bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are prolonged sitting and sleep restriction a dual curse for the modern workforce? a randomised controlled trial protocol
Authors: Vincent Grace E , Gupta Charlotte C , Sprajcer Madeline , Vandelanotte Corneel , Duncan Mitch J , Tucker Phil , Lastella Michele , Tuckwell Georgia A , Ferguson Sally A 
Published: July 2020

IntroductionProlonged sitting and inadequate sleep are a growing concern in society and are associated with impairments to cardiometabolic health and cognitive performance. However, the combined effect of prolonged sitting and inadequate sleep on measures of health and cognitive performance are unknown. In addition, the circadian disruption caused by shiftwork may further impact workers’ cardiometabolic health and cognitive performance. This protocol paper outlines the methodology for exploring the impact of simultaneous exposure to prolonged sitting, sleep restriction and circadian disruption on cardiometabolic and cognitive performance outcomes.Methods and analysisThis between-subjects study will recruit 208 males and females to complete a 7-day in-laboratory experimental protocol (1 Adaptation Day, 5 Experimental Days and 1 Recovery Day). Participants will be allocated to one of eight conditions that include all possible combinations of the following: dayshift or nightshift, sitting or breaking up sitting and 5 hour or 9 hour sleep opportunity. On arrival to the laboratory, participants will be provided with a 9 hour baseline sleep opportunity (22:00 to 07:00) and complete five simulated work shifts (09:00 to 17:30 in the dayshift condition and 22:00 to 06:30 in the nightshift condition) followed by a 9 hour recovery sleep opportunity (22:00 to 07:00). During the work shifts participants in the sitting condition will remain seated, while participants in the breaking up sitting condition will complete 3-min bouts of light-intensity walking every 30 mins on a motorised treadmill. Sleep opportunities will be 9 hour or 5 hour. Primary outcome measures include continuously measured interstitial blood glucose, heart rate and blood pressure, and a cognitive performance and self-perceived capacity testing battery completed five times per shift. Analyses will be conducted using linear mixed models.Ethics and disseminationThe CQUniversity Human Ethics Committee has approved this study (0000021914). All participants who have already completed the protocol have provided informed consent. Study findings will be disseminated via scientific publications and conference presentations.Trial registration detailsThis study has been registered on Australian New Zealand Clinical Trials Registry (12619001516178) and is currently in the pre-results stage.
Characteristics of family meetings for patients with advanced disease in an Australian metropolitan tertiary hospital
Authors: Wang Amy , Thomas Kristina , Weil Jennifer , Hudson Peter 
Published: July 2020

ObjectivesFamily meetings (FMs) between clinicians, patients and family are recommended as a valuable communication and care planning method in the delivery of palliative care. However, there is a dearth of knowledge regarding FM characteristics, with few studies describing the prevalence, circumstances and content of FMs. The aims of this study were to: (1) measure the prevalence of FMs, (2) examine circumstance and timing of FMs, and (3) explore the content of FMs.MethodsA retrospective medical record audit was conducted of 200 patients who died in an Australian hospital of an expected death from advanced disease. Details of FMs were collected using an audit tool, along with patient demographics and admission data.Results33 patients (16.5%) had at least one FM during their inpatient stay. The majority of FMs occurred for patients admitted to an inpatient palliative care unit (59.5%) and were most commonly facilitated by doctors (81.0%). Patient attendance was frequent (40.5%). FM content fell into six categories: medical information, supportive communication behaviours of clinicians, psychosocial support for patients and families, end-of-life discussions, discharge planning and administrative arrangements.ConclusionsDespite the benefits FMs confer, FMs appear to be infrequently used at the end of life. When FMs are used, there is a strong medical focus on both facilitation and content. Available FM documentation tools also appear to be underused. Clinicians are encouraged to have a greater understanding of FMs to optimise their use and adopt a proactive and structured approach to the conduct and documentation of FMs.
Predictors and outcomes of acute respiratory failure in hospitalised patients with acute pancreatitis
Authors: Gajendran Mahesh , Prakash Bharat , Perisetti Abhilash , Umapathy Chandraprakash , Gupta Vineet , Collins Laura , Rawla Prashanth , Loganathan Priyadarshini , Dwivedi Alok , Dodoo Christopher , Unegbu Fortune , Schuller Dan , Goyal Hemant , Saligram Shreyas 
Published: July 2020

