bluuebunny/crossref_metadata_2025_split huggingface dataset:
Late‐onset hypogonadism: a concept comes of age
Authors: Nieschlag E. 
Published: October 2019

AbstractThe termLate‐onset hypogonadism(LOH) was coined in 2002 and defined as a disease entity in the ISA, ISSAM, EAU, EAA and ASA endorsed Recommendations for Investigation, Treatment and Monitoring of LOH (2005 and 2008) as ‘a clinicalandbiochemical syndrome associated with advancing age, characterized by symptomsanda deficiency in serum testosterone (T)’. LOH was classified as a combined primary and secondary hypogonadism since the endocrine capacity of the testes and the pituitary are impaired. Symptoms of LOH include loss of libido, erectile dysfunction, loss of muscle mass, increased body fat, anemia, osteoporosis, depressed mood, decreased vitality, sweating, and hot flushes. Since these symptoms may also have origins other than LOH, exclusion of other disease entities and subnormal serum T levels are considered prerequisites for the diagnosis and possible treatment of LOH. However, during following years these guidelines were often neglected and, especially in the USA, indiscriminate prescribing of T was widely practised so that the US FDA warned against such irresponsible behavior. In Europe, T prescribing remained largely restricted to LOH as defined above. Nevertheless, a discussion started whether LOH really exists or is only a consequence of age‐related comorbidities. Numerous studies have helped to clarify the situation, in particular, the European Male Aging Study (EMAS) and the US‐initiated7 T trials. Consequently, the newest US Endocrine Society Practice Guideline on T treatment (2018) includes advanced age as a cause of organic hypogonadism and recommends that ‘in men >65 years who have symptoms or conditions suggestive of T deficiency … and consistently and unequivocally low morning T concentrations we suggest that clinicians offer T therapy on an individualised basis after explicit discussion of the potential risks and benefits’. Thus, the concept of LOH as conceived two decades ago has weathered criticism and survived the times.
Opioid use prior to elective surgery is strongly associated with persistent use following surgery: an analysis of 14 354 Medicare patients
Authors: Catchpool Max , Knight Josh , Young Jesse T. , Clarke Philip , Barrington Michael J. , Choong Peter F. M. , Dowsey Michelle M. 
Published: October 2019

AbstractBackgroundPersistent opioid use following total joint replacement (TJR) surgery is common; however, the association between pre‐surgical opioid use and surgery type has not been established. The objective of this study was to determine the association between pre‐surgery opioid use and persistent post‐surgery opioid use in TJR patients compared to other elective surgical patients.MethodsThis is a retrospective cohort study, of univariate and multinomial logistic regression of linked, de‐identified Medicare Benefits Schedule and Pharmaceutical Benefits Schedule data, adjusted for perioperative opioid use, age and sex. Oral morphine equivalents daily doses (OMEDD) were calculated and opioid use was categorized into three mutually exclusive categories for each observation window: low (0–5 OMEDD), moderate (5–10 OMEDD), high (10+ OMEDD). Persistent opioid use was defined as opioid use between 180 and 270 days after the date of surgery.ResultsPersistent opioid use was associated with older age, female gender and pre‐surgery opioid use. There was no increased risk for persistent opioid use for TJR patients compared to other surgical patients. The intensity of pre‐surgery opioid usage is strongly associated with persistent opioid use in all observed surgical patients.ConclusionsOur results suggest that many patients who use opioids prior to surgery will persist in their opioid use following surgery. No association was found between persistent opioid use and TJR surgery, but rather a risk reduction compared to other elective surgeries when associations with opioid use are controlled for. Primary care clinicians and surgeons should monitor the duration and dosage of perioperative opioid use.
Lessons learned from relocating an acute surgical unit to a new quaternary referral centre in Adelaide, South Australia: a tale of two hospitals
Authors: Barnett Dylan R. , Lu Ha , Finlay Ben , Coventry Charlie , Granchi Nelson , Marshall‐Webb Matthew , Heitmann Paul , Dobbins Christopher 
Published: October 2019

