bluuebunny/crossref_metadata_2025_split huggingface dataset:
Suicide risk after psychiatric discharge: study protocol of a naturalistic, long-term, prospective observational study
Authors: Krause Tim J. , Lederer Annette , Sauer Magdalena , Schneider Jasmin , Sauer Cathrin , Jabs Burkhard , Etzersdorfer Elmar , Genz Axel , Bauer Michael , Richter Susann , Rujescu Dan , Lewitzka Ute 
Published: September 2020

Abstract
Background
Suicide risk of psychiatric patients has proven to be strongly increased in the months after discharge from a psychiatric hospital. Despite this high risk, there is a lack of systematic research on the causes of this elevated suicide risk as well as a lack of treatment and intervention for patients at high risk after discharge. The main objective of this pilot study is, firstly, to examine the factors contributing to the elevated suicide risk and, secondly, to investigate whether an additional setting of care starting at discharge may reduce suicidality.

Methods
In this multi-centre pilot study, treatment as usual is complemented by an additional 18-month post-discharge setting of care for psychiatric patients at high risk for suicide. Two groups of patients differing in the amount of post-discharge personal contacts will be compared. One group of patients will be offered continuous personal contacts after discharge (months 1–6: monthly contacts; months 6–18: every 2 months) while another group of patients will receive contacts only at months 6, 12, and 18 after discharge. Data on suicidality, as well as associated with other symptoms, treatment, and significant events, will be collected. In the case of health-related severe events, the setting of care allows the patient to have the opportunity to connect with the doctor or therapist treating the patient.

Discussion
The results of this study will contribute to identifying critical factors raising suicide risk after discharge and will demonstrate the potential influence on suicide prevention of a setting of care with regular personal contact after discharge.

Trial registration
ZMVI1-2517FSB135 – funded by the German Federal Ministry of Health.
Early surgical intervention for structural infantile spasms in two patients under 6 months old: a case report
Authors: Yang Haiyan , Yang Zhiquan , Peng Jing , Huang Yehong , Yang Zhuanyi , Yin Fei , Wu Liwen 
Published: September 2020

AbstractBackgroundInfantile spasms (IS) are the most common childhood epileptic encephalopathy. Focal cortical dysplasia (FCD) and gray matter heterotopias (GH) are common structural causes of IS. The recommended first-line treatment for IS patients with structural causes is surgical intervention, according to the International League Against Epilepsy (ILAE) commission guidelines. However, there is currently no consensus on appropriate timings of surgery.Case presentationsTwo structural IS cases are presented here: one was caused by FCD, and the other by GH. Both patients exhibited recurrent seizures at the age of 2 months, had poor responses to various antiepileptic drugs (AEDs) and displayed severe mental and motor developmental retardation. Seizure types included focal seizures and spasms. Brain magnetic resonance imaging showed abnormal gray signal or suspicious FCD lesions that coincided with the origin of the focal seizures. The patients underwent lesion resection before the age of 6 months. Follow-up observation showed that seizures of both patients were completely controlled several days after the surgery. All AEDs were gradually reduced in dosage within 1 year, and the mental and motor development almost returned to normal.ConclusionEarly resection of lesions in structural IS patients has benefits of effectively controlling convulsions and improving developmental retardation. Infants at several months of age can well tolerate craniotomy, and their cognitive development is more likely to return to normal after early surgery.
Effects of soluble starch synthase genes on eating and cooking quality in semi waxy japonica rice with Wxmp
Authors: Yao Shu , Zhang Yadong , Liu Yanqing , Zhao Chunfang , Zhou Lihui , Chen Tao , Zhao Qing Yong , Pillay Balakrishna , Wang Cailin 
Published: September 2020