Background and aimAcute pancreatitis (AP) is associated with organ failures and systemic complications, most commonly acute respiratory failure (ARF) and acute kidney injury. So far, no studies have analysed the predictors and hospitalisation outcomes, of patients with AP who developed ARF. The aim of this study was to measure the prevalence of ARF in AP and to determine the clinical predictors for ARF and mortality in AP.MethodsThis is a retrospective cohort study using the Nationwide Inpatient Sample database from the year 2005–2014. The study population consisted of all hospitalisations with a primary or secondary discharge diagnosis of AP, which is further stratified based on the presence of ARF. The outcome measures include in-hospital mortality, hospital length of stay and hospitalisation cost.ResultsIn our study, about 5.4% of patients with AP had a codiagnosis of ARF, with a mortality rate of 26.5%. The significant predictors for ARF include sepsis, pleural effusion, pneumonia and cardiogenic shock. Key variables that were associated with a higher risk of mortality include mechanical ventilation, age more than 65 years, sepsis and cancer (excluding pancreatic cancer). The presence of ARF increased hospital stay by 8.3 days and hospitalisation charges by US$103 460.ConclusionIn this study, we demonstrate that ARF is a significant risk factor for increased hospital mortality, greater length of stay and higher hospitalisation charges in patients with AP. This underlines significantly higher resource utilisation in patients with a dual diagnosis of AP-ARF.
ABC score: a new risk score that accurately predicts mortality in acute upper and lower gastrointestinal bleeding: an international multicentre study
Authors: Laursen Stig Borbjerg , Oakland Kathryn , Laine Loren , Bieber Vered , Marmo Riccardo , Redondo-Cerezo Eduardo , Dalton Harry R , Ngu Jeffrey , Schultz Michael , Soncini Marco , Gralnek Ian , Jairath Vipul , Murray Iain A , Stanley Adrian J 
Published: July 2020

ObjectivesExisting scores are not accurate at predicting mortality in upper (UGIB) and lower (LGIB) gastrointestinal bleeding. We aimed to develop and validate a new pre-endoscopy score for predicting mortality in both UGIB and LGIB.Design and settingInternational cohort study. Patients presenting to hospital with UGIB at six international centres were used to develop a risk score for predicting mortality using regression analyses. The score’s performance in UGIB and LGIB was externally validated and compared with existing scores using four international datasets. We calculated areas under receiver operating characteristics curves (AUROCs), sensitivities, specificities and outcome among patients classified as low risk and high risk.Participants and resultsWe included 3012 UGIB patients in the development cohort, and 4019 UGIB and 2336 LGIB patients in the validation cohorts. Age, Blood tests and Comorbidities (ABC) score was closer associated with mortality in UGIB and LGIB (AUROCs: 0.81–84) than existing scores (AUROCs: 0.65–0.75; p≤0.02). In UGIB, patients with low ABC score (≤3), medium ABC score (4–7) and high ABC score (≥8) had 30-day mortality rates of 1.0%, 7.0% and 25%, respectively. Patients classified low risk using ABC score had lower mortality than those classified low risk with AIMS65 (threshold ≤1) (1.0 vs 4.5%; p<0.001). In LGIB, patients with low, medium and high ABC scores had in-hospital mortality rates of 0.6%, 6.3% and 18%, respectively.ConclusionsIn contrast to previous scores, ABC score has good performance for predicting mortality in both UGIB and LGIB, allowing early identification and targeted management of patients at high or low risk of death.
Hyperkalaemia during general anaesthesia: six cases
Authors: Louro Luís Filipe , Raszplewicz Joanna , Alderson Briony 
Published: July 2020

SUMMARYThe objective of this case series is to describe the clinical course, treatment and outcome in six dogs following acute hyperkalaemia during general anaesthesia. A total of six dogs were presented for routine surgical and/or imaging procedures requiring general anaesthesia. All patients developed hyperkalaemia (ranging from 7.0 to 8.7 mmol/L, reference interval: 3.4–4.9 mmol/L), and electrocardiographic changes were seen in all but one case. The prognosis for treatment of hyperkalaemia during general anaesthesia appears to be excellent as all dogs fully recovered following treatment. To the authors’ knowledge, this is the first reported case series of hyperkalaemia during general anaesthesia in dogs. Our objective is to provide further information regarding possible causes for the development of hyperkalaemia in dogs under general anaesthesia.
Inhibition of MAN2A1 Enhances the Immune Response to Anti–PD-L1 in Human Tumors
Authors: Shi Sailing , Gu Shengqing , Han Tong , Zhang Wubing , Huang Lei , Li Ziyi , Pan Deng , Fu Jingxin , Ge Jun , Brown Myles , Zhang Peng , Jiang Peng , Wucherpfennig Kai W. , Liu X. Shirley 
Published: July 2020

Abstract

Purpose:
Immune checkpoint blockade has shown remarkable efficacy, but in only a minority of patients with cancer, suggesting the need to develop additional treatment strategies. Aberrant glycosylation in tumors, resulting from the dysregulated expression of key enzymes in glycan biosynthesis, modulates the immune response. However, the role of glycan biosynthesis enzymes in antitumor immunity is poorly understood. We aimed to study the immunomodulatory effects of these enzymes.

