bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interhospital transport of critically ill patients: A prospective observational study of patient and transport characteristics
Authors: Eiding Helge , Kongsgaard Ulf E. , Olasveengen Theresa M. , Heyerdahl Fridtjof 
Published: November 2021

AbstractBackgroundThe cohort of critically ill patients transported between Intensive Care Units (ICUs) in Norway has not been studied previously. The aim of this study was to describe the characteristics of patients and transports for different types of interhospital transfers and explore whether there were differences in morbidity and mortality between the different transfer categories and the general Norwegian ICU population.MethodsAll transports of critically ill adult patients transferred between two geographically different Intensive Care Units during a one‐year period were registered. Patient and transport data were obtained from The Norwegian Intensive Care Registry, The Norwegian Cause of Death Registry, the hospital Electronic Patient Journal, the Air Ambulance Journal System, and the Emergency Medical Communication Centre database.Results821 transports of 788 surgical and medical patients were enrolled. Simplified Acute Physiology Scores (SAPSII) were 43, 36 and 38 for urgent secondary transport, non‐urgent secondary transport and return transfers, respectively. These were comparable to nationwide SAPSII scores that were 40 for university hospitals and 34 for local hospitals during the same time period. The return transfers had a median SOFA‐score of 4.7 and 53% were mechanically ventilated. Only 33% of return transfers were performed by established teams.ConclusionIntensive care patients transferred between ICUs are as critically ill as the rest of the ICU population, with a similar morbidity and mortality. The return transfers of ICU‐patients appear under‐triaged compared to secondary transports in terms of allocated resources.
Indications and diagnosis‐specific features of maternal and neonatal peripartum intensive care unit admissions: A retrospective study
Authors: Taube Hamutal S. , Matot Idit , Levy Nadav , Goren Or , Marom Ronella , Weiniger Carolyn F. 
Published: November 2021

AbstractBackgroundAlthough peripartum intensive care unit admission indications are well‐reported, clinical and laboratory details rarely are. We described admission indications and categorised laboratory values and vital signs according to admission diagnosis.MethodsRetrospective Institutional Review Board approved study. We identified intensive care unit admission diagnosis, laboratory values and vital signs from patient charts. Groups were compared according to admission diagnoses. Data were analysed using descriptive statistics.ResultsWe included 91 general intensive care unit admissions among 56,865 deliveries (2011–2015) with complete data. The most common admission diagnosis was postpartum haemorrhage followed by hypertensive diseases of pregnancy and respiratory complications. Women with postpartum haemorrhage had lower mean (standard deviation) platelet counts (120.2 (45.8) vs. 181.2 (109.9), p = .003) and temperatures (35.7 (1.1) vs. 36.5 (1.2), p = .002). Women with hypertensive diseases of pregnancy had higher mean (standard deviation) blood pressures (systolic 150.4 (29.1) vs. 127.4 (21.0), p = .013, diastolic 100.3 (18.7) vs. 76.1 (16.1), p = .001), creatinine (1.1 (0.6) vs. 0.8 (0.3), p = .003), urea (14.6 (7.7) vs. 10.5 (4.7), p = .005) and liver enzymes, including aspartate transaminase (258.4 (297.0) vs. 41.4 (42.9), p = .000), alanine transaminase (184.4 (199.2) vs. 35.1 (75.9), p = .000), and alkaline phosphatase (166.6 (112.6) vs. 96.0 (60.0), p = .006). Women with respiratory complications had lower mean (standard deviation) oxygen saturations (93.7 (6.1) vs. 98.0 (2.6), p = .000), and higher mean (standard deviation) temperatures (37.1 (0.8) vs. 36.0 (1.2), p = .001).ConclusionsWe report differences in laboratory values and vital signs, according to intensive care unit admission diagnosis. Recognising these differences might help individualise patient assessment and care.
α‐synuclein suppresses microglial autophagy and promotes neurodegeneration in a mouse model of Parkinson’s disease
Authors: Tu Hai‐Yue , Yuan Bao‐Shi , Hou Xiao‐Ou , Zhang Xiao‐Jun , Pei Chong‐Shuang , Ma Ya‐Ting , Yang Ya‐Ping , Fan Yi , Qin Zheng‐Hong , Liu Chun‐Feng , Hu Li‐Fang 
Published: November 2021