AbstractThe purpose of this study is to reveal the genetic mechanism of the variation of amylose content among different semi waxy or glutinous japonica rice in the background of Wxmp gene. Sixty-four semi waxy lines derived from the hybrid progenies of Wujing 13 and Milky Princess (Kantou 194) with polymorphism in soluble starch synthase gene SSIIa (SSII-3) and SSIIIa (SSIII-2) but no polymorphism in other starch synthase related genes were used as test materials. The genotypes of SSIIa and SSIIIa allele were identified by molecular markers, and the allelic effects of SSIIa and SSIIIa gene on amylose content (AC), gel consistency (GC), gelatinization temperature (GT) and rapid visco analyzer (RVA) profile characteristics were analyzed. The significant effects of SSIIa and SSIIIa alleles and the interactive effects between two genes on AC, GT, GC and RVA profile characteristics were found. The SSIIa and SSIIIa alleles from Wujing13 shown positive effects on AC with an average increase of 1.87 and 1.23% in 2 years respectively. There was no significant effect on GT for SSIIa or SSIIIa allele but remarkable influence on GT when the co-existence of the two genes. The genotype SSIIampSSIIIamp shown 1.34 °C higher GT than genotype SSIIawjSSIIIawj (mp and wj indicated that the gene was derived from Milky Princess and Wujing 13 respectively, the same as in the below). Different genes and alleles resulted in significant different GC. The genetic effect of SSIIawj and SSIIIamp on GC was 8.74 and 9.62 mm respectively. The GC of SSIIawjSSIIIamp was 10.64 and 16.95 mm higher than that of SSIIampSSIIIawj and SSIIawjSSIIIawj, respectively. The allele SSIIawj could increase the peak viscosity (PKV), hot paste viscosity (HPV), cool paste viscosity (CPV) and breakdown viscosity (BDV), while decrease the consistency viscosity (CSV) and setback viscosity (SBV). However for the allele SSIIIawj the opposite was true. The genotype SSIIawjSSIIIamp had the largest PKV, HPV and CPV, the genotype SSIIawjSSIIIawj had the largest BDV and CSV, but the genotype SSIIawjSSIIIamp had the least SBV. According to the comprehensive effect of each trait, the genotype SSIIawjSSIIIamp was the best. The allelic variation and interaction effect of SSIIa and SSIIIa genes have important reference value for improving cooking and eating quality of semi waxy japonica rice.
Identifying Breast Cancer Care Quality Measures for a Cancer Facility in Rural Sub-Saharan Africa: Results of a Systematic Literature Review and Modified Delphi Process
Authors: Pace Lydia E. , Schleimer Lauren E. , Shyirambere Cyprien , Ilbawi André , Dusengimana Jean Marie Vianney , Bigirimana Jean Bosco , Uwizeye Francois Regis , Chamberlin Mary , Lee Yeonsoo Sara , Shulman Lawrence N. , Troyan Susan , Anderson Benjamin O. , Duggan Catherine , O’Neil Daniel S. , Dvaladze Allison , Brock Jane , Nguyen Cam , Ruhangaza Deogratias , Habimana Olivier , Nsabimana Nicaise , Butonzi John , Nkusi Eugene , Mpunga Tharcisse , Keating Nancy L. 
Published: September 2020

PURPOSE The burden of cancer is growing in low- and middle-income countries (LMICs), including sub-Saharan Africa. Ensuring the delivery of high-quality cancer care in such regions is a pressing concern. There is a need for strategies to identify meaningful and relevant quality measures that are applicable to and usable for quality measurement and improvement in resource-constrained settings. METHODS To identify quality measures for breast cancer care at Butaro Cancer Center of Excellence (BCCOE) in Rwanda, we used a modified Delphi process engaging two panels of experts, one with expertise in breast cancer evidence and measures used in high-income countries and one with expertise in cancer care delivery in Rwanda. RESULTS Our systematic review of the literature yielded no publications describing breast cancer quality measures developed in a low-income country, but it did provide 40 quality measures, which we adapted for relevance to our setting. After two surveys, one conference call, and one in-person meeting, 17 measures were identified as relevant to pathology, staging and treatment planning, surgery, chemotherapy, endocrine therapy, palliative care, and retention in care. Successes of the process included participation by a diverse set of global experts and engagement of the BCCOE community in quality measurement and improvement. Anticipated challenges include the need to continually refine these measures as resources, protocols, and measurement capacity rapidly evolve in Rwanda. CONCLUSION A modified Delphi process engaging both global and local expertise was a promising strategy to identify quality measures for breast cancer in Rwanda. The process and resulting measures may also be relevant for other LMIC cancer facilities. Next steps include validation of these measures in a retrospective cohort of patients with breast cancer.
Association Among Preoperative Cognitive Performance, Regional Cerebral Oxygen Saturation, and Postoperative Delirium in Older Portuguese Patients
Authors: Susano Maria J. , Thedim Mariana , Seixas Francisco S. , Vide Sérgio , Grasfield Rachel , Abelha Fernando J. , Crosby Gregory , Culley Deborah J. , Amorim Pedro 
Published: September 2020

BACKGROUND:
Postoperative delirium is common among older patients and preoperative identification of high-risk patients is widely recommended. The aim of this study was to assess whether preoperative cognitive performance using brief screening tools or regional cerebral oxygen saturation (Scto
2) was associated with the development of postoperative delirium in older Portuguese patients undergoing elective surgery.