Experimental Design:
We integrated transcriptional profiles of treatment-naïve human tumors and functional CRISPR screens to identify glycometabolism genes with immunomodulatory effects. We further validated our findings using in vitro coculture and in vivo syngeneic tumor growth assays.

Results:
We identified MAN2A1, encoding an enzyme in N-glycan maturation, as a key immunomodulatory gene. Analyses of public immune checkpoint blockade trial data also suggested a synergy between MAN2A1 inhibition and anti–PD-L1 treatment. Loss of Man2a1 in cancer cells increased their sensitivity to T-cell–mediated killing. Man2a1 knockout enhanced response to anti–PD-L1 treatment and facilitated higher cytotoxic T-cell infiltration in tumors under anti–PD-L1 treatment. Furthermore, a pharmacologic inhibitor of MAN2A1, swainsonine, synergized with anti–PD-L1 in syngeneic melanoma and lung cancer models, whereas each treatment alone had little effect.

Conclusions:
Man2a1 loss renders cancer cells more susceptible to T-cell–mediated killing. Swainsonine synergizes with anti–PD-L1 in suppressing tumor growth. In light of the limited efficacy of anti–PD-L1 and failed phase II clinical trial on swainsonine, our study reveals a potential therapy combining the two to overcome tumor immune evasion.
See related commentary by Bhat and Kabelitz, p. 5778
A Better Predictor of Acute Kidney Injury After Cardiac Surgery: The Largest Area Under the Curve Below the Oxygen Delivery Threshold During Cardiopulmonary Bypass
Authors: Oshita Tomoya , Hiraoka Arudo , Nakajima Kosuke , Muraki Ryosuke , Arimichi Masahisa , Chikazawa Genta , Yoshitaka Hidenori , Sakaguchi Taichi 
Published: July 2020

Background

The aim of this study was to compare the predictive accuracy of acute kidney injury (AKI) after cardiac surgery using cardiopulmonary bypass for the largest area under the curve (AUC) below the oxygen delivery (DO
2
) threshold and the cumulative AUC below the DO
2
threshold.

Methods and Results

From March 2017 to October 2019, 202 patients who had undergone cardiac surgery with cardiopulmonary bypass were enrolled. The perfusion parameters were recorded every 20 seconds, and the DO
2
(10×pump flow index [L/min per m
2
]×[hemoglobin (g/dL)×1.36×arterial oxygen saturation (%)+partial pressure of arterial oxygen (mm Hg)×0.003]) threshold of 300 mL/min per m
2
was considered to define sufficient DO
2
. The nadir DO
2
, the cumulative AUC below the

, and the largest AUC below the

were used to predict the incidence of AKI. Postoperative AKI was observed in 12.4% of patients (25/202). By multivariable analysis, the largest AUC below the

≥880 (odds ratio [OR], 4.9; 95% CI, 1.2–21.5 [
P
=0.022]), preoperative hemoglobin concentration ≤11.6 g/dL (OR, 7.6; 95% CI, 2.0–32.3 [
P
=0.004]), and red blood cell transfusions during cardiopulmonary bypass ≥2 U (OR, 3.3; 95% CI, 1.0–11.1 [
P
=0.041]) were detected as independent risk factors for AKI. Receiver operating curve analysis revealed that the largest AUC below the

was more accurate to predict postoperative AKI compared with the nadir DO
2
and the cumulative AUC below the

(differences between areas, 0.0691 [
P
=0.006] and 0.0395 [
P
=0.001]).

Conclusions

These data suggest that a high AUC below the

is an important independent risk factor for AKI after cardiopulmonary bypass, which could be considered for risk prediction models of AKI.
Population Density Analysis of Percutaneous Coronary Intervention for ST‐Segment–Elevation Myocardial Infarction in Japan
Authors: Yamaji Kyohei , Kohsaka Shun , Inohara Taku , Numasawa Yohei , Ishii Hideki , Amano Tetsuya , Ikari Yuji 
Published: July 2020

Background
Despite recent progress in the treatment of ST‐segment–elevation myocardial infarction, data on geographic disparities application of the evidence‐based therapy remain limited.