AbstractThe cell‐to‐cell transfer of α‐synuclein (α‐Syn) greatly contributes to Parkinson's disease (PD) pathogenesis and underlies the spread of α‐Syn pathology. During this process, extracellular α‐Syn can activate microglia and neuroinflammation, which plays an important role in PD. However, the effect of extracellular α‐Syn on microglia autophagy is poorly understood. In the present study, we reported that extracellular α‐Syn inhibited the autophagy initiation, as indicated by LC3‐II reduction and p62 protein elevation in BV2 and cultured primary microglia. The in vitro findings were verified in microglia‐enriched population isolated from α‐Syn‐overexpressing mice induced by adeno‐associated virus (AAV2/9)‐encoded wildtype human α‐Syn injection into the substantia nigra (SN). Mechanistically, α‐Syn led to microglial autophagic impairment through activating toll‐like receptor 4 (Tlr4) and its downstream p38 and Akt‐mTOR signaling because Tlr4 knockout and inhibition of p38, Akt as well as mTOR prevented α‐Syn‐induced autophagy inhibition. Moreover, inhibition of Akt reversed the mTOR activation but failed to affect p38 phosphorylation triggered by α‐Syn. Functionally, the in vivo evidence showed that lysozyme 2 Cre (Lyz2cre)‐mediated depletion of autophagy‐related gene 5 (Atg5) in microglia aggravated the neuroinflammation and dopaminergic neuron losses in the SN and exacerbated the locomotor deficit in α‐Syn‐overexpressing mice. Taken together, the results suggest that extracellular α‐Syn, via Tlr4‐dependent p38 and Akt‐mTOR signaling cascades, disrupts microglial autophagy activity which synergistically contributes to neuroinflammation and PD development.
Observation unit use among patients with cancer following emergency department visits: Results of a multicenter prospective cohort from CONCERN
Authors: Klotz Adam D. , Caterino Jeffrey M. , Durham Danielle , Felipe Rico Juan , Pallin Daniel J. , Grudzen Corita R. , McNaughton Caroline , Marcelin Isabelle , Abar Beau , Adler David , Bastani Aveh , Bernstein Steven L. , Bischof Jason J. , Coyne Christopher J. , Henning Daniel J. , Hudson Matthew F. , Lyman Gary H , Madsen Troy E. , Reyes‐Gibby Cielito C. , Ryan Richard J. , Shapiro Nathan I. , Swor Robert , Thomas Charles R. , Venkat Arvind , Wilson Jason , Jim Yeung Sai‐Ching , Yilmaz Sule , Stutman Robin , Baugh Christopher W. 
Published: November 2021

AbstractPurposeEmergency department (ED) visits by patients with cancer frequently end in hospitalization. As concerns about ED and hospital crowding increase, observation unit care may be an important strategy to deliver safe and efficient treatment for eligible patients. In this investigation, we compared the prevalence and clinical characteristics of cancer patients who received observation unit care with those who were admitted to the hospital from the ED.MethodsWe performed a multicenter prospective cohort study of patients with cancer presenting to an ED affiliated with one of 18 hospitals of the Comprehensive Oncologic Emergency Research Network (CONCERN) between March 1, 2016 and January 30, 2017. We compared patient characteristics with the prevalence of observation unit care usage, hospital admission, and length of stay.ResultsOf 1051 enrolled patients, 596 (56.7%) were admitted as inpatients, and 72 (6.9%) were placed in an observation unit. For patients admitted as inpatients, 23.7% had a length of stay ≤2 days. The conversion rate from observation to inpatient was 17.1% (95% CI 14.6–19.4) among those receiving care in an observation unit. The average observation unit length of stay was 14.7 h. Patient factors associated ED disposition to observation unit care were female gender and low Charlson Comorbidity Index.ConclusionIn this multicenter prospective cohort study, the discrepancy between observation unit care use and short inpatient hospitalization may represent underutilization of this resource and a target for process change.
Phase 1 trial of intraperitoneal paclitaxel in combination with intravenous cisplatin and oral capecitabine in patients with advanced gastric cancer and peritoneal metastases (IPGP study)
Authors: Vatandoust Sina , Bright Tim , Roy Amitesh Chandra , Abbas Muhammad Nazim , Watson David Ian , Gan Susan , Bull Jeff , Sorich Michael , Scott‐Hoy Alex , Luu Lee‐Jen , Karapetis Christos Stelios 
Published: November 2021

