bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased long‐term mortality after emergency colon resections
Authors: Fahim M. , Dijksman L. M. , van der Nat P. , Derksen W. J. M. , Biesma D. H. , Smits A. B. 
Published: July 2020

AbstractAimEmergency surgery is a known predictor for 30‐day mortality. However, its relationship with long‐term mortality is still a matter of debate. The aim of this study was to analyse the effect of emergency surgery compared with elective surgery on long‐term survival.MethodData from the Dutch Colorectal Audit and the Dutch Cancer Centre registry of a large nonacademic teaching hospital were used to analyse outcomes of patients who underwent surgery for colon cancer from 2009 until 2017. Univariable and multivariable Cox regression were used to assess the effect of emergency surgery on long‐term mortality with adjustment for patient, tumour and treatment characteristics.ResultsA total of 1139 patients with a median follow‐up of 40 months (interquartile range 23–65 months) were included. Emergency surgery was performed in 158 patients (14%). The 5‐year survival after emergency surgery was 46% compared with 72% after elective surgery. After adjusting for baseline differences there was an independent and significant association between emergency surgery and increased long‐term mortality (hazard ratio 1.79, 95% CI 1.28–2.51, P = 0.001).ConclusionEmergency surgery for colon cancer seems to lead to a significantly increased risk of long‐term mortality compared with elective surgery. Detection and treatment of early symptoms that can lead to emergency surgery might be the way forward.
Uterus Transplants and the Potential for Harm: Lessons From Commercial Surrogacy
Authors: Barn Gulzaar 
Published: July 2020

AbstractThe human uterine transplant (UTx) is being developed as a procedure to alleviate absolute uterine factor infertility (AUFI). In light of recent UTx advances in India, I suggest that key ethical concerns would emerge if this procedure were to become established as part of India’s liberalised assisted reproduction industry. On evidence‐based projections, UTx would be likely to harm vulnerable populations in two key ways. Firstly, I suggest that a commercial model for uteri procurement is primed to develop due to various structural factors that facilitated the boom in commercial surrogacy remaining in place, despite commercial surrogacy having been outlawed. I outline ways in which Indian commercial surrogacy arrangements exhibited exploitation and suggest that a commercial UTx model would be similarly exploitative, with many background features of exploitative surrogacy remaining constant. The second way in which the development of UTx in India might pose harm is through the difficulty in obtaining proper informed consent, even under altruistic arrangements. I argue that structural factors, including a cultural deference to doctors, lack of medical understanding displayed by vulnerable populations, and a privatised healthcare system with little regulatory oversight, would render it difficult to obtain proper informed consent from living donors. Further, factors peculiar to UTx, such as its experimental nature, and the unknown and novel risks and harms it poses, heighten this difficulty. Accordingly, UTx in India would be unlikely to meet the Montreal criteria for the ethical feasibility of uterine transplantation and should thus raise ethical alarm.
Diabetes, obesity and COVID‐19: A complex interplay
Authors: Vas Prashanth , Hopkins David , Feher Michael , Rubino Francesco , B. Whyte Martin 
Published: July 2020

AbstractWith the accumulation of observational data showing an association of metabolic co‐morbidities with adverse outcomes from COVID‐19, there is a need to disentangle the contributions of pre‐existing macro‐ and microvascular disease, obesity and glycaemia. This article outlines the complex mechanistic and clinical interplay between diabetes and COVID‐19, the clinical and research questions which arise from this relationship, and the types of studies needed to answer those questions. The authors are clinicians and academics working in diabetes and obesity medicine, but the article is pitched to an audience of generalists with clinical experience of or interest in the management of COVID‐19.
Decreased risk‐taking and loss‐chasing after subthalamic nucleus lesion in rats
Authors: Breysse Emmanuel , Meffre Julie , Pelloux Yann , Winstanley Catharine A. , Baunez Christelle 
Published: July 2020

