bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinically Meaningful Change in Quality of Life and Associated Factors Among Older Patients With Atrial Fibrillation
Authors: Abu Hawa O. , Saczynski Jane S. , Mehawej Jordy , Tisminetzky Mayra , Kiefe Catarina I. , Goldberg Robert J. , McManus David D. 
Published: September 2020

Background
Among older patients with atrial fibrillation, there are limited data examining clinically meaningful changes in quality of life (QoL). We examined the extent of, and factors associated with, clinically meaningful change in QoL over 1‐year among older adults with atrial fibrillation.

Methods and Results
Patients from cardiology, electrophysiology, and primary care clinics in Massachusetts and Georgia were enrolled in a cohort study (2015–2018). The Atrial Fibrillation Effect on Quality‐of‐Life questionnaire was used to assess overall QoL and across 3 subscales: symptoms, daily activities, and treatment concern. Clinically meaningful change in QoL (ie, difference between 1‐year and baseline QoL score) was categorized as either a decline (≤−5.0 points), no clinically meaningful change (−5.0 to +5.0 points), or an increase (≥+5.0 points). Ordinal logistic models were used to examine factors associated with QoL changes. Participants (n=1097) were on average 75 years old, 48% were women, and 87% White. Approximately 40% experienced a clinically meaningful increase in QoL and 1 in every 5 patients experienced a decline in QoL. After multivariable adjustment, women, non‐Whites, those who reported depressive and anxiety symptoms, fair/poor self‐rated health, low social support, heart failure, or diabetes mellitus experienced clinically meaningful declines in QoL.

Conclusions
These findings provide insights to the magnitude of, and factors associated with, clinically meaningful change in QoL among older patients with atrial fibrillation. Assessment of comorbidities and psychosocial factors may help identify patients at high risk for declining QoL and those who require additional surveillance to maximize important clinical and patient‐centered outcomes.
Regulator of G‐Protein Signaling 5 Maintains Brain Endothelial Cell Function in Focal Cerebral Ischemia
Authors: Sladojevic Nikola , Yu Brian , Liao James K. 
Published: September 2020

Background
Regulator of G‐protein signaling 5 (RGS5) is a negative modulator of G‐protein–coupled receptors. The role of RGS5 in brain endothelial cells is not known. We hypothesized that RGS5 in brain microvascular endothelial cells may be an important mediator of blood‐brain barrier function and stroke severity after focal cerebral ischemia.

Methods and Results

Using a transient middle cerebral artery occlusion model, we found that mice with global and endothelial‐specific deletion of
Rgs5
exhibited larger cerebral infarct size, greater neurological motor deficits, and increased brain edema. In our in vitro models, we observed increased G
q
activity and elevated intracellular Ca
2+
levels in brain endothelial cells. Furthermore, the loss of endothelial RGS5 leads to decreased endothelial NO synthase expression and phosphorylation, relocalization of endothelial tight junction proteins, and increased cell permeability. Indeed, RGS5 deficiency leads to increased Rho‐associated kinase and myosin light chain kinase activity, which were partially reversed in our in vitro model by pharmacological inhibition of G
q
, metabotropic glutamate receptor 1, and ligand‐gated ionotropic glutamate receptor.

Conclusions
Our findings indicate that endothelial RGS5 plays a novel neuroprotective role in focal cerebral ischemia. Loss of endothelial RGS5 leads to hyperresponsiveness to glutamate signaling pathways, enhanced Rho‐associated kinase– and myosin light chain kinase–mediated actin‐cytoskeleton reorganization, endothelial dysfunction, tight junction protein relocalization, increased blood‐brain barrier permeability, and greater stroke severity. These findings suggest that preservation of endothelial RGS5 may be an important therapeutic strategy for maintaining blood‐brain barrier integrity and limiting the severity of ischemic stroke.
Diapycnal Transport near a Sloping Bottom Boundary
Authors: Holmes R. M. , McDougall Trevor J. 
Published: September 2020

