulate and orbitofrontal cortex. However, across the whole brain, we did not find any evidence that cannabidiol altered reward-related brain activity. Moreover, our Bayesian analyses showed that activity in our regions-of-interest was similar following cannabidiol and placebo. Additionally, our behavioural measures of motivation for reward did not show a significant difference between cannabidiol and placebo. Discussion: Cannabidiol did not acutely affect the neural correlates of reward anticipation and feedback in healthy participants. Future research should explore the effects of cannabidiol on different components of reward processing, employ different doses and administration regimens, and test its reward-related effects in people with psychiatric disorders.
Development of Voluntary Assisted Dying Training in Victoria, Australia: A Model for Consideration
Authors: White Ben P. , Willmott Lindy , Close Eliana , Hewitt Jayne , Meehan Rebecca , Greaves Laura Ley , Parker Malcolm H. , Yates Patsy 
Published: August 2020

Background: Voluntary assisted dying was legalized in Victoria, Australia in June 2019, and was the first jurisdiction internationally to legislatively mandate training for doctors conducting eligibility assessments of patients. Mandatory training was designed as a safeguard to ensure compliance within the system, so that only eligible patients would gain access to voluntary assisted dying. Objective: This article outlines the development of training mandated for doctors prior to undertaking eligibility assessments for voluntary assisted dying. The training addressed required legal knowledge, including doctors’ roles, duties and legal protections, and also provided instruction on relevant clinical skills. Design: Training design was based on 2 main principles: to comprehensively impart the legal duties imposed by the legislation; and to be readily accessible for busy doctors. The law was first mapped into a curriculum, and circulated to medical colleges, societies and professional organizations as well as international experts for feedback. The training was converted into an online e-learning format and tested at a focus group of doctors. Results: The training comprises 9 modules including an assessment module. While the predominant focus of the modules is on law, they also contain some clinical components and links to further resources. Modules also contain videos, case studies and interactive exercises. The assessment consists of 30 questions, selected randomly from a question bank, with a pass mark of 90%. Conclusion: The Victorian legislatively-mandated voluntary assisted dying training provides standardized baseline knowledge to enhance the quality and consistency of decision-making by doctors. While further evaluation of this training is needed, it may provide a model for other jurisdictions considering making voluntary assisted dying lawful.
Extensor Retinaculum Flap and Fibular Periosteum Ligamentoplasty After Failed Surgery for Chronic Lateral Ankle Instability
Authors: Pintore Ernesto , Cipollaro Lucio , Pintore Raffaele , Oliva Francesco , Maffulli Nicola 
Published: August 2020

Background: The anterior talofibular ligament and the calcaneofibular ligament are 2 of the most frequently injured structures in sports, being damaged in 30% to 45% of all sports injuries. Most reconstructive procedures are successful but can deteriorate with time and can lead to low-grade radiographic degeneration. Methods: We operated on 26 consecutive patients from 2001 to 2008 who had failed previous surgical procedures for the lateral ligamentous complex of the ankle, with an average of 104 (range, 75-140) months. Results: The overall functional rating was excellent in 14 ankles, good in 10, fair in 1, and poor in 1. Twenty-four patients (92.3%) were satisfied with the procedure and 15 (57.7%) were able to return to their preinjury level of activity. Local complications were detected in 2 patients who presented with skin necrosis; 1 patient developed severe reflex sympathetic dystrophy. Conclusion: Revision surgery for the management of failure after surgical treatment of chronic lateral ankle instability is under debate, and the literature is devoid of clinical studies with long-term follow-up. The technique described offers a high rate of long-term excellent and good results, with a low rate of complications and a good rate of return to preinjury level. Level of Evidence: Level IV, retrospective case series.
Limitations of Plain Film Radiography in Identification of Hyperextension Fractures in Patients With Ankylosing Spinal Disorders
Authors: Barkay Gal , Dan Lantsman Christine , Menachem Shay , Shtewee Anan , Ackshota Nissim , Caspi Israel , Eshed Iris , Friedlander Alon 
Published: August 2020

Study Design: Efficacy study. Objectives: To elucidate the limitations of radiography in patients with spinal ankylosing disorders (SAD) with an emphasis on thoracolumbar injuries, which have been less focused upon. Methods: We searched our hospital’s emergency room database for patients who underwent a total spine computed tomography (CT) following a diagnosis of SAD on radiographs following a minor fall. A high-quality presentation containing 50 randomly situated anteroposterior + lateral radiographs was created. Of these, 24 contained a hyperextension type fracture diagnosed by CT. Twelve physicians—4 spine surgeons, 4 senior orthopedic residents and 4 junior orthopedic residents were requested to identify the pathologic radiographs and note the fracture level. Results: Fracture diagnosis stood at 65% for the best reader. When examining the different subgroups, the mean rate of diagnosis for spine surgeons was 55% and for orthopedic residents 32%. Mean diagnosis of thoracic fractures was 26%, of lumbar fractures was 55%, and for the entire thoracolumbar spine was 40%. The interobserver agreement (kappa coefficient) was found to be 0.37 for the entire group and 0.39 for spine surgeons. This finding was statistically significant. Conclusions: The simple radiograph is an inefficient modality for diagnosis of hyperextension type thoracolumbar fractures in patients with SAD. The poor interobserver agreement rate further amplifies this finding. Advanced imaging is recommended in these patients.
When it counts the most: Trauma-informed care and the COVID-19 global pandemic
Authors: Collin-Vézina Delphine , Brend Denise , Beeman Irene 
Published: August 2020

