bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient-Controlled Analgesia Following Lumbar Spinal Fusion Surgery Is Associated With Increased Opioid Consumption and Opioid-Related Adverse Events
Authors: Patel Arpan A , Walker Corey T , Prendergast Virginia , Radosevich John J , Grimm Doneen , Godzik Jakub , Whiting Alexander C , Kakarla U Kumar , Mirzadeh Zaman , Uribe Juan S , Turner Jay D 
Published: March 2020

Abstract

BACKGROUND
Optimal postoperative pain control is critical after spinal fusion surgery. There remains significant variability in the use of postoperative intravenous opioid patient-controlled analgesia (PCA) and few data evaluating its utility compared with nurse-controlled analgesia (NCA) among patients with lumbar fusion.

OBJECTIVE
To investigate the efficacy of postoperative PCA compared with NCA to improve opiate prescription practices.

METHODS
A retrospective review from a single institution was conducted in consecutive patients treated with posterior lumbar spinal fusion for degenerative pathology. Patients were divided into cohorts on the basis of postoperative treatment with PCA or NCA. Postoperative pain scores, length of stay, and total opioid consumption data were collected. Patients were stratified according to preoperative opioid consumption as opioid naive (0 morphine milligram equivalents [MME] daily), low consumption (1-60 MME), high consumption (61-90 MME), or very high consumption (>90 MME).

RESULTS
A total of 240 patients were identified, including 62 in the PCA group and 178 in the NCA group. PCA patients had higher mean preoperative opioid consumption than NCA patients (49.2 vs 24.3 MME, P = .009). PCA patients had higher mean opioid consumption in the first 72 h in all 4 of the preoperative opioid consumption subcategories. Pain control and adverse event rates were similar between PCA and NCA in the low to high preoperative opioid consumption groups.

CONCLUSION
Postoperative PCA is associated with significantly more opioid consumption in the first 72 h after surgery and equal or worse postoperative pain scores compared with NCA after lumbar spinal fusion surgery.
Transitioning to a higher retirement age with exponential and quasi-hyperbolic discounters in mixed economies
Authors: Daway-Ducanes Sarah Lynne Salvador 
Published: March 2020

Abstract
This paper analyses the macroeconomic and welfare effects of a higher retirement age within a dynamic overlapping generations framework, wherein exponential discounting and sophisticated quasi-hyperbolic discounting agents coexist in ‘mixed economies’. The transitional dynamics of economic aggregates depend on the proportion of QHD agents, and the extent to which reducing the social security tax rate mitigates crowding-out effects on savings and enables both lower pension contributions and higher pension benefits. Welfare impacts across agent types and cohorts differ accordingly: QHD agents employ the higher retirement age as a commitment mechanism to mitigate the adverse welfare implications of present-biasedness.
Phenomenal Relations and Collective Essence
Authors: Kappes Yannic 
Published: March 2020

Abstract
Antonin Broi (2019) argues that the thesis of phenomenal revelation is in tension with the best available accounts of similarity and certain other relations between phenomenal properties and should hence be rejected. In the following, I investigate Broi’s argument, show how the notion of collective essence can be used to withstand it, and consider a corresponding “collective” version of the revelation thesis.
Statistical noise from recombinant plasmids can be abated via complementation of a ribosomal protein gene deletion
Authors: Matsumura Ichiro , Chyong Donian 
Published: March 2020

Abstract
The phenotypes conferred by recombinant plasmids upon host cells often exhibit variability between replicate populations. This statistical noise is mostly a consequence of adaptive evolution in response to fitness burdens imposed by the plasmids themselves. We developed a novel strategy, ‘ribosome pegging’, to exclude common unwanted mutations that benefit host cells at the expense of heterologous gene expression. Plasmids that constitutively co-expressed the fluorescent reporter tagRFP and ribosomal protein L23 (rplW) were used to transform Escherichia coli cells that lacked the essential chromosomal rplW gene. Cells within the population that expressed too little L23, or too much, were evidently inviable. Ribosome pegging obviates the need for antibiotics, thus facilitating the deployment of recombinant bacteria in uncontrolled environments. We show that ribosome-pegged E. coli carrying a plasmid that constitutively expresses L23 and an artificially evolved enzyme protects fruit flies from otherwise toxic doses of the insecticide malathion.
Vitamin D is associated with the hypertriglyceridemic waist phenotype in Brazilian children
Authors: Milagres Luana Cupertino , Filgueiras Mariana De Santis , Rocha Naruna Pereira , Juvanhol Leidjaira Lopes , Franceschini Sylvia do Carmo Castro , Farias de Novaes Juliana 
Published: March 2020

