bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intrathecal morphine is associated with reduction in postoperative opioid requirements and improvement in postoperative analgesia in patients undergoing open liver resection
Authors: Tang Jefferson , Churilov Leonid , Tan Chong Oon , Hu Raymond , Pearce Brett , Cosic Luka , Christophi Christopher , Weinberg Laurence 
Published: August 2020

Abstract
Background
Our study aimed to test the hypothesis that the addition of intrathecal morphine (ITM) results in reduced postoperative opioid use and enhanced postoperative analgesia in patients undergoing open liver resection using a standardized enhanced recovery after surgery (ERAS) protocol with multimodal analgesia.

Methods
A retrospective analysis of 216 adult patients undergoing open liver resection between June 2010 and July 2017 at a university teaching hospital was conducted. The primary outcome was the cumulative oral morphine equivalent daily dose (oMEDD) on postoperative day (POD) 1. Secondary outcomes included postoperative pain scores, opioid related complications, and length of hospital stay. We also performed a cost analysis evaluating the economic benefits of ITM.

Results
One hundred twenty-five patients received ITM (ITM group) and 91 patients received usual care (UC group). Patient characteristics were similar between the groups. The primary outcome - cumulative oMEDD on POD1 - was significantly reduced in the ITM group. Postoperative pain scores up to 24 h post-surgery were significantly reduced in the ITM group. There was no statistically significant difference in complications or hospital stay between the two study groups. Total hospital costs were significantly higher in the ITM group.

Conclusion
In patients undergoing open liver resection, ITM in addition to conventional multimodal analgesic strategies reduced postoperative opioid requirements and improved analgesia for 24 h after surgery, without any statistically significant differences in opioid-related complications, and length of hospital stay. Hospital costs were significantly higher in patients receiving ITM, reflective of a longer mandatory stay in intensive care.

Trial registration
Registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) under ACTRN12620000001998.
Safety and bactericidal efficacy of cold atmospheric plasma generated by a flexible surface Dielectric Barrier Discharge device against Pseudomonas aeruginosa in vitro and in vivo
Authors: Dijksteel Gabrielle S. , Ulrich Magda M. W. , Vlig Marcel , Sobota Ana , Middelkoop Esther , Boekema Bouke K. H. L. 
Published: August 2020

Abstract
Background
Cold atmospheric plasma (CAP), which is ionized gas produced at atmospheric pressure, could be a novel and potent antimicrobial therapy for the treatment of infected wounds. Previously we have shown that CAP generated with a flexible surface Dielectric Barrier Discharge (sDBD) is highly effective against bacteria in vitro and in ex vivo burn wound models. In the current paper, we determined the in vitro and in vivo safety and efficacy of CAP generated by this sDBD device.

Methods
The effect of CAP on DNA mutations of V79 fibroblasts was measured using a hypoxanthine–guanine-phosphoribosyltransferase (HPRT) assay. Furthermore, effects on cell proliferation, apoptosis and DNA damage in ex vivo burn wound models (BWMs) were assessed using immunohistochemistry. Next, 105 colony forming units (CFU) P. aeruginosa strain PAO1 were exposed to CAP in a 3D collagen-elastin matrix environment to determine the number of surviving bacteria in vitro. Finally, rat excision wounds were inoculated with 107 CFU PAO1 for 24 h. The wounds received a single CAP treatment, repeated treatments on 4 consecutive days with CAP, 100 µL of 1% (wt/wt) silver sulfadiazine or no treatment. Wound swabs and punch biopsies were taken to determine the number of surviving bacteria.

Results
Exposure of V79 fibroblasts to CAP did not increase the numbers of mutated colonies. Additionally, the number of proliferative, apoptotic and DNA damaged cells in the BWMs was comparable to that of the unexposed control. Exposure of PAO1 to CAP for 2 min resulted in the complete elimination of bacteria in vitro. Contrarily, CAP treatment for 6 min of rat wounds colonized with PAO1 did not effectively reduce the in vivo bacterial count.

