bluuebunny/crossref_metadata_2025_split huggingface dataset:
An observational study of international normalized ratio control according to NICE criteria in patients with non-valvular atrial fibrillation: the SAIL Warfarin Out of Range Descriptors Study (SWORDS)
Authors: Harris Daniel E , Thayer Daniel , Wang Ting , Brooks Caroline , Murley Geoff , Gravenor Mike , Hill Nathan R , Lister Steven , Halcox Julian 
Published: November 2019

AbstractAims In patients with non-valvular atrial fibrillation prescribed warfarin, the UK National Institute of Health and Care Excellence (NICE) defines poor anticoagulation as a time in therapeutic range (TTR) of &lt;65%, any two international normalized ratios (INRs) within a 6-month period of ≤1.5 (‘low’), two INRs ≥5 within 6 months, or any INR ≥8 (‘high’). Our objectives were to (i) quantify the number of patients with poor INR control and (ii) describe the demographic and clinical characteristics associated with poor INR control.Method and resultsLinked anonymized health record data for Wales, UK (2006–2017) was used to evaluate patients prescribed warfarin who had at least 6 months of INR data. 32 380 patients were included. In total, 13 913 (43.0%) patients had at least one of the NICE markers of poor INR control. Importantly, in the 24 123 (74.6%) of the cohort with an acceptable TTR (≥65%), 5676 (23.5%) had either low or high INR readings at some point in their history. In a multivariable regression female gender, age (≥75 years), excess alcohol, diabetes heart failure, ischaemic heart disease, and respiratory disease were independently associated with all markers of poor INR control.Conclusion Acceptable INR control according to NICE standards is poor. Of those with an acceptable TTR (&gt;65%), one-quarter still had unacceptably low or high INR levels according to NICE criteria. Thus, only using TTR to assess effectiveness with warfarin has the potential to miss a large number of patients with non-therapeutic INRs who are likely to be at increased risk.
Candida albicans infection disturbs the redox homeostasis system and induces reactive oxygen species accumulation for epithelial cell death
Authors: Ren Tongtong , Zhu Hangqi , Tian Lei , Yu Qilin , Li Mingchun 
Published: November 2019

ABSTRACTCandida albicans is a common pathogenic fungus with high mortality in immunocompromised patients. However, the mechanism by which C. albicans invades host epithelial cells and causes serious tissue damage remains to be further investigated. In this study, we established the C. albicans–293T renal epithelial cell interaction model to investigate the mechanism of epithelial infection by this pathogen. It was found that C. albicans infection causes severe cell death and reactive oxygen species (ROS) accumulation in epithelial cells. Further investigations revealed that C. albicans infection might up-regulate expression of nicotinamide adenine dinucleotide phosphate (NAPDH) oxidase (NOX), inhibit the activity of the antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT), and suppress the p38–Nrf2–heme oxygenase-1 (HO-1) pathway which plays an important role in the elimination of intracellular ROS. Furthermore, epithelial cell death caused by the fungal infection could be strikingly alleviated by addition of the antioxidant agent glutathione, indicating the critical role of ROS accumulation in cell death caused by the fungus. This study revealed that disturbance of the redox homeostasis system and ROS accumulation in epithelial cells is involved in cell death caused by C. albicans infection, which sheds light on the application of antioxidants in the suppression of tissue damage caused by fungal infection.
Evolutionary Dynamics of Structural Variation at a Key Locus for Color Pattern Diversification in Cichlid Fishes
Authors: Kratochwil Claudius F , Liang Yipeng , Urban Sabine , Torres-Dowdall Julián , Meyer Axel 
Published: November 2019

Abstract
Color patterns in African cichlid fishes vary spectacularly. Although phylogenetic analysis showed already 30 years ago that many color patterns evolved repeatedly in these adaptive radiations, only recently have we begun to understand the genomic basis of color variation. Horizontal stripe patterns evolved and were lost several times independently across the adaptive radiations of Lake Victoria, Malawi, and Tanganyika and regulatory evolution of agouti-related peptide 2 (agrp2/asip2b) has been linked to this phenotypically labile trait. Here, we asked whether the agrp2 locus exhibits particular characteristics that facilitate divergence in color patterns. Based on comparative genomic analyses, we discovered several recent duplications, insertions, and deletions. Interestingly, one of these events resulted in a tandem duplication of the last exon of agrp2. The duplication likely precedes the East African radiations that started 8–12 Ma, is not fixed within any of the radiations, and is found to vary even within some species. Moreover, we also observed variation in copy number (two to five copies) and secondary loss of the duplication, illustrating a surprising dynamic at this locus that possibly promoted functional divergence of agrp2. Our work suggests that such instances of exon duplications are a neglected mechanism potentially involved in the repeated evolution and diversification that deserves more attention.
Plant–frugivore interactions in an urban nature reserve and its nearby gardens
Authors: Zietsman Mariki Y , Montaldo Norberto H , Devoto Mariano 
Published: November 2019