AbstractBackgroundOn 4 September 2017, patient care was relocated from one quaternary hospital that was closing, to another proximate greenfield site in Adelaide, Australia, this becoming the new Royal Adelaide Hospital. There are currently no data to inform how best to transition hospitals. We conducted a 12‐week prospective study of admissions under our acute surgical unit to determine the impact on our key performance indicators. We detail our results and describe compensatory measures deployed around the move.MethodsUsing a standard proforma, data were collected on key performance indicators for acute surgical unit patients referred by the emergency department (ED). This was supplemented by data obtained from operative management software and coding data from medical records to build a database for analysis.ResultsFive hundred and eight patients were admitted during the study period. Significant delays were seen in times to surgical referral, surgical review and leaving the ED. Closely comparable was time spent in the surgical suite. Uptake of the Ambulatory Care Pathway fell by 67% and the Rapid Access Clinic by 46%. Overall mortality and patient length of stay were not affected.ConclusionWe found the interface with ED was most affected. Staff encountered difficulties familiarizing with a new environment and an anecdotally high number of ED presentations. Delays to referral and surgical review resulted in extended patient stay in ED. Once in theatre, care was comparable pre‐ and post‐transition. This was likely from early identification of patients requiring an emergency operation, close consultant surgeon involvement and robust working relationships between surgeons, anaesthetists and nurses.
Examining perinatal subdural haematoma as an aetiology of extra‐axial hygroma and chronic subdural haematoma
Authors: Zahl Sverre Morten , Wester Knut , Gabaeff Steven 
Published: October 2019

AbstractAimBenign external hydrocephalus (BEH), hygroma and chronic subdural haematoma are extra‐axial fluid collections in infants. MRI studies have shown that almost half of all new‐borns have perinatal subdural blood, generally referred to as subdural haematoma (SDH) or perinatal SDH. Epidemiologically there are striking similarities between chronic SDH and BEH in infants.MethodsDiscussion of pathophysiological mechanisms for BEH and chronic SDH, based on existing literature.ResultsPerinatal SDH is common, and we hypothesise that this condition in some infants develop into extra‐axial fluid collections, known as hygroma, BEH or chronic subdural haematoma. The mechanism seems to be an intradural bleeding that creates an obstructive layer preventing normal CSF absorption. The site where the bleeding originates from and those areas enveloped in blood from the primary damaged area are prone to later rebleeds, seen as ‘acute on chronic’ haematomas. With steady production of CSF and the blockage, increased intracranial pressure drives the accelerated skull growth seen in many of these children.ConclusionPerinatal SDH hampers CSF absorption, possibly leading to BEH and chronic SDH, with a high risk of false accusations of abuse. Close monitoring of head circumference could prove vital in detecting children with this condition.
Usability and acceptability of an automated respiratory rate counter to assess children for symptoms of pneumonia: A cross‐sectional study in Ethiopia
Authors: Ward Charlotte , Baker Kevin , Smith Helen , Maurel Alice , Getachew Dawit , Habte Tedila , McWhorter Cindy , LaBarre Paul , Karlstrom Jonas , Black Jim , Bassat Quique , Ameha Agazi , Tariku Abraham , Petzold Max , Källander Karin 
Published: October 2019

AbstractAimManually counting respiratory rate (RR) is commonly practiced by community health workers to detect fast breathing, an important sign of childhood pneumonia. Correctly counting and classifying breaths manually is challenging, often leading to inappropriate treatment. This study aimed to determine the usability of a new automated RR counter (ChARM) by health extension workers (HEWs), and its acceptability to HEWs, first‐level health facility workers (FLHFWs) and caregivers in Ethiopia.MethodsA cross‐sectional study was conducted in one region of Ethiopia between May and August 2018. A total of 131 HEWs were directly observed conducting 262 sick child consultations after training and 337 after 2 months. Usability was measured as adherence to the WHO requirements to assess fast breathing and device manufacturer instructions for use (IFU). Acceptability was measured through semi‐structured interviews.ResultsAfter 2 months, HEWs were shown to adhere to the requirements in 74.6% consultations; an increase of 18.6% after training (P < .001). ChARM is acceptable to users and caregivers, with HEWs suggesting that ChARM increased client flow and stating a willingness to use ChARM in future.ConclusionFurther research on the performance, cost‐effectiveness and implementation of this device is warranted to inform policy decisions in countries with a high childhood pneumonia burden.
It is better to be ignorant of our moral enhancement: A reply to Zambrano
Authors: Crutchfield Parker 
Published: October 2019

