bluuebunny/crossref_metadata_2025_split huggingface dataset:
Population pharmacokinetics of anidulafungin in ICU patients assessing inter‐ and intrasubject variability
Authors: Kapralos Iasonas , Mainas Efstratios , Apostolopoulou Olympia , Siopi Maria , Neroutsos Efthymios , Apostolidi Stella , Dimopoulos George , Sambatakou Helen , Valsami Georgia , Meletiadis Joseph , Dokoumetzidis Aristides 
Published: July 2020

AimsThe population pharmacokinetics (PK) of anidulafungin in critically ill patients hospitalized in intensive care units (ICUs) was explored with the intention of evaluating and optimizing dosing regimens.MethodsA PK study was conducted in a cohort of 13 patients treated with anidulafungin using intensive sampling during multiple periods per patient and the high‐performance liquid chromatography method for drug quantification. A population PK model was developed to describe the concentration‐time course of anidulafungin and the inter‐individual (IIV) and interoccasion variability (IOV) of the PK parameters. Model‐based PK simulations have been performed to estimate the probability of target attainment (PTA), given the pharmacokinetic/pharmacodynamic target of free 24‐hour area under the free drug concentration‐time curve over minimum inhibitory concentration for several dosing regimens.ResultsA two‐compartment PK model, with first‐order elimination, best described the data with population clearance (CL) and central/peripheral volume of distribution (V1/V2) of 0.778 L/h and 10.2/21.1 L, respectively, and a mean ± s.d. AUC0‐24 of 119.97 ± 46.23 mg·h/L. Pronounced IIV and IOV variability was found for CL (38% and 31%) and V1 (47% and 30%), respectively. Sequential Organ Failure Assessment (SOFA) and Body Mass Index (BMI) were found to be covariates on CL and V1, respectively. Low PTA values were calculated for borderline Clinical & Laboratory Standards Institute (CLSI)‐susceptible Candida strains.ConclusionsAlthough anidulafungin exposure was found comparable to that in healthy volunteers, elevated interindividual and significant interoccasion variability was found in critically ill ICU patients, which resulted in reduced PTA values in these patients.
Women's experience of social media breastfeeding support and its impact on extended breastfeeding success: A social cognitive perspective
Authors: Black Rachel , McLaughlin Marian , Giles Melanie 
Published: July 2020

ObjectiveThis paper investigates the experiences of women using a social media Facebook group for breastfeeding support and attempts to explore whether it has aided in extended breastfeeding success. In addition, it aims to explore the value of social cognitive theory (SCT) in explaining these experiences.DesignExploratory, deductive approach.MethodsQualitative, audio‐recorded, semi‐structured interviews were conducted from eight women who were members of a private Facebook group'. Data were analysed using theoretical thematic analysis, and SCT was used as a theoretical lens through which the data were interrogated.ResultsA number of themes were identified from the women's experiences, with analysis uncovering the superordinate theme ‘increased self‐efficacy' which provided an understanding of how the group impacted women's experiences and aided them in breastfeeding success. The sub‐themes of education, accessibility, online community, normalization, and extended goals provided a more detailed understanding of how self‐efficacy was increased through group membership.ConclusionThe symbiotic relationship between members of a social media group facilitates greater breastfeeding success and a longer duration of breastfeeding through the central concept of the SCT: reciprocal determinism. Therefore, it is posited that the SCT is a suitable theory of behaviour change which can potentially be used to develop interventions aiming to increase breastfeeding rates and duration.
Do specific types of sleep disturbances represent risk factors for poorer health‐related quality of life in inflammatory bowel disease? A longitudinal cohort study
Authors: Scott Alexander J. , Flowers Olivia , Rowse Georgina 
Published: July 2020