Abstract

Background
Prevalence of cardiometabolic risk factors is increasing and vitamin D insufficiency/deficiency has become a worldwide public health problem, even in tropical countries. Therefore, we identified the prevalence of hypertriglyceridemic waist phenotype (HWP) and evaluate its relationship with vitamin D insufficiency/deficiency.

Methods
A cross-sectional study with 378 children aged 8 and 9 enrolled in all urban schools in the city of Viçosa, MG, Brazil. Anthropometric measurements, body composition (dual energy X-ray absorptiometry), biochemical tests and clinical evaluation were performed. Poisson regression was used to analyze the association between vitamin D and HWP.

Results
Prevalence of HWP was 16.4%. This prevalence was higher among children with vitamin D insufficiency and deficiency and in those with a greater number of other cardiometabolic risk factors. Multiple regression analysis showed that children with vitamin D insufficiency and deficiency had, respectively, prevalence 85% (95% CI: 1.03–3.30) and 121% (95% CI: 1.11–4.45) higher of HWP than the vitamin D sufficiency group.

Conclusion
Vitamin D insuffiency and deficiency were associated with a higher prevalence of HWP among children, regardless of the presence of other cardiometabolic risk factors, indicating an additional risk of inadequate vitamin D status to cardiometabolic health in childhood.
Financialization, wealth and the changing political aftermaths of banking crises
Authors: Chwieroth Jeffrey M , Walter Andrew 
Published: March 2020

AbstractHouseholds face two politically salient risks associated with financial instability. The first risk, which has existed for perhaps centuries, is associated with the indirect effect of systemic banking crises on employment and income flows. The second risk arises from the direct effects of crises on asset prices and thus household wealth stocks. Historically, the second risk mainly affected only a narrow wealthy elite. We argue that the rapid expansion and financialization of middle-class wealth since the mid-20th century mean that many voters now have ‘great expectations’ regarding government responsibility to protect their wealth. The political risks of financial instability for incumbent governments have thus increased sharply, especially when institutional constraints hamper their ability to respond to voters’ new expectations. We show that the probability of incumbent governments facing significant institutional constraints retaining office after systemic banking crises has indeed fallen sharply in recent decades compared to the pre-1945 period.
Sleep disorders in essential tremor: systematic review and meta-analysis
Authors: Jiménez-Jiménez Félix Javier , Alonso-Navarro Hortensia , García-Martín Elena , Agúndez José A G 
Published: March 2020

AbstractSleep disorders are frequent in patients diagnosed with essential tremor (ET). The present review focuses on sleep disorders and the results of polysomnographic studies performed in patients with ET. For this purpose we performed a systematic review crossing the search term “essential tremor” with “sleep,” “sleep disorders,” “sleep disturbances” and “polysomnography,” and with specific sleep disorders, according to the International Classification of the Sleep Disorders—Third Edition, using the PubMed, EMBASE, MEDLINE, and Web of Science Databases. The most frequent sleep problems reported by patients with ET were the bad quality of sleep and excessive daytime somnolence (the latter could be related to drugs commonly used for the treatment of ET). Probable rapid eye movement sleep behavior disorder, coexistent restless legs syndrome, insomnia, and nocturia were not infrequent complaints, while the presence of other sleep disorders in patients with ET was restricted to anecdotal reports or not described. Meta-analyses of previous reports showed that patients with ET (according to the PRISMA and MOOSE guidelines) showed higher scores in the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale than controls and lower scores than those of patients diagnosed with Parkinson’s disease. Studies using polysomnography in patients with ET are scarce and do not permit to establish valid conclusions regarding polysomnographic features in this disorder.
Serological evidence of Mayaro virus infection in blood donors from São Carlos, São Paulo, Brazil
Authors: Romeiro Marilia Farignoli , Fumagalli Marcílio Jorge , dos Anjos Ana Beatriz , Figueiredo Luiz Tadeu Moraes 
Published: March 2020