AbstractThe subthalamic nucleus (STN) is known to play a role in the control of impulsivity of action and in impulsivity of choice under certain conditions. In order to assess its influence on decision‐making under uncertainty, we have tested here the effects of bilateral STN lesions in rats performing a probability discounting task (PDT) and a “loss‐chasing” task, both tasks assessing risky decision under uncertainty, but one in a positive context (probability to obtain a larger reward) and the other in a negative context (risk for a larger loss). The PDT measures the choice between a small certain and a large uncertain reward. Conversely, in the “loss‐chasing” task, animals choose between accepting a small certain loss versus risking a larger but uncertain penalty. The results show that STN lesions reduce risk‐taking in both the PDT and the loss‐chasing task, suggesting that STN inactivation could decrease risky decision‐making whatever the nature of the outcome in an ambiguous context. Interestingly, opposite results were found in a small number of animals for which the lesions extended to the area dorsal to the STN (in the zona incerta), such that these animals increased choice of the uncertain option in the PDT. These results confirm the specificity of STN involvement in these processes and may provide explanations for some side‐effects reported in patients when STN manipulations extend to the Zona Incerta. They also support the choice of the STN as a target for the treatment of impulse control disorders in Parkinson’s disease and in obsessive compulsive disorders.
An algorithm for fast critical plane search in computer‐aided engineering durability analysis under multiaxial random loadings: Application to the Carpinteri–Spagnoli–Vantadori spectral method
Authors: Marques Julian Marcel Enzveiler , Benasciutti Denis , Carpinteri Andrea , Spagnoli Andrea 
Published: July 2020

AbstractThis paper presents a new algorithm to implement the Carpinteri–Spagnoli–Vantadori (CSV) multiaxial fatigue criterion for random loading and to shorten the computation time. This goal is achieved after calculating the exact expressions of stress spectral moments in every rotated plane, which allow the maximum variance and expected maximum peak of normal/shear stress to be computed directly. This permits the new algorithm to determine the five rotations of the critical plane without using ‘for/end’ loops (which represent a slow numerical operation), although some information on stress signals examined is lost. Two examples are presented to demonstrate the advantages of the new algorithm in comparison with its standard version, which are particularly remarkable when considering the stress output of all finite element model nodes. The approach behind the new algorithm can be extended to other multiaxial spectral criteria that use angular rotations or direction cosines to locate the critical plane or the direction of maximum stress variance.
Fatigue life evaluation of tension‐compression asymmetric material using local stress–strain method
Authors: Chen Jiwei , Yao Weixing , Gao Daiyang 
Published: July 2020

AbstractIn this paper, the low‐cycle fatigue characteristics of cold‐drawn steel were investigated under strain‐controlled uniaxial fatigue load. Cyclic softening was observed throughout fatigue life except for the initial relatively short period which exhibited cyclic hardening. Positive mean stress was found under fully reversed strain loading, indicating that there was a significant cyclic asymmetry. A modified local stress–strain method was proposed to estimate fatigue life of notched tension‐compression asymmetric material. In order to verify this method, fatigue experiments on two kinds of notched specimens with different notch radius were carried out under constant and block load spectrum. It was found that the modified local stress–strain method was more accurate than the traditional ones, the maximum relative error between predicted and experimental fatigue life was less than 6%.
Effects of LAB inoculant and cellulase on the fermentation quality and chemical composition of forage soybean silage prepared with corn stover
Authors: Cheng Qiming , Li Ping , Xiao Bingxue , Yang Fuyu , Li Daxu , Ge Gentu , Jia Yushan , Bai Shiqie 
Published: July 2020

AbstractThe objective of the present study was to evaluate the silage quality of forage soybean‐corn stover silage in the south of China. Forage soybean were combined manually with corn stover by ratios of R1 (25:75), R2 (50:50) and R3 (75:25) in fresh weight (FM) and ensiled in bag silos for 60 days at room temperature (20–25°C). All silages were treated without (control) or with lactic acid bacteria (LAB) inoculant (G, Lactobacillus plantarum and Lactobacillus buchneri, 105 cfu/g, of FM), cellulase (C, 0.02% of FM) and C + G. R1 silage had appropriate V‐score value with high lactic acid content and low pH value and ammonia‐N (NH3‐N) content, undetectable levels of propionic acid (PA) and butyric acid (BA). C and C + G reduced undesirable microorganisms of aerobic bacteria, yeasts and molds, resulting in improved nutritive value of R2 silage, as indicated by lower neutral detergent fiber and acid detergent fiber contents, and higher crude protein content, in vitro ruminal dry matter digestibility, gross energy and metabolizable energy values as compared to the control. Additives did not improve the quality of R3 silage with high pH value and NH3‐N content, BA and PA contents and undesirable microorganism counts. These results confirmed that high‐quality silage produced from mixtures (25:75) of forage soybean and corn stover in the south of China; additives (especially for C + G) could enhance the silage quality of forage soybean‐corn stover (50:50); and high proportion (>75%) of forage soybean was difficult to ensile.
Incidence rate, predictors and outcomes of interruption of HIV care: nationwide results from the Belgian HIV cohort
Authors: Van Beckhoven D , Florence E , De Wit S , Wyndham‐Thomas C , Sasse A , Van Oyen H , Macq J ,   the Belgian Research on AIDS, HIV Consortium (BREACH)
Published: July 2020