ObjectivesPoor global sleep quality is commonly reported in people with inflammatory bowel disease (IBD) and is linked to poorer health‐related quality of life (HRQoL). However, understanding is currently limited by a lack of: (1) longitudinal research and (2) research investigating the impact of specific types of problems sleeping on IBD‐related outcomes, particularly on HRQoL.DesignObservational longitudinal cohort study.MethodsN = 276 participants with IBD completed measures at baseline (T1) and 4 weeks later at T2. Four specific sleep disturbances associated with IBD including sleep apnoea, insomnia, restless legs, and nightmares were measured alongside depression, anxiety and stress, and HRQoL.ResultsAfter controlling for participant demographics and clinical characteristics, T1 depression, anxiety, stress, and T1 HRQoL, more severe symptom severity of sleep apnoea (B = −0.30, p < .05) and insomnia symptoms (B = −0.23, p < .05) at T1 significantly predicted poorer HRQoL at T2. However, the experience of restless legs (B = −0.03, p > .87) and nightmares (B = −0.14, p > .11) at T1 did not predict HRQoL.ConclusionSymptoms synonymous with sleep apnoea and insomnia might represent modifiable risk factors that provide independent contributions to HRQoL over time in those with IBD. These findings suggest that interventions designed to improve sleep apnoea and insomnia could confer benefits to HRQoL in those with IBD. However, more longitudinal research is needed to understand the contribution of sleep disturbances over the longer term, as well as more randomized controlled trials testing the effect of improving sleep on IBD‐related outcomes.
Early outcomes of single‐port robot‐assisted radical prostatectomy: lessons learned from the learning‐curve experience
Authors: Covas Moschovas Marcio , Bhat Seetharam , Onol Fikret , Rogers Travis , Patel Vipul 
Published: July 2020

ObjectiveTo describe the crucial factors related to the implementation of the da Vinci single‐port (SP) system (Intuitive Surgical Inc., Sunnyvale, CA, USA), and the early outcomes after the introduction of this robot for robot‐assisted radical prostatectomy (RARP).Patients and methodsWe prospectively collected data from 50 consecutive patients with prostate adenocarcinoma who underwent RARP using this robot. The median follow‐up was 53 days. We performed a transperitoneal technique. The robotic (multiport) trocar was placed on the supra‐umbilical midline 20 cm from the pubis and an assistant trocar placed in the right lower quadrant. We report our initial experience describing the intra‐ and postoperative outcomes associated with this new robot. Also, we report the early functional and oncological outcomes in the follow‐up period considered. Continuous variables were described as medians and interquartile ranges, while categorical variables as frequencies and proportions.ResultsThe median total operative time was 118 min, median console time was 80 min, and median estimated blood loss was 50 mL. There were no intraoperative complications or blood transfusions. The final pathology reported 18% Grade Group (GrGp)1, 58% GrGp2, 18% GrGp3, 2% GrGp4, and 4% GrGp5. In all, 40 patients (80%) were pT2 and 20% were ≥pT3a. The overall positive surgical margin rate was 14%. In all, 39 patients (78%) achieved full continence at median of 21 days after RARP. The median pain scale (0–10) score at 8, 12 and 16 h after RARP was 2, 2, and 0, respectively.ConclusionThe use of the da Vinci SP robot with an additional assistant port for RARP is technically safe and feasible, with acceptable short‐term functional and oncological outcomes. However, there is a technical learning curve for this new platform due to the smaller scope of the operative field and the decreased flexibility and strength of the surgical instruments.
Efficiency in the transformation of schooling into competences: A cross‐country analysis using PIAAC data
Authors: Calero Jorge , Murillo Huertas Inés P. , Raymond José L. 
Published: July 2020

AbstractThis study (i) compares the competence levels of the adult population in a set of OECD countries; (ii) assesses the comparative efficiency with which the education system in each country transforms schooling into competences, distinguishing by educational level, and (iii) tracks the evolution of this efficiency by birth cohorts. Using PIAAC data, the paper applies standard parametric frontier techniques under two alternative specifications. The results obtained identify Finland, Sweden, Denmark and Japan as being the most efficient and Spain, the United Kingdom, Italy, Ireland and Poland as the least efficient.
Eating in case of emotion dys‐regulation, depression and anxiety: Different pathways to emotional eating in moderate and severe obesity
Authors: Willem Clémence , Gandolphe Marie‐Charlotte , Doba Karyn , Roussel Méline , Verkindt Hélène , Pattou François , Nandrino Jean‐Louis 
Published: July 2020