AbstractIn the current global context of growing urbanization, urban nature reserves play a crucial role as habitats that serve educational, recreational and conservation purposes. Biodiversity conservation within urban reserves is a challenging task, particularly since connectivity between a reserve and its surrounding artificial green spaces (e.g. gardens and parks) may affect the ecological processes within the reserve in complex ways. In this context, we studied the feeding interactions between plants and birds to provide evidence that an urban nature reserve is connected to its surrounding artificial habitats by mobile organisms. We focused on fleshy-fruited plants and frugivorous birds, and we used a network approach to describe the feeding interactions between these two guilds. The most important connecting bird was Turdus rufiventris, an abundant and obligate frugivore, whose abundance was positively linked to fruit availability in most of the study sites. The apparent increase in the abundance of T. rufiventris in one habitat when it decreases in the other suggests that the two habitats may be complementary for this species. The nature reserve, with many native plants, however, seems to be the preferred site when both habitats offer an abundant fruit supply. Our results suggest changes in either habitat can have consequences in the other one, which has broad implications for the design of management plans of urban nature reserves.
Grief and Composition as Identity
Authors: Garland C E 
Published: November 2019

Abstract
‘It feels like I have lost a part of myself’ is frequently uttered by those grieving the death of a loved one. Despite the ubiquity of such utterances, and the palpable sense that they express something true, few philosophers have considered what, if anything, accounts for their truth. Here, I develop a suggestion from Donald Baxter according to which Composition as Identity provides us a means to understand the grief utterances literally. In doing so, I identify and develop a version of Leibniz's Law required for Composition as Identity to account for the truth of the grief utterances. In turn, this principle helps shed light on Composition as Identity's central claim: that the parts are identical to the whole. By considering objections to the resulting view, I construct a list of desiderata for other philosophers interested in accounting for the grief utterances.
Infrared renormalon in $SU(N)$ QCD(adj.) on $\mathbb{R}^3\times S^1$
Authors: Ashie Masahiro , Morikawa Okuto , Suzuki Hiroshi , Takaura Hiromasa , Takeuchi Kengo 
Published: November 2019

Abstract
We study the infrared renormalon in the gluon condensate in the $SU(N)$ gauge theory with $n_W$-flavor adjoint Weyl fermions (QCD(adj.)) on $\mathbb{R}^3\times S^1$ with the $\mathbb{Z}_N$ twisted boundary conditions. We rely on the so-called large-$\beta_0$ approximation as a conventional tool to analyze the renormalon, in which only Feynman diagrams that dominate in the large-$n_W$ limit are considered, while the coefficient of the vacuum polarization is set by hand to the one-loop beta function $\beta_0=11/3-2n_W/3$. In the large $N$ limit within the large-$\beta_0$ approximation, the W-boson, which acquires the twisted Kaluza–Klein momentum, produces the renormalon ambiguity corresponding to the Borel singularity at $u=2$. This provides an example that the system in the compactified space $\mathbb{R}^3\times S^1$ possesses the renormalon ambiguity identical to that in the uncompactified space $\mathbb{R}^4$. We also discuss the subtle issue that the location of the Borel singularity can change depending on the order of two necessary operations.
The difference between hypertension determined by self-report versus examination in the adult population of the USA: Continuous NHANES 1999–2016
Authors: Delhey Leanna , Shoults Catherine , Johnson Kemmian , Orloff Mohammed , Faramawi Mohammed F , Delongchamp Robert 
Published: November 2019

Abstract

Background
Studies have considered the validity of self-reported hypertension relative to hypertension detected by examination; no study has explored trends in the difference between these two measures. Our objective was to calculate these differences overtime within subpopulations of the USA.