CONTEXT: Evidence from the COVID-19 crisis suggests that children and youth are more likely to be subjected to maltreatment and exposure to family violence, while experiencing limited access to the usual services that support vulnerable families and provide targeted services to meet their needs. The current global pandemic itself can also be experienced as a traumatic event. Trauma-informed care draws attention to the potential impacts, from the individual to the global, that myriad traumatic experiences can illicit and proposes using these understandings as foundational to the development and implementation of policy and practice. OBJECTIVE: The aim of this opinion paper is to offer insights to guide practices and policies during this unprecedented global crisis through a discussion of the Substance Abuse and Mental Health Services Administration (2014)’s six trauma-informed care principles: trustworthiness and transparency; safety; peer support; collaboration and mutuality; empowerment and choice; and cultural, historical and gender issues. FINDINGS: Specific recommendations based on these six principles and applied to the current situation are presented and discussed. These principles can serve both in the immediate crisis and as preventative measures against unforeseen future traumatic contexts. CONCLUSION: COVID-19 renews the imperative to maintain and strengthen trauma-informed practices and policies. We argue that never before has trauma-informed care been so important to promote the health and well-being of all and to protect our marginalized populations at greatest risk.
Performance of penicillinase detection tests in Staphylococcus epidermidis: comparison of different phenotypic methods
Authors: Aubry Benjamin , Lemarié Carole , Chenouard Rachel , Kempf Marie , Eveillard Matthieu , Pailhoriès Hélène 
Published: August 2020

Abstract
Background
Staphylococcus epidermidis is the leading coagulase negative staphylococci (CoNS) species associated with healthcare associated infections. In order to de-escalate antimicrobial therapy, isolates of S. epidermidis lacking the blaZ gene should be eligible for targeted antimicrobial therapy. However, testing the susceptibility of coagulase negative staphylococci (CoNS) to penicillin G is no longer recommended by EUCAST, given the low performances for penicillinase detection in CoNS. The objective of this work was to determine a phenotypic method with high performance for detecting penicillinase production in S. epidermidis.

Results
Four techniques for the detection of penicillinase production (disk diffusion, zone edge test, nitrocefin test, Minimal Inhibitory Concentration (MIC) by automated system Vitek2®) were evaluated on 182 S. epidermidis isolates, using identification of blaZ gene by PCR as the reference method. The performance of the methods for penicillinase detection was compared by the sensitivity, the specificity, the negative predictive value and the positive predictive value, and with Cohen’s kappa statistical test. Among the 182 S. epidermidis included in this study, 55 carried the blaZ gene. The nitrocefin test, characterized by a poor sensitivity (91%), was therefore excluded from S. epidermidis penicillinase detection. The algorithm proposed here for the penicillinase detection in S. epidermidis involved two common antimicrobial susceptibility techniques: disk diffusion method and MIC by Vitek2® system. Disk diffusion method, interpreted with a 26 mm breakpoint for penicillin G, was associated with a high sensitivity (98%) and specificity (100%). This method was completed with zone edge test for S. epidermidis with penicillin G diameter from 26 to 35 mm (sensitivity of 98%). The Vitek2® system is associated with a low sensitivity (93%) and a high specificity (99%) This low sensitivity is associated with false negative results, in isolates with 0.12 mg/L Penicillin G MIC values and blaZ positive. Thus for penicillin G MIC of 0.06 mg/L or 0.12 mg/L, a second step with disc diffusion method is suggested.

Conclusions
According to our results, the strategy proposed here allows the interpretation of penicillin G susceptibility in S. epidermidis isolates, with an efficient detection of penicillin G resistance.
Significant association between genes encoding virulence factors with antibiotic resistance and phylogenetic groups in community acquired uropathogenic Escherichia coli isolates
Authors: Yazdanpour Zahra , Tadjrobehkar Omid , Shahkhah Motahareh 
Published: August 2020

Abstract
Background
Antibiotic resistance is an increasing phenomenon in many bacterial pathogens including uropathogenic Escherichia coli. Hypothetical anti-virulent agents could be a solution, but first clear virulence associated gene-pool of antibiotic resistant isolates have to be determined. The aim of this study is to investigate the significant associations between genes encoding VFs with antibiotic resistance and phylogenetic groups in UPEC isolates.

