bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased mortality in patients with secondary diagnosis of atrial fibrillation: Report from Chinese AF registry
Authors: Shao Xing‐Hui , Yang Yan‐Min , Zhu Jun , Yu Li‐Tian , Liu Li‐Sheng 
Published: July 2020

AbstractBackgroundThe relationship between mortality and the primary diagnosis in AF patients is poorly recognized. The purpose of the study is to compare the differences on mortality in patients with a primary or secondary diagnosis of AF and to identify risk factors amenable to treatment.MethodsThis was a prospective cohort study using data from the Chinese AF registry. For admitted patients, a follow‐up was completed to obtain the outcomes during 1 year.ResultsA total of 2015 patients with confirmed AF were included. AF was the primary diagnosis in 40.9% (n = 825) of them. 78.9% (n = 939) of the secondary AF diagnosis patients and 55.5% (n = 458) of the primary AF diagnosis patients were sustained AF. Compared with primary AF diagnosis group, the secondary AF diagnosis group was older with more comorbidities. At 1 year, the unadjusted mortality was much higher in the secondary AF diagnosis groups compared with the primary AF diagnosis groups. In Cox regression analysis with adjustment for confounding factors, patients with secondary AF diagnosis were associated with an increased mortality (relative risk 1.723; 95% CI: 1.283 to 2.315, p < .001). On multivariate analysis, age ≥ 75, LVSD, COPD, and diabetes were independent predictors of mortality in patients with primary AF diagnosis, while for the secondary AF diagnosis group, the risk factors were age ≥ 75, heart failure, and previous history of stroke.ConclusionsPatients presenting to ED with secondary diagnosis of AF were suffering from higher mortality risks compared with primary AF diagnosis patients. Physicians should distinguish these two groups in clinical practice.
Continuous deep sedation and the doctrine of double effect: Do physicians not intend to make the patient unconscious until death if they gradually increase the sedatives?
Authors: Arima Hitoshi 
Published: July 2020

AbstractContinuous deep sedation (CDS) has the effect of making the patient unconscious until death, and that it has this effect is clearly an undesirable aspect of CDS. However, some authors have recently maintained that many physicians do not intend this effect when practicing CDS. According to these authors, CDS is differentiated into two types; in what is called “gradual” CDS (or CDS as a result of proportionate palliative sedation), physicians start with low doses of sedatives and increase them only gradually, whereas in “rapid” CDS (or palliative sedation to unconsciousness), physicians rapidly administer a heavy dose that clearly induces unconsciousness from the beginning. The claim is that the physicians intend permanent unconsciousness only if they rapidly administer a heavy dose, but they do not intend it when the unconsciousness is the result of a gradual increase of sedatives. This paper attempts to refute these claims based on a close examination of the protocol of gradual CDS. If my argument is valid, the doctrine of double effect would not be useful in justifying most, if not all, cases of CDS.
Human disturbance and the activity patterns and temporal overlap of tapirs and jaguars in reserves of NW Belize
Authors: Monette Victoria D. , Kelly Marcella J. , Buchholz Richard 
Published: July 2020

AbstractHuman disturbance from tourism and other non‐consumptive activities in protected areas may be stressful to wildlife. Animals may move away in space or time to avoid human interaction. For species of particular conservation concern, such as Baird's tapirs (Tapirus bairdii) and jaguars (Panthera onca), a better understanding of how they respond to different levels and types of disturbance is needed in order to manage human visitation to parks in ways that minimize negative outcomes for wildlife. We describe the overlap in activity patterns of tapirs, jaguars, and humans at logged and unlogged sites and at places with low versus high human visitation using camera survey data from protected areas of NW Belize, 2013–2016. Tapirs were nocturnal in all study sites, with > 80% of all tapir detections occurring between 1900 hr and 0500 hr. Their activity patterns were not different in unlogged versus logged sites and did not change with increased human traffic. Jaguars were cathemeral across sites but had more nocturnal activity at the site with the most human impact. Activity pattern overlap between tapirs and jaguars did not differ significantly between logged and unlogged sites, nor between areas with low and high human activity. Human traffic increased from 2013 to 2016 at most of the study locations. In conclusion, this camera trap dataset suggests that non‐consumptive human disturbance does not alter the activity patterns of tapirs and jaguars in protected areas lacking hunting pressure.Abstract in Spanish is available with online material.
In vivo demonstration of immunologic cross‐reactivity to octylisothiazolinone in patients primarily and strongly sensitized to methylisothiazolinone
Authors: Russo Juan Pedro , Aerts Olivier 
Published: July 2020