Methods
We included non-Hispanic white, non-Hispanic black and Hispanic adults who participated in the National Health and Nutrition Examination Surveys from 1999 to 2016, in the analysis (N = 44 333). We subtracted self-reported hypertension from hypertension detected by examination to calculate blood pressure difference (BPD). We fit weighted linear regression models that included important covariates along with all combination of two- and three-way interactions to predict the BPD. We used the fitted lines of the models to depict the patterns of differences in the different subpopulations.

Results
Age ≥ 45 years, lack of annual clinical visit, body mass index (BMI) &lt; 25 and time were important factors associated with increased BPD.

Conclusions
People who are ≥ 45 years, have normal BMI, or do not have annual medical visits are more likely to have a bigger BPD. We can use the calculated BPD, to adjust estimates of the prevalence of self-reported hypertension.
CRISPR‐Cas9–induced IGF1 gene activation as a tool for enhancing muscle differentiation via multiple isoform expression
Authors: Roberston Matthew J. , Raghunathan Suchi , Potaman Vladimir N. , Zhang Fan , Stewart M. David , McConnell Bradley K. , Schwartz Robert J. 
Published: November 2019

AbstractMuscle wasting, or muscle atrophy, can occur with age, injury, and disease; it affects the quality of life and complicates treatment. Insulin‐like growth factor 1 (IGF1) is a key positive regulator of muscle mass. The IGF1/Igf1 gene encodes multiple protein isoforms that differ in tissue expression, potency, and function, particularly in cellular proliferation and differentiation, as well as in systemic versus localized signaling. Genome engineering is a novel strategy for increasing gene expression and has the potential to recapitulate the diverse biology seen in IGF1 signaling through the overexpression of multiple IGF1 isoforms. Using a CRISPR‐Cas9 gene activation approach, we showed that the expression of multiple IGF1 or Igf1 mRNA variants can be increased in human and mouse skeletal muscle myoblast cell lines using a single‐guide RNA (sgRNA). We found increased IGF1 protein levels in the cell culture media and increased cellular phosphorylation of AKT1, the main effector of IGF1 signaling. We also showed that the expression of Class 1 or Class 2 mRNA variants can be selectively increased by changing the sgRNA target location. The expression of multiple IGF1 or Igf1 mRNA transcript variants in human and mouse skeletal muscle myoblasts promoted myotube differentiation and prevented dexamethasone‐induced atrophy in myotubes in vitro. Our findings suggest that this novel approach for enhancing IGF1 signaling has potential therapeutic applications for treating skeletal muscle atrophy.
Neuraxial Block for Delivery Among Women With Low Platelet Counts: A Retrospective Analysis
Authors: Levy N. , Goren O. , Cattan A. , Weiniger C.F. , Matota I. 
Published: November 2019

(Int J Obstet Anesth. 2018;35:4–9)
Pregnant women with low platelet counts may be denied neuraxial block due to concerns about causing a spinal-epidural hematoma (SEH). As a result of this denial, they may not receive adequate labor analgesia. In the event of a cesarean delivery, there will be a need for general anesthesia, which has increased risk in parturients. The lowest safe platelet count to perform neuraxial block is unknown.
Perinatal Depression: Recommendations for Prevention and the Challenges of Implementation
Authors: Freeman M.P. 
Published: November 2019

(JAMA. 2019;321(6):550–552)
The US Preventive Services Task Force (USPSTF) issued a recommendation of referring women at risk for perinatal depression to counseling. Perinatal depression affects 11.5% of mothers in the United States annually and is associated with short and long term risks to both mother and infant. Although the USPSTF had previously recommended screening for depression in all adults, including pregnant and postpartum women, the new recommendation focused on prevention instead of screening. To enact this advised change in approach, more research is needed to determine how to identify at-risk women, connect the identified women to effective treatments, and gage the outcomes of this new approach.
Anesthetic Management of Parturients With Arnold Chiari Malformation-I: A Multicenter Retrospective Study
Authors: Gruffi T.R. , Peralta F.M. , Thakkar M.S. , Arif A. , Anderson R.F. , Orlando B. , Coffman J.C. , Nathan N. , McCarthy R.J. , Toledo P. , Habib A.S. 
Published: November 2019

