bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of standardized clinical pathways on esophagectomy: a systematic review and meta-analysis
Authors: Puccetti Francesco , Wijnhoven Bas P L , Kuppusamy MadhanKumar , Hubka Michal , Low Donald E 
Published: May 2021

Summary
Esophageal surgery is historically associated with adverse postoperative outcomes. Selected high-volume centers have previously reported the effect on clinical outcomes following the adoption of a standardized clinical pathway (SCP). This meta-analysis aims to evaluate the current literature to document the effect of SCP and enhanced recovery after surgery (ERAS) on esophagectomy outcomes. A literature search was conducted through the main search engines (PubMed, Embase, Medline, and Cochrane database) in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. All eligible comparative studies (randomized control trial, prospective, retrospective, and combined) were identified and assessed based on Methodological Index for Non-Randomized Studies and Jadad quality criteria. Data concerning overall morbidity, early mortality, and length of stay (LOS) were primarily collected and compared. Secondary outcomes included anastomotic leaks, pulmonary complications, and readmission rate. Twenty-six articles (including five randomized controlled trials and six prospective trials) were included in the analysis. Overall study quality was moderate and the included studies utilized a variable approach to SCP. No statistically significant differences were found between groups in terms of overall morbidity, postoperative mortality, anastomotic leak, and readmission rates. Significant improvements included pulmonary complications (odds ratios [OR] 0.66, 95% confidence interval [CI] 0.49–0.94) and hospital LOS (OR −3.68, 95% CI −4.49 to −2.87). Previous reports of SCP within esophagectomy programs have demonstrated clinical improvements in postoperative pulmonary complications and LOS. Given the high heterogeneity historically demonstrated within SCPs, further improvement in outcomes should be expected following the adoption of standardized ERAS guidelines.
Immunological Networks Defining the Heterogeneity of Inflammatory Bowel Diseases
Authors: Selin Katja A , Hedin Charlotte R H , Villablanca Eduardo J 
Published: May 2021

AbstractCurrent practice in IBD is to classify patients based on clinical signs and symptoms and provide treatments accordingly. However, the response of IBD patients to available treatments is highly variable, highlighting clinically significant heterogeneity among patients. Thus, more accurate patient stratification is urgently needed to more effectively target therapeutic interventions to specific patients. Here we review the degree of heterogeneity in IBD, discussing how the microbiota, genetics, and immune system may contribute to the variation among patients. We highlight how molecular heterogeneity may relate to clinical phenotype, but in other situations may be independent of clinical phenotype, encouraging future studies to fill the gaps. Finally, we discuss novel stratification methodologies as a foundation for precision medicine, in particular a novel stratification strategy based on conserved genes across species. All of these dimensions of heterogeneity have potential to provide strategies for patient stratification and move IBD practice towards personalised medicine.
Pre-hospital heparin use for ST-elevation myocardial infarction is safe and improves angiographic outcomes
Authors: Bloom Jason E , Andrew Emily , Nehme Ziad , Dinh Diem T , Fernando Himawan , Shi William Y , Vriesendorp Pieter , Nanayakarra Shane , Dawson Luke P , Brennan Angela , Noaman Samer , Layland Jamie , William Jeremy , Al-Fiadh Ali , Brooks Matthew , Freeman Melanie , Hutchinson Adam , McGaw David , Van Gaal William , Willson William , White Anthony , Prakash Roshan , Reid Christopher , Lefkovits Jeffrey , Duffy Stephen J , Chan William , Kaye David M , Stephenson Michael , Bernard Stephen , Smith Karen , Stub Dion 
Published: May 2021

Abstract

Aims
This study aims to evaluate if pre-hospital heparin administration by paramedics is safe and improves clinical outcomes.

