bluuebunny/crossref_metadata_2025_split huggingface dataset:
Revisiting the use of hydroxyethyl starch solutions in equine fluid therapy
Authors: Hepworth‐Warren K. L. 
Published: August 2020

SummaryThe last decade has led to major shifts in opinions on the use of hydroxyethyl starch (HES) solutions in fluid therapy, specifically in human patients with sepsis. The majority of evidence documenting adverse effects of HES solutions on coagulation and renal health come from studies in people. However, these findings have led to investigation into the safety of HES solutions in veterinary species. While there are now studies investigating the effects of HES solutions on coagulation and renal health in dogs, cats and horses, information regarding long‐term follow‐up, clinical significance of these changes and use of these solutions in critically ill animals is still lacking. The information presented here serves to review the physiology of oncotic pressure and the rationale behind colloid use, specifically HES solutions. Additionally, the foundation of arguments against the use of HES and the available literature regarding HES use in animals will be summarised.
The influence of mode mixity and adhesive system on the fatigue life of adhesive joints
Authors: Sousa Fernando Castro , Akhavan‐Safar Alireza , Goyal Rakesh , da Silva Lucas F. M. 
Published: August 2020

AbstractIn real applications, adhesive joints are commonly subjected to fatigue and mixed mode loading conditions. The aim of the current work is to experimentally analyse the influence of mode mixity on the fatigue strength of joints with an epoxy‐based adhesive. Different adhesive systems (acrylic and epoxies) were considered for pure mode I fatigue loading conditions. To achieve this, Arcan joints with an epoxy adhesive were manufactured and tested at different mode mixities. Based on stiffness degradation, monitored during the tests, damage evolution was calculated for different loading conditions and for all the tested adhesives. Finally, fatigue envelopes were constructed for different fatigue life regimes. Results show that a shear loading component reduces both the static strength and fatigue life of the joints. A small reduction rate of the stiffness was found throughout the most part of the life until a sudden drop was observed, indicating a smooth damage evolution.
Experimental investigation on creep‐fatigue behaviours of as‐received and service‐exposed turbine blades: Mechanism and life evaluation
Authors: Li Zhenlei , Shi Duoqi , Li Shaolin , Yang Xiaoguang , Li Nina 
Published: August 2020

AbstractIn the present study, both the as‐received and the 600‐h‐serviced turbine blades were tested under the creep‐fatigue loading. The results showed that the service‐exposed blades exhibited a longer creep‐fatigue life than the as‐received ones due to the refinement of grain size and the increasing of hardness during the service process. Micro structural characterization revealed that there was no directional coarsening or rafting of γ′ precipitate after 600 h of service. Moreover, the as‐received blades exhibited initial cyclic hardening followed by saturation and softening, whereas the 600‐h‐serviced blades only exhibited continuous softening until fracture. A conservative service life prediction approach was proposed considering the experienced mission profile. This service life estimation method provides a new way to assess the durability of turbine blade.
Chair‐stand exercise improves post‐stroke dysphagia
Authors: Yoshimura Yoshihiro , Wakabayashi Hidetaka , Nagano Fumihiko , Bise Takahiro , Shimazu Sayuri , Shiraishi Ai 
Published: August 2020

AimTo elucidate the effects of whole‐body exercise on clinical outcomes, including dysphagia status, between stroke patients with dysphagia who are undergoing convalescent rehabilitation.MethodsThis retrospective cohort study included consecutive patients with post‐stroke dysphagia in a rehabilitation hospital in Japan between 2016 and 2018. Dysphagia was defined as a Food Intake Level Scale (FILS) score <7. Participants were asked to perform a repeated chair‐stand exercise as a whole‐body exercise in addition to the convalescence rehabilitation program. Study outcomes included the FILS score and presence of dysphagia at discharge, the Functional Independence Measure‐motor (FIM‐motor) score and length of stay. Multivariate analyses were used to determine whether the frequency of daily chair‐stand exercise was independently associated with study outcomes, after adjusting for potential confounders; P < 0.05 was considered statistically significant.ResultsOf the 637 patients admitted, 148 stroke patients with dysphagia (mean age 72.7 years; 48.6% men) were included in the final analysis dataset. The median daily frequency of repeated chair‐stand exercise was 36 (12–65). In multivariate analyses, the frequency of chair‐stand exercise was independently associated with the FILS score at discharge (β = 0.231, P = 0.015), the presence of dysphagia at discharge (odds ratio: 0.982, P = 0.035), FIM‐motor at discharge (β = 0.205, P = 0.008) and its gain (β = 0.237, P = 0.013), and length of hospital stay (β = −0.042, P < 0.001).ConclusionsChair‐stand exercise is associated with preferable clinical outcomes, including dysphagia status, activities of daily living and length of hospital stay, in stroke patients with dysphagia. Post‐stroke dysphagia rehabilitation should include whole‐body exercises in addition to conventional rehabilitation programs. Geriatr Gerontol Int 2020; 20: 885–891.
β3 integrin immunohistochemistry as a method to predict sentinel lymph node status in patients with primary cutaneous melanoma
Authors: Quattrocchi Enrica , Sominidi‐Damodaran Sindhuja , Murphree Dennis H. , Meves Alexander 
Published: August 2020