SummaryEmotion dys‐regulation is thought to be involved in the development and maintenance of emotional eating (EE), notably through its links with anxious and depressive symptoms. AIM: The aims of the study were to: (a) examine the mediating effect of depressive and anxious symptoms on the relationship between emotion dys‐regulation and EE in obesity and (b) compare those links with various degrees of obesity severity. One hundred and twenty patients with obesity, including 60 with “n” (MO) (30 ≤ BMI < 40) and 60 with “severe obesity” (SO) (BMI > 40), completed self‐report measures of emotion dys‐regulation, depression, anxiety and EE. Partial least square structural equation modelling and multi‐group analyses were performed. Emotion dys‐regulation was found to be significantly associated with EE only when the severity of obesity was taken into account. In addition, although the MO and SO groups reported similar levels of emotional and eating disorders, significant differences were found between the groups in pathways leading to EE. In MO, emotion dys‐regulation was only associated with more EE through more anxiety. In SO, emotion dys‐regulation was both directly and indirectly associated with more EE, but only through more depression in the latter. Emotion dys‐regulation, anxiety and depression do not have the same impact on EE depending on the severity of obesity. Psychotherapeutic interventions should aim at reducing emotion dys‐regulation in obesity from MO onwards, but the focus should be on the management of anxiety‐related affects in MO and depression‐related affects in SO.
Assessing the current state of ecological connectivity in a large marine protected area system
Authors: Roberts Kelsey E. , Cook Carly N. , Beher Jutta , Treml Eric A. 
Published: July 2020

AbstractThe establishment of marine protected areas (MPAs) is a critical step in ensuring the continued persistence of marine biodiversity. Although the area protected in MPAs is growing, the movement of individuals (or larvae) among MPAs, termed connectivity, has only recently been included as an objective of many MPAs. As such, assessing connectivity is often neglected or oversimplified in the planning process. For promoting population persistence, it is important to ensure that protected areas in a system are functionally connected through dispersal or adult movement. We devised a multi‐species model of larval dispersal for the Australian marine environment to evaluate how much local scale connectivity is protected in MPAs and determine whether the extensive system of MPAs truly functions as a network. We focused on non‐migratory species with simplified larval behaviors (i.e., passive larval dispersal) (e.g., no explicit vertical migration) as an illustration. Of all the MPAs analyzed (approximately 2.7 million km2), outside the Great Barrier Reef and Ningaloo Reef, <50% of MPAs (46‐80% of total MPA area depending on the species considered) were functionally connected. Our results suggest that Australia's MPA system cannot be referred to as a single network, but rather a collection of numerous smaller networks delineated by natural breaks in the connectivity of reef habitat. Depending on the dispersal capacity of the taxa of interest, there may be between 25 and 47 individual ecological networks distributed across the Australian marine environment. The need to first assess the underlying natural connectivity of a study system prior to implementing new MPAs represents a key research priority for strategically enlarging MPA networks. Our findings highlight the benefits of integrating multi‐species connectivity into conservation planning to identify opportunities to better incorporate connectivity into the design of MPA systems and thus to increase their capacity to support long‐term, sustainable biodiversity outcomes.
Outcomes after heart transplantation for al compared to ATTR cardiac amyloidosis
Authors: Griffin Jan M. , Chiu Leonard , Axsom Kelly M. , Bijou Rachel , Clerkin Kevin J. , Colombo Paolo , Cuomo Margaret O. , De Los Santos Jeffeny , Fried Justin A. , Goldsmith Jeff , Habal Marlena , Haythe Jennifer , Helmke Stephen , Horn Evelyn M. , Latif Farhana , Hi Lee Sun , Lin Edward F. , Naka Yoshifumi , Raikhelkar Jayant , Restaino Susan , Sayer Gabriel T. , Takayama Hiroo , Takeda Koji , Teruya Sergio , Topkara Veli , Tsai Emily J. , Uriel Nir , Yuzefpolskaya Melana , Farr Maryjane A. , Maurer Mathew S. 
Published: July 2020