Methods and results
Using the multicentre Victorian Cardiac Outcomes Registry, linked with state-wide ambulance records, we identified consecutive patients undergoing primary percutaneous coronary intervention for STEMI between January 2014 and December 2018. Information on thrombolysis in myocardial infarction (TIMI) flow at angiography was available in a subset of cases. Patients receiving pre-hospital heparin were compared to those who did not receive heparin. Findings at coronary angiography and 30-day clinical outcomes were compared between groups. Propensity-score matching was performed for risk adjustment. We identified a total of 4720 patients. Of these, 1967 patients had TIMI flow data available. Propensity-score matching in the entire cohort yielded 1373 matched pairs. In the matched cohort, there was no observed difference in 30-day mortality (no-heparin 3.5% vs. heparin 3.0%, P = 0.25), MACCE (no-heparin 7% vs. heparin 6.2%, P = 0.44), and major bleeding (no-heparin 1.9% vs. heparin 1.4%, P = 0.64) between groups. Propensity-score analysis amongst those with TIMI data produced 552 matched pairs. The proportion of cases with TIMI 0 or 1 flow in the infarct-related artery (IRA) was lower among those receiving pre-hospital heparin (66% vs. 76%, P &lt; 0.001) compared to those who did not.

Conclusion
In this multicentre, propensity-score matched study, the use of pre-hospital heparin by paramedics was safe and is associated with fewer occluded IRAs in patients presenting with STEMI.
Directly measured vs. calculated remnant cholesterol identifies additional overlooked individuals in the general population at higher risk of myocardial infarction
Authors: Varbo Anette , Nordestgaard Børge G 
Published: May 2021

Abstract

Aims
We tested the hypothesis that high directly measured remnant cholesterol is associated with increased risk of ischaemic heart disease (IHD) and myocardial infarction (MI) in the general population. We also explored whether directly measured vs. calculated remnant cholesterol is superior in identifying individuals at increased risk.

Methods and results
Overall, 16 207 individuals from the Copenhagen General Population Study with both directly measured and calculated remnant cholesterol, both representing cholesterol content in triglyceride-rich lipoproteins, were followed up for 14 years to analyse the risk for IHD and MI. For directly measured and calculated remnant cholesterol, hazard ratios for individuals with concentrations ≥95th percentile vs. &lt;40th percentile were 1.75 (95% confidence interval 1.42–2.15) and 1.76 (1.42–2.17) for IHD and 2.05 (1.50–2.80) and 1.93 (1.40–2.66) for MI. Compared to individuals with both directly measured and calculated remnant cholesterol &lt;80th percentile (75% of the whole population), those with only directly measured remnant cholesterol ≥80th percentile (5%) had hazard ratios of 1.42 (1.15–1.75) for IHD and 1.83 (1.35–2.47) for MI. Corresponding hazard ratios for individuals with only calculated remnant cholesterol ≥80th percentile (5%) were 1.14 (0.91–1.44) and 1.14 (0.80–1.62), respectively, and corresponding hazard ratios for individuals with both directly measured and calculated remnant cholesterol ≥80th percentiles (15%) were 1.48 (1.30–1.68) and 1.67 (1.38–2.01), respectively. In individuals with high directly measured or high calculated remnant cholesterol, the median directly measured remnant cholesterol was 1.9 and 1.5 mmol/L, the median plasma triglycerides were 2.0 and 2.7 mmol/L, and the median plasma apolipoprotein B was 132 and 142 mg/dL, respectively.

Conclusions
Directly measured vs. calculated remnant cholesterol identifies 5% overlooked individuals in the general population with cholesterol-rich, triglyceride-poor remnants and 1.8-fold increased risk of MI.
Effectiveness and safety of a single freeze strategy of cryoballoon ablation of atrial fibrillation: an EHRA systematic review and meta-analysis
Authors: Farkowski Michal Miroslaw , Karlinski Michal , Barra Sergio , Providencia Rui , Golicki Dominik , Pytkowski Mariusz , Anic Ante , Chun Julian Kyoung Ryul , de Asmundis Carlo , Lane Deirdre Anne , Boveda Serge 
Published: May 2021