AbstractBackgroundIntegrins are heterodimeric proteins composed of noncovalently linked ɑ and β subunits which are essential for a wide range of normal physiology and also play prominent roles in cancer. Here we tested whether integrin expression in diagnostic skin biopsies is associated with sentinel lymph node (SLN) metastasis.MethodsWe utilized a cohort of 854 consecutive patients with primary cutaneous melanoma to quantify the expression of β integrin subunits by reverse transcriptase quantitative PCR (RT‐qPCR). In addition, we quantified the expression of β3 integrin by immunohistochemistry (IHC) in a subset of 271 patients by H score. Outcome of interest was SLN biopsy metastasis within 90 days of melanoma diagnosis. Logistic regression analyses were used to develop models for the likelihood of SLN metastasis from molecular, clinical, and histologic variables.Resultsβ3 integrin expression quantified by IHC or RT‐qPCR was associated with SLN metastasis. β1, β5, β6, and β8 integrin expression was not associated with SLN metastasis. The incremental gain in performance of a predictive model which included β3 integrin expression as quantified by IHC in combination with established clinicopathologic variables (Breslow depth and patient age) was limited.Conclusionsβ3 integrin is the principal integrin subunit associated with sentinel lymph node biopsy (SLNb) metastasis in primary cutaneous melanoma. However, β3 integrin H score does not significantly improve models for the likelihood of SLN metastasis over Breslow depth and patient age.
Employee voice and lifelong education capabilities in France and Germany: two models of responsibility
Authors: Zimmermann Bénédicte 
Published: August 2020

This paper discusses the scope of the employee’s voice in lifelong education decisions, with a focus on qualified assembly‐line workers and professional development schemes allowing their upward mobility out of the assembly line. Using a capability approach, it investigates voice as part of people’s agency. Beyond examining the channels that allow employees to have a say in training matters – weak definition of voice – it addresses voice as a process that participates in the conversion of the available training resources and opportunities into lifelong education achievements – strong definition of voice. Comparing two subsidiaries of a multinational firm, one located in Germany and the other in France, we ask under what institutional and organizational conditions employees are able to express and then achieve what they value. In adopting a multi‐level perspective which integrates qualitative data of an institutional, organizational and individual nature, we show how in France and Germany the worker’s voice in training matters pertains to two different models of responsibility sharing. In Germany the worker’s voice is associated with self‐determination and self‐care as a consequence of the externalization of lifelong education outside the confines of the firm; this results in a weak voice that requires personal or family resources in order to get converted into a strong voice. In France, where national legislation obliges firms to devote a percentage of the gross wage bill to training, companies have historically played an important role in the lifelong education of workers, so that until the country’s last training reforms introducing a personal training account in 2014, the worker’s voice was strongly shaped by organizational factors. Whether this voice is weak or strong depends upon the organizational strategy, processes and involvement in lifelong training.
Cadaveric Penile Prosthesis Workshop training improves surgical confidence levels of urologists: South Asian Society for Sexual Medicine course survey
Authors: Krishnappa Pramod , Srini Vasan S , Shah Rupin , Lentz Aaron C , Garaffa Giulio , Martinez‐Salamanca Juan Ignacio , Moncada Ignacio 
Published: August 2020