Abstract

Background
Human infections by Mayaro virus (MAYV) occur by insect bites upon exposure to rural or sylvatic areas. Information regarding MAYV transmission is limited due to a lack of commercial diagnostic assays and diagnostic confusion on account of similarities of clinical signs with other co-circulating arboviral diseases.

Methods
A serological survey of MAYV and Chikunguya virus (CHIKV) antibodies was performed by ELISA. Between 2017 and 2018, 5608 blood donor samples were tested.

Results
Specific IgM and IgG antibodies to MAYV were detected respectively in 36 and 11 samples, indicating a total seroprevalence of approximately 0.83%. Neutralization activity was observed in two IgG positive sera. Additionally, eight distinct samples had IgM antibodies to CHIKV alone.

Conclusions
Our data suggest previously unreported circulation of MAYV in São Carlos city, from southeastern Brazil.
Physical Rehabilitation in Critically Ill Children: A Multicenter Point Prevalence Study in the United States
Authors: Kudchadkar Sapna R. , Nelliot Archana , Awojoodu Ronke , Vaidya Dhananjay , Traube Chani , Walker Tracie , Needham Dale M. ,   for the Prevalence of Acute Rehabilitation for Kids in the PICU (PARK-PICU) Investigators and the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network
Published: March 2020

Objectives:
With decreasing mortality in PICUs, a growing number of survivors experience long-lasting physical impairments. Early physical rehabilitation and mobilization during critical illness are safe and feasible, but little is known about the prevalence in PICUs. We aimed to evaluate the prevalence of rehabilitation for critically ill children and associated barriers.

Design:
National 2-day point prevalence study.

Setting:
Eighty-two PICUs in 65 hospitals across the United States.

Patients:
All patients admitted to a participating PICU for greater than or equal to 72 hours on each point prevalence day.

Interventions:
None.

Measurements and Main Results:
The primary outcome was prevalence of physical therapy– or occupational therapy–provided mobility on the study days. PICUs also prospectively collected timing of initial rehabilitation team consultation, clinical and patient mobility data, potential mobility–associated safety events, and barriers to mobility. The point prevalence of physical therapy– or occupational therapy–provided mobility during 1,769 patient-days was 35% and associated with older age (adjusted odds ratio for 13–17 vs < 3 yr, 2.1; 95% CI, 1.5–3.1) and male gender (adjusted odds ratio for females, 0.76; 95% CI, 0.61–0.95). Patients with higher baseline function (Pediatric Cerebral Performance Category, ≤ 2 vs > 2) less often had rehabilitation consultation within the first 72 hours (27% vs 38%; p < 0.001). Patients were completely immobile on 19% of patient-days. A potential safety event occurred in only 4% of 4,700 mobility sessions, most commonly a transient change in vital signs. Out-of-bed mobility was negatively associated with the presence of an endotracheal tube (adjusted odds ratio, 0.13; 95% CI, 0.1–0.2) and urinary catheter (adjusted odds ratio, 0.28; 95% CI, 0.1–0.6). Positive associations included family presence in children less than 3 years old (adjusted odds ratio, 4.55; 95% CI, 3.1–6.6).

