bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early antimicrobial stewardship team intervention on appropriateness of antimicrobial therapy in suspected sepsis: a randomized controlled trial
Authors: Rashidzada Zohal , Cairns Kelly A , Peel Trisha N , Jenney Adam W , Doyle Joseph S , Dooley Michael J , Cheng Allen C 
Published: August 2021

AbstractObjectivesThere has been concern that the imperative to administer rapid antimicrobials in septic patients may result in inappropriate antimicrobial use. We aimed to determine the impact of early antimicrobial stewardship (AMS) team intervention in patients with Medical Emergency Team (MET) calls for suspected sepsis.MethodsWe performed a randomized controlled trial of non-ICU inpatients who had a MET call for suspected sepsis. Patients were randomized to standard care (management of antimicrobial therapy by the treating team) or early targeted intervention (AMS review 48 h post-MET call). The primary outcome was appropriateness of antimicrobial therapy 72 h post-MET call, as determined by a panel of blinded infectious diseases physicians.ResultsIn total, 90 patients were enrolled; 45 were randomly allocated to the intervention group, and 45 to the control group. More patients in the AMS intervention group were receiving appropriate antimicrobials 72 h following the MET call (67% versus 44%, P = 0.03). In the intervention group, 27 recommendations were made by the AMS team; 74% of recommendations were accepted, including 30% of cases where antimicrobials were discontinued or de-escalated. There were non-significant differences in total duration of antimicrobial therapy (8.7 versus 10.7 days, P = 0.39), sepsis-related ICU-admission rates (13% versus 18%, P = 0.56) and sepsis-related in-hospital mortality (7% versus 9%, P = 0.71) between intervention and control groups, respectively.ConclusionsAMS team intervention resulted in significant improvement in appropriateness of antimicrobial therapy following MET calls due to suspected sepsis. Targeted AMS review should be implemented to support early antimicrobial de-escalation and optimization in patients with suspected sepsis.
Peritoneal mesothelioma with invasion of the urinary bladder 20 years post radiation therapy for colon adenocarcinoma
Authors: Ong Mingjing Nicole , Asamu Abdul Samad , Pace Keith , Bugeja Simon 
Published: August 2021

Abstract
We present the case of a 66-year-old male with a history of iatrogenic bladder injury and radiation therapy for colon adenocarcinoma 20 years prior. A computed tomography of the thorax, abdomen and pelvis, reported a presacral mass with invasion to the bladder, ureters and lymph nodes. An initial bladder biopsy was histologically inconclusive. A later biopsy taken during emergency bypass surgery for small bowel obstruction, while the patient was positive for coronavirus disease of 2019, concluded that the mass was a peritoneal mesothelioma of epithelioid origin. The combination management of cytoreductive surgery with intraperitoneal chemotherapy has been a near universal standard of care for epithelioid peritoneal mesothelioma provided that the patient is an appropriate candidate for surgical interventions. To the best of our knowledge, this is the first case report of malignant peritoneal mesothelioma as a second primary carcinoma, many years after exposure to radiation therapy for colon adenocarcinoma.
Red Blood Cell Alloimmunization Rates and Related Factors of Patients with Thalassemia in Shiraz, Iran
Authors: Kasraian Leila , Khodadi Elahe , Talei Abolfazl , Morvarid Mohamad Reza , Haddadi Davood , Foruozandeh Hossein 
Published: August 2021

Abstract

Objective
The development of antibodies against red blood cell (RBC) antigens is one of the most significant adverse effects of chronic blood transfusions. This study aimed to estimate the frequency and causes of RBC immunization in patients with major thalassemia.

Methods
The findings could help determine the limitation of current practices and help future developments in the selection of suitable blood units for the transfusion support of patients with thalassemia.

Results
The alloimmunization rate was detected in 52 of 650 patients with major thalassemia (8%). The most frequent antibodies were against K (50%), D (26%), and E (15.4%). Sex, age, and splenectomy did not have any impact on the immunization rate. Immunization was lower in patients who had received only leuko-reduced blood units.