ObjectivesTo analyze the impact of South Asia’s first cadaveric hands‐on workshop on urologists’ training in inflatable penile prosthesis surgery.MethodsA total of 72 urologists/andrologists participated in the 2019 South Asian Society for Sexual Medicine Pre‐congress Penile Prosthesis hands‐on workshop. The workshop included 4 h of lectures and 2 h of hands‐on cadaveric laboratory experience using three‐piece inflatable penile prosthesis. The Shapiro–Wilk test was used on self‐rated procedural confidence levels, which proved the normality. A non‐parametric McNemar test was used to examine the change in the number of correct answers.ResultsOf those who attended the cadaver laboratory, just 45 who answered the survey both before and after the workshop were included for analysis. Significant objective improvements were noted in procedural knowledge test scores (44.30 ± 0.027 vs 72.44 ± 0.024, P < 0.05) and median surgical confidence levels (4 vs 3 and 2, P < 0.001) of the urologists after the completion of the workshop.ConclusionsCadaveric hands‐on workshop training improves urologists’ procedural knowledge and surgical confidence levels in carrying out three‐piece inflatable penile prosthesis surgery. The feasibility of such workshops should be considered in increasing the surgical expertise of general urologists in prosthetic urology.
Effect of visitors on the behaviour of three Asian small‐clawed ottersAonyx cinereusat Cattolica Aquarium
Authors: Rossi C. , Accorsi P. A. , Petrulli C. , Florio D. , Gridelli S. , Marliani G. 
Published: August 2020

The Asian small‐clawed otterAonyx cinereusis classified as Vulnerable by the International Union for Conservation of Nature Red List. The aim of this study was to evaluate the effects of the presence of visitors on the behavioural repertoire of three Asian small‐clawed otters at Cattolica Aquarium, Italy. Observational data sampling took place over two periods of 11 days each. The first period was in August when the Aquarium was open and there were visitors present (open period = OP). The second period was between September and October, on days when the Aquarium was closed to visitors (closed period = CP). Focal sampling was integrated with behaviour sampling during data collection. To evaluate the significant differences in frequency and duration of behaviours during the OP and CP periods, a Wilcoxon Signed Rank test was performed. The results of this study showed that the absence of visitors stimulated significant differences in frequency and duration of activity (such as ‘locomotion’ and ‘waiting’) and social behaviours (such as ‘play’). The otters also spent significantly more time visible than ‘out of sight’ when there were no visitors present. This preliminary research provides information that may influence the way zoos and aquatic parks manage their otters, and contributes to the improvement of the welfare of animals in human care.
What is required for achieving hepatitis C virus elimination in Singapore? A modeling study
Authors: Chaillon Antoine , Thurairajah Prem Harichander , Hsiang John Chen , Martin Natasha K 
Published: August 2020

AbstractBackground and AimThe vast majority of hepatitis C virus (HCV) infection in Singapore is among those with a history of injecting drug use (IDU), yet harm reduction is not available and what is required to achieve the World Health Organization (WHO) HCV elimination targets (80% incidence reduction and 65% mortality reduction by 2030) is unknown. We model the intervention scale‐up required to achieve WHO targets in Singapore.MethodsA dynamic model of HCV transmission and progression among those with a history of IDU was calibrated to Singapore, a setting with declining IDU and no harm reduction (~11 000 people with IDU history in 2017 and 45% HCV seropositive). We projected HCV treatment scale‐up from 2019 required to achieve WHO targets with varying prioritization scenarios, with/without opiate substitution therapy scale‐up (to 40% among people who inject drugs [PWID]).ResultsWe estimated 3855 (95% confidence interval: 2635–5446) chronically HCV‐infected individuals with a history of IDU and 148 (87–284) incident HCV cases in Singapore in 2019. Reaching the HCV incidence target requires 272 (187–384) treatments in 2019, totaling 2444 (1683–3452) across 2019–2030. By prioritizing PWID or PWID and cirrhotics, 60% or 30% fewer treatments are required, respectively, whereas the target cannot be achieved with cirrhosis prioritization. Opiate substitution therapy scale‐up reduces treatments required by 21–24%. Achieving both WHO targets requires treating 631 (359–1047) in 2019, totaling 3816 (2664–5423) across 2019–2030.ConclusionsHepatitis C virus elimination is achievable in Singapore but even with declining IDU requires immediate treatment scale‐up among PWID. Harm reduction provision reduces treatments required and provides additional benefits.
Improving diagnostic accuracy in neonates with left heart obstruction in a transport setting
Authors: Boyd Stephanie M , Staub Eveline , Browning Carmo Kathryn 
Published: August 2020