AbstractBackgroundNotwithstanding that concomitant exposure to different isothiazolinone derivatives may result in concomitant sensitization, clinical and animal studies have suggested cross‐reactivity between these derivatives, notably between methylisothiazolinone (MI) and octylisothiazolinone (OIT).ObjectiveTo investigate if patients sensitized to MI show cross‐reactions to OIT and/or to benzisothiazolinone (BIT) by applying the concept of the re‐test method.Patients And MethodsFrom March to October 2019 consecutive patients were patch tested with MI 0.2% aqueous in duplicate at the two lower corners of both shoulder blades. Patients sensitized to MI, but not to OIT 0.1% petrolatum (pet.) nor to BIT 0.1% pet., were re‐tested, 2 months later, with the latter two derivatives at the skin sites where the MI reactions had fully disappeared.ResultsOf 116 patients, 15 (13%) were sensitized to MI, eight of these not sensitized to BIT nor to OIT. Of these, seven patients, all (very) strongly sensitized to MI, were re‐tested: five patients showed positive patch test reactions to OIT 0.1% pet.; one patient to OIT 0.1% pet. and BIT 0.1% pet.; and one other patient showed no reactions.ConclusionThis study suggests that patients primarily and strongly sensitized to MI may show immunologic cross‐reactions to OIT, and to a far lesser extent to BIT.
Provision of dietary advice for people with an ileostomy: a survey in the UK and Ireland
Authors: Mitchell A. , England C. , Atkinson C. 
Published: July 2020

AbstractAimThe aim was to explore whether people with an ileostomy in the UK and Ireland receive the dietary advice they require.MethodAn online survey with multiple‐choice questions asked people with an ileostomy about the dietary advice they received and would have preferred to receive. Participants were recruited via websites of the Ileostomy and Internal Pouch Association and Crohn’s and Colitis UK and via social media. People with a current ileostomy, age 16 years or over, and living in the UK or Ireland were eligible for inclusion. Responses were analysed using descriptive statistics.ResultsIn all, 291 eligible responses were received and included in the analysis; 201 (69%) received advice on diet for their ileostomy from a healthcare professional or the internet. Of the 90 who did not receive dietary advice, 82 (91%) would have liked advice. Stoma nurses were the most common source of dietary advice (55%), but many other sources were frequently reported. Most (62%) felt that at least some dietary advice they received was conflicting. Over half (55%) felt anxious about managing their diet with a new ileostomy, 39% were confused, and 31% frustrated. Of 291 respondents, 29% received advice from a dietitian compared to 60% who would have preferred advice from a dietitian.ConclusionMany people undergoing ileostomy surgery do not receive the dietary advice and support they require. Healthcare professionals working with people with an ileostomy should be mindful they are often anxious about their diet and require clear and consistent dietary advice and support.
Alpha‐1‐antitrypsin deficiency (carrier) as possible risk factor for development of colonic diverticula. A multicentre prospective case–control study: the ALADDIN study
Authors: Rottier S. J. , Dreuning L. C. , van Pelt J. , van Geloven A. A. W. , Beele X. D. Y. , Huisman P. M. , Deurholt W. Y. , Rottier C. A. , van Leeuwen K. , de Boer M. , van Mierlo G. , Boermeester M. A. , Schreurs W. H. ,   for the ALADDIN Collaborative Study Group
Published: July 2020