Conclusion
It is recommended that antibody screening before the first transfusion and extended RBC matching particularly for the most frequent antigens (ABO/Rh/Kell) should be performed for patients with thalassemia.
Secular dynamics of a test particle perturbed by a Miyamoto–Nagai disc
Authors: Liu Tao , Gong Shengxia , Liao Xinhao 
Published: August 2021

ABSTRACT
We study the secular behaviour of a test particle orbiting a dominant central body and perturbed by a Miyamoto–Nagai (MN) disc. We derive a quadrupole-level secular Hamiltonian of this system, which involves a dimensionless parameter η that is used to characterize the flattening of MN disc. (The smaller η, the flatter disc; and η = 0 gives the infinitely thin Kuzmin disc.) We find that, in the quadrupole approximation, the perturbation of the MN disc can give rise to the von Zeipel–Lidov–Kozai (ZLK)-like dynamics and depending on the value of η the dynamics has two different manifestations: (i) when η &lt; 1/3, the test particle’s behaviour is similar to that described in the classical ZLK problem. In particular, as η increases from 0 to 1/3, the critical inclination for the large eccentricity oscillations decreases from $26{_{.}^{\circ}}56$ to 0°, ; (ii) when η &gt; 1/3, the orbital evolution of the test particle and the phase-space morphology are opposite to the classical ZLK case. This leads to a striking result that the test particle cannot remain on a near-coplanar orbit if its eccentricity is sufficiently large. However, as η increases further the ZLK-like dynamics would be gradually suppressed by the spherical term in the Hamiltonian. We also survey the global secular dynamics numerically in which the quadrupole approximation is no longer valid.
Dynamics of binary black holes in low-mass young star clusters
Authors: Rastello Sara , Mapelli Michela , Di Carlo Ugo N , Iorio Giuliano , Ballone Alessandro , Giacobbo Nicola , Santoliquido Filippo , Torniamenti Stefano 
Published: August 2021

ABSTRACT
Young star clusters are dynamically active stellar systems and are a common birthplace for massive stars. Low-mass star clusters (∼300–103 M⊙) are more numerous than massive systems and are characterized by a two-body relaxation time-scale of a few Myr: the most massive stars sink to the cluster core and dynamically interact with each other even before they give birth to compact objects. Here, we explore the properties of black holes (BHs) and binary black holes (BBHs) formed in low-mass young star clusters, by means of a suite of 105 direct N-body simulations with a high original binary fraction (100 per cent for stars with mass &gt;5 M⊙). Most BHs are ejected in the first ∼20 Myr by dynamical interactions. Dynamical exchanges are the main formation channel of BBHs, accounting for ∼40–80 per cent of all the systems. Most BBH mergers in low-mass young star clusters involve primary BHs with mass &lt;40 M⊙ and low-mass ratios are extremely more common than in the field. Comparing our data with those of more massive star clusters (103 − 3 × 104 M⊙), we find a strong dependence of the percentage of exchanged BBHs on the mass of the host star cluster. In contrast, our results show just a mild correlation between the mass of the host star cluster and the efficiency of BBH mergers.
Noisy neighbours: inference biases from overlapping gravitational-wave signals
Authors: Antonelli Andrea , Burke Ollie , Gair Jonathan R 
Published: August 2021

ABSTRACTUnderstanding and dealing with inference biases in gravitational-wave (GW) parameter estimation when a plethora of signals are present in the data is one of the key challenges for the analysis of data from future GW detectors. Working within the linear signal approximation, we describe generic metrics to predict inference biases on GW source parameters in the presence of confusion noise from unfitted foregrounds, from overlapping signals that coalesce close in time to one another, and from residuals of other signals that have been incorrectly fitted out. We illustrate the formalism with simplified, yet realistic, scenarios appropriate to third-generation ground-based (Einstein Telescope) and space-based (LISA) detectors, and demonstrate its validity against Monte Carlo simulations. We find it to be a reliable tool to cheaply predict the extent and direction of the biases. Finally, we show how this formalism can be used to correct for biases that arise in the sequential characterization of multiple sources in a single data set, which could be a valuable tool to use within a global-fit analysis pipeline.
Brightest cluster galaxies are statistically special from z = 0.3 to z = 1
Authors: Dalal Roohi , Strauss Michael A , Sunayama Tomomi , Oguri Masamune , Lin Yen-Ting , Huang Song , Park Youngsoo , Takada Masahiro 
Published: August 2021