Methods and Results

The J‐PCI (Japanese Percutaneous Coronary Intervention) registry is a nationwide registry to assure the quality of delivered care. Between January 2014 and December 2018, 209 521 patients underwent percutaneous coronary intervention for ST‐segment–elevation myocardial infarction in 1126 institutions. The patients were divided into tertiles according to the population density (PD) of the percutaneous coronary intervention institution location (low: <951.7/km
2
, n = 69 797; medium: 951.7–4729.7/km
2
, n = 69 750; high: ≥4729.7/km
2
, n = 69 974). Patients treated in high PD administrative districts were younger and more likely to be male. No significant correlation was observed between PD and door‐to‐balloon time (regression coefficients: 0.036 per 1000 people/km
2
; 95% CI, −0.232 to 0.304;
P
= 0.79). Patients treated in low‐PD areas had higher crude in‐hospital mortality rates than those treated in high‐PD areas (low: 2.89%; medium: 2.60%; high: 2.38%;
P
< 0.001); PD and in‐hospital mortality had a significantly inverse association, before and after adjusting for baseline characteristics (crude odds ratio [OR], 0.983 per 1000/km
2
; 95% CI, 0.973–0.992;
P
< 0.001; adjusted OR, 0.980 per 1000/km
2
; 95% CI, 0.964–0.996;
P
= 0.01, respectively). Higher‐PD districts had more operators per institution (low: 6; interquartile range, 3–10; medium: 7; IQR, 3–13; high: 8; IQR, 5–13;
P
< 0.001), suggesting an inverse association with in‐hospital mortality (OR, 0.992; 95% CI, 0.986–0.999;
P
= 0.03).

Conclusions
Geographic inequality was observed in in‐hospital mortality of patients with ST‐segment–elevation myocardial infarction who underwent percutaneous coronary intervention. Variation in the number of operators per institution, rather than traditional quality indicators (eg, door‐to‐balloon time) might explain the difference in in‐hospital mortality.
Spatial Presence in Real and Remote Immersive Environments and the Effect of Multisensory Stimulation
Authors: Khenak Nawel , Vézien Jeanne , Théry David , Bourdot Patrick 
Published: July 2020

Abstract
This article presents a user experiment that assesses the feeling of spatial presence, defined as the sense of “being there” in both a real and a remote environment (respectively the so-called “natural presence” and “telepresence”). Twenty-eight participants performed a 3D-pointing task while being either physically located in a real office or remotely transported by a teleoperation system. The evaluation also included the effect of combining audio and visual rendering. Spatial presence and its components were evaluated using the ITC-SOPI questionnaire (Lessiter, Freeman, Keogh, & Davidoff, 2001). In addition, objective metrics based on user performance and behavioral indicators were logged. Results indicate that participants experienced a higher sense of spatial presence in the remote environment (hyper-presence), and a higher ecological validity. In contrast, objective metrics prove higher in the real environment, which highlights the absence of correlation between spatial presence and the objective metrics used in the experiment. Moreover, results show the benefit of adding audio rendering in both environments to increase the sense of spatial presence, the performance of participants, and their engagement during the task.
Accuracy of abbreviated multiparametric MRI-derived protocols in predicting local staging of prostate cancer in men undergoing radical prostatectomy
Authors: Giannarini Gianluca , Cereser Lorenzo , Como Giuseppe , Bonato Filippo , Pizzolitto Stefano , Valotto Claudio , Ficarra Vincenzo , Dal Moro Fabrizio , Zuiani Chiara , Girometti Rossano 
Published: July 2020