Conclusions
CAP treatment was safe but showed limited efficacy against PAO1 in our rat wound infection model.
A new method for the inoculation of Phytophthora palmivora (Butler) into cacao seedlings under greenhouse conditions
Authors: Delgadillo-Durán Paola , Soto-Suárez Mauricio , Rodriguez-Polanco Leonora , Carrero-Gutierrez Martha , Torres-Rojas Esperanza , Yockteng Roxana 
Published: August 2020

AbstractBackgroundThe black pod disease affects cacao plantations worldwide; it is caused by the oomycete species of the genusPhytophthora. The resistance of cacao plants to the black pod is commonly evaluated by artificial inoculation of the pathogen and the monitoring of the disease symptoms. However, it is difficult to identify resistant plants because the commonly used methods for the inoculation of the pathogens produce inconsistent results. Therefore, this study aimed to develop an efficient and reliable method to evaluate the resistance ofTheobroma cacaoseedlings to the infection byPhytophthora palmivora.ResultsSeedlings of different cacao genotypes were inoculated withP. palmivoraunder greenhouse conditions using the previously reported inoculation methods and a newly proposed method, the agar–water solution method. While none of the previously reported methods was effective, the agar–water solution method ensured a 100% seedling infection under greenhouse conditions. The proposed agar–water methodology is fast, simple and reproducible. Furthermore, the evaluation of this method in susceptible (CCN-51) and tolerant (SCA-6)T. cacaogenotypes produced the expected contrasting results.ConclusionsThe agar–water solution method presented in this study is an efficient alternative inoculation protocol for the identification of cacao genotypes that are resistant to black pod under greenhouse conditions.
Coexistence of recurrent chromosomal abnormalities and the Philadelphia chromosome in acute and chronic myeloid leukemias: report of five cases and review of literature
Authors: Gong Jin-Ying , Zhang Zhen-Hao , Zhang Wei , Wang Hui-Jun , Feng Xiao-Fang , Zhou Ji , Zhu Guo-Qing 
Published: August 2020

AbstractProgression of chronic myelogenous leukemia (CML) is frequently accompanied by cytogenetic evolution. Additional genetic abnormalities are seen in 10–20% of CML cases at the time of diagnosis, and in 60–80% of cases of advanced disease. Unbalanced chromosomal changes such as an extra copy of the Philadelphia chromosome (Ph), trisomy 8, and i(17)(q10) are common. Balanced chromosomal translocations, such as t(3;3), t(8;21), t(15;17), and inv(16) are typically found in acute myeloid leukemia, but rarely occur in CML. Translocations involving 11q23, t(8;21), and inv(16) are relatively common genetic abnormalities in acute leukemia, but are extremely rare in CML. In the literature to date, there are at least 76 Ph+ cases with t(3;21), 47 Ph+ cases with inv(16), 16 Ph+ cases with t(8;21), and 9 Ph+ cases with t(9;11). But most of what has been published is now over 30 years old, without the benefit of modern immunophenotyping to confirm diagnosis, and before the introduction of treatment regimes such as TKI. In this study, we explored the rare concomitant occurrence of coexistence current chromosomal translocation and t(9;22) in CML or acute myeloid leukemia (AML).
Comparison of freshly cultured versus freshly thawed (cryopreserved) mesenchymal stem cells in preclinical in vivo models of inflammation: a protocol for a preclinical systematic review and meta-analysis
Authors: Dave Chintan , McRae Andrea , Doxtator Emily , Mei Shirley H. J. , Sullivan Katrina , Wolfe Dianna , Champagne Josee , McIntyre Lauralyn 
Published: August 2020

Abstract
Background
Mesenchymal stem cells (MSCs) are multipotent cells that demonstrate therapeutic potential for the treatment of acute and chronic inflammatory-mediated conditions. Especially for acute conditions, it is critical to have a readily available freshly thawed (cryopreserved) MSC product for rapid administration. Although controversial, some studies suggest that MSCs may lose their functionality with cryopreservation which in turn could render them non-efficacious.

Objective
In controlled preclinical in vivo models of inflammation, to determine if there are differences in surrogate measures of preclinical efficacy between freshly cultured and freshly thawed MSCs

Methods/design
A systematic search for pre-clinical in vivo inflammatory model studies will compare freshly cultured to freshly thawed MSCs from any source. The primary outcomes will include measures of in vivo preclinical efficacy; secondary outcomes will include measures of in vitro MSC potency. Electronic searches for MEDLINE and EMBASE will be constructed and reviewed by the Peer Review of Electronic Search Strategies (PRESS) process. If applicable, study outcomes will be meta-analyzed using a random effects model. Risk of bias will be assessed by the SYRCLE “Risk of Bias” assessment tool for preclinical in vivo studies.

