bluuebunny/crossref_metadata_2025_split huggingface dataset:
Size-at-maturity shift in a male-only fishery: factors affecting molt-type outcomes in Newfoundland and Labrador snow crab (Chionoecetes opilio)
Authors: Mullowney Darrell R J , Baker Krista D 
Published: August 2020

Abstract
A sex-asymmetric downward shift in size-at-terminal-molt has recently occurred in males in some portions of the Newfoundland and Labrador (NL) snow crab stock range, a first known occurrence for such processes in snow crab (Chionoecetes opilio) stocks. This study examines plausible factors promoting the shift in size-at-terminal-molt [synonymous with size-at-maturity (SaM)] including individual size, temperature, population density, and sex ratio. Analyses highlight expanse of cold water and large male density as being significant predictors of molt-type outcomes. A confluence of cold conditions and low density of large males promoted the SaM shift. In turn, the low male density was associated with recently elevated fishery exploitation rates under quota-controlled management. It remains unknown the extent to which the reduction in terminal size reflects a phenotypic vs. genotypic process. Factors affecting skip-molting in male snow crab are investigated, and we find that skip-molting occurs most frequently under extreme cold and high population density conditions. Potential complications arising from altered growth dynamics are discussed. Overall, the results advance knowledge on intraspecific competition processes within snow crab populations and inform fisheries management systems that male-only harvest strategies do not provide full protection from biological harm to aquatic resources through fishing.
Faster HbA1c Turnaround Times Using a Dedicated Analyzer Based on Turbidimetric Inhibition Immunoassay Technology
Authors: Lau Chin Shern , Lim Melva , Hoo See Ping , Gan Cherlyn , Aw Tar Choon 
Published: August 2020

Abstract

Introduction
The Roche Cobas c513 (c513) is a dedicated stand-alone high throughput HbA1c analyzer. We evaluated the performance and the difference in turnaround times (TAT) of the c513 against our Cobas 8000 c502 (c502).

Methods
We assessed the linearity and precision of the c513, and its agreement (Deming regression and Bland–Altman analysis) with the c502 assay. We compared TAT for these analyzers for a single run of 50 samples and for all samples run over 2 comparable time periods.

Results
The c513 assay was linear from 4.4–18.3% HbA1c. Interassay precision (CV%) was 1.2 and 0.8 at HbA1c levels of 5.7 and 10.5%, respectively. The c513 assay showed excellent concordance with the c502 assay (r = 0.997) with no significant difference between methods by Bland–Altman analysis (mean difference = 0.021% HbA1c, P = 0.1422). The c513 took 17 min to analyze 50 samples, compared to 40 min on the c502. Over comparable 2-month periods, 90% of samples requiring HbA1c tests only were completed under 25 min (c513) vs 30–35 min (c502). For tubes sharing complete blood count (CBC) testing with HbA1c, the 90th percentile TAT was 35–40 min (c513) compared to 45–50 min (c502).

Conclusion
The c513 assay performs well with excellent correlation to the c502 assay. The improved TAT of the c513 is suitable when there are demands for rapid HbA1c results and it may forestall requests for point-of-care testing. It is also attractive to sites with heavy workloads with a claimed throughput of 400 tests / h.
Patterns of Neonatal Co-Exposure to Gabapentin and Commonly Abused Drugs Observed in Umbilical Cord Tissue
Authors: Okoye Nkemakonam C , McMillin Gwendolyn A 
Published: August 2020