Results
The majority of 248 UPEC isolates belonged to phylogenetic group B2 (67.3%). The maximum and minimum resistance was attributed to amoxicillin (90.3%) and both fosfomycin and imipenem (1.6%) respectively. 11.3% of isolates were resistant to all antibiotic agents except that of imipenem, nitrofurantoin and fosfomycin. These highly resistant isolates were placed only in group B2 and D. The most prevalent virulence gene was ompA (93.5%). The hlyA was the only virulence gene that was significantly more prevalent in the highly resistant isolates. The ompA, malX and hlyA genes were obviously more abundant in the antibiotic resistant isolates in comparison to susceptible isolates. The papC gene was associated with amoxicillin resistance (p-value = 0.006, odds ratio: 26.00).

Conclusions
Increased resistance to first line drugs prescribed for UTIs were detected in CA-UPEC isolates in our study.. Minimal resistance was observed against nitrofurantoin, fosfomycin and imipenem. Therefore, they are introduced for application in empirical therapy of UTIs. Fosfomycin may be the most effective antibiotic agent against highly resistant UPEC isolates. The presence of the ompA, malX and hlyA genes were significantly associated with resistance to different antibiotic agents. We assume that the ability of UPEC isolates to upgrade their antibiotic resistance capacity may occurs in compliance with the preliminary existence of specific virulence associated genes. But, more investigation with higher number of bacterial isolates, further virulence associated genes and comparison of gene pools from CA-UPEC isolates with HA-UPEC are proposed to confirm these finding and discovering new aspects of this association.
The correlation of intraoperative hypotension and postoperative cognitive impairment: a meta-analysis of randomized controlled trials
Authors: Feng Xiaojin , Hu Jialing , Hua Fuzhou , Zhang Jing , Zhang Lieliang , Xu Guohai 
Published: August 2020

AbstractBackgroundThere is no consensus on whether intraoperative hypotension is associated with postoperative cognitive impairment. Hence, we performed a meta-analysis to evaluate the correlation of intraoperative hypotension and the incidence of postoperative delirium (POD) or postoperative cognitive dysfunction (POCD).MethodsWe searched PubMed, Embase, and Cochrane Library databases to find randomized controlled trials (RCTs) in which reported the relationship between intraoperative hypotension and POD or POCD. The retrieval time is up to January 2020, without language restrictions. Quality assessment of the eligible studies was conducted by two researchers independently with the Cochrane evaluation system.ResultsWe analyzed five eligible RCTs. Based on the relative mean arterial pressure (MAP), participants were divided into low-target and high-target groups. For the incidence of POD, there were two studies with 99 participants in the low-target group and 94 participants in the high-target pressure group. For the incidence of POCD, there were four studies involved 360 participants in the low-target group and 341 participants in the high-target group, with a study assessed both POD and POCD. No significant difference between the low-target and the high-target group was observed in the incidence of POD (RR = 3.30, 95% CI 0.80 to 13.54,P = 0.10), or POCD (RR = 1.26, 95% CI 0.76 to 2.08,P = 0.37). Furthermore, it also demonstrates that intraoperative hypotension prolonged the length of ICU stay, but did not increased the mortality, the length of hospital stay, and mechanical ventilation (MV) time.ConclusionsThere is no significant correlation between intraoperative hypotension and the incidence of POD or POCD.
The utility of cerebrospinal fluid white cell count during the prognostic assessment for cryptococcal meningitis patients: a retrospective study
Authors: Qu Junyan , Jiang Jingwen , Lv Xiaoju 
Published: August 2020

Abstract
Background
The incidence of cryptococcal meningitis (CM) has gradually increased in recent years. Cerebrospinal fluid (CSF) cytology and cell count are very important for CM on etiology diagnosis and assessment of disease status and therapeutic response. However, the clinical significance of CSF white cell count (WCC) in CM patients is not fully understood. Using longitudinal data of CSF WCC and its relationship with clinical outcomes in CM patients, we aimed to elucidate the clinical significance of this test.

Methods
We retrospectively analyzed the medical records of 150 CM patients admitted to our hospital between January 2008 and December 2018.

Results
CM patients with lower baseline CSF WCC, CSF protein concentration or CD4/CD8 ratio, and those with altered mentation or HIV coinfection were more likely to have poor clinical outcome (P<0.05). CM patients with triple therapy during the induction period presented with a better clinical outcome (P<0.05). Baseline CSF WCC had a moderate positive correlation with peripheral CD4+ T lymphocyte count (r = 0.738, P < 0.001) and CD4+ T lymphocyte percentage (r = 0.616, P < 0.001). The best cut-off value to predict a poor clinical outcome was 40 cells/μL during baseline CSF WCC. The predictive model incorporating longitudinal data of CSF WCC had better sensitivity, specificity, and accuracy than a model incorporating only baseline CSF WCC data.

Conclusions
Our results indicated that baseline CSF WCC and changes in CSF WCC over time could be used to assess the prognosis of CM patients.