METHODS:
Prospective observational cohort study where preoperative cognitive screening tools (Mini-Cog, Mini-Mental State Examination, verbal fluency) and Scto
2 (INVOS 5100C; Medtronic, Ireland) were assessed in 238 patients ≥65 years old undergoing elective surgery between July 2017 and May 2019 at a tertiary academic center in Portugal. The primary outcome was postoperative delirium detected by the 3D-Confusion Assessment Method. Data were analyzed by univariate analysis and multivariable logistic regression.

RESULTS:
Delirium was identified in 53 patients (22%); 162 patients (68%) had completed only 4 years of education. On multivariable analysis, probable cognitive impairment tested by the Mini-Cog (odds ratio [OR] = 1.57; 95% confidence interval [CI], 0.70–3.53; corrected P value >.999), by the Mini-Mental State Examination (OR = 2.75; 95% CI, 1.23–6.13; corrected P value = .052), and by the animal verbal fluency test (OR = 1.24; 95% CI, 0.49–3.16; corrected P value >.999) were not significantly associated with the development of postoperative delirium. In contrast, lower preoperative Scto
2 (OR = 1.08; 95% CI, 1.02–1.14; corrected P value = .024 for each point decrease in Scto
2) was associated with postoperative delirium.

CONCLUSIONS:
We did not find enough evidence to suggest that poor preoperative cognitive performance was significantly associated with the development of postoperative delirium in an older Portuguese surgical population with an overall low level of formal education, but rather that preoperative Scto
2 may be helpful in identifying patients at risk for delirium.
A Comparison of the Required Bronchial Cuff Volume Obtained by 2 Cuff Inflation Methods, Capnogram Waveform-Guided Versus Pressure-Guided: A Prospective Randomized Controlled Study
Authors: Yamada Yuko , Tanabe Kumiko , Nagase Kiyoshi , Ishihara Takuma , Iida Hiroki 
Published: September 2020

BACKGROUND:
Double-lumen endobronchial tubes (DLTs) are used for one-lung ventilation (OLV) during thoracic surgery. Overinflation into the bronchial cuff causes damage to the tracheobronchial mucosa, whereas underinflation leads to an incomplete collapse of the nonventilated lung or incomplete ventilation of the ventilated lung. However, how to determine the appropriate bronchial cuff volume and pressure during OLV is unclear. The objective of this study is to compare the required bronchial cuff volume for lung separation obtained by 2 different cuff inflation methods under closed- and open-chest conditions.

METHODS:
A total of 64 patients scheduled to undergo elective thoracic surgery requiring OLV were recruited. Left DLTs were used for both right- and left-sided surgery. The patients were randomly assigned to 1 of 2 inflation-type groups to estimate the bronchial cuff volume. In the capnogram waveform–guided bronchial cuff inflation group (capno group, n = 27), the bronchial cuff was inflated until a capnometer sampling gas containing CO2 from the nonventilated lung displayed a flat line. The corresponding bronchial cuff volume and pressure were then recorded. In the pressure–guided bronchial cuff inflation group (pressure group, n = 29), the bronchial cuff was inflated by a cuff inflator to a pressure of 20 cm H2O. Lung separation was confirmed when a flat line of a capnometer was observed after gas sampling from the nonventilated lung.

RESULTS:
Under closed-chest conditions, the bronchial cuff sealing volume for the capno group was significantly lower than that for the pressure group (mean [standard deviation {SD}], 1.00 [0.65] mL vs 1.44 [0.59] mL, mean difference, −0.44; 97.5% confidence interval [CI], −0.78 to −0.11; P = .010). Under open-chest conditions, the bronchial cuff sealing volume for the capno group was also significantly lower than that for the pressure group (mean [SD], 0.65 [0.66] mL vs 1.22 [0.45] mL, mean difference, −0.58; 97.5% CI, −0.88 to −0.27; P < .001).