AbstractGabapentin was thought to have low abuse potential, but it is increasingly being abused by people with substance use disorder in an attempt to potentiate the euphoric effects from opioids and other CNS depressants. Additionally, infants co-exposed to gabapentin and opioids during pregnancy tend to exhibit prolonged and more severe neonatal abstinence syndrome. In this study, we describe positivity rates among commonly abused drugs and rates of co-medication with gabapentin in a large dataset of umbilical cord tissue specimens (n = 25,422) submitted for routine newborn drug testing at a national clinical reference laboratory (ARUP Laboratories, Salt Lake City, UT, USA). Detection of prenatal drug exposure in umbilical cord tissue specimens was accomplished using a semi-quantitative liquid chromatography–tandem mass spectrometry assay designed to detect 47 specific drugs and drug metabolites including opioids, stimulants, sedative-hypnotics and hallucinogens. A positive result for at least one of the measured drugs or drug metabolites was reported in 7,054 (28%) of the umbilical cord tissues analyzed. Gabapentin had a positivity rate of ~2% with 562 positive results. Of the 562 gabapentin-positive samples, 395 (70%) also had a positive result for at least one other drug or drug metabolite, with the highest co-positivity rate observed for norbuprenorphine (32%, n = 182) followed by amphetamine (15%, n = 84), buprenorphine (13%, n = 74), methamphetamine (12%, n = 68), morphine (11%, n = 64), fentanyl (10%, n = 54) and naloxone (10%, n = 54). Notably, the concentration of gabapentin in gabapentin-positive umbilical cord specimens was higher in buprenorphine-containing specimens as compared to specimens containing other opioids, stimulants or benzodiazepines. Identification of neonatal co-exposure to gabapentin and opioids, particularly buprenorphine, may guide clinicians in rapid initiation of monitoring and intervention for neonatal abstinence syndrome.
HIF-1α Enhances Vascular Endothelial Cell Permeability Through Degradation and Translocation of Vascular Endothelial Cadherin and Claudin-5 in Rats With Burn Injury
Authors: Jiang Wei , Sun Youjun , Wang Huan , Hu Zijian , Song Junhui , Meng Chengying , Duan Shengliang , Jiang Zhiyong , Yu Youxin , Hu Delin 
Published: August 2020

Abstract
The mechanism underlying burn injury-induced enhanced vascular endothelial permeability and consequent body fluid extravasation is unclear. Here, the rat aortic endothelial cells (RAECs) were treated with the serum derived from rats with burn injury to elucidate the mechanism. Sprague–Dawley (SD) rats were grouped as follows (10 rats/group): control, 2, 4, 8, 12, and 24 hours postburn groups. The heart, liver, kidney, lung, jejunum, and ileum of rats injected with 2% Evans blue (EB) through the tail vein were excised to detect the EB level in each organ. The serum levels of hypoxia-inducible factor-1α (HIF-1α) and endothelin-1 (ET-1) were examined using enzyme-linked immunosorbent assay (ELISA). The effect of serum from 12-hour postburn group on the membrane permeability of RAEC monolayer, as well as on the mRNA and protein levels of ET-1, endothelin receptor A (ETA), ETB, and zonula occludens (ZO-1), was analyzed using quantitative real-time polymerase chain reaction (qRT–PCR) and western blotting. The membrane permeability of GV230/HIF-1α-transfected or shRNA-HIF-1α-transfected RAECs, as well as the expression levels of HIF-1α, ET-1, ETA, ETB, vascular endothelial (VE)-cadherin, and claudin-5, was analyzed using qRT–PCR and western blotting, whereas the localization of VE-cadherin and claudin-5 was examined using immunofluorescence. The serum HIF-1α and ET-1 levels in the burn groups, which peaked at 12 hours postburn, were significantly upregulated (P &lt; .01) when compared with those in the control group. Additionally, the serum HIF-1α levels were positively correlated with vascular permeability. Compared with the shRNA-negative control-transfected RAECs, the shRNA-II/HIF-1α-transfected RAECs exhibited downregulated expression of HIF-1α, ET-1, ETA, and ETB (P &lt; .01), and upregulated expression of ZO-1, claudin-5, and VE-cadherin (P &lt; .05). Compared with the GV230-transfected RAECs, the GV230/HIF-1α-transfected RAECs exhibited upregulated expression of HIF-1α, ET-1, ETA, and ETB (P &lt; .01), and downregulated expression of ZO-1, claudin-5, and VE-cadherin (P &lt; .05). The GV230/HIF-1α-transfected RAECs exhibited degradation and translocation of VE-cadherin and claudin-5. In addition to degradation of VE-cadherin and claudin-5, HIF-1α mediated enhanced endothelial cell permeability through upregulation of ET-1, ETA, and ETB, and downregulation of ZO-1 and VE-cadherin in rats with burn injury.
Gastric Pneumatosis in a Critically Ill Pediatric Burn Patient: Case Report and Overview of Risk Factors, Diagnosis, and Management
Authors: Bisgaard Erika , Hewgley William Preston , Gee Kristin Minei , Pandya Samir , Akarichi Chiaka , Arnoldo Brett , Park Caroline 
Published: August 2020

AbstractPneumatosis intestinalis and gastric pneumatosis are rare, but potentially morbid conditions in the burn-injured patient. They present a pediatric patient with severe scald injuries and isolated gastric pneumatosis who was successfully treated with a multidisciplinary approach and nonoperative management.
First-trimester rupture of a gravid bicornuate uterus after prior vaginal deliveries, simulating a ruptured ectopic pregnancy: a case report
Authors: Tochie Joel Noutakdie , Tcheunkam Landry Wakheu , Tchakounté Collince , Fobellah Nkengafac Nyiawung , Cumber Samuel Nambile 
Published: August 2020