AbstractThe diapycnal motion in the stratified ocean near a sloping bottom boundary is studied using analytical solutions from one-dimensional boundary layer theory. Bottom-intensification of the diapycnal mixing intensity ensures that in the stratified mixing layer (SML), where isopycnals are relatively flat, the diapycnal motion is downward toward denser fluid. In contrast, convergence of the diffusive buoyancy flux near the seafloor drives diapycnal upwelling in what we define as the bottom boundary layer (BBL). Much of the one-dimensional BBL is characterized by a stratification only slightly reduced from that in the SML because the maximum in the buoyancy flux at the top of the BBL, where the diapycnal velocity changes sign, must occur in well-stratified fluid. The diapycnal upwelling in the BBL is determined by variations not only in the magnitude of the buoyancy gradient but also in the curvature of isopycnals. The net diapycnal upwelling is concentrated in the bottom half of the BBL where the magnitude of the buoyancy gradient changes most rapidly. The curvature effect drives upwelling near the seafloor that only makes a significant contribution to the net upwelling for steep slopes. The structure of the diapycnal velocity in this stratified BBL differs from the case of a turbulent well-mixed BBL that has been assumed in some recent theoretical studies on bottom-intensified mixing. This work therefore extends recent theories in a way that should be more applicable to abyssal ocean observations where well-mixed BBLs are not common.
Numerical simulations of concealed residential sprinkler head activation time in a standard thermal response room test
Authors: Hopkin Charlie , Spearpoint Michael 
Published: September 2020

It is common for sprinkler heads in residential buildings to be of the concealed type. Key parameters for the thermal sensitivity of sprinkler heads are the response time index (m½s½) and conductivity factor (C factor, m½s−½). BS 9252:2011 and BS EN 12259-14:2020 outline test methods to determine whether sprinkler heads achieve adequate thermal sensitivity, stipulating that a room test be undertaken for concealed heads. In carrying out this test, neither the response time index nor C factor is defined. This paper uses computational modelling tools Fire Dynamics Simulator and B-RISK to simulate the room test. In running these simulations, maximum values for the ‘effective’ response time index and C factor needed to pass the room test can be estimated, assuming concealed heads can be represented as equivalent pendent heads. Initial deterministic simulations are used to calibrate results between Fire Dynamics Simulator and B-RISK. Monte Carlo modelling is then utilised within B-RISK, with variable parameters for the response time index and C factor (C), to estimate the relationship between the two parameters necessary to pass the room test. As a result, it is proposed that this relationship can be represented using a simple, empirical power law equation of response time index = 100 (5.4–C)2/3, where C < 5.4. Practical application: The results indicate that the minimum RTI and C factor values needed to pass the room test are greater than those needed to pass wind tunnel testing methods. In observing that equivalency is not demonstrated by the room test, and by defining the RTI/C factor relationship needed to pass the test, this paper provides fire safety engineers with amended values for concealed heads to be adopted in future assessments. In the absence of any detailed specification for sprinkler heads, it is recommended that an RTI of 290 m½s½ and a C factor of 0.5 m½s−½ may be applied.
An Introduction to Integrated Project Support Environments
Authors: Brown Alan W. 
Published: September 2020

In the last few years the rapidly expanding application of computer technology has brought the problems of software production increasingly to the fore, and it is widely accepted that current software development techniques are unable to produce high quality software at the rate required to keep pace with this. To try to improve this imbalance, the field of software engineering has been advanced as a possible solution, attempting to apply the formal methods of an engineering discipline to software design and implementation. One of the most promising areas to be developed in this field is that of integrated project support environments (IPSEs), which attempt to spread the focus of attention during software development from the coding stage to embrace the whole development cycle, from initial requirements specification through to operational maintenance. These environments hope to improve production efficiency and quality by providing a complete set of support tools to help with each stage of software development, and to supply the necessary tool integration to ensure a smooth transition of use between these tools. This paper provides an introduction to IPSEs through analysing the motivation for providing integrated support for the production of software, and describing something of the evolution of environments for software development. This provides the context for describing current and future research trends in this area.
Anti-drug antibodies anti-trastuzumab in the treatment of breast cancer
Authors: Padrón Ivette Mourani , García Jonathan González , Díaz Ruth Ramos , Lenza Isaac Ceballos , Nicolás Fernando Gutiérrez 
Published: September 2020