AbstractIn a recent issue of Bioethics, I argued that compulsory moral bioenhancement should be administered covertly. Alexander Zambrano has criticized this argument on two fronts. First, contrary to my claim, Zambrano claims that the prevention of ultimate harm by covert moral bioenhancement fails to meet conditions for permissible liberty‐restricting public health interventions. Second, contrary to my claim, Zambrano claims that covert moral bioenhancement undermines autonomy to a greater degree than does overt moral bioenhancement. In this paper, I rebut both of these arguments, then finish by noting important avenues of research that Zambrano’s arguments motivate.
Investigation of the thermal history of the Delaware Basin (West Texas, USA) using carbonate clumped isotope thermometry
Authors: Naylor H. Nathan , Defliese William F. , Grossman Ethan L. , Maupin Christopher R. 
Published: October 2019

AbstractWe utilized carbonate clumped isotope thermometry to explore the thermal history of the Delaware Basin, West Texas, USA. Carbonate wellbore cuttings from five oil/gas wells across the basin yielded clumped isotope temperatures (T(Δ47)) ranging from 27°C to 307°C, interpreted to reflect a combination of initial precipitation/recrystallization temperature and solid‐state C‐O bond reordering during burial. Dolomite samples generally record lower apparent T(Δ47)s than calcite, reflecting greater resistance to reordering in dolomite. In all five wells, clumped isotope temperatures exceed modern downhole temperature measurements, indicating higher heat flow in the past. Using modelled burial curves based on sedimentological history, we created unique time‐temperature histories by linearly applying a geothermal gradient. Applying two different thermal history reordering models, we modelled the extent of solid‐state C–O bond reordering to iteratively find the time‐averaged best‐fit geothermal gradients for each of the five wells. Results of this modelling suggest that the shallower, southwestern portion of the study area experienced higher geothermal gradients throughout the sediment history (~45°C/km) than did the deeper, southeastern portion (~32°C/km), with the northern portion experiencing intermediate geothermal gradients (~35–38°C/km). This trend is in agreement with the observed gas/oil ratios of the Delaware Basin, increasing from east to west. Furthermore, our clumped isotope temperatures agree well with previously published vitrinite reflectance data, confirming previous observations and demonstrating the utility of carbonate clumped isotope thermometry to reconstruct basin thermal histories.
Autoimmune encephalomyelitis
Authors: Tanaka Keiko 
Published: October 2019

AbstractRecent discoveries of several autoantibodies produced in patients with autoimmune encephalomyelitis have contributed largely to categorize new clinical entities in this field, and also provided a deep understanding of the background of neurological symptoms in these disorders together with new insights in the basic neuroscience. Most of these recently identified autoantibodies bind to the neuronal or glial cell surface synaptic receptors. They alter synaptic functions and develop characteristic clinical features depending on each target antigen. Among them, N‐methyl‐D‐aspartate receptor (NMDAR) is the most frequent antibody, causing NMDAR encephalitis syndrome, which has various characteristic clinical features including acute psychosis, memory disturbance, seizures, dyskinetic abnormal movements, conscious disturbance and respiratory dysfunction mainly in young women with ovarian teratoma. The next most frequently detected antibody is anti‐leucine‐rich glioma‐inactivated 1(LGI1) antibody, formerly designated as voltage‐gated potassium channel antibody. The anti‐LGI1 antibodies are detected in older patients of both sex and show symptoms related to the limbic system without having associated tumors. Patients with these cell‐surface antibodies show neurological symptoms closely related to the function of target synapse/channel antigens, which also bring new insights in signal transduction research. The triggers to develop specific antibody production and inducing encephalopathy are not known yet; however, they tend to respond to antigen‐removal treatment even if they have tumors. Thus, it is important to diagnose autoantibody production and initiate therapy as early as possible.
Impact of audiovisual information on anxiety and fear in patients undergoing dental implant treatment
Authors: Camacho‐Alonso Fabio , Vilaplana‐Vivo Jaime , Caballero‐Guerrero Pedro M. , Pato‐Mourelo Jesús , Sánchez‐Siles Mariano 
Published: October 2019