ABSTRACT
We study brightest cluster galaxies (BCGs) in ∼5000 galaxy clusters from the Hyper Suprime-Cam (HSC) Subaru Strategic Program. The sample is selected over an area of 830 deg2 and is uniformly distributed in redshift over the range of z = 0.3−1.0. The clusters have stellar masses in the range of 1011.8−1012.9M⊙. We compare the stellar mass of the BCGs in each cluster to what we would expect if their masses were drawn from the mass distribution of the other member galaxies of the clusters. The BCGs are found to be ‘special’, in the sense that they are not consistent with being a statistical extreme of the mass distribution of other cluster galaxies. This result is robust over the full range of cluster stellar masses and redshifts in the sample, indicating that BCGs are special up to a redshift of z = 1.0. However, BCGs with a large separation from the centre of the cluster are found to be consistent with being statistical extremes of the cluster member mass distribution. We discuss the implications of these findings for BCG formation scenarios.
Twice exploration of tRNA +1 frameshifting in an elongation cycle of protein synthesis
Authors: Gamper Howard , Mao Yujia , Masuda Isao , McGuigan Henri , Blaha Gregor , Wang Yuhong , Xu Shoujun , Hou Ya-Ming 
Published: August 2021

Abstract
Inducing tRNA +1 frameshifting to read a quadruplet codon has the potential to incorporate a non-natural amino acid into the polypeptide chain. While this strategy is being considered for genome expansion in biotechnology and bioengineering endeavors, a major limitation is a lack of understanding of where the shift occurs in an elongation cycle of protein synthesis. Here, we use the high-efficiency +1-frameshifting SufB2 tRNA, containing an extra nucleotide in the anticodon loop, to address this question. Physical and kinetic measurements of the ribosome reading frame of SufB2 identify twice exploration of +1 frameshifting in one elongation cycle, with the major fraction making the shift during translocation from the aminoacyl-tRNA binding (A) site to the peptidyl-tRNA binding (P) site and the remaining fraction making the shift within the P site upon occupancy of the A site in the +1-frame. We demonstrate that the twice exploration of +1 frameshifting occurs during active protein synthesis and that each exploration is consistent with ribosomal conformational dynamics that permits changes of the reading frame. This work indicates that the ribosome itself is a determinant of changes of the reading frame and reveals a mechanistic parallel of +1 frameshifting with –1 frameshifting.
Le caractère d’ordre public du principe de la libre transmissibilité des actions en droit des sociétés commerciales de l’OHADA
Authors: Tsopbeing Marcel Williams 
Published: August 2021

Abstract
In order to protect various interests and guarantee legal certainty, the OHADA legislator has provided the essential rules for each form or category of company. Thus, the distinction between joint stock companies and public limited companies is based, in particular, on free negotiability and/or the free transferability of shares. To preserve this distinction, the principle of the free transferability of shares is of a public policy nature and therefore justifies a restriction of the contractual freedom of the partners. The latter may in fact have recourse to agreements relating to the transfer of shares (approval clause, preemption clause, inalienability clause) only on condition that this does not entail the abolition of the principle of the free transferability of shares.
Nucleic acid vaccines and CpG oligodeoxynucleotides for allergen immunotherapy
Authors: Jacquet Alain 
Published: August 2021

Purpose of review
Molecular forms of allergen-specific immunotherapy (AIT) are continuously emerging to improve the efficacy of the treatment, to shorten the duration of protocols and to prevent any side effects. The present review covers the recent progress in the development of AIT based on nucleic acid encoding allergens or CpG oligodeoxynucleotides (CpG-ODN).

Recent findings
Therapeutic vaccinations with plasmid deoxyribonucleic acid (DNA) encoding major shrimp Met e 1 or insect For t 2 allergen were effective for the treatment of food or insect bite allergy in respective animal models. DNA expressing hypoallergenic shrimp tropomyosin activated Foxp3+ T regulatory (Treg) cells whereas DNA encoding For t 2 down-regulated the expression of pruritus-inducing IL-31. Co-administrations of major cat allergen Fel d 1 with high doses of CpG-ODN reduced Th2 airway inflammation through tolerance induction mediated by GATA3+ Foxp3hi Treg cells as well as early anti-inflammatory TNF/TNFR2 signaling cascade. Non-canonical CpG-ODN derived from Cryptococcus neoformans as well as methylated CpG sites present in the genomic DNA from Bifidobacterium infantis mediated Th1 or Treg cell differentiation respectively.