CONCLUSIONS:
The lowest cuff volume providing an air-tight bronchial seal was obtained by the capnogram waveform–guided bronchial cuff inflation method. Since the cuff volume required to achieve an air-tight seal decreases after opening the chest, readjustment of the bronchial cuff volume to prevent bronchial cuff damage to the tracheobronchial mucosa after opening the chest may be advisable.
A Continuous Noninvasive Method to Assess Mixed Venous Oxygen Saturation: A Proof-of-Concept Study in Pigs
Authors: Karlsson Jacob , Lönnqvist Per-Arne , Wallin Mats , Hallbäck Magnus 
Published: September 2020

BACKGROUND:
Mixed venous oxygen saturation (Svo
2) is important when evaluating the balance between oxygen delivery and whole-body oxygen consumption. Monitoring Svo
2 has so far required blood samples from a pulmonary artery catheter. By combining volumetric capnography, for measurement of effective pulmonary blood flow, with the Fick principle for oxygen consumption, we have developed a continuous noninvasive method, capnodynamic Svo
2, for assessment of Svo
2. The objective of this study was to validate this new technique against the gold standard cardiac output (CO)-oximetry Svo
2 measurement of blood samples obtained from a pulmonary artery catheter and to assess the potential influence of intrapulmonary shunting.

METHODS:
Eight anesthetized mechanically ventilated domestic-breed piglets of both sexes (median weight 23.9 kg) were exposed to a series of interventions intended to reduce as well as increase Svo
2. Simultaneous recordings of capnodynamic and CO-oximetry Svo
2 as well as shunt fraction, using the Berggren formula, were performed throughout the protocol. Agreement of absolute values for capnodynamic and CO-oximetry Svo
2 and the ability for capnodynamic Svo
2 to detect change were assessed using Bland-Altman plot and concordance analysis.

RESULTS:
Overall bias for capnodynamic versus CO-oximetry Svo
2 was −1 percentage point (limits of agreement −13 to +11 percentage points), a mean percentage error of 22%, and a concordance rate of 100%. Shunt fraction varied between 13% at baseline and 22% at the end of the study and was associated with only minor alterations in agreement between the tested methods.

CONCLUSIONS:
In the current experimental setting, capnodynamic assessment of Svo
2 generates absolute values very close to the reference method CO-oximetry and is associated with 100% trending ability.
Predicting Perioperative Respiratory Adverse Events in Children With Sleep-Disordered Breathing
Authors: Pehora Carolyne , Faraoni David , Obara Soichiro , Amin Reshma , Igbeyi Brenda , Al-Izzi Adel , Sayal Aman , Sayal Aarti , Mc Donnell Conor 
Published: September 2020

BACKGROUND:
No evidence currently exists to quantify the risk and incidence of perioperative respiratory adverse events (PRAEs) in children with sleep-disordered breathing (SDB) undergoing all procedures requiring general anesthesia. Our objective was to determine the incidence of PRAEs and the risk factors in children with polysomnography-confirmed SDB undergoing procedures requiring general anesthesia.

METHODS:
Retrospective review of all patients with polysomnography-confirmed SDB undergoing general anesthesia from January 2009 to December 2013. Demographic and perioperative outcome variables were compared between children who experienced PRAEs and those who did not. Generalized estimating equations were used to build a predictive model of PRAEs.

RESULTS:
In a cohort of 393 patients, 51 PRAEs occurred during 43 (5.6%) of 771 anesthesia encounters. Using generalized estimating equations, treatment with continuous positive airway pressure or bilevel positive airway pressure (odds ratio, 1.63; 95% confidence interval [CI], 1.05–2.54; P = .031), outpatient (odds ratio, 1.37; 95% CI, 1.03–1.91; P = .047), presence of severe obstructive sleep apnea (odds ratio, 1.63; 95% CI, 1.09–2.42; P = .016), use of preoperative oxygen (odds ratio 1.82; 95% CI, 1.11–2.97; P = .017), history of prematurity (odds ratio, 2.31; 95% CI, 1.33–4.01; P = .003), and intraoperative airway management with endotracheal intubation (odds ratio, 3.03; 95% CI, 1.79–5.14; P < .001) were associated with PRAEs.