AbstractAimsGastric cancer with peritoneal involvement has a poor prognosis. Intraperitoneal (IP) paclitaxel has shown promising results in these patients. However, this approach has only been studied in the Asian population, and in combination with S‐1. We investigated the maximum tolerated dose of IP paclitaxel, with a standard chemotherapy combination, in the Australian population.MethodsThe study of the population included metastatic human epidermal growth factor receptor 2 (HER2) negative gastric adenocarcinoma with peritoneal involvement. Treatment included six 21‐day cycles of cisplatin (80 mg/m2 IV, day 1) plus capecitabine (1000 mg/m2 PO BD, days 1–14) plus IP paclitaxel (days 1 and 8). IP paclitaxel doses for cohort 1–3 were 10, 20, and 30 mg/m2, respectively, in a 3 + 3 standard dose‐escalation design.ResultsFifteen patients were enrolled of which 6 were female and the median age was 63. Two patients developed dose‐limiting toxicities. No grade 4/5 toxicities were recorded. The maximum tolerated dose was not reached. Therefore, as defined by the study protocol, the recommended phase‐2 dose for IP paclitaxel was determined to be 30 mg/m2. The 12‐month survival rate was 46.7%, and the median survival was 11.5 months (interquartile range [IQR]: 15.3–6.9).ConclusionsIP paclitaxel is safe in combination with cisplatin and capecitabine and the recommended phase‐2 dose is 30 mg/m2.
Regorafenib outcomes from the population based South Australian Metastatic Colorectal Cancer Registry
Authors: Alawawdeh Anas , Price Timothy , Karapetis Christos , Piantadosi Cynthia , Padbury Rob , Roy Amitesh , Maddern Guy , Moore James , Carruthers Scott , Roder David , Townsend Amanda R. 
Published: November 2021

AbstractAimReviewing outcomes of regorafenib use in metastatic colorectal cancer using real‐world data from the South Australian Metastatic Colorectal Cancer Registry.MethodsA retrospective review of the characteristics and outcomes of patients who received regorafenib in the Registry up to December 2018. The registry started in February 2006.ResultsFifty‐three patients received regorafenib therapy since approved by the therapeutic goods administration in November 2013. The median age was 66 (range 34–82). 66% were male, 66% had stage IV disease at diagnosis, 53% had liver only involvement, whereas 13% had liver and lung disease and 6% had lung only involvement. 75% had left‐sided primary. KRAS was available in 35/53 patients with 49% of them being WT. BRAF status was known in 8/53 with 25% of them having a mutated variant. MSI testing was known in 14 patients in whom 21% of them had MSI‐High tumors. Prior lines of treatment received: one line 4%, two 9%, three 23%, four 26%, >four 37%. Prior biological use: bevacizumab 72%, anti‐EGFR 100% (for RAS WT). Median survival from diagnosis was 3.3 years (95% CI, 2.8–3.8 years). Median survival from the start of regorafenib was 7.1 months (95% CI, 4.8–9.4 months) and the 12‐month survival rate was 28%.ConclusionThe survival outcome for those patients from our population‐based registry who access regorafenib is in keeping with reports from large, randomized trials. Thus, clinicians can quote local real world data when discussing efficacy and access to regorafenib therapy for mCRC patients.
Watching fracking
Authors: SZOLUCHA ANNA 
Published: November 2021