Abstract
To conduct a systematic review and meta-analysis to compare the effectiveness and safety of cryoballoon ablation of atrial fibrillation (AF) performed using a single freeze strategy in comparison to an empiric double (‘bonus’) freeze strategy. We systematically searched MEDLINE, EMBASE, and CENTRAL databases from inception to 12 July 2020, for prospective and retrospective studies of patients undergoing cryoballoon for paroxysmal or persistent AF comparing a single vs. bonus freeze strategy. The main outcome was atrial arrhythmia-free survival and eligible studies required at least 12 months of follow-up; the primary safety outcome was a composite of all complications. Study quality was assessed using the Cochrane risk of bias tool and the Newcastle–Ottawa Scale. Thirteen studies (3 randomized controlled trials and 10 observational studies) comprising 3163 patients were eligible for inclusion (64% males, 71.5% paroxysmal AF, mean CHA2DS2-VASc score 1.3 ± 0.9). There was no significant difference in pooled effectiveness between single freeze strategy compared to double freeze strategy [relative risk (RR) 1.03; 95% confidence interval (CI): 0.98–1.07; I2 = 0%]. Single freeze procedures were associated with a significantly lower adverse event rate (RR 0.72; 95% CI: 0.53–0.98; I2 = 0%) and shorter average procedure time (90 ± 27 min vs. 121 ± 36 min, P &lt; 0.001). A trend for lower risk of persistent phrenic nerve palsy was observed (RR 0.61; 95% CI: 0.37–1.01; I2 = 0%). The quality of included studies was moderate/good, with no evidence of significant publication bias. Single freeze strategy for cryoballoon of AF is as effective as an empiric double (‘bonus’) freeze strategy while appearing safer and probably quicker (PROSPERO registration number CRD42020158696).
Fe-S coordination defects in the replicative DNA polymerase delta cause deleterious DNA replication in vivo and subsequent DNA damage in the yeast Saccharomyces cerevisiae
Authors: Chanet Roland , Baïlle Dorothée , Golinelli-Cohen Marie-Pierre , Riquier Sylvie , Guittet Olivier , Lepoivre Michel , Huang Meng-Er , Vernis Laurence 
Published: May 2021

Abstract
B-type eukaryotic polymerases contain a [4Fe-4S] cluster in their C-terminus domain, whose role is not fully understood yet. Among them, DNA polymerase delta (Polδ) plays an essential role in chromosomal DNA replication, mostly during lagging strand synthesis. Previous in vitro work suggested that the Fe-S cluster in Polδ is required for efficient binding of the Pol31 subunit, ensuring stability of the Polδ complex. Here, we analyzed the in vivo consequences resulting from an impaired coordination of the Fe-S cluster in Polδ. We show that a single substitution of the very last cysteine coordinating the cluster by a serine is responsible for the generation of massive DNA damage during S phase, leading to checkpoint activation, requirement of homologous recombination for repair, and ultimately to cell death when the repair capacities of the cells are overwhelmed. These data indicate that impaired Fe-S cluster coordination in Polδ is responsible for aberrant replication. More generally, Fe-S in Polδ may be compromised by various stress including anti-cancer drugs. Possible in vivo Polδ Fe-S cluster oxidation and collapse may thus occur, and we speculate this could contribute to induced genomic instability and cell death, comparable to that observed in pol3-13 cells.
Construction of a high-density genetic map for hexaploid kiwifruit (Actinidia chinensis var. deliciosa) using genotyping by sequencing
Authors: Popowski Elizabeth , Thomson Susan J , Knäbel Mareike , Tahir Jibran , Crowhurst Ross N , Davy Marcus , Foster Toshi M , Schaffer Robert J , Tustin D Stuart , Allan Andrew C , McCallum John , Chagné David 
Published: May 2021

Abstract
Commercially grown kiwifruit (genus Actinidia) are generally of two sub-species which have a base haploid genome of 29 chromosomes. The yellow-fleshed Actinidia chinensis var. chinensis, is either diploid (2n = 2x = 58) or tetraploid (2n = 4x = 116) and the green-fleshed cultivar A. chinensis var. deliciosa “Hayward,” is hexaploid (2n = 6x = 174). Advances in breeding green kiwifruit could be greatly sped up by the use of molecular resources for more efficient and faster selection, for example using marker-assisted selection (MAS). The key genetic marker that has been implemented for MAS in hexaploid kiwifruit is for gender testing. The limited marker-trait association has been reported for other polyploid kiwifruit for fruit and production traits. We have constructed a high-density linkage map for hexaploid green kiwifruit using genotyping-by-sequence (GBS). The linkage map obtained consists of 3686 and 3940 markers organized in 183 and 176 linkage groups for the female and male parents, respectively. Both parental linkage maps are co-linear with the A. chinensis “Red5” reference genome of kiwifruit. The linkage map was then used for quantitative trait locus (QTL) mapping, and successfully identified QTLs for king flower number, fruit number and weight, dry matter accumulation, and storage firmness. These are the first QTLs to be reported and discovered for complex traits in hexaploid kiwifruit.
Rampant Genome-Wide Admixture across theHeliconiusRadiation
Authors: Kozak Krzysztof M , Joron Mathieu , McMillan W Owen , Jiggins Chris D 
Published: May 2021