AbstractAimConnective tissue changes due to ageing or diseases leading to changes in the colonic wall are one theory for the development of diverticula. Alpha‐1‐antitrypsin (A1AT), a protease inhibitor that protects connective tissue, possibly plays a role in the aetiology of diverticulosis. The aim of this study was to explore associations between the development of diverticula and A1AT deficiency.MethodsThis was a multicentre prospective case–control study. A total of 221 patients aged ≥ 60 years with acute abdominal pain undergoing abdominal CT were included and analysed. Patients with diverticula were defined as the research group, patients without diverticula as controls. Genotype analysis for A1AT deficiency was performed.ResultsTwenty‐six of 221 (11.8%) patients were diagnosed with (being a carrier of) A1AT deficiency. A non‐significant difference in prevalence between patients with and without diverticula was found, 20 (13.9%) of 144 vs 6 (7.8%) of 77, respectively, with a crude OR of 1.9 (95% CI 0.7–5.0; P = 0.186) and after adjustment for confounders an adjusted OR of 1.5 (95% CI 0.5–4.0; P = 0.466). A non‐significant difference in 30‐day mortality rate from acute diverticulitis between A1AT deficient patients (or carriers) and those without was observed: two (22.2%) of nine patients with A1AT deficiency vs 1 (1.8%) of 55 without.ConclusionWe found no convincing evidence that A1AT deficiency plays a role in the aetiology of diverticulitis, although deficient patients and carriers had a higher mortality when experiencing diverticulitis. Diverticulitis is a multifactorial disease and larger numbers may be needed to explore the role of A1AT deficiency among other contributing factors.
The challenging diagnosis of overlapping oral primary/secondary syphilis with nonreactive serology
Authors: Ramírez‐Amador Velia , Anaya‐Saavedra Gabriela , Calva‐Mercado Juan Jose 
Published: July 2020

AbstractThe prevalence of oral syphilis, known as “the great imitator” because of its diagnostic complexity and varied clinical manifestations, is increasing worldwide, particularly in people living with HIV (PLWH), who could present false‐negative serological results. Although some studies have described the variable presentation of oral syphilis in the context of HIV infection, the difficulty in distinguishing between the primary and secondary stages, clinically and histopathologically, underscores the need to describe atypical cases. We report the case of a 28‐year‐old HIV‐positive man presenting with a 3‐month history of painless white/red ulcerated lesion on the soft palate. Physical examination revealed an ulcerated lesion with local signs of inflammation. Initial biopsy revealed a nonspecific inflammatory process and immunohistochemistry (IHC) using anti‐Treponema pallidum antibodies showed negative results. The results of serological tests for syphilis (Venereal Disease Research Laboratory and fluorescent treponemal antibody‐absorption test) were negative on repeated occasions. Nonetheless, polymerase chain reaction (PCR) assay and subsequent IHC for T. pallidum showed positive results, confirming the diagnosis of oral syphilis. This case illustrates that the diagnosis of oral syphilis is challenging in the absence of serological evidence, and specific tests such as PCR and IHC are useful complementary diagnostic tools.
Subverting Process‐Based Controls: Oscillation in Automotive Recalls and a Simulation on Opportunism within a Network
Authors: DuHadway Scott , Narasimhan Ram 
Published: July 2020

ABSTRACTThe increase in the frequency and impact of automotive recalls has had broad reaching economic and social consequences. Recent examples of automotive recalls suggest that some are due to deliberate actions of firms to subvert processes designed to ensure quality. Such controls are dependent on partners acting in good faith in the relationship and abiding by relational norms and so do not recognize the risks of firms lying, falsifying data, or intentionally circumventing process‐based controls. Data on automotive recalls shows that recalls exhibit a statistically significant oscillatory pattern with an estimated period of around 3.6 years. We argue that the cyclical pattern in automotive recalls is due, in part, to opportunistic behavior within a network, which is likely to spread and be reciprocated. To test whether opportunism can lead to similar network effects, we develop an agent‐based simulation to model opportunism within a network of connected firms. The simulation is based on an extension of the prisoner's dilemma where the cooperate/defect decision is based on a dyadic relational model driven by trust, knowledge, and dependence levels within each relationship. The results from the simulation suggest that cyclical patterns, similar to those in automotive recalls, emerge as well as “behavioral clustering” within the network, where connected firms exhibit highly similar behaviors that tend to cycle within small clusters. Therefore, opportunistic behavior in supply networks might be an important, relational determinant of product recalls. Our dynamic modeling approach differs from current perspectives on understanding product recalls, contributing to the current literature.
Fatigue behaviour of the bond interface between carbon fibre‐reinforced polymer sheets and concrete
Authors: Wei Mu‐Wang , Xie Jian‐He , Huang Pei‐Yan , Huang Kun‐Hong 
Published: July 2020