Conclusions:
Younger children, females, and patients with higher baseline function less commonly receive rehabilitation in U.S. PICUs, and early rehabilitation consultation is infrequent. These findings highlight the need for systematic design of rehabilitation interventions for all critically ill children at risk of functional impairments.
Attention to breath sensations does not engage endogenous opioids to reduce pain
Authors: Wells Rebecca E. , Collier Jason , Posey Grace , Morgan Afrayem , Auman Timothy , Strittmatter Brian , Magalhaes Rossana , Adler-Neal Adrienne , McHaffie John G. , Zeidan Fadel 
Published: March 2020

Abstract
The endogenous opioidergic system is critically involved in the cognitive modulation of pain. Slow-breathing-based techniques are widely used nonpharmacological approaches to reduce pain. Yet, the active mechanisms of actions supporting these practices are poorly characterized. Growing evidence suggest that mindfulness-meditation, a slow-breathing technique practiced by nonreactively attending to breathing sensations, engages multiple unique neural mechanisms that bypass opioidergically mediated descending pathways to reduce pain. However, it is unknown whether endogenous opioids contribute to pain reductions produced by slow breathing. The present double-blind, placebo-controlled crossover study examined behavioral pain responses during mindfulness-meditation (n = 19), sham-mindfulness meditation (n = 20), and slow-paced breathing (n = 20) in response to noxious heat (49°C) and intravenous administration (0.15 mg/kg bolus + 0.1 mg/kg/hour maintenance infusion) of the opioid antagonist, naloxone, and placebo saline. Mindfulness significantly reduced pain unpleasantness ratings across both infusion sessions when compared to rest, but not pain intensity. Slow-paced breathing significantly reduced pain intensity and unpleasantness ratings during naloxone but not saline infusion. Pain reductions produced by mindfulness-meditation and slow-paced breathing were insensitive to naloxone when compared to saline administration. By contrast, sham-mindfulness meditation produced pain unpleasantness reductions during saline infusion but this effect was reversed by opioidergic antagonism. Sham-mindfulness did not lower pain intensity ratings. Self-reported “focusing on the breath” was identified as the operational feature particularly unique to the mindfulness-meditation and slow paced-breathing, but not sham-mindfulness meditation. Across all individuals, attending to the breath was associated with naloxone insensitive pain-relief. These findings provide evidence that slow breathing combined with attention to breath reduces pain independent of endogenous opioids.
Initiating palliative care consultation for acute critically ill patients in the emergency department intensive care unit
Authors: Yang Che , Yang Tsu-Te , Tsou Yu-Ju , Lin Ming-Hui , Fan Ju-Sing , Huang Hsien-Hao , Tsai Ming-Che , Yen David Hung-Tsang 
Published: March 2020

Background:
Little is known about the characteristics of patients needing palliative care consultation in the emergency department (ED). This study aimed to investigate the impacts of initiating screening in acute critically ill patients needing palliative care on mortality, health care resources, and end-of-life (EOL) care in the intensive care unit in ED (EICU).

Methods:
We conducted an analysis study in Taipei Veterans General Hospital. From February 1 to July 31, 2018, acute critically ill patients in EICU were recruited. The primary outcomes were inhospital mortality and EOL care. The secondary outcomes included clinical characteristics and health care utilization.

Results:
A total of 796 patients were screened, with 396 eligible and 400 noneligible patients needing palliative care consultations. The mean age was 74.8 ± 17.1 years, and 62.6% of the patients were male. According to logistic regression analysis, clinical predictors, including age (adjusted odds ratio [AOR], 1.028; 95% CI, 1.015-1.042), respiratory distress and/or respiratory failure (AOR, 2.670; 95% CI, 1.829-3.897), the Acute Physiology and Chronic Health Evaluation II score (AOR, 1.036; 95% CI, 1.009-1.064), Charlson Comorbidity Index score (AOR, 1.212; 95% CI, 1.125-1.306), and Glasgow Coma Scale (AOR, 0.843; 95% CI, 0.802-0.885), were statistically more significant in eligible patients than in noneligible patients. The inhospital mortality rate was significantly higher in eligible patients than that in noneligible patients (40.7% vs 11.5%, p < 0.01). Eligible patients have a higher ratio in both vasopressor and narcotic use and withdrawal of endotracheal tube than noneligible patients (p < 0.05).