AbstractHow frequent is gene flow between species? The pattern of evolution is typically portrayed as a phylogenetic tree, yet gene flow between good species may be an important mechanism in diversification, spreading adaptive traits and leading to a complex pattern of phylogenetic incongruence. This process has thus far been studied mainly among a few closely related species, or in geographically restricted areas such as islands, but not on the scale of a continental radiation. Using a genomic representation of 40 out of 47 species in the genus, we demonstrate that admixture has played a role throughout the evolution of the charismatic Neotropical butterflies Heliconius. Modeling of phylogenetic networks based on the exome uncovers up to 13 instances of interspecific gene flow. Admixture is detected among the relatives of Heliconius erato, as well as between the ancient lineages leading to modern clades. Interspecific gene flow played a role throughout the evolution of the genus, although the process has been most frequent in the clade of Heliconius melpomene and relatives. We identify Heliconius hecalesia and relatives as putative hybrids, including new evidence for introgression at the loci controlling the mimetic wing patterns. Models accounting for interspecific gene flow yield a more complete picture of the radiation as a network, which will improve our ability to study trait evolution in a realistic comparative framework.
A bioenergetic model to address carbon sequestration potential of shellfish farming: example from Ruditapes philippinarum in the Venice lagoon
Authors: Bertolini C , Bernardini I , Brigolin D , Matozzo V , Milan M , Pastres R 
Published: May 2021

Abstract
Shellfish are increasingly been looked at as sustainable food sources that provide additional ecosystem services. However, their role as CO2 sinks or sources is still debated. To quantify it, shell accretion dynamics should be accounted for. However, the shell component is usually calculated with allometric scaling, in most bivalve models. With this study, shell accretion was added to a bioenergetic model of the Manilla clam (Ruditapes philippinarum), and a parameter linking assimilated energy towards shell growth (KSH) was calibrated for four sites, where clams from the same cohort were monitored during a transplant experiment. The model was then used to calculate CO2 fluxes resulting from respiration and shell calcification, taking into account CaCO3 stocked in the shell and CO2 emission. The findings show that KSH varied slightly among sites and that clams played a role as a moderate sink of CO2 over a whole year. CO2 fluxes were characterized by a seasonal variability: clams were net sources in wintertime and sinks in summer time, suggesting the need of accounting for seasonality and growth should shellfish farming be included in carbon markets.
Ensuring quality qualitative research reporting in community pharmacy: a systematic literature review
Authors: Aref Heba A T , Witry Matthew , Olufemi-Yusuf Damilola , Guirguis Lisa M 
Published: May 2021

Abstract

Objectives
To evaluate the reporting quality for a sample of community pharmacy qualitative research articles based on the Standards for Reporting Qualitative Research (SRQR) guidelines, data interpretation and use of theory.

Methods
A systematic literature search was conducted using Ovid MEDLINE to identify qualitative research related to community pharmacy. Data were extracted and evaluated based on the SRQR standards, data interpretation level and use of theory. Adherence to standards was analysed using descriptive statistics.

Key findings
Eighty-one studies were retrieved through the database search (n = 81). Then, 31 studies met the inclusion criteria after screening abstracts and full texts. Twelve out of 21 SRQR were present in more than 80% of the studies. However, essential standards, such as research approach, reflexivity and trustworthiness techniques, were absent or partially present in 30 (97%) studies, 30 (97%) studies and 21 (68%) studies, respectively. Data interpretation level was descriptive in 27 (87%) studies and interpretive or partially interpretive in 4 (13%) studies. Theory was absent in 19 (60%) and implied, partially integrated or retrospectively applied in 12 (40%) of the studies.