CONCLUSIONS:
We propose the risk factors identified within this cohort of SDB patients could be incorporated into a preoperative risk assessment tool that might better to identify the risk of PRAE during general anesthesia. Further investigation and validation of this model could contribute to improved preoperative risk stratification, decision-making (postoperative admission and level of monitoring), and health care resource allocation.
Total Laparoscopic Resection of Hilar Cholangiocarcinoma Type 3b: Applying a Parachute Technique for Hepaticojejunostomy
Authors: Sucher Robert , Scheuermann Uwe , Seehofer Daniel 
Published: September 2020

Abstract
Background
Laparoscopic liver resection for perihilar cholangiocarcinoma (pCCA) is still in its infancy. The biliary-enteric reconstruction represents one of the most delicate parts of this minimally invasive procedure.

Methods
In this study, a 78-year old woman with perihilar cholangiocarcinoma (pCCA) type 3b underwent a hepaticojejunostomy performed by a parachute technique.

Results
The operation, performed totally by minimally invasive resections, was completed in 386 min, with a blood loss of less than 400 ml and no transfusion requirements. Two intraluminal stents were placed during the hepaticojenunostomy for splinting of the biliary-enteric anastomosis. The patient required prolonged antibiotic treatment for postoperative cholangitis and finally was discharged on postoperative day 15. The histopathologic grading displayed a G 2–3 adenocarcinoma, pT3 pN0, M0, L1, V1, pN1, UICC IIIc R0, and the patient was referred to adjuvant chemotherapy.

Conclusion
Resections of pCCAs, performed totally by minimally invasive techniques, may be feasible and safe for a selected group of patients. With this approach, a running-suture hepaticojejunostomy using the parachute technique represents a worthwhile strategy for biliary-enteric reconstruction.
Determinants of skilled care during delivery among mothers in Bomachoge Chache, Kisii county, Kenya
Authors: Malachi Zillah , Onkware Richard Seme 
Published: September 2020

Background/Aims Utilisation of skilled care delivery remains low in developing countries, including Kenya. Literature shows that predictors of skilled birth attendance differ from region to region. This study aimed to identify predictors of skilled birth attendance for delivery among women in Bomachoge Chache, Kenya. Methods This was a case control study conducted in 2015, in Bomachoge Chache Sub County, Kisii County, Kenya. The study targeted postnatal mothers who brought their children for immunisation. A total of 322 postnatal mothers (n=161 delivered at home; n=161 delivered in a health facility) answered questions about sociodemographic characteristics on a pretested researcher-administered questionnaire. Association of characteristics with skilled birth attendance was analysed using the chi square test. Multivariate logistic regression was used to determine the strength of the associations and to control for confounders, with significance assumed at P<0.05. Results The likelihood of mothers delivering at home was higher in mothers who had two or more children (adjusted odds ratio=28.4, P=0.0005) and in mothers whose spouses were casual labourers (adjusted odds ratio=16.9, P=0.0048). However, the likelihood of delivering at home was lower in mothers who had at least secondary level education (adjusted odds ratio=0.33, P=0.03) and in mothers who were farmers (adjusted odds ratio=0.32, P=0.03). Conclusions Sociodemographic characteristics including parity, occupation, spousal occupation and education impact the use of skilled care at birth and should be evaluated to inform policy for maternal and neonatal care. Further studies at a household level are recommended to fully understand disparities in skilled attendance at birth.
Axiology in Latvia`s Insolvency policy
Authors: Savickis Valdis 
Published: September 2020

The closing period for the validity of the policy planning documents in the sphere of insolvency proceedings in the Republic of Latvia is approaching (the Insolvency Policy Development Guidelines 2016-2020, as well as their implementation plan). Given the extensive work done by the state on reforming and reorganizing the insolvency and regulatory framework, the author focuses on the axiological aspect of the insolvency policy. Parallel to the modernization of the insolvency process, because of which the role of the state in the control and supervision of the insolvency sector has significantly increased and considering the correlation between the speed and efficiency of insolvency process, there will be conducted value-oriented study on the insolvency sector. The aim of the paper is to carry out research and analysis of insolvency policy through the prism of axiology. The study uses analytical, descriptive, and deduction/induction methods, evaluating the various policy planning documents that make up insolvency policy, paying attention to the specifics of the insolvency process of legal entities.
Keywords: Insolvency policy, axiology, value, business environment