Background Abbreviated magnetic resonance imaging (aMRI) protocols have emerged as an alternative to multiparametric MRI (mpMRI) to reduce examination time and costs. Purpose To compare multiple aMRI protocols for predicting pathological stage ≥T3 (≥pT3) prostate cancer (PCa). Material and Methods One hundred and eight men undergoing staging mpMRI before radical prostatectomy (RP) were retrospectively evaluated. 3.0-T imaging was performed with a 32-channel surface coil and a protocol including diffusion-weighted imaging (DWI), transverse T2-weighted (tT2W) imaging, coronal T2W (cT2W) imaging, sagittal T2W (sT2) imaging, and dynamic contrast-enhanced (DCE) imaging. Two readers independently assessed whether any MRI observation showed stage ≥T3 on each sequence (reading order: DWI, cT2W, tT2W, sT2W, DCE). Final stage was assessed by matching readers’ assignments to pathology, and combining them into eight protocols: DWI + tT2W, DWI + cT2W + tT2W, DWI + tT2W + sT2W, DWI + cT2W + tT2W + sT2W, DWI + tT2W + DCE, DWI + cT2W + tT2W + DCE, DWI + tT2W + sT2W + DCE, and mpMRI. Diagnostic accuracy and inter-reader agreement for aMRI protocols were calculated. Results Prevalence of ≥pT3 PCa was 31.5%. Sensitivity, specificity, positive (PPV) and negative predictive value (NPV) of aMRI protocols were comparable to mpMRI for R1. Sensitivity was 74.3% (95% confidence interval [CI] 64.8–72.0) to 77.1% (95% CI 67.9–84.4), and NPV 86.8% (95% CI 78.6–92.3) to 88.1% (95% CI 80.1–93.3). All accuracy measures of the various aMRI protocols were similar to mpMRI also for R2, albeit all slightly lower compared to R1. On a per-protocol basis, there was substantial inter-reader agreement in predicting stage ≥pT3 (k 0.63–0.67). Conclusion When comparing the diagnostic accuracy of multiple aMRI protocols against mpMRI for predicting stage ≥pT3 PCa, the protocol with the fewest sequences (DWI + tT2W) is apparently equivalent to standard mpMRI.
Effect of Low-dose ColchiciNe on the InciDence of Atrial Fibrillation in Open Heart Surgery Patients: END-AF Low Dose Trial
Authors: Tabbalat Ramzi A. , Alhaddad Imad , Hammoudeh Ayman , Khader Yousef S. , Khalaf Hassan Abu , Obaidat Mohammad , Barakat Jude 
Published: July 2020

Background Studies using 1 mg of colchicine to prevent postoperative atrial fibrillation (POAF) reported conflicting results. Moreover, colchicine was associated with significant gastrointestinal (GI) side effects. This study examined whether low-dose colchicine effectively prevents POAF and whether low-dose therapy is associated with lower rates of colchicine-induced GI side effects. Methods In this prospective, randomized, double-blind, placebo-controlled study, consecutive adult patients admitted for elective cardiac surgeries randomly received a 1-mg dose of colchicine (n = 81) or placebo (n = 71) orally 12 to 24 hours before surgery followed by a daily dose of 0.5 mg until hospital discharge. The primary efficacy endpoint was the development of at least one episode of POAF of ≥5 minutes. The primary safety endpoint was the development of adverse events, especially diarrhea. Results The in-hospital mortality rate was 3.9%. POAF occurred in 13 patients (16.1%) in the colchicine group and 13 patients (18.3%) in the placebo group (odds ratio 0.85 [95% Confidence Interval = 0.37−1.99]). Diarrhea occurred in two patients in each group and necessitated treatment discontinuation in one patient in each group. Conclusion Low-dose colchicine did not prevent POAF in patients undergoing cardiac surgery. These results should be interpreted cautiously because of the small sample size and early study termination. ClinicalTrials.gov Unique Identifier number: NCT03015831
Neurally adjusted ventilatory assist after surgical treatment of intracerebral hemorrhage: a randomized crossover study
Authors: Yu Tao , Wu Rongrong , Yao Lin , Wang Kui , Wang Guiliang , Fan Zhen , Wu Nianlong , Fang Xinggen 
Published: July 2020

Objective We assessed the neuromechanical efficiency (NME), neuroventilatory efficiency (NVE), and diaphragmatic function effects between pressure support ventilation (PSV) and neutrally adjusted ventilatory assist (NAVA). Methods Fifteen patients who had undergone surgical treatment of intracerebral hemorrhage were enrolled in this randomized crossover study. The patients were assigned to PSV for the first 24 hours and then to NAVA for the following 24 hours or vice versa. The monitored ventilatory parameters under the two ventilation models were compared. NME, NVE, and diaphragmatic function were compared between the two ventilation models. Results One patient’s illness worsened during the study. The study was stopped for this patient, and intact data were obtained from the other 14 patients and analyzed. The monitored tidal volume was significantly higher with PSV than NAVA (487 [443–615] vs. 440 [400–480] mL, respectively). NME, NVE, diaphragmatic function, and the partial pressures of arterial carbon dioxide and oxygen were not significantly different between the two ventilation models. Conclusion The tidal volume was lower with NAVA than PSV; however, the patients’ selected respiratory pattern during NAVA did not change the NME, NVE, or diaphragmatic function. Clinical trial registration no. ChiCTR1900022861