AimDifferentiating left heart obstruction (LHO) from other severe illness in the neonatal period is challenging, and important for guiding clinical management. The aim of this study was to identify factors distinguishing LHO from non‐LHO in neonates.MethodsA retrospective, cohort study of neonates referred to the Newborn and Paediatric Emergency Transport Service, New South Wales, with suspected LHO during the epoch 1996–2016.ResultsA total of 273 neonates were included; 240 with confirmed LHO. Administration of prostaglandin E1 to infants with a structurally normal heart was not associated with impaired acid–base or oxygenation status. Pre‐transport diagnostic accuracy of LHO was 74.4%; sensitivity 84.5%, positive predictive value 86.0%. On multivariable logistic regression, hepatomegaly (odds ratio 2.54; 95% confidence interval 1.05–6.16) was associated with confirmed LHO.ConclusionsA low threshold for prostaglandin E1 infusion should be maintained in infants with suspected LHO. Hepatomegaly is associated with a diagnosis of LHO and may be more useful than other parameters in predicting the condition.
Dual delivery of platelet‐derived growth factor and bone morphogenetic factor‐6 on titanium surface to enhance the early period of implant osseointegration
Authors: Keceli H. Gencay , Bayram Cem , Celik Ekin , Ercan Nuray , Demirbilek Murat , Nohutcu Rahime Meral 
Published: August 2020

AbstractObjectiveTo test the surface properties and in vitro effects of a new sequential release system on MC3T3‐E1 cells for improved osseointegration.BackgroundBMP6‐loaded anodized titanium coated with PDGF containing silk fibroin (SF) may improve osseointegration.MethodsTitanium surfaces were electrochemically anodized, and SF layer was covered via electrospinning. Five experimental groups (unanodized Ti (Ti), anodized Ti (AnTi), anodized + BMP6‐loaded Ti (AnTi‐BMP6), anodized + BMP6 loaded + silk fibroin‐coated Ti (AnTi‐BMP6‐SF), and anodized + BMP6‐loaded + silk fibroin with PDGF‐coated Ti (AnTi‐BMP6‐PDGF‐SF)) were tested. After SEM characterization, contact angle analysis, and FTIR analysis, the amount of released PDGF and BMP6 was detected using ELISA. Cell proliferation (XTT), mineralization, and gene expression (RUNX2 and ALPL) were also evaluated.ResultsAfter successful anodization and loading of PDGF and BMP6, contact angle measurements showed hydrophobicity for TiO2 and hydrophilicity for protein‐adsorbed surfaces. In FTIR, protein‐containing surfaces exhibited amide‐I, amide‐II, and amide‐III bands at 1600 cm‐1‐1700 cm‐1, 1520 cm‐1‐1540 cm‐1, and 1220 cm‐1‐1300 cm‐1 spectrum levels with a significant peak in BMP6‐ and/or SF‐loaded groups at 1100 cm‐1. PDGF release and BMP6 release were delayed, and relatively slower release was detected in SF‐coated surfaces. Higher MC3T3‐E1 proliferation and mineralization and lower gene expression of RUNX2 and ALPL were detected in AnTi‐BMP6‐PDGF‐SF toward day 28.ConclusionThe new system revealed a high potential for an improved early osseointegration period by means of a better factor release curve and contribution to the osteoblastic cell proliferation, mineralization, and associated gene expression.
Altered cardiac repolarisation in highlanders with high‐altitude pulmonary hypertension during wakefulness and sleep
Authors: Aeschbacher Sayaka S. , Latshang Tsogyal D. , Sheraliev Ulan , Marazhapov Nuriddin H. , Ulrich Silvia , Sooronbaev Talant M. , Bloch Konrad E. , Furian Michael 
Published: August 2020