Summary
Recent studies on plasmid DNA encoding allergens evidenced their therapeutic potential for the treatment of food allergy and atopic dermatitis. Unmethylated or methylated CpG-ODNs were shown to activate dose-dependent Treg/Th1 responses. Large clinical trials need to be conducted to confirm these promising preclinical data. Moreover, tremendous success of messenger ribonucleic acid (mRNA) vaccines against severe acute respiratory syndrome coronavirus 2 must encourage as well the re-exploration of mRNA vaccine platform for innovative AIT.
Changes in Rates of Hospitalizations due to Cannabis Harms in Ontario, Canada Before the Legalization of Nonmedical Cannabis: Retrospective Population-level Study Between 2003 and 2017
Authors: Zygmunt Austin , Tanuseputro Peter , Brown Catherine , Lima Isac , Rhodes Emily , Myran Daniel 
Published: August 2021

Objectives
To assess the burden of hospitalizations due to cannabis harms in Ontario, Canada before Canada’s legalization of nonmedical cannabis.

Methods
We conducted a retrospective population-level study that included all individuals living in Ontario between 2003 and 2017. We described patterns of hospitalizations due to cannabis harms in men and women by demographics, socioeconomic factors, and mental health comorbidities. We calculated annual crude rates of hospitalizations due to cannabis harms and assessed time trends using Poisson regression models.

Results
There were 39,092 hospitalizations due to cannabis harms among 32,811 unique individuals. Annual hospitalizations due to a cannabis harm increased by 176% between 2003 and 2017 (1712 vs 4730), with increases noted for all age groups and sexes. Rates of hospitalizations due to cannabis harms were greater in young adults, low-income individuals, and those with mental health comorbidities. Overall, the rate of hospitalizations due to cannabis harms increased on average by 7.8% per year (95% CI 7.5–8.0). Women aged 15 to 24 experienced the largest average annual increase (12.2% per year, 95% CI 11.5 to 12.8).

Conclusions
There are distinct patterns of hospitalizations due to cannabis harms in different priority populations. Young women aged 15 to 24 are a key demographic that is disproportionately burdened with a rapid increase in hospitalizations due to cannabis harms. Jurisdictions considering new approaches to cannabis control policy and addiction services should consider the rising burden of harms faced by youth and young adults when planning interventions.
Validation of the AO Spine Sacral Classification System: Reliability Among Surgeons Worldwide
Authors: Schroeder Gregory D. , Karamian Brian A. , Canseco Jose A. , Vialle Luiz R. , Kandziora Frank , Benneker Lorin M. , Rajasekaran Shanmuganathan , Holstein Jörg H. , Schnake Klaus J. , Kurd Mark F. , Dvorak Marcel F. , Vialle Emiliano N. , Joaquim Andrei F. , Kanna Rishi M. , Fehlings Michael , Wilson Jefferson R. , Chapman Jens R. , Krieg James C. , Kleweno Conor P. , Firoozabadi Reza , Öner F. Cumhur , Kepler Christopher K. , Vaccaro Alexander R. 
Published: August 2021

Objectives:
To (1) demonstrate that the AO Spine Sacral Classification System can be reliably applied by general orthopaedic surgeons and subspecialists universally around the world and (2) delineate those injury subtypes that are most difficult to classify reliably to refine the classification before evaluating clinical outcomes.

Design:
Agreement study.

Setting:
All-level trauma centers, worldwide.

Participants:
One hundred seventy-two members of the AO Trauma and AO Spine community.

Intervention:
The AO Sacral Classification System was applied by each surgeon to 26 cases in 2 independent assessments performed 3 weeks apart.

Main Outcome Measurements:
Interobserver reliability and intraobserver reproducibility.