AbstractThe first-trimester rupture of a bicornuate uterus (BU) is a rare obstetrical emergency, especially following previous normal vaginal deliveries where it is often misdiagnosed. A 24-year-old G3P2002 woman presented at 11 weeks of gestation with sudden onset of severe left iliac fossa pain without other symptoms. On examination, she was fully conscious and hemodynamically unstable with signs of peritoneal irritation, a distended pouch of Douglas and a slightly enlarged uterus and a tender left adnexal mass. The diagnosis of a ruptured ectopic pregnancy was made and a laparotomy was done. Intra-operative findings were hemoperitoneum, a left ruptured BU and a dead fetus. Surgical management entailed hysterorrarphy, left salpingectomy and conservation of both ovaries. Her postoperative course was uneventful and future fertility was preserved. We recommend a high index of suspicion of ruptured BU as a differential diagnosis of acute abdomen in the first trimester in women with previous term vaginal deliveries.
Adverse Events and Healthcare Utilization Associated With Outpatient Parenteral Antimicrobial Therapy Among Older Versus Younger Adults
Authors: Brzozowski Kaylen , Datta Rupak , Canterino Joseph , Malinis Maricar , Juthani-Mehta Manisha 
Published: August 2020

Abstract
Among older (n = 204) versus younger (n = 253) adults, there was no difference in adverse events (adjusted odds ratio [aOR] = 0.98; 95% confidence interval [CI] = 0.6–1.6) or healthcare utilization (incidence rate ratio = 1.09; 95% CI = 0.9–1.3) within 30 days after discontinuing outpatient parenteral antimicrobial therapy. Vancomycin (aOR = 1.92) and oxacillin (aOR = 3.12) were independently associated with adverse events.
Impact of a 24/7 Rapid Molecular Assay for Influenza Detection on the Prescription of Oseltamivir
Authors: Jacquier Hervé , Péan de Ponfilly Gauthier , Chauvin Anthony , Amarsy Rishma , Benmansour Hana , Hoang-Nguyen Dan-Thanh , Lecorché Emmanuel , Mesnil Céline , Mougari Faiza , Munier Anne-Lise , Salmona Maud , Berçot Béatrice , Le Goff Jérôme , Cambau Emmanuelle 
Published: August 2020

Abstract
We assessed the impact of a rapid molecular assay for influenza detection whether outsourced or performed onsite 24/7 in a University Hospital in Paris, France. Shorter median time-to-results (16.8 vs 2.3 hours, P &lt; .05) and an increased rate of adequate prescription of oseltamivir (76.6% vs 95.3%, P &lt; .05) were observed.
Rethinking police legitimacy in postcolonial Hong Kong: Paramilitary policing in protest management
Authors: Lawrence Ka-Ki Ho 
Published: August 2020

Abstract
This article addresses a frequently asked question regarding Hong Kong policing since the outbreak of prolonged civil unrest in June 2019: How can we understand the tactics adopted by the police in their attempts to de-escalate street violence, and why did the highly regarded police quickly lose its legitimacy among the public? This article argues that these phenomena can be explained by the abrupt change in the structural and policing context. This combined and interacted with the limitations of the ‘paramilitary policing model’ and public order legislation of Hong Kong adopted since the realignment of Beijing’s Hong Kong policy under the ‘One Country Two Systems’ principle in 2012. In the face of growing resistance to change this shift demystified the ‘professionalism’, ‘neutrality’, and ‘accountability’ that had continually been associated with the public’s perception of the Hong Kong Police since the 1970s. The protests pulled the police back to the escalated force in protest policing which in turn led to further declines in perceptions of police legitimacy across the population of the special administrative region. The findings also provide the platform for further conceptual debate on police legitimacy.
Change of serum B-cell activating factor level in patients with positive antiphospholipid antibodies and previous adverse pregnancy outcomes and its significance
Authors: Li Xin-Yi , Duan Hong-Ji , Liu Xiang-Yuan , Deng Xiao-Li 
Published: August 2020

Abstract

Background:
B-cell activating factor (BAFF) is vital for B cell survival. Serum BAFF levels are elevated in thrombotic antiphospholipid syndrome, but little is known about levels in patients with positive antiphospholipid antibodies (aPLs) and previous adverse pregnancy outcomes (APOs). We aimed to analyze serum BAFF concentrations of these patients in early pregnancy along with different pregnancy outcomes.