Conclusion
Trustworthiness and quality of qualitative inferences within community pharmacy research could be enhanced with increasing awareness about reporting; the approach and paradigm, reflexivity, trustworthiness techniques, data interpretation level and theoretical use.
The Rankings Game: A Relational Approach to Country Performance Indicators
Authors: Beaumont Paul , Towns Ann E 
Published: May 2021

Abstract
As the number of international rankings has risen dramatically since the 1990s, a large body of scholarship has emerged to examine and understand them. The aim of this article is to provide an overview of this body of work and to chart out fruitful directions for future research. In short, prior scholarship has been surprisingly quiet on the relations among multiple actors and their economic dimensions at the core of country performance indicator (CPI) activities. To foreground crucial socioeconomic relations, we develop a relational heuristic based upon a sports analogy: the actors involved in the creation and maintenance of CPIs can fruitfully be approached as a complex of players, referees, coaches, and audiences. Such an account helps us better understand how CPIs emerge and are sustained, even when they rely on dodgy data and their effects are perverse. We use nation brand rankings—overlooked in international relations research—as empirical illustration.
Between the Prophetic and Priestly: The Role of Black Pastoral Authority in Health and Science Promotion
Authors: Schneider Rachel C , Bolger Daniel 
Published: May 2021

AbstractHealth researchers often seek to leverage pastoral authority in Black churches to forge community partnerships that address racial health disparities in the United States. Yet, researchers have not fully recognized the range (and limits) of pastoral authority as well as the complex role of religion in African American health. Here we explore how health and science are engaged in Black Church contexts and what role pastoral authority plays in this process. Drawing on focus groups with Black pastors and interviews with congregants, we outline three different dimensions of pastoral authority: gatekeeper, connector, and moral exemplar. We argue that these dimensions create tensions between the priestly and prophetic mandates of Black pastors, which in turn impact how church members engage with health resources and scientific knowledge. These results complicate current understandings of how authority functions in Black churches while underscoring the need to seriously consider Black Religion in studies of religion, health, and science.
Temporal Trends in Pollination Deficits and Its Potential Impacts on Chinese Agriculture
Authors: Mashilingi Shibonage K , Zhang Hong , Chen Wenfeng , Vaissière Bernard E , Garibaldi Lucas A , An Jiandong 
Published: May 2021

Abstract
Worldwide, there is increasing evidence that shows a decline in pollinators, limiting crop pollination and production. However, it is unclear to what extent Chinese agriculture could be impacted by pollinator deficits. Data for 84 major crops in China between 1961 and 2018 were analyzed for the temporal trends in crop area and production, agricultural economic contribution of pollination, crop yield deficits, and honey bee pollination demand. We found a rapid increase in agricultural dependence on insect pollinators: both the cultivated area and total production of pollinator-dependent crops increased faster than those of pollinator-independent crops during 1961–2018. The total economic value of pollination amounted to US$ 106.08 billion in 2010, representing 19.12% of the total production value of Chinese agriculture, approximately twice the 9.5% value estimated for global agriculture. Crops with higher pollinator dependence showed greater mean growth in cultivated area than those with lower dependence, but lower mean growth of crop production and yield. Crop yield growth was also more unstable with increasing pollinator dependence. The minimum pollination demand for honey bee colonies was about three times the stock of honey bee colonies available in 2018. Furthermore, we found a decline in crop yield deficit with the increase in honey bee colony pollination service capacity. We considered that the shortage of pollinators resulted in the yield deficits for pollinator-dependent crops. Future increase in the area of pollinator-dependent crops will increase the need for more pollinators, suggesting the importance of implementing measures to protect pollinators to ensure a better-secured future for agricultural production in China.
“So delightful a temporary home”: The Material Culture of Domesticity in Late Nineteenth-century English Convalescent Institutions
Authors: Anders Eli Osterweil 
Published: May 2021

Abstract
This article examines the material culture of domesticity in late nineteenth-century English convalescent institutions. Convalescent homes drew on powerful Victorian ideas about the physical and moral benefits of “home-like” domestic comfort, which they contrasted with the “institutional” environment of hospitals and the degrading surroundings of urban slums. Administrative records, press accounts, photographs, and patient letters reveal how convalescent homes cultivated temporary home-like environments through architecture, interior decoration, and behavioral expectations and routines. Convalescent homes drew on heterogeneous models of domesticity, including the grand architecture of country estates, the possession-packed spaces of middle-class homes, and the recreational spaces of male social clubs. Nevertheless, they shared a belief in the power of domestic spaces, comforts, and practices to support the recovery of convalescents and to influence their identity and behavior. The material culture and practices of domesticity deployed in convalescent homes encouraged reflection, self-improvement, and self-control—qualities essential to the cultivation of respectable, self-governing, liberal citizens. Nevertheless, the meanings and experiences of these spaces were also shaped by inmates, whose expectations and experiences did not always align with the ideal image of home that authorities wished to create.