Results:
A total of 8097 case assessments were performed. The kappa coefficient for interobserver agreement for all cases was 0.72/0.75 (assessment 1/assessment 2), representing substantial reliability. When comparing classification grading (A/B/C) regardless of subtype, the kappa coefficient was 0.84/0.85, corresponding to excellent reliability. The kappa coefficients for interobserver reliability were 0.95/0.93 for type A fractures, 0.78/0.79 for type B fractures, and 0.80/0.83 for type C fractures. The overall kappa statistic for intraobserver reliability was 0.82 (range 0.18–1.00), representing excellent reproducibility. When only evaluating morphology type (A/B/C), the average kappa value was 0.87 (range 0.18–1.00), representing excellent reproducibility.

Conclusion:
The AO Spine Sacral Classification System is universally reliable among general orthopaedic surgeons and subspecialists worldwide, with substantial interobserver and excellent intraobserver reliability.
Efficacy and Safety of Locally Injected Tranexamic Acid in Hip Fracture Patients: A Retrospective Review
Authors: Witmer Daniel , Solomito Matthew J. , Kumar Mandeep , Shearier Emily , Davis Stephen 
Published: August 2021

Objective:
To determine whether locally injected tranexamic acid (TXA) used in the surgical treatment of fragility hip fractures can lower transfusion rates without increasing the risk of complications.

Design:
Retrospective comparative cohort.

Setting:
Tertiary referral orthopaedic specialty hospital, Level I trauma center.

Patients/Participants:
A total of 490 patients (252 patients received TXA) 50 years of age and older who underwent surgery for a low-energy fragility fracture of the proximal femur between March 2018 and February 2020 were included in this study.

Intervention:
Use of locally injected TXA at the time of wound closure.

Main Outcome:
The main outcomes of this study were the number of patients requiring postoperative blood transfusions, incidences of venous thromboembolism, and surgical site infections.

Results:
A statistically significant difference was noted in the frequency of transfusion between patients who received TXA compared with those who did not receive TXA (33% vs. 43%, respectively) (P = 0.034). There were no significant differences in venous thromboembolism incidence (0.4% vs. 0.8% TXA vs. No TXA) (P = 0.526) or infections (0.4% vs. 0.4% TXA vs. No TXA) (P = 0.965). Regression analysis indicated that the use of TXA reduced the need for postoperative blood transfusion by 31% (odds ratio: 0.688, 95% CI: 0.477–0.993, P = 0.045).

Conclusion:
Locally injected TXA significantly reduced the need for postoperative transfusion in the surgical treatment of fragility hip fractures. In addition, there was no increased risk of complications in those receiving TXA versus those who did not. Locally injected TXA seems to be both a safe and effective way to reduce postoperative blood transfusions in patients with fragility hip fractures.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Adaptation of the Measure of Processes of Care for the Evaluation of Family-Centeredness of Services in India
Authors: Srinivasan Roopa , Marathe Ashwini , Sane Anushree Arvind , Krishnamurthy Vibha 
Published: August 2021

ABSTRACT:

Objective:
This study aims to (1) adapt the Measure of Processes of Care (MPOC-20) for use in India and (2) evaluate family-centered services for children with disabilities and their caregivers in an urban Indian context.

Methods:
In this cross-sectional observational study, we translated the MPOC-20 into Hindi. Caregivers of children diagnosed with developmental disabilities who read and/or understood Hindi and had received services for ≥6 months were recruited. The psychometric properties of the Hindi MPOC-20 were assessed using factor analysis followed by reliability analyses. The Hindi MPOC-20 was used to assess caregiver perceptions about the family-centeredness of services delivered between October 2016 and February 2017 at Ummeed Child Development Center.

Results:
Of the 170 eligible children, 141 (83%) comprised the study sample. Most were boys (66%) with a median age of 67 months. Factor analyses yielded a 4-factor scale with items loading differently from the original measure. The resulting Hindi MPOC-20 had acceptable to good internal consistency (Cronbach's alpha of scales: 0.71–0.86). On the Hindi MPOC-20, Respectful and Coordinated Care, Enabling Partnership, and Providing Specific Information were identified as strengths and Providing General Information as a relative limitation of the service by caregivers across different income and education groups.

Conclusion:
The Hindi MPOC-20 shows acceptable psychometric properties for use with caregivers of children with disabilities in India. The availability of Hindi MPOC-20 paves the way for the assessment of the family-centeredness of services in India and provides a roadmap for adaptations in other low- and middle-income countries.