(Int J Obstet Anesth. 2019;37:52–56)
In patients with Arnold Chiari malformations (ACM) the cerebellum herniates through the foramen magnum and displaces the lower pons and medulla. In addition, the flow of cerebrospinal fluid from the fourth ventricle is impaired, and dynamic or static herniation of brain tissue can occur. In ∼25% of patients with ACM, the pressure gradient generated by this condition can lead to the development of a syringomyelia, which is an abnormal cavitation within the spinal cord. Type 1 Arnold Chiari malformations (ACM-1) is the most common of 4 categories of ACM, and women with ACM-I are usually not diagnosed until adulthood. Some of these patients are asymptomatic while others may manifest symptoms such as headache, ataxia, and sensorimotor impairments of the extremities.
Uterotonics in Elective Caesarean Delivery: A Randomised Noninferiority Study Comparing Carbetocin 20 and 100 µg
Authors: Tabl S. , Balki M. , Downey K. , Tomlinson G. , Farine D. , Seaward G. , Carvalho J.C.A. 
Published: November 2019

(Anaesthesia. 2019;74:190–196)
Postpartum hemorrhage (PPH) is the most common cause of maternal mortality worldwide and accounts for 35% of maternal deaths. Active management of the third stage of labor is recommended in all parturients, with prophylactic uterotonic drug administration after delivery of the infant being the primary component of this active management. This strategy alone has been shown to decrease the incidence of PPH by up to 40%. The 2009 guidelines from the Society of Obstetricians and Gynaecologists of Canada (SOGC) recommended a single 100 µg intravenous bolus dose of carbetocin as the uterotonic agent of choice, rather than an oxytocin infusion, to prevent PPH after elective cesarean delivery. The rationale for recommending this dose was based on the manufacturer’s recommendation and some clinical trials. Some more recent studies, however, have suggested that doses as low as 15 µg may be effective at preventing PPH after elective cesarean delivery. The current investigators believed a larger trial comparing this smaller dose with the standard 100 µg dose was warranted to confirm these findings. This study was undertaken to compare the uterine tone intensity achieved with 20 carbetocin versus 100 µg carbetocin in women at low risk of PPH undergoing elective cesarean delivery under spinal anesthesia.
Admission Cardiotocography Versus Intermittent Auscultation of the Fetal Heart in Low-risk Pregnancy During Evaluation for Possible Labour Admission—A Multicentre Randomised Trial: The ADCAR Trial
Authors: Smith V. , Begley C. , Newell J. , Higgins S. , Murphy D.J. , White M.J. , Morrison J.J. , Canny S. , O'Donovan D. , Devane D. 
Published: November 2019

(BJOG. 2019;126:114–121)
To identify which deliveries might be at greater risk of intrapartum fetal compromise and therefore may benefit from continuous cardiotocography (cCTG) during labor, either intermittent auscultation (IA) or admission cardiotocography (ACTG) is performed on women upon admission with possible labor onset. Current guidelines are based on studies evaluating the effects of ACTG on women in diagnosed labor, rather than those with signs and symptoms of possible labor onset. This study aimed to compare ACTG with IA in terms of cesarean section, obstetric intervention, and neonatal morbidity in a low-risk population of healthy pregnant women presenting for possible labor onset, before confirmation of labor.
Norepinephrine Infusion for Preventing Postspinal Anesthesia Hypotension During Cesarean Delivery
Authors: Hasanin A.M. , Amin S.M. , Agiza N.A. , Elsayed M.K. , Refaat S. , Hussein H.A. , Rouk T.I. , Alrahmany M. , Elsayad M.E. , Elshafaei K.A. , Refaie A. 
Published: November 2019

(Anesthesiology. 2019;130:55–62)
Vasopressors, such as phenylephrine and ephedrine, are important tools for preventing postspinal hypotension in women undergoing cesarean delivery. Norepinephrine, a vasopressor with minimal cardiac depressant effect, has recently been introduced into obstetric anesthesia. Previous studies have supported the use of norepinephrine in the prevention of postspinal hypotension; however, there is a lack of evidence regarding optimum dosing. This study aimed to investigate optimal dosing of norepinephrine for prophylaxis against postspinal hypotension during cesarean delivery by comparing 3 infusion rates following an initial 5 μg bolus.
Nursing Skill Mix Inversely Associated with Critical Patient Outcomes
Authors: Rosenberg Karen 
Published: November 2019

According to this study:

A higher nursing skill mix (that is, one that includes more RNs) is associated with improvements in 12 patient outcomes.These 12 outcomes are length of stay; ulcer, gastritis, and upper gastrointestinal bleeds; acute myocardial infarction; restraint use; failure to rescue; pneumonia; sepsis; urinary tract infection; mortality/30-day mortality; pressure injury; infections (other than urinary tract infection); and shock, cardiac arrest, or heart failure.
Postoperative neurocognitive disorders
Authors: Olotu Cynthia 
Published: November 2019

Purpose of reviewAlterations in cognitive functions are common in the perioperative course. Although often unnoticed by physicians, these alterations might have distinct long-term consequences for the patient with regard to everyday functioning, self-dependency, and quality of life. In recent years, however, perioperative cognition has gained increased interest, both by clinicians and scientists, and knowledge of the preventive measures of postoperative cognitive decline has become mandatory for anesthetists and surgeons.Recent findingsThis review offers a brief overview of the current state of knowledge concerning perioperative changes in cognition, including its pathophysiology and prevention strategies.SummaryPostoperative neurocognitive disorders are frequent complications, especially in elderly patients, with postoperative delirium being its most pronounced and acute postoperative form, predisposing the patient for long-term cognitive impairment. The incidence of postoperative cognitive decline can be reduced by implementing preventive measures during perioperative patient care as recommended by national and international guidelines.
Human Umbilical Cord Mesenchymal Stromal Cells Attenuate Systemic Sepsis in Part by Enhancing Peritoneal Macrophage Bacterial Killing via Heme Oxygenase-1 Induction in Rats
Authors: Jerkic Mirjana , Gagnon Stéphane , Rabani Razieh , Ward-Able Taylor , Masterson Claire , Otulakowski Gail , Curley Gerard F. , Marshall John , Kavanagh Brian P. , Laffey John G. 
Published: November 2019

Abstract

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background
Mesenchymal stromal cells have therapeutic potential in sepsis, but the mechanism of action is unclear. We tested the effects, dose-response, and mechanisms of action of cryopreserved, xenogeneic-free human umbilical cord mesenchymal stromal cells in a rat model of fecal peritonitis, and examined the role of heme oxygenase-1 in protection.

Methods
Separate in vivo experiments evaluated mesenchymal stromal cells in fecal sepsis, established dose response (2, 5, and 10 million cells/kg), and the role of heme oxygenase-1 in mediating human umbilical cord–derived mesenchymal stromal/stem cell effects. Ex vivo studies utilized pharmacologic blockers and small inhibitory RNAs to evaluate mechanisms of mesenchymal stromal cell enhanced function in (rodent, healthy and septic human) macrophages.

Results
Human umbilical cord mesenchymal stromal cells reduced injury and increased survival (from 48%, 12 of 25 to 88%, 14 of 16, P = 0.0033) in fecal sepsis, with dose response studies demonstrating that 10 million cells/kg was the most effective dose. Mesenchymal stromal cells reduced bacterial load and peritoneal leukocyte infiltration (from 9.9 ± 3.1 × 106/ml to 6.2 ± 1.8 × 106/ml, N = 8 to 10 per group, P < 0.0001), and increased heme oxygenase-1 expression in peritoneal macrophages, liver, and spleen. Heme oxygenase-1 blockade abolished the effects of mesenchymal stromal cells (N = 7 or 8 per group). Mesenchymal stromal cells also increased heme oxygenase-1 expression in macrophages from healthy donors and septic patients. Direct ex vivo upregulation of macrophage heme oxygenase-1 enhanced macrophage function (phagocytosis, reactive oxygen species production, bacterial killing). Blockade of lipoxin A4 production in mesenchymal stromal cells, and of prostaglandin E2 synthesis in mesenchymal stromal cell/macrophage cocultures, prevented upregulation of heme oxygenase-1 in macrophages (from 9.6 ± 5.5-fold to 2.3 ± 1.3 and 2.4 ± 2.3 respectively, P = 0.004). Knockdown of heme oxygenase-1 production in macrophages ablated mesenchymal stromal cell enhancement of macrophage phagocytosis.

Conclusions
Human umbilical cord mesenchymal stromal cells attenuate systemic sepsis by enhancing peritoneal macrophage bacterial killing, mediated partly via upregulation of peritoneal macrophage heme oxygenase-1. Lipoxin A4 and prostaglandin E2 play key roles in the mesenchymal stromal cell and macrophage interaction.