Introduction Trastuzumab is a monoclonal antibody which could induce the activation of a humoral immune response generating anti-drug antibodies (ADAs). Such response depends of the protein nature and the route of administration (intravenous or subcutaneous). The formation of these antibodies could block the action of trastuzumab (ADA-Tras) and forming immune complexes which decrease its efficacy, so it would be interesting to determine the presence of ADA-Tras in patients treated with trastuzumab. Material and methods The blood samples were centrifuged to separate the plasma. The presence of ADA-Tras in plasma was determined using an ELISA-type automated immunoassay. Results Fifty-one women with non-metastatic HER2-positive breast cancer treated with trastuzumab were included. Two groups were studied: patients treated intravenously and subcutaneously. In neither case was there any presence of ADA-Tras. Discussion This study may be the first ever conducted under usual clinical practice conditions to detect the presence of ADA-Tras in patients with non-metastatic HER2-positive breast cancer. We have wanted to show the antibodies anti-trastuzumab determination as a possible tool that would enable comparison of potential differences in immunogenic behavior between trastuzumab and its biosimilars.
Prolonging the flush-lock interval of totally implantable venous access ports in patients with cancer: A systematic review and meta-analysis
Authors: Wu Xiaohong , Zhang Tiantian , Chen Lichan , Chen Xisui 
Published: September 2020

Background: Recently, some studies have shown that prolonging flush interval is safe and feasible for patients who complete chemotherapy. However, there is no consensus about the optimal flush interval for those patients. Objective: The purpose of this review was to evaluate whether the flush interval could be prolonged based on monthly interval for regular maintenance and to explore the optimal flush interval. Data sources: We searched the following databases for articles published between 1 January 1982 and 21 February 2020: PubMed, Cochrane Library, Web of Science, EMBASE, CINAHL, and Ovid. Study eligibility criteria: Randomized controlled trials, retrospective and prospective cohort studies of flush interval less than 4 weeks versus longer than 4 weeks for patients who completed chemotherapy, were included. Results: Two reviewers extracted information and assessed the quality of the articles independently. In total, 389 articles were retrieved, and 4 studies including 862 cases fulfilled the inclusion criteria. There was no statistical heterogeneity ( I2 = 0, p > 0.05) among the included studies. Hence, the fixed-effects model was used for the meta-analysis. The meta-analysis showed that the total complication rate associated with longer than 4-week interval was higher than that associated with less than 4-week interval. Nevertheless, there was no significant difference between the two groups (7.2% vs 7.6%, p = 0.83). Moreover, the meta-analysis showed that the total complication and catheter occlusion rates associated with the 4-week interval were higher than those associated with the 8-week interval. However, there was no significant difference between the two groups (total complications: 11.4% vs 9.5%, p = 0.68; catheter occlusions: 4.9% vs 4.1%, p = 0.89). Limitations: Only four non-randomized controlled studies were included, and the outcomes of the included studies were reported incompletely. Conclusion: Extending the flush interval to longer than 4 weeks is safe and feasible. Based on previous studies, extending the flush interval to 8 weeks might not increase the incidence of total complications and catheter occlusions. However, there is no conclusion on whether the flush interval could be extended to 3 months or longer.
Prognostic Value of Lymph Node Density in Patients With T3 and T4 Pyriform Sinus Carcinoma
Authors: Jia Lifeng , Li Jingya , Zhou Ziyuan , Yuan Wei 
Published: September 2020