ABSTRACTThe UK government's efforts to facilitate shale gas exploration have been matched by a surge of public opposition. The latter has manifested in a broad spectrum of activities in which local communities have “watched fracking”—meaning they have observed, protested, and filmed outside the drilling site, often taking note of when the pumps start and stop. Drawing on ethnographic fieldwork in northwest England, I analyze residents’ various “watching” activities as one dynamic through which they sought to mediate situated modes of sociopolitical erasure. Watching fracking was a form of directly participating in public matters, compensating the watchers for the state's perceived failures and those of corporate models of community engagement. It also helped members of the anti‐fracking community distance themselves from the state and their own feelings of alienation. By thus highlighting how disappointment with state formations interacts with an activist subjectivity, anthropologists can deepen our understanding of the changing relationship between state and society. [fracking, public engagement, state, citizen science, protest, extractive industry, Lancashire, United Kingdom]
Role of the supinator muscle in the pathophysiological mechanism of a pulled elbow
Authors: Kimura Masahiko 
Published: November 2021

AbstractA pulled elbow is a common childhood orthopaedic injury that is usually caused by longitudinal traction on the hand. The pathophysiological mechanism of a pulled elbow involves interposition of the annular ligament into the radiohumeral joint. Recent ultrasonographic studies have shown that both the supinator muscle and annular ligament were trapped into the radiohumeral joint. This paper discusses why pulled elbows can occur during pronation and how a pulled elbow can be reduced either by hyperpronation or supination followed by elbow flexion based on the function of the supinator muscle.
Acute drug poisonings leading to hospitalization
Authors: Andersen Charlotte Uggerhøj , Nielsen Lars Peter , Møller Jørn Munkhof , Olesen Anne Estrup 
Published: November 2021

AbstractKnowledge about current trends and epidemiology in poisonings is important to maintain quality in diagnostics, treatment and prevention. We performed a cross‐sectional study of all cases (n = 261) admitted with drug poisoning to Aalborg University Hospital during 1 year in 2017–2018. Median age was 30 (22–49) years, and 58% were female. Fifty percent were suicide attempts. In most cases, involved drugs were identified by history taking; blood analysis barely revealed any additional paracetamol and salicylicate poisonings. Drugs prescribed to the patient or available over the counter were involved in nearly two thirds of cases. Weak analgesics dominated by paracetamol (n = 91, 35%) was the most frequently involved group of drugs followed by opioids and benzodiazepines. Gender differences were observed with respect to involvement of weak analgesics and central stimulants. A higher prevalence of unidentified involved drugs was observed in 26 cases (10%) in which the length of admission exceeded 2 days and/or intensive care was needed. No deaths, cardiac arrhythmias or physical complications occurred. Thus, current handling of the acute poisoning seems effective in most cases. However, a more tailored use of blood analyses including a toxicological screen in selected cases may represent an opportunity for improvement.
Home pharmacological therapy in early COVID‐19 to prevent hospitalization and reduce mortality: Time for a suitable proposal
Authors: Pandolfi Sergio , Chirumbolo Salvatore , Ricevuti Giovanni , Valdenassi Luigi , Bjørklund Geir , Lysiuk Roman , Doşa Monica Daniela , Lenchyk Larysa , Fazio Serafino 
Published: November 2021

AbstractThe COVID‐19 pandemic is a highly dramatic concern for mankind. In Italy, the pandemic exerted its major impact throughout the period of February to June 2020. To date, the awkward amount of more than 134,000 deaths has been reported. Yet, post‐mortem autopsy was performed on a very modest number of patients who died from COVID‐19 infection, leading to a first confirmation of an immune‐