Methods:
Thirty-six pregnant patients positive for aPLs and previous APOs (patient group), 25 healthy pregnant females (HP group) and 35 healthy non-pregnant females (HNP group) from the Peking University Third Hospital, between October 2018 and March 2019, were enrolled in this study. Serum of HNP and serum of patients as well as HP in the first gestational trimester were collected. Enzyme-linked immunosorbent assay kits were used to measure serum BAFF and interferon-alpha (IFN-α) concentrations. Cytometric bead array analysis was used to measure serum concentrations of cytokines. The patient group was further divided into APOs and non-APOs (NAPOs) group, fetal loss and live birth group according to pregnancy outcomes. The Mann-Whitney U-test was used to assess significance between and within groups. Spearman rank-order was used to evaluate correlation coefficients between BAFF and related cytokines.

Results:
The serum BAFF level in HP group was significantly lower than HNP group (245.24 [218.80, 265.90] vs. 326.94 [267.31, 414.80] pg/mL, Z = −3.966, P < 0.001). The BAFF level was obviously elevated in patient group compared to that in HP group (307.77 [219.86, 415.65] vs. 245.24 [218.80, 265.90] pg/mL, Z = −2.464, P = 0.013). BAFF levels in APOs group tended to be higher than that in NAPOs group (416.52 [307.07, 511.12] vs. 259.37 [203.59, 375.81] pg/mL, Z = −2.718, P = 0.006). Compared to HP group, concentrations of IFN-α, interleukin (IL-6) and tumor necrosis factor were higher in patient group (33.37 [18.85, 48.12] vs. 13.10 [6.85, 25.47] pg/mL, Z = −2.023, P = 0.043; 39.16 [4.41, 195.87] vs. 3.37 [2.92, 3.90] pg/mL, Z
= −3.650, P < 0.001; 8.23 [2.27, 64.46] vs. 1.53 [1.25, 2.31] pg/mL, Z = −3.604, P < 0.001, respectively). Serum BAFF levels had a positive correlation with the concentrations of both IL-6 and IL-10 (IL-6: r = 0.525, P = 0.002; IL-10: r = 0.438, P = 0.012).

Conclusions:
Serum BAFF levels are increased in patients with positive aPLs and previous APOs as compared to healthy pregnant females and tend to be higher in individuals with current APOs. The BAFF levels have a positive correlation with serum IL-6 and IL-10.
Explaining the Sex Effect on Survival in Cystic Fibrosis: a Joint Modeling Study of UK Registry Data
Authors: Taylor-Robinson David , Schlüter Daniela K. , Diggle Peter J. , Barrett Jessica K. 
Published: August 2020

Background:
Male sex is associated with better lung function and survival in people with cystic fibrosis but it is unclear whether the survival benefit is solely due to the sex-effect on lung function.

Methods:
This study analyzes data between 1996 and 2015 from the longitudinal registry study of the UK Cystic Fibrosis Registry. We jointly analyze repeated measurements and time-to-event outcomes to assess how much of the sex effect on lung function also explains survival. These novel methods allow examination of association between percent of forced expiratory volume in 1 second (%FEV1) and covariates such as sex and genotype, and survival, in the same modeling framework. We estimate the probability of surviving one more year with a probit model.

Results:
The dataset includes 81,129 lung function measurements of %FEV1 on 9,741 patients seen between 1996 and 2015 and captures 1,543 deaths. Males compared with females experienced a more gradual decline in %FEV1 (difference 0.11 per year 95% confidence interval [CI] = 0.08, 0.14). After adjusting for confounders, both overall level of %FEV1 and %FEV1 rate of change are associated with the concurrent hazard for death. There was evidence of a male survival advantage (probit coefficient 0.15; 95% CI = 0.10, 0.19) which changed little after adjustment for %FEV1 using conventional approaches but was attenuated by 37% on adjustment for %FEV1 level and slope in the joint model (0.09; 95% CI = 0.06, 0.12).

Conclusions:
We estimate that about 37% of the association of sex on survival in cystic fibrosis is mediated through lung function.
Identifying Infants and Young Children at Risk of Unplanned Hospital Admissions and Clinic Visits in Dar es Salaam, Tanzania
Authors: Rees Chris A. , Kisenge Rodrick , Manji Karim P. , Liu Enju , Fawzi Wafaie W. , Duggan Christopher P. 
Published: August 2020

Background:
Pediatric inpatient mortality rates are as high as 11% in parts of sub-Saharan Africa. Unscheduled clinic visits also burden children in sub-Saharan Africa. Our objective was to identify factors associated with hospital admissions and unscheduled clinic visits among Tanzanian children < 24 months of age.