ObjectivesWe aimed to study the incidence rate, predictors and outcomes of HIV care interruption (HCI) in Belgium.MethodsWe analysed data for adult patients with at least two HIV care records in the Belgian HIV cohort between 1 January 2007 and 31 December 2016. An HCI episode was defined as 1 year without an HIV care record. The HCI incidence rate was analysed using Poisson regression, return to HIV care using a cumulative incidence function with death as a competing risk, and viral load (VL) status upon return to HIV care using logistic regression.ResultsWe included 16 066 patients accounting for 78 625 person‐years of follow‐up. The incidence rate of HCI was 5.3/100 person‐years [95% confidence interval (CI) 5.1–5.4/100 person‐years]. The incidence of return to HIV care after HCI was estimated at 77.5% (95% CI 75.7–79.2%). Of those who returned to care, 43.7% had a VL ≤ 200 HIV‐1 RNA copies/mL, suggesting care abroad or suboptimal care (without an HIV‐related care record) in Belgium during the HCI, and 56.3% returned without controlled VL and were therefore considered as having experienced a real gap in HIV care; they represented 2.3/100 person‐years of follow‐up. Factors individually associated with HCI were no antiretroviral therapy (ART) uptake, lower age, injecting drug use, non‐Belgian nationality, male gender, not being a man who has sex with men, a shorter time since HIV diagnosis, no high blood pressure and CD4 count < 350 cells/µL.ConclusionsThis study highlights the need to investigate return to care and viral status at return, to better understand HCI. Identified predictors can help health care workers to target patients at higher risk of HCI for awareness and support.
Pharmacy services and role development in UK general practice: a cross-sectional survey
Authors: Savickas Vilius , Foreman Ellie , Ladva Anmol , Bhamra Sukvinder K , Sharma Ravi , Corlett Sarah A 
Published: July 2020

Abstract

Background
The ‘Clinical Pharmacists in General Practice’ (CPGP) pilot provided a template for general practice pharmacy professionals’ (GPPPs) roles encouraging NHS England to fund &gt;2000 practice-based pharmacists. However, many GPPPs work outside the CPGP initiative and little is known about the services they provide.

Objectives
To explore services provided by all UK GPPPs (pharmacists/pharmacy technicians), including the types of services, perceived benefits and barriers to role development.

Methods
A 26-item electronic questionnaire was developed using SurveyMonkey and piloted during cognitive interviews. A cross-sectional survey was conducted via social media, primary care organisations and emails to CPGP pilot sites between November 2018 and March 2019. Three reminders were sent 1 week apart.

Key findings
Ninety-one complete responses were received (81 pharmacists; 10 technicians). Over 80% of pharmacists provided clinical services, such as medication reviews or management of long-term conditions. More pharmacists within CPGP pilot managed repeat prescribing requests (P = 0.035). Technicians took responsibility for primarily non-clinical roles, including commissioning or safety alerts/drug recalls. A third of GPPPs wished to develop care home services. Perceived benefits of GPPPs’ services included improved utilisation/development of professional skills, identifying medicines-related issues and reduction in medication waste. Respondents were satisfied with professional relationships but reported workload issues, limited patient awareness of their roles and restricted opportunities to contribute to service development, which was associated with unsatisfactory support/mentorship (P &lt; 0.001).