AbstractBackgroundFew studies have reported the impact of audiovisual implant surgery information on anxiety and fear.PurposeTo investigate the impact of audiovisual information on anxiety and fear in patients undergoing dental implant treatment.Materials and MethodsThis study included 300 patients due to undergo surgery to place a single implant. An interview topic guide and the Krantz Health Opinion Survey (KHOS) survey were used to assess the information patients already had about treatment and how much information they were seeking. Afterwards were randomized into two groups (n = 150): group 1 (verbal information) and group 2 (audiovisual information). Before surgery, anxiety and fear were assessed using State‐Trait Anxiety Inventory (STAI), Modified Corah Dental Anxiety Scale (MDAS), and Dental Fear Scale (DFS) scales. After treatment, all patients described their satisfaction with the information received with a VAS.ResultsBefore receiving information, both groups were homogenous in their knowledge of the implant procedure (P = .825) and the quantity of information sought (KHOS; P = .080). After receiving information, group 2 patients presented more anxiety and fear than group 1 (STAI‐State, STAI‐Treat, MDAS, DFS; P < .001). After surgery, both groups were equally satisfied with the information received and the need for additional information (P = .689; P = .199, respectively).ConclusionsAudiovisual information generated greater anxiety and fear than conventional verbal information in patients undergoing implant surgery.
CRYAB promotes osteogenic differentiation of human bone marrow stem cells via stabilizing β‐catenin and promoting the Wnt signalling
Authors: Zhu Bin , Xue Feng , Li Guangyi , Zhang Changqing 
Published: October 2019

AbstractObjectivesThe osteogenesis differentiation of human bone marrow stem cells (BMSCs) is essential for bone formation and bone homeostasis. In this study, we aim to elucidate novel molecular targets for bone metabolism diseases.Materials and methodsThe dataset GSE80614 which includes mRNA expression profile during BMSCs osteogenic differentiation was obtained from the GEO database (https://www.ncbi.nlm.nih.gov/geo/). The osteogenic differentiation of BMSCs was measured by ALP staining, AR staining and expression of osteogenic markers in vitro. For in vivo assay, we seeded BMSCs onto beta‐tricalcium phosphate (β‐TCP) and transplanted them into muscle pockets of nude mice. Luciferase assay, co‐immunoprecipitation assay and in vitro ubiquitination assay were carried out to investigate the molecular mechanism.ResultsWe found that α‐B‐crystallin (CRYAB) expression was elevated during the process of BMSCs osteogenic differentiation. Further studies showed that upregulation of CRYAB significantly enhanced the osteogenic differentiation, while downregulation of CRYAB suppressed it. CRYAB regulated BMSCs osteogenic differentiation mainly through the canonical Wnt/β‐catenin signalling. In addition, we found that CRYAB could physically interact with β‐catenin and protect it from ubiquitination and degradation, which stabilized β‐catenin and promoted the Wnt signalling.ConclusionsThe present study provides evidences that CRYAB is an important regulator of BMSCs osteogenic differentiation by protecting β‐catenin from ubiquitination and degradation and promoting the Wnt signalling. It may serve as a potential therapeutic target for diseases related to bone metabolism.
Fournier's gangrene and sodium‐glucose co‐transporter‐2 inhibitors: A meta‐analysis of randomized controlled trials
Authors: Silverii Giovanni Antonio , Dicembrini Ilaria , Monami Matteo , Mannucci Edoardo 
Published: October 2019