Background/Aim: Lymph node density is a parameter used to more accurately predict tumor recurrence and patient survival. However, its association with surgical outcome in pyriform sinus carcinoma remains unclear. The purpose of this study was to assess the prognostic value of lymph node density in advanced pyriform sinus carcinoma. Patients and Methods: A total of 87 patients with pyriform sinus carcinoma treated between 2008 and 2015 were enrolled. Then, 5-year overall survival, 5-year disease-specific survival, 5-year disease-free survival, and 5-year regional recurrence-free survival were utilized to assess the prognostic significance of lymph node density. Results: With a median follow-up period of 31.8 months, 5-year overall survival, disease-specific survival, disease-free survival, and regional recurrence-free survival were 37.9%, 46.0%, 41.4%, and 54.0%, respectively. Univariate analysis revealed that lymph node density ≥ 0.093 was a significant predictor of poor 5-year overall survival ( P = .005), disease-specific survival ( P = .008), disease-free survival ( P = .0013), and regional recurrence-free survival ( P = .003). Furthermore, multivariate analysis demonstrated that lymph node density was negatively associated with adverse 5-year overall survival (hazard ratio = 1.62, 95% CI: 1.15-2.29, P = .006), disease-specific survival (hazard ratio = 1.86, 95% CI: 1.24-2.80, P = .003), disease-free survival (hazard ratio = 0.45, 95% CI: 0.24-0.85, P = .014), and regional recurrence-free survival (hazard ratio = 2.97, 95% CI: 1.43-6.17, P = .004). Conclusion: Taken together, these results reveal that lymph node density is a powerful prognostic factor for patients with T3 and T4 pyriform sinus carcinoma, and the median lymph node density cutoff values ≥ 0.093 are associated with a greater risk of recurrence and poorer survival.
Precision Liver Resection: Three-Dimensional Reconstruction Combined with Fluorescence Laparoscopic Imaging
Authors: Ni Zhong-Kai , Lin Da , Wang Zi-Qiang , Jin Hai-Min , Li Xiao-Wen , Li Ye , Huang Hai 
Published: September 2020

Liver surgery has entered the era of precision surgery. Therefore, how to optimize the resection of lesions and reduce the unnecessary time of liver ischemia and hypoxia have become the focus. A total of 11 patients who underwent fluorescence laparoscopic liver mass resection and preoperative three-dimensional (3D) reconstruction between August 2018 and July 2020 were evaluated. Liver cirrhosis occurred in 3 patients. The mean intraoperative blood loss was 166.8 ± 105.7 mL. The average length of the operation time was 152.0 ± 45.3 minutes. The average intraoperative hilar occlusion time was 9.3 minutes (except for hilar cholangiocarcinoma). The liver function of all patients, except patients with hilar bile duct carcinoma, returned to the preoperative level at 72 hours, and no serious complications occurred. 3D reconstruction combined with fluorescence laparoscopic imaging is safe and effective for precision liver resection.
Breaking the breach in Latin America: A pilot study of mechanical thrombectomy in the public healthcare system in Chile
Authors: Rivera Rodrigo , Amudio Cristian , Brunetti Enzo , Catalan Pascual , Sordo Juan Gabriel , Badilla Lautaro , Echeverria Daniel , Cruz Juan Pablo , Ojeda Hector , Bravo Loreto , Bravo Fabian , Gonzalez Walter , Orellana Maria Luisa , Pinto Camila , Merino-Osorio Catalina , Oportus Monica , Salazar Alejandro , Nogueira Raul G 
Published: September 2020

Background Mechanical Thrombectomy (MT) is the standard of care for treatment of large vessel occlusion stroke. Until the beginning of 2020 MT was not funded nor widely implemented at the public healthcare level in Chile. Objective To describe the results of a pilot program created to provide access to public MT in Santiago - Chile. Methods Analysis from a prospectively collected database of MT cases performed between September 2017 and September 2019 in one center. A stroke network was developed with a single MT capable stroke center and five primary stroke centers. The primary efficacy endpoint was the rate of functional independence (mRS 0-2) at 90 days. Successful reperfusion was defined as 2 b-3 according to the thrombolysis in cerebral infarction scale. Safety outcomes include the rates of symptomatic intracranial hemorrhage and 90-day mortality. Results A total of 100 patients were treated over the study period. Their mean age was 62.8 ± 11.8 years and median baseline National Institute of Health Stroke Scale (NIHSS) measurement was 17. Seventy-seven percent of the patients received intra venous thrombolysis. Successful reperfusion was achieved in 95% of the cases. NIHSS at 24 hours showed a median drop of 7 points from baseline (p < 0.00001) and 50% of the follow-up patients were functionally independent at 90 days. Symptomatic Intracerebral hemorrhage occurred in 5% of the patients and 90-day all case mortality was 11%. Conclusions We demonstrated the feasibility of a publicly funded MT program in Chile, with similar results as other international randomized control trials.
Faculty promotion evaluation and gender equity in business schools
Authors: Dandalt Ed , Brutus Stephane 
Published: September 2020