Conclusion
General practice pharmacy professionals deliver clinical and non-clinical services which may benefit patients, general practice and the healthcare system. General practices and national organisations should provide GPPPs with tailored support and exploit the combined strengths of pharmacists and pharmacy technicians to tackle increased workload.
Development of a questionnaire to assess the quality of service trajectories in autism spectrum disorder from families' perspective
Authors: Rivard Mélina , Mello Catherine , Mercier Céline , Lefebvre Christine , Millau Marie , Morin Marjorie , Morin Diane , Abouzeid Nadia , Chatenoud Céline 
Published: July 2020

AbstractBackgroundETAP‐1 was created to evaluate the quality of services trajectory from families’ perspective. The items of ETAP‐1 were developed from previous studies on integrated care, existing quality assessments, and consultations with families and experts in evaluation and in autism spectrum disorder (ASD).MethodThe questionnaire was completed by 200 parents of children aged 5 and under who were recently diagnosed with ASD or intellectual disability. Of these, 183 received diagnostic evaluation through a clinic specialized in ASD; the other 17 underwent diagnostic evaluation in hospital settings.ResultsFactor analysis supported the a priori dimensions of quality and distinctions between experiences before and during diagnostic evaluation. The instrument had high internal consistency, convergent and discriminant validity with other measures and was sensitive to differences in service delivery models.DiscussionETAP‐1 is useful in organizing information on families’ experiences throughout their services trajectories and according to a dynamic perspective.
Impact of left common pulmonary veins in the contact force versus cryoballoon atrial fibrillation ablation (CIRCA‐DOSE) study
Authors: Larsen Jacob M. , Deyell Marc W. , Macle Laurent , Champagne Jean , Sarrazin Jean‐Francois , Leong‐Sit Peter , Badra‐Verdu Mariano , Sapp John , Khairy Paul , Andrade Jason G. 
Published: July 2020

AbstractBackgroundConcerns remain regarding the effectiveness of pulmonary vein isolation (PVI) using the fixed diameter noncompliant cryoballoon in the presence of a left common pulmonary vein (LCPV). We sought to evaluate the effectiveness of PVI performed by contact force–guided radiofrequency (CF‐RF) versus second‐generation cryoballoon‐based ablation in patients with LCPV.Methods and ResultsWe enrolled 346 patients with paroxysmal atrial fibrillation (AF) and randomized them to CF‐RF or cryoballoon ablation. Pulmonary vein (PV) anatomy was not assessed before enrollment, and there were no exclusions based on PV anatomy. All patients received an implantable cardiac monitor. LCPV was observed in 13.6% of patients (47 of 346). Left atrial time and fluoroscopy time did not differ between those with and without LCPV (p = .58 andp = .06, respectively). Freedom from any atrial tachyarrhythmia at 1 year was observed in 46.8% with LCPV and 54.5% without LCPV (p = .06). In those with LCPV, the freedom from any atrial tachyarrhythmia did not differ between those randomized to CF‐RF or cryoballoon ablation (hazard ratio for recurrence: 1.19, 95% confidence interval: 0.53–2.65,p = .69). In those with LCPV, the AF burden was reduced to a similar extent with CF‐RF and cryoballoon ablation (99.7% vs. 99.5%, respectively;p = .97).ConclusionsIn this randomized clinical trial, the presence of an LCPV was associated with a trend towards higher rates of arrhythmia recurrence following PVI. No significant difference in arrhythmia recurrence was observed between patients with LCPV randomized to cryoballoon ablation or CF‐RF ablation, suggesting that either ablation modality is suitable in this population.
Autophagy regulation is an effective strategy to improve the prognosis of chemically induced acute liver injury based on experimental studies
Authors: Hu Chenxia , Zhao Lingfei , Shen Miaoda , Wu Zhongwen , Li Lanjuan 
Published: July 2020