Methods:
We conducted a secondary analysis of 2 trials conducted in Dar es Salaam, Tanzania. We performed univariate and Poisson multivariable regression analyses to identify factors associated with hospital admissions and unscheduled clinic visits.

Results:
Of 4784 children < 24 months of age, 293 (6.1%) were hospitalized at least once and 1308 (27.3%) had ≥ 1 unscheduled clinic visit. Infants and children who were exposed to but HIV-negative had increased risk of hospital admission [adjusted risk ratios (aRR): 3.67; 95% CI: 2.45–5.50; P < 0.001] compared with HIV-unexposed children. Those who were HIV-positive had even higher risk of hospital admission compared with those not exposed to HIV (aRR: 10.87; 95% CI: 7.01–16.89; P < 0.001). Birth weight and breast-feeding status were not associated with increased risk of hospital admission. Children with Apgar scores < 7 (aRR: 1.32; 95% CI: 1.03–1.69; P = 0.001), not exclusively breast-fed up to 6 months of age (aRR: 1.34; 95% CI: 1.12–1.60; P = 0.001), and who were HIV-exposed and HIV-negative (aRR: 2.35; 95% CI: 2.08–2.66; P < 0.001) or HIV-positive (aRR: 3.02; 95% CI: 2.52–3.61; P < 0.001) had higher risk of unscheduled clinic visits.

Conclusions:
Exposure to HIV and being HIV-positive were associated with the greatest risk for hospital admission and unplanned clinic visits among infants and children in Tanzania. Targeting these vulnerable populations in interventional studies may reduce morbidity.
Parents' Experiences of Transition From Hospital to Home After Their Infant's First-Stage Cardiac Surgery
Authors: Gaskin Kerry L. , Barron David , Wray Jo 
Published: August 2020

Background
The intersurgical stage is a critical time for fragile infants with complex congenital heart disease, but little is known about the impact on parents.

Objective
The aim of this study was to explore parents' experiences of the transition from hospital to home with their infant after stage 1 cardiac surgery for complex congenital heart disease.

Method
This is a prospective, longitudinal, mixed methods feasibility study using semistructured interviews and self-report instruments at 4 time points: before discharge (baseline), 2 weeks post discharge, 8 weeks post discharge, and after stage 2 surgery. Qualitative data were analyzed thematically; and quantitative data, descriptively.

Results
Sixteen parents of 12 infants participated. All parents described signs of acute stress disorder; 4 parents described symptoms of posttraumatic stress disorder before discharge. Parents' fear and uncertainty about going home were multifaceted, underpinned by exposure to numerous traumatic events. By 8 weeks post discharge, parents' feelings and emotions were positive, relieved, and relaxed. Mean generalized anxiety and depression scores were higher before discharge; most individual anxiety and depression scores decreased over time. Physiological survival included self-care needs, such as eating and sleeping properly. Physical survival included preparation of the home environment and home alterations adapting to their infant's equipment needs. Financial survival was a burden, particularly for those unable to return to work.

Conclusion
Patterns of experience in surviving the transition included psychological, physical, physiological, and financial factors. Authors of further longitudinal research could test the effectiveness of psychological preparation interventions, while encouraging early consideration of the other factors influencing parents' care of their infant after discharge from hospital.
Measuring Adherence to U.S. Preventive Services Task Force Diabetes Prevention Guidelines Within Two Healthcare Systems
Authors: Brunisholz Kimberly D. , Conroy Molly B. , Belnap Thomas , Joy Elizabeth A. , Srivastava Raj 
Published: August 2020

ABSTRACT
Measuring adherence to the 2015 U.S. Preventive Services Task Force (USPSTF) diabetes prevention guidelines can inform implementation efforts to prevent or delay Type 2 diabetes. A retrospective cohort was used to study patients without a diagnosis of diabetes attributed to primary care clinics within two large healthcare systems in our state to study adherence to the following: (1) screening at-risk patients and (2) referring individuals with confirmed prediabetes to participate in an intensive behavioral counseling intervention, defined as a Center for Disease Control and Prevention (CDC)-recognized Diabetes Prevention Program (DPP). Among 461,866 adults attributed to 79 primary care clinics, 45.7% of patients were screened, yet variability at the level of the clinic ranged from 14.5% to 83.2%. Very few patients participated in a CDC-recognized DPP (0.52%; range 0%–3.53%). These findings support the importance of a systematic implementation strategy to specifically target barriers to diabetes prevention screening and referral to treatment.