AbstractLight‐chain (AL) cardiac amyloidosis (CA) has a worse prognosis than transthyretin (ATTR) CA. In this single‐center study, we compared post‐heart transplant (OHT, orthotopic heart transplantation) survival for AL and ATTR amyloidosis, hypothesizing that these differences would persist post‐OHT. Thirty‐nine patients with CA (AL, n = 18; ATTR, n = 21) and 1023 non‐amyloidosis subjects undergoing OHT were included. Cox proportional hazards modeling was used to evaluate the impact of amyloid subtype and era (early era: from 2001 to 2007; late era: from 2008 to 2018) on survival post‐OHT. Survival for non‐amyloid patients was greater than ATTR (P = .034) and AL (P < .001) patients in the early era. One, 3‐, and 5‐year survival rates were higher for ATTR patients than AL patients in the early era (100% vs 75%, 67% vs 50%, and 67% vs 33%, respectively, for ATTR and AL patients). Survival in the non‐amyloid cohort was 87% at 1 year, 81% at 3 years, and 76% at 5 years post‐OHT. In the late era, AL and ATTR patients had unadjusted 1‐year, 3‐year, and 5‐year survival rates of 100%, which was comparable to non‐amyloid patients (90% vs 84% vs 81%). Overall, these findings demonstrate that in the current era, differences in post‐OHT survival for AL compared to ATTR are diminishing; OHT outcomes for selected patients with CA do not differ from non‐amyloidosis patients.
A rare case of lupoid leishmaniasis defying diagnosis for a decade
Authors: Gehlhausen Jeff , Sibindi Cosmas , Ko Christine J. , Grant Matthew , Zubek Amanda 
Published: July 2020

AbstractCutaneous leishmaniasis (CL) is a common disease affecting millions in endemic areas worldwide. We present a case of lupoid leishmaniasis, a rare variant of CL, which clinically mimicked sarcoidosis and/or granulomatous rosacea for 10 years until ultimate diagnosis. An 82‐year‐old U.S. citizen with an extensive travel history presented with a 10‐year history of facial plaques on the cheeks and was previously diagnosed and treated as sarcoidosis. Multiple biopsies (previously and at presentation) revealed tuberculoid granulomas with negative special stains for microorganisms and negative sterile tissue cultures for acid‐fast bacilli, bacteria, and fungal organisms. A diagnosis of granulomatous rosacea was rendered and multiple medical therapies were attempted, none with sustained improvement. Repeat biopsy of a new lesion revealed intracellular organisms consistent with leishmaniasis, which was confirmed by polymerase chain reaction (PCR). Lupoid leishmaniasis is a rare presentation of CL including facial plaques that can mimic granulomatous diseases affecting the face including sarcoidosis and granulomatous rosacea. CL can sometimes be challenging to diagnose through standard histopathologic examination; immunohistochemistry for CD1a can be used to augment tissue‐based examination and PCR should be sent early in cases with sufficient concern.
Trichoblastic carcinosarcoma with panfollicular differentiation (panfollicular carcinosarcoma) and CTNNB1 (beta‐catenin) mutation
Authors: Giang Jenny , Biswas Asok , Mooyaart Antien L. , Groenendijk Floris H. , Dikrama Petra , Damman Jeffrey 
Published: July 2020

AbstractWe present a case of trichoblastic carcinosarcoma with panfollicular differentiation. An 80‐year‐old man presented with a lesion on the left ear, which had been present for several months. Histopathology revealed a well‐demarcated neoplasm in the dermis composed of intimately intermingled malignant epithelial and mesenchymal cells. The epithelial component showed multilineage follicular differentiation toward all of the elements of a normal hair follicle. Molecular analysis revealed identical molecular aberrations in both epithelial and mesenchymal components including CTNNB1 and SUFU mutations. To the best of our knowledge, this is the first report of panfollicular carcinosarcoma and of the presence of a CTNNB1 mutation in trichoblastic carcinosarcoma.
Seeing the forest through many trees: Multi‐taxon patterns of phylogenetic diversity in the Atlantic Forest hotspot
Authors: Brown Jason L. , Paz Andrea , Reginato Marcelo , Renata Cecilia Amaro , Assis Claydson , Lyra Mariana , Caddah Mayara K. , Aguirre‐Santoro Julian , d’Horta Fernando , Raposo do Amaral Fabio , Goldenberg Renato , Lucas Silva‐Brandão Karina , Freitas André Victor Lucci , Rodrigues Miguel T. , Michelangeli Fabian A. , Miyaki Cristina Y. , Carnaval Ana C. 
Published: July 2020