Discussion
The results of this systematic review will provide translational scientists, clinical trialists, health regulators, and the clinical and public community with the current pre-clinical evidence base related to the efficacy and potency of freshly cultured versus freshly thawed MSCs, help identify evidence gaps, and guide future related research.

Systematic review registration
Protocol is submitted to PROSPERO for registration (pending confirmation) and will be submitted to Collaborative Approach to Meta-Analysis and Review of Animal Data from Experimental Studies (CAMARADES) for public posting.
Do inquiry-based teaching and school climate influence science achievement and critical thinking? Evidence from PISA 2015
Authors: Gómez Ricardo L. , Suárez Ana María 
Published: August 2020

Abstract
Background
Inquiry-based teaching (IBT) and improving school climate are the two most commonly used strategies for fostering learning and critical thinking skills in students. IBT has positioned itself as one of the most recommended “active” methodologies for developing intellectual autonomy and complex thought processes, whereas school climate is considered to be a protective factor that helps mitigate adverse conditions and has a positive impact on teaching and learning. This study investigates the relationship between IBT and school climate with the academic performance of Colombian students in the PISA 2015 test.

Results
Using a two-level Hierarchical Linear Modeling (HLM), the results show a negative association between IBT and students’ scientific performance in the test. However, results show a positive association between IBT and students’ self-reported critical thinking skills. Results also show that school climate is a positive moderating factor on learning. Contextual factors such as the student’s grade level at the time of sitting for the PISA test, gender, and socioeconomic characteristics are strong predictors of science achievement in PISA.

Conclusions
These results reveal the need for additional research on the effect of the so-called active methodologies and school context on student learning. Regarding IBT, it seems that its influence is greater on student’s perception and motivation, than in acquisition of scientific knowledge. Positive school climate is a protective factor that can help to improve student learning. In Colombia, the quality of students’ educational outcomes has largely been attributed to their socioeconomic background. However, the results of this study show that, although students’ and schools’ socioeconomic characteristics continue to be strong predictors of academic performance, teaching practices can have an even larger impact.
Circadian misalignment on submarines and other non-24-h environments – from research to application
Authors: Guo Jin-Hu , Ma Xiao-Hong , Ma Huan , Zhang Yin , Tian Zhi-Qiang , Wang Xin , Shao Yong-Cong 
Published: August 2020

AbstractCircadian clocks have important physiological and behavioral functions in humans and other organisms, which enable organisms to anticipate and respond to periodic environmental changes. Disturbances in circadian rhythms impair sleep, metabolism, and behavior. People with jet lag, night workers and shift workers are vulnerable to circadian misalignment. In addition, non-24-h cycles influence circadian rhythms and cause misalignment and disorders in different species, since these periods are beyond the entrainment ranges. In certain special conditions, e.g., on submarines and commercial ships, non-24-h watch schedules are often employed, which have also been demonstrated to be deleterious to circadian rhythms. Personnel working under such conditions suffer from circadian misalignment with their on-watch hours, leading to increased health risks and decreased cognitive performance. In this review, we summarize the research progress and knowledge concerning circadian rhythms on submarines and other environments in which non-24-h watch schedules are employed.
Big and open linked data analytics: a study on changing roles and skills in the higher educational process
Authors: Lnenicka Martin , Kopackova Hana , Machova Renata , Komarkova Jitka 
Published: August 2020

AbstractThe concept of openness and information sharing (linking) together with increasing amounts of data available significantly affect the current educational system. Institutions as well as other stakeholders are facing challenges how to successfully deal with them and potentially profit from them. In this regard, this paper explores opportunities of big and open linked data analytics in the educational process intended to develop the new set of skills. A comprehensive literature review resulted in a framework of relevant skills, namely soft, hard, and data analytics skills. Their importance was evaluated using a Delphi method. In order to determine the relationships between involved stakeholders, their roles and requirements, a stakeholder theory is utilized. It resulted in the identification of current and emerging roles of stakeholders in the data analytics ecosystem. A structural classification of stakeholders’ influences and impacts then represents a necessary background for establishing strategies for the development of the right skills needed to gain the value from these data. This paper provides a comprehensive view on big and open linked data analytics in the educational context, defines and interlinks data-related with current roles as well as the skills required to perform data analytics.
Early-Middle Permian palynoflora of Shandong Province, eastern North China
Authors: Yin Tian-Tao , Li Shou-Jun , Zhang Xiang-Yu , Zhao Xiu-Li 
Published: August 2020