AbstractExternally bonded carbon fibre‐reinforced polymers (CFRPs) have been applied to retrofit and strengthen civil structures. In this study, four‐point bending beams were manufactured and tested to examine the fatigue behaviour of the CFRP–concrete interface. The results indicated that the specimens exhibited debonding failure in the concrete beneath the adhesive layer under static loading. However, when cyclic loads were imposed on the small beams, debonding failure may occur in the adhesive layer. Moreover, fitting expressions were proposed to predict the shear stress–slip relationship between the CFRP sheets and concrete and the flexural strength of the CFRP‐strengthened beams under static loads, and good agreement with the test data was obtained. Finally, a fatigue life prediction model was also presented to capture the fatigue life of the CFRP–concrete interface under cyclic loads. The calculation results showed that the fatigue strength of the CFRP–concrete bond interface was approximately 65% of the ultimate load capacity.
Efficacy and Contextual (Placebo) Effects of CGRP Antibodies for Migraine: Systematic Review and Meta‐analysis
Authors: Forbes Raeburn B. , McCarron Mark , Cardwell Chris R. 
Published: July 2020

BackgroundCGRP Antibodies are high‐cost newly licensed migraine preventatives.ObjectiveTo calculate the overall reduction in monthly migraine days and the proportion contextual effect (PCE) using meta‐analysis. The PCE is the ratio between the reduction in Monthly Migraine Days in the placebo group and the reduction in Monthly Migraine Days in the CGRP‐Ab group after 3 months of treatment.MethodsMeta‐analysis of randomized double‐blind placebo‐controlled trials of anti‐CGRP antibodies in people with episodic migraine (EM) or chronic migraine (CM) in persons aged 18 or over. Non‐randomized trials and trials in persons under 18 years excluded. Search of National Clinical Trials Register 2000‐2019, MEDLINE to September 2019, Hand search of major headache conference abstract books 2012‐2019. Two investigators used standard proforma to reach consensus. Trial quality assessed using Cochrane Collaboration risk of bias tool. PRISMA guidelines followed.Results21 completed trials with 13367 participants (8075 EM, 5292 CM). Compared to placebo, pooled reduction in MMD was 1.50 days in 15 EM trials (95%CI 1.16, 1.84; I2 = 69%, Phetereogeneity < .001) and 2.24 days in 7 CM trials (95%CI 1.82, 2.65, I2 = 15%, Phetereogeneity = .320). In EM trials, pooled PCE was 0.66 (95%CI 0.59,0.75; I2 = 64%, Phetereogeneity = .001). In CM trials the PCE was .68 (95%CI 0.61, 0.75; I2 = 20%, Phetereogeneity = .280). Industry funded every study, but risk of bias was low.ConclusionsCGRPAbs are effective but sixty‐six percent of the benefit is from contextual effects, including placebo effect. Contextual effects merit further scrutiny as a means of improving migraine headache.
Clinical and cost effectiveness of a multi-professional medication reviews in care homes (CAREMED)†
Authors: Desborough James A , Clark Allan , Houghton Julie , Sach Tracey , Shaw Val , Kirthisingha Viveca , Holland Richard C , Wright David J 
Published: July 2020

Abstract

Objectives
With 70% of care home residents experiencing a medication error every day in the UK, better multi-professional working between medical practitioners, pharmacists and care homes was recommended. The aim of this study was to determine the effectiveness (falls reduction) and cost-effectiveness, of a multi-professional medication review (MPMR) service in care homes for older people.

Method
A total of care homes in the East of England were cluster randomised to ‘usual care’ or two multi-professional (General practitioner, clinical pharmacist and care homes staff) medication reviews during the 12-month trial period. Target recruitment was 900 residents with 10% assumed loss to follow-up. Co-primary outcome measures were number of falls and potentially inappropriate prescribing assessed by the Screening Tool of Older Persons Prescriptions.

Key findings
A total of 826 care home residents were recruited with 324 lost to follow-up for at least one primary outcome measure. The mean number of falls per resident per annum was 3.3 for intervention and 3.0 for control (P = 0.947). Each resident was found to be prescribed 0.69 (intervention) and 0.85 (control) potentially inappropriate medicines after 12 months (P = 0.046). No significant difference identified in emergency hospital admissions or deaths. Estimated unadjusted incremental mean cost per resident was £374.26 higher in the intervention group.