This article aims to address the fairness of promotion evaluation (appointments to the rank of full professor) process in Canadian business schools as perceived by tenured business female faculty. Our analysis is underscored by two studies with two different data collection methods (survey data analysis, policy content analysis) and driven by procedural justice as the main theoretical lens. The first study addresses the perspective of our survey participants ( N=198) by revealing that they believe the process of promotion evaluations is fair. Intrigued by this result, we undertook a second study to review the language of faculty collective agreements in these schools to explain partially why our participants believe in the fairness of promotion evaluations. The language of these faculty collective agreements suggests that the above result makes sense considering that they regulate promotion evaluations and decisions. However, this does not mean that the process of faculty promotions is free of gender discrimination as these faculty collective agreements have not addressed all the antecedents and predictors of gender inequity per se. The findings of this article are relevant because the issue of the underrepresentation of female faculty as related to promotion in senior academic ranks in Canadian business schools is under-researched. The existing studies on faculty promotion evaluations are too general and have not specifically addressed the fairness of business schools’ faculty promotion evaluation systems from the perspective of tenured business female faculty. Plus, the relevance of the findings of this article lies in the fact that contrary to most general studies on female faculty experience with promotion evaluations at Canadian universities and internationally, these findings suggest that such experience in Canadian business schools is not always associated with gender discrimination and negative perspectives among female faculty.
Observational assessment of safety in seroquel (OASIS): a specialist cohort event monitoring (SCEM) study in England
Authors: Osborne Vicki , Davies Miranda , Evans Alison , Shakir Saad A. W. 
Published: September 2020

Background: This study was designed to monitor the short-term (up to 12 weeks) use and safety of quetiapine (Seroquel) extended release (XL) and quetiapine immediate release (IR) prescribed to patients with a clinical diagnosis of schizophrenia, and/or manic episodes associated with bipolar disorder by psychiatrists under normal conditions of use. Methods: A Specialist Cohort Event Monitoring (SCEM) study was conducted in England February 2010–April 2013. This observational cohort study recruited patients prescribed quetiapine XL within the secondary care setting by psychiatrists. A reference cohort of quetiapine IR users was also recruited. Baseline and 12 week observational data were collected from psychiatrists who abstracted information from medical records onto bespoke questionnaires. Data were collected on demographics, indication, past medical history, prescribing information and events of interest. Summary descriptive statistics were calculated. Results: The final cohort consisted of 869 eligible patients; 646 XL users and 223 IR users. The majority of XL and IR users were female (56.2% and 55.6%, respectively), with a median age of 40 (interquartile range [IQR]: 29, 49) and 39 (IQR: 28, 50) years, respectively. The most frequent indication for treatment was Manic episodes associated with Bipolar Affective disorder (53.4% XL and 49.8% IR). Median index dose was 200 mg/day (IQR: 100, 300) for XL users and 50 mg/day (IQR: 50, 100) for IR users, while median final maintenance dose was 400mg/day (IQR: 250, 600) and 300 mg/day (IQR: 100, 400), respectively. The most frequently reported event of interest in both cohorts was sedation ( n = 151, 23.9% XL cohort and n = 49, 23.0% IR cohort). Conclusion: Utilisation of quetiapine XL appeared to be in line with prescribing guidelines in terms of dose, and commonly reported events of interest were in concordance with the known safety profile. Overall, this SCEM study provided important information on the safety and utilisation of quetiapine XL in the secondary care setting in England.