AbstractThe Permian Taiyuan and Shanxi formations exposed in Shandong Province, eastern North China, contain abundant spores and pollen. In this study, a total of 42 genera and 146 species of spores and pollen from these Permian formations, native to northern China, are identified and related to the three epochs of the Permian Period (Cisuralian, Guadalupian, and Lopingian Epochs) as two assemblages: Assemblage I — the Laevigatosporites–Granulatisporites assemblage, inferred as the Cisuralian (~ 298.9–272.9 Ma); and, Assemblage II — the Gulisporites–Sinulatisporites assemblage, inferred as the Guadalupian (~ 272.9–259.1 Ma). Assemblage I represents growing ferns, whereas Assemblage II represents gymnosperms. The assemblage division and analysis indicated that the palaeoclimate of the study area during Early-Middle Permian time was dominated by warm and humid conditions, and later in the Middle Permian changed into moderately dry conditions.
Investigating the relationship between changes in oil prices and unemployment rate in Nigeria: linear and nonlinear autoregressive distributed lag approaches
Authors: Raifu Isiaka Akande , Aminu Alarudeen , Folawewo Abiodun O. 
Published: August 2020

AbstractThe increasing unemployment in Nigeria has motivated several empirical studies on the causes of the problem in the country. However, attention has not been paid to the contribution of the changes in oil prices to the unemployment problem. As a net exporting oil country, a fluctuation in oil prices in the international market can have impact on economic growth and employment. In the light of this, we investigate the effect of changes in oil prices on unemployment rate in Nigeria, using real oil prices of Brent and West Texas International with linear and nonlinear autoregressive distributed lag (NARDL) estimation methods. Findings from linear ARDL show that changes in oil prices have little or no significant effects on unemployment rate. The NARDL results indicate that an increase and a decrease in oil prices have an insignificant positive effect on unemployment in the short run. However, in the long run, an increase in oil prices worsens unemployment situation, while a decrease has insignificant reducing effect. We also find evidence of a long-run asymmetric relationship between oil prices and unemployment. The need for government to invest oil revenues in generating more electricity or in providing alternative sources of energy with the objective to reduce the costs of production of firms is recommended.
Oxygen Reserve Index: Utility as an Early Warning for Desaturation in High-Risk Surgical Patients
Authors: Fleming Neal W. , Singh Amrik , Lee Leonard , Applegate Richard L. 
Published: August 2020

BACKGROUND:
Perioperative pulse oximetry hemoglobin saturation (Spo
2) measurement is associated with fewer desaturation and hypoxia episodes. However, the sigmoidal nature of oxygen–hemoglobin dissociation limits the accuracy of estimation of the partial pressure of oxygen (Pao
2) >80 mm Hg and correspondingly limits the ability to identify when Pao
2 >80 mm Hg but falling. We hypothesized that a proxy measurement for oxygen saturation (Oxygen Reserve Index [ORI]) derived from multiwavelength pulse oximetry may allow additional warning time before critical desaturation or hypoxia. To test our hypothesis, we used a Masimo multiwavelength pulse oximeter to compare ORI and Spo
2 warning times during apnea in high-risk surgical patients undergoing cardiac surgery.

METHODS:
This institutional review board–approved prospective study (NCT03021473) enrolled American Society of Anesthesiologists physical status III or IV patients scheduled for elective surgery with planned preinduction arterial catheter placement. In addition to standard monitors, an ORI sensor was placed and patients were monitored with a pulse oximeter displaying the ORI, a nondimensional parameter that ranges from 0 to 1. Patients were then preoxygenated until ORI plateaued. Following induction of anesthesia, mask ventilation with 100% oxygen was performed until neuromuscular blockade was established. Endotracheal intubation was accomplished using videolaryngoscopy to confirm placement. The endotracheal tube was not connected to the breathing circuit, and patients were allowed to be apneic. Ventilation was resumed when Spo
2 reached 94%. We defined ORI warning time as the time from when the ORI alarm registered (based on the absolute value and the rate of change) until the Spo
2 decreased to 94%. We defined the Spo
2 warning time as the time for Spo
2 to decrease from 97% to 94%. The added warning time provided by ORI was defined as the difference between ORI warning time and Spo
2 warning time.