AbstractAimWe combine phylogenetic and point locality data from selected lineages of the Atlantic Forest flora and fauna to compare spatial patterns of biodiversity sustained by the current configuration of forest remnants to a scenario of complete forest preservation. We then ask the question "how much biodiversity is likely lost, already"? Specifically, we assess how habitat loss likely impacted the climatic spaces occupied by the local species, the inferred composition of local communities and the spatial distribution of phylogenetic diversity and endemism.LocationAtlantic Forest, Brazil.MethodsUsing carefully curated point localities, phylogenetic data and parameterized models of species distributions, we generate maps of phylogenetic diversity, phylogenetic endemism and phylogenetic turnover for the entire Atlantic Forest. We map patterns of clade‐specific diversity under complete preservation of forest and then incorporate present‐day deforestation patterns to provide a more realistic scenario.ResultsInstead of a singular pattern, three different reoccurring syndromes described the flora and fauna of the Atlantic Forest. These patterns emerged irrespectively of clade age and life history traits. General turnover patterns were highly consistent with previous analyses of species composition and panbiogeographical studies. Deforestation has altered the availability of climatic spaces in the Atlantic Forest, its biological communities and the distribution of evolutionary lineages in space. However, approximately 60% of the pre‐Columbian climatic space persists in forest remnants, and today's biological communities are estimated to be 45% similar to pre‐deforestation times.Main conclusionsThe Atlantic Forest has been reduced to 8% of its once largely continuous range. However, the disproportionately large amounts of climate, community and lineage diversity that persist in remnants provide hope and support for conservation efforts that combine species occurrence and phylogenetic data. Inclusion of evolutionary thinking into strategic approaches to restoring Brazilian ecosystems could further conservation effectiveness by incorporating the adaptive potential of local assemblages in the face of further environmental shifts.
Eco‐evolutionary dynamics driven by fishing: From single species models to dynamic evolution within complex food webs
Authors: Perälä Tommi , Kuparinen Anna 
Published: July 2020

AbstractEvidence of contemporary evolution across ecological time scales stimulated research on the eco‐evolutionary dynamics of natural populations. Aquatic systems provide a good setting to study eco‐evolutionary dynamics owing to a wealth of long‐term monitoring data and the detected trends in fish life‐history traits across intensively harvested marine and freshwater systems. In the present study, we focus on modelling approaches to simulate eco‐evolutionary dynamics of fishes and their ecosystems. Firstly, we review the development of modelling from single species to multispecies approaches. Secondly, we advance the current state‐of‐the‐art methodology by implementing evolution of life‐history traits of a top predator into the context of complex food web dynamics as described by the allometric trophic network (ATN) framework. The functioning of our newly developed eco‐evolutionary ATNE framework is illustrated using a well‐studied lake food web. Our simulations show how both natural selection arising from feeding interactions and size‐selective fishing cause evolutionary changes in the top predator and how those feed back to its prey species and further cascade down to lower trophic levels. Finally, we discuss future directions, particularly the need to integrate genomic discoveries into eco‐evolutionary projections.
Carbon storage dynamics in peatlands: Comparing recent‐ and long‐term accumulation histories in southern Patagonia
Authors: Bunsen Michael S. , Loisel Julie 
Published: July 2020

AbstractPeatlands have been important terrestrial carbon (C) reservoirs throughout the Holocene, yet whether these ecosystems will become stronger or weaker C sinks in the future remains debated. While surface peat layers (acrotelm) have a greater apparent rate of C accumulation than deeper, millennial‐aged peat (catotelm), it is difficult to project how much more aerobic decomposition will take place before the younger surface cohorts join the older deeper ones. Studies have suggested that warming could lead to weakened C accumulation in peatlands due to enhanced aerobic decay in the acrotelm, which would lead to a slower transfer of peat into the catotelm, if any. Conversely, other studies have suggested increased C accumulation in the acrotelm and thus, larger long‐term C transfer into the catotelm under warming conditions because of greater plant productivity and faster peat accumulation. Improving our predictions about the rate of present and future peatland development is important to forecast feedbacks on the global C cycle and help inform land management decisions. In this study, we analyzed two peat cores from southern Patagonia to calculate their long‐ versus short‐peat C accumulation rates. The acrotelm rates were compared to the catotelm peat C legacies using an empirical modeling approach that allows calculating the future catotelm peat storage based on today's acrotelm characteristics, and thus predict if those recent rates of C accumulation will lead to greater or weaker long‐term C storage in the future. Our results indicate that, depending on local bioclimatic parameters, some peatlands may become stronger C sinks in the future, while others may become weaker. In the case of this study, the wetter site is expected to increase its C sink capacity, while our prediction for the drier site is a net decrease in C sequestration in the coming decades to centuries.