AbstractHigh‐altitude pulmonary hypertension (HAPH) is an altitude‐related illness associated with hypoxaemia that may promote sympathetic excitation and prolongation of the QT interval. The present case‐control study tests whether QT intervals, markers of malignant cardiac arrhythmias, are prolonged in highlanders with HAPH (HAPH+) compared to healthy highlanders (HH) and healthy lowlanders (LL). The mean pulmonary artery pressure (mPAP) was measured by echocardiography in 18 HAPH+ (mPAP, 34 mmHg) and 18 HH (mPAP, 23 mmHg) at 3,250 m, and 18 LL (mPAP, 18 mmHg) at 760 m, Kyrgyzstan (p < .05 all mPAP comparisons). Groups were matched for age, sex and body mass index. Electrocardiography and pulse oximetry were continuously recorded during nocturnal polysomnography. The heart rate‐adjusted QT interval, QTc, was averaged over consecutive 1‐min periods. Overall, a total of 26,855 averaged 1‐min beat‐by‐beat periods were semi‐automatically analysed. In HAPH+, maximum nocturnal QTc was longer during sleep (median 456 ms) than wakefulness (432 ms, p < .05) and exceeded corresponding values in HH (437 and 419 ms) and LL (430 and 406 ms), p < .05, respectively. The duration of night‐time QTc >440 ms was longer in HAPH+ (median 144 min) than HH and LL (46 and 14 min, p < .05, respectively). HAPH+ had higher night‐time heart rate (median 78 beats/min) than HH and LL (66 and 65 beats/min, p < .05, respectively), lower mean nocturnal oxygen saturation than LL (88% versus 95%, p < .05) and more cyclic oxygen desaturations (median 24/hr) than HH and LL (13 and 3/hr, p < .05, respectively). In conclusion, HAPH was associated with higher night‐time heart rate, hypoxaemia and longer QTc versus HH and LL, and may represent a substrate for increased risk of malignant cardiac arrhythmias.
Educator perceptions on teaching Indigenous health: Racism, privilege and self‐reflexivity
Authors: Vass Alyssa , Adams Karen 
Published: August 2020

AbstractIntroductionGeneral practitioners (GPs) and family medicine clinicians should respond to Indigenous peoples’ health needs. However, medical graduates feel underprepared for this work. The foundational elements of racism, white privilege and cultural self‐reflexivity remain conspicuously absent from medical education in general practice programmes, despite inclusion in curriculum frameworks. This study explored the perception and experiences of Australian GP educators in teaching this content.MethodsWe undertook a qualitative study that gathered data through semi‐structured interviews with GP educators (n = 12) at a medical school in Victoria, Australia. We utilised the Reflection learning domain of the Aboriginal and Torres Strait Islander Health Curriculum Framework to shape interview questions on racism, white privilege and cultural self‐reflexivity. Data were analysed from constructivist and Critical Indigenous Theory paradigms to formulate key themes.ResultsGeneral practitioner educators were challenged by Reflection content, struggled to articulate a refined pedagogy for provision of anti‐racist, self‐reflexive learning and felt poorly qualified to teach Indigenous health, articulating preference for delegation of teaching to Indigenous peoples. They simultaneously stated the importance of inclusion of Reflection teaching in general practice, alongside expressing beliefs that appeared to devalue its perceived relevance. Students were perceived as being either disinterested or incapable of Reflection learning, or conversely, more engaged than previous generations with these topics.DiscussionThe results call into question how skilled are GP educators to teach elements of Indigenous health education such as racism, white privilege and cultural self‐reflexivity. Unskilled educators can reinforce colonialism in curricula, including through minimisation of content. Stronger anti‐racist pedagogy is urgently required in medical education. Vital to this is active research on educator preparedness, evidence‐based teaching models and accountable curriculum accreditation.
Feeding ecology of the highly threatened common bottlenose dolphin of the Gulf of Ambracia, Greece, through stable isotope analysis
Authors: Borrell Asunción , Vighi Morgana , Genov Tilen , Giovos Ioannis , Gonzalvo Joan 
Published: August 2020

AbstractThe Gulf of Ambracia, in northwestern Greece, hosts a highly threatened community of about 150 common bottlenose dolphins (Tursiops truncatus). Until now, information on their feeding habits was derived exclusively from fish scale samples collected during surface‐feeding events targeting small schooling epipelagic fish. The aim of this study was to determine the diet of bottlenose dolphins living in the Gulf of Ambracia through the application of Bayesian isotopic mixing models. Skin biopsy samples of 16 dolphins were analyzed and no difference related to sex or age‐class was found in δ13C and δ15N values. Results suggested that the dolphin diet was mainly based on Trachurus trachurus, species belonging to the family Sparidae: Diplodus annularis, Lithognathus mormyrus, and Sepia officinalis, which represented together about 42% ± 15% of the biomass ingested, followed by species belonging to the order Clupeiformes (Engraulis encrasicolus, Sardinella aurita, and Sardina pilchardus) and the genus Gobius (37% ± 17%). A better understanding of the feeding habits of these dolphins sheds light on the feeding ecology of this highly threatened population by, for instance, evidencing interactions with artisanal fisheries sharing the same target species, and is key for identifying adequate management measures consistent with an ecosystem‐based approach.