Conclusion:
Our study results demonstrated that initiating palliative consultation for acute critically ill patients in ED had an impact on the utilization of health care resources and quality of EOL care. Further assessments of the viewpoints of ED patients and their family on palliative care consultations and hospice care are required.
Hematologic adverse drug reactions leading to hospitalization among cancer patients: A retrospective case-control study
Authors: Chiou Be-Ling , Ho Chin-Chin , Yang Chen-Chang 
Published: March 2020

Background:
Cancer is one of the leading causes of death worldwide. Despite the rapid evolution of cancer treatment, chemotherapy remains the mainstay in the management of cancer. Chemotherapy can result in various adverse drug reactions (ADRs), which may lead to hospitalization and even life-threatening side-effects. Hematologic ADRs are among the most severe forms of ADR following chemotherapy, as they generally lead to hospitalization. It is important to realize the predictors and outcome of hematologic ADRs in cancer patients.

Methods:
We conducted a hospital-based case-control study to include all the cancer patients who were hospitalized to receive chemotherapy in Taipei Veterans General Hospital during 2013. Among them the patients rehospitalized after chemotherapy due to neutropenia, leucopenia, or pancytopenia were identified as the study group. Control subjects consisted of hospitalized cancer patients who did not display the aforementioned ADRs. The study and control groups were numbered in the ratio of 1:4 and were age- and gender-matched. Their demographic and clinical characteristics were collected through chart review. Determinants of hematologic ADRs were then analyzed.

Results:
During the study period, we collected a total of 64 patients into the study group and 256 as control subjects. The mean length of hospitalization was 11 days in the study group of patients, which was 5 days longer than that in the control group (p < 0.001). Predictors of hematologic ADR-related hospitalization included history of hematologic ADRs, hypertension, cisplatin treatment, and a Charlson comorbidity score of 2 to 3.

Conclusion:
Severe outcomes of hematologic ADRs may increase healthcare costs and decrease patient productivity. Therefore, the determinants of ADR-related hospitalization identified in this study may help improve the quality of healthcare for cancer patients.
A comparison of thyroid blockade strategies in paediatric 123I-meta-iodobenzylguanidine scanning: a dual centre study
Authors: Thurlow Ben , Morris Elizabeth , Price Leanne , Melhuish Timothy , Michopoulou Sofia , King Simon , Easty Marina , Biassoni Lorenzo 
Published: March 2020

Objective
The aim of this study was to evaluate three thyroid blockade regimes to determine which protocol provides the optimal level of thyroidal protection for paediatric 123-I-meta-iodobenzylguanidine (mIBG) imaging and estimate the relative radiation dose inferred from unbound radioiodine.

Methods
A total of 231 patients were retrospectively evaluated for thyroid uptake and categorised into five subgroups depending upon the protocol of thyroid blockade received. Efficacy of thyroid blockade was established by visual scoring and image quantitation with comparison against a control group.

Results
Visual Likert scale responses were subjected to the Mann–Whitney U and Kruskal–Wallis tests, respectively. Statistical significance was reached for observed thyroid uptake in potassium perchlorate recipients (U = 1107, P = 0.001). No statistically significant difference was observed in thyroid uptake for iohexol blockade (U = 176, P = 0.71) or potassium iodate blockade despite variations in iodate dosage and duration (χ
2(2) = 0.203, P = 0.93). The analyses were repeated for the image quantitation data. A statistically significantly higher absorbed thyroid dose was observed using potassium perchlorate blockade compared with the control group (U = 719, P = 0.001). The Mann–Whitney U did not reach statistical significance in absorbed thyroid dose for iohexol blockade (U = 126, P = 0.209, r = −0.13). The Kruskal–Wallis test, conducted across the potassium iodate groups, did not reach statistical significance (χ
2(2) = 0.513, P = 0.774). The median absorbed thyroid dose across the iodate groups ranged from 3.58 to 3.91 mGy indicating comparable blockade effectiveness for single-dose potassium iodate.

Conclusion
Potassium iodate blockade is more efficacious compared with potassium perchlorate within the cohort observed. Both visual and quantitative data indicate that potassium iodate given at 30–60 min before 123I-mIBG injection provides comparable blockade effectiveness to lengthier administrations, suggesting that a single dose is well tolerated and practical.