AbstractFournier's gangrene (FG) is a rare, life‐threatening necrotizing fasciitis of the perineum. The US Food and Drug Administration (FDA) released a Drug Safety Communication regarding the risk of FG associated with sodium‐glucose co‐transporter‐2 inhibitors (SGLT2i), relying on the FDA Adverse Event Reporting System. To verify this association, we performed a meta‐analysis of all randomized controlled trials enrolling patients with type 2 diabetes, comparing SGLT2i with placebo or different therapies, collecting cases of FG reported as a serious adverse event. Risk of abscess, cellulitis and erysipela were secondary outcomes. We retrieved 84 trials enrolling 42 415 patients in the SGLT2i group and 27 158 patients in comparator groups. No difference was observed between SGLT2i and comparators in the risk of FG (Mantel‐Haenzel odds ratio [MH‐OR] 0.41 [0.09, 1.82]), abscess (MH‐OR 0.94 [0.54, 1.65]), cellulitis (MH‐OR 0.90 [0.71, 1.13] or erysipela (MH‐OR 0.89 [0.45, 1.77]). The number of events was small, leading to a wide confidence interval that does not allow ruling out an increase in FG or skin and subcutaneous tissue infections.
Ecological memory at millennial time‐scales: the importance of data constraints, species longevity and niche features
Authors: Benito Blas M. , Gil‐Romera Graciela , Birks H. John B. 
Published: October 2019

Ecological memory describes how antecedent conditions drive the dynamics of an ecological system. Palaeoecological records are paramount to understand ecological memory at millennial time‐scales, but the concept is widely neglected in the literature, and a formal approach is lacking. Here, we fill such a gap by introducing a quantitative framework for ecological memory in palaeoecology, and assessing how data constraints and taxa traits shape ecological memory patterns.We simulate the population dynamics and pollen abundance of 16 virtual taxa with different life and niche traits as a response to an environmental driver. The data is processed to mimic a realistic sediment deposition and sampled at increasing depth intervals. We quantify ecological memory with Random Forests, and assess how data properties and taxa traits shape ecological memory.We find that life‐span and niche features modulate the relative importance of the antecedent values of the driver and the pollen abundance over periods of 240 yr and longer. Additionally, we find that accumulation rate and decreasing pollen‐sampling resolution inflate the importance of antecedent pollen abundance.Our results suggest that: 1) ecological memory patterns are sensitive to varying accumulation rates. A better understanding on the numerical basis of this effect may enable the assimilation of ecological memory concepts and methods in palaeoecology; 2) incorporating niche theory and models is essential to better understand the nature of ecological memory patterns at millennial time‐scales. 3) Long‐lived generalist taxa are highly decoupled from the environmental signal. This finding has implications on how we interpret the abundance‐environment relationship of real taxa with similar traits, and how we use such knowledge to forecast their distribution or reconstruct past climate.
Individual tree context and contrast dictate tree physiological features and arthropod biodiversity patterns across multiple trophic levels
Authors: Swart Rudi C. , Samways Michael J. , Pryke James S. , Roets Francois 
Published: October 2019

1. The present study tested the hypothesis that tree context (natural, semi‐natural or planted) and contrast (height of surrounding vegetation) affect tree physiological characters (leaf size, nutrient content, and stress‐related factors), and also alter the arthropod biodiversity patterns either directly or indirectly.2. Arthropods were collected from tree canopies using chemical fogging from the ecologically important South African native tree Podocarpus elongatus.3. Low contrast trees had significantly larger leaves than those in high contrast environments and harboured an overall higher richness, abundance, and biomass of arthropods, although this was guild‐dependent.4. Trees in natural contexts had less foliar δ13C, suffered less from artificial nitrogen enrichment, and harboured significantly higher herbivore and predator arthropod richness and unique assemblages, compared with planted trees.5. Semi‐natural trees supported natural levels of arthropod richness, although these were mostly generalist species.6. Tree context and contrast can therefore dictate associated biota at multiple trophic levels and native trees may fail to maintain natural biodiversity in transformed landscapes.