RESULTS:
Forty subjects were enrolled. Complete data for analysis were available from 37 patients. The ORI alarm registered before Spo
2 decreasing to 97% in all patients. Median (interquartile range [IQR]) ORI warning time was 80.4 seconds (59.7–105.9 seconds). Median (IQR) Spo
2 warning time was 29.0 seconds (20.5–41.0 seconds). The added warning time provided by ORI was 48.4 seconds (95% confidence interval [CI], 40.4–62.0 seconds; P < .0001).

CONCLUSIONS:
In adult high-risk surgical patients, ORI provided clinically relevant added warning time of impending desaturation compared to Spo
2. This additional time may allow modification of airway management, earlier calls for help, or assistance from other providers. The potential patient safety impact of such monitoring requires further study.
Echocardiogram Utilization Patterns and Association With Mortality Following Severe Traumatic Brain Injury
Authors: Chen Fangyu , Komisarow Jordan M. , Mills Brianna , Vavilala Monica , Hernandez Adrian , Laskowitz Daniel T. , Mathew Joseph P. , James Michael L. , Haines Krista L. , Raghunathan Karthik , Fuller Matt , Bartz Raquel R. , Krishnamoorthy Vijay 
Published: August 2020

BACKGROUND:
Severe traumatic brain injury (TBI) can result in left ventricular dysfunction, which can lead to hypotension and secondary brain injuries. Although echocardiography is often used to examine cardiovascular function in multiple clinical settings, its use and association with outcomes following severe TBI are not known. To address this gap, we used the National Trauma Data Bank (NTDB) to describe utilization patterns of echocardiography and examine its association with mortality following severe TBI.

METHODS:
A retrospective cohort study was conducted using a large administrative trauma registry maintained by the NTDB from 2007 to 2014. Patients >18 years with isolated severe TBI, and without concurrent severe polytrauma, were included in the study. We examined echocardiogram utilization patterns (including overall utilization, factors associated with utilization, and variation in utilization) and the association of echocardiography utilization with hospital mortality, using multivariable logistic regression models.

RESULTS:
Among 47,808 patients, echocardiogram was utilized as part of clinical care in 2548 patients (5.3%). Clinical factors including vascular comorbidities and hemodynamic instability were associated with increased use of echocardiograms. Nearly half (46.0%, 95% confidence interval [CI], 40.3%–51.7%) of the variation in echocardiogram utilization was explained at the individual hospital level, above and beyond patient and injury factors. Exposure to an echocardiogram was associated with decreased odds of in-hospital mortality following severe TBI (adjusted odds ratio [OR] = 0.77; 95% CI, 0.69–0.87; P < .001).

CONCLUSIONS:
Echocardiogram utilization following severe TBI is relatively low, with wide variation in use at the hospital level. The association with decreased in-hospital mortality suggests that the information derived from echocardiography may be relevant to improving patient outcomes but will require confirmation in further prospective studies.
Nuclear Quantum Effect on the Geometry of NH4+(H2O)
Authors: Kuwahata Kazuaki , Tachikawa Masanori 
Published: August 2020

Abstract
The nuclear quantum effect of a singly hydrated ammonium ion cluster, NH4+(H2O), is investigated using an ab initio on-the-fly path integral molecular dynamics (PIMD) simulation with a BHandHLYP/6-31++G(d,p) level of calculations. Owing to the nuclear quantum effect with a PIMD simulation, the bond length of N–O (RNO) is shortened and the distribution of the angle of O–N–Hb ($\theta _{\text{ONH}_{\text{b}}}$) is greater. These results indicate that the nuclear quantum effect has two apparent contradictory contributions. One is the strengthening of the hydrogen bond arising from the zero-point energy (ZPE), whereas the other is facilitating the rotation of NH4+ in water owing to a quantum fluctuation.