AbstractAcute liver injury (ALI) induced by chemicals in current experimental studies is characterized by inflammation, oxidative stress and necrosis, which can greatly influence the long‐term outcome and lead to liver failure. In liver cells, different autophagy forms envelop cytoplasm components, including proteins, endoplasmic reticulum (ER), mitochondria and lipids, and they effectively participate in breaking down the cargo enclosed inside lysosomes to replenish cellular energy and contents. In general, autophagy serves as a cell survival mechanism in stressful microenvironments, but it also serves as a destructive mechanism that results in cell death in vitro and in vivo. In experimental animals, multiple chemicals are used to mimic ALI in patients to clarify the potential pathological mechanisms and develop effective strategies in the clinic. In this review, we summarize related publications about autophagy modulation to attenuate chemically induced ALI in vitro and in vivo. We also analysed the underlying mechanisms of autophagy regulators and genetic modifications to clarify how to control autophagy to protect against chemically induced ALI in animal models. We anticipate that selectively controlling the dual effects of hepatic autophagy will help to protect against ALI in various animals, but the detailed mechanisms and effects should be determined further in future studies. In this way, we are more confident that modulating autophagy in liver regeneration can improve the prognosis of ALI.
D1 receptor‐mediated endogenous tPA upregulation contributes to blood‐brain barrier injury after acute ischaemic stroke
Authors: Wang Yan , Wang Xiaona , Zhang Xinyu , Chen Shuang , Sun Yanyun , Liu Wenlan , Jin Xinchun , Zheng Guoqing 
Published: July 2020

AbstractBlood‐brain barrier (BBB) integrity injury within the thrombolytic time window is becoming a critical target to reduce haemorrhage transformation (HT). We have previously reported that BBB damage was initially damaged in non‐infarcted striatum after acute ischaemia stroke. However, the underlying mechanism is not clear. Since acute ischaemic stroke could induce a significant increase of dopamine release in striatum, in current study, our aim is to investigate the role of dopamine receptor signal pathway in BBB integrity injury after acute ischaemia using rat middle cerebral artery occlusion model. Our data showed that 2‐h ischaemia induced a significant increase of endogenous tissue plasminogen activator (tPA) in BBB injury area and intra‐striatum infusion of tPA inhibitor neuroserpin, significantly alleviated 2‐h ischaemia‐induced BBB injury. In addition, intra‐striatum infusion of D1 receptor antagonist SCH23390 significantly decreased ischaemia‐induced upregulation of endogenous tPA, accompanied by decrease of BBB injury and occludin degradation. More important, inhibition of hypoxia‐inducible factor‐1 alpha with inhibitor YC‐1 significantly decreased 2‐h ischaemia‐induced endogenous tPA upregulation and BBB injury. Taken together, our data demonstrate that acute ischaemia disrupted BBB through activation of endogenous tPA via HIF‐1α upregulation, thus representing a new therapeutic target for protecting BBB after acute ischaemic stroke.
Calpain‐2 plays a pivotal role in the inhibitory effects of propofol against TNF‐α‐induced autophagy in mouse hippocampal neurons
Authors: Li Ying , He Zhiyong , Lv Hu , Chen Wei , Chen Jiawei 
Published: July 2020

AbstractCalpains are calcium‐dependent proteases and play critical roles in neuronal autophagy induced by inflammation. Propofol has been reported to exert anti‐inflammatory effects in neurons. We aimed to identify whether and how propofol‐modulated calpain activity and neuron autophagy in response to tumour necrosis factor‐α (TNF‐α). Mouse hippocampal neurons were pre‐treated with propofol and exposed to TNF‐α. Autophagy was evaluated by fluorescent autophagy assay and by measuring LC3I and LC3II expression. Intracellular calcium concentration was measured by fluorescent assay. Calpain activation was measured by calpain activity assay. The protein expression of intracellular signalling molecules was detected by Western blot analysis. Compared with untreated control neurons, 40 ng/mL TNF‐α treatment for 2 hours induced neuron autophagy, which was attenuated by 25 μmol/L propofol. TNF‐α induced intracellular calcium accumulation, the phosphorylation of calcium/calmodulin‐dependent protein kinase II (CAMK II) and calpain‐2, calpain activation and lysosomal cathepsin B release as well as tyrosine kinase receptor B (TrkB) truncation. These effects were alleviated by propofol, calcium chelator, CAMK II inhibitor, calpain‐2 inhibitor, calpain‐2 siRNA transfection and N‐Methyl‐d‐aspartic acid (NMDA) receptor antagonist. Propofol, via NMDA receptor, inhibited TNF‐α‐mediated hippocampal neuron autophagy. The mechanism may involve calcium and calcium‐dependent signalling pathway, especially CAMK II and calpain‐2.