Conclusions
In line with other medication review based interventions in care homes, two MPMRs improved medication appropriateness but failed to demonstrate improvements in clinical outcomes. From a health system perspective costs where estimated to increase overall and therefore a different model of medicines management is required.
How COVID‐19 has pushed us into a medical education revolution
Authors: Torda Adrienne 
Published: July 2020

AbstractThe COVID‐19 pandemic has had a profound effect on society and higher education in Australia. In just a few weeks, entire courses have been re‐structured and are now delivered online. The need to adapt rapidly has prompted many innovative changes that will ultimately have long‐term benefits for medical education in Australia and New Zealand.
Creating the data basis to adapt agricultural decision support tools to new environments, land management and climate change—A case study of the RiceAdvice App
Authors: Cotter Marc , Asch Folkard , Abera Bayuh Belay , Andre Chuma Boshuwenda , Senthilkumar Kalimuthu , Rajaona Arisoa , Razafindrazaka Ando , Saito Kazuki , Stuerz Sabine 
Published: July 2020

AbstractIncreasing demand for land to ensure human food security in the future has already impelled agricultural production into marginal areas. The environmental conditions found there have a more pronounced impact on agricultural productivity than in the systems used so far under favourable conditions. In addition to this challenge, climate change is expected to increase the unreliability of weather conditions (through increased variability and occurrence of extremes) for farmers considerably. This unreliability is even more serious in developing countries’ farming system where food security is vulnerable. Current efforts in digitalization offer great possibilities to improve farmers` decision‐making processes. A wide range of online tools and smartphone applications is available to support both agricultural extension services and smallholder farmers alike. These apps are often parameterized and validated to certain environments and are troubled when applied to new geographical locations and different environmental conditions. We have conducted field trials to demonstrate potential methods to close knowledge gaps in the data background for one of these apps, RiceAdvice, concerning three key aspects: shifting of cropping calendar, adjustment of fertilizer management and genotype selection. Sites in Ethiopia, Madagascar and Rwanda were selected to represent altitudinal gradients, with overlapping elevations reflecting differences in temperature to enable cross‐country comparisons. Planting dates were distributed throughout three calendar years, with continuous iterative planting dates taking place in Madagascar, in‐ and off‐season planting dates in Rwanda with different fertilizer applications, and one planting date during each rainy season in Ethiopia with different management options. With these trials, we have been able to identify key data sets needed for the adaptation of agricultural decision support tools to new environments. These include the assessment of climatic constraints on innovations to cropping calendars (e.g. double cropping), informed selection of alternative varieties able to complete crucial parts of their phenological development to avoid temperature‐related stress inducing, for example spikelet sterility in rice in late development stages and the effectivity of potential innovations in fertilizer management strategies.
Use of cardiovascular drugs and risk of incident heart failure in patients with atrial fibrillation
Authors: Wändell Per , Carlsson Axel C. , Li Xinjun , Holzmann Martin J. , Sundquist Jan , Sundquist Kristina 
Published: July 2020

AbstractCongestive heart failure (CHF) is the most important cause of death in patients with atrial fibrillation (AF). We aimed to study the association between cardiovascular drugs in AF patients and incident CHF. The study population included all adults (n = 120 756) aged ≥45 years diagnosed with AF in Sweden diagnosed for the period 1998‐2006. Outcome was incident congestive heart failure (follow‐up 2007‐2015) in AF patients. Associations between treatment with cardiovascular pharmacotherapies and CHF were evaluated using Cox regression to estimate hazard ratios (HRs) with 95% CIs, after adjustment for age, sociodemographic variables, and comorbidities. During a mean 5.3 years (SD 3.0) of follow‐up, there were 28 257 (23.4%) incident cases of CHF. Treatment with beta‐1‐selective and non‐selective beta‐blockers and statins was associated with lower risks of incident CHF in men, HR, (95% CI); 0.90, (0.87‐0.94); 0.90, (0.84‐0.97), and 0.94, (0.90‐0.99), respectively. Only beta‐1‐selective beta‐blockers were protective in women 0.94 (0.91‐0.98). Treatment with loop diuretics, potassium‐saving agents, ACE inhibitors, and angiotensin receptor blockers was associated with a higher risk of CHF. For men, treatment with heart‐active calcium channel blockers also led to a higher risk of CHF. In conclusion, we found that beta‐blockers, in particular, but also statins were associated with lower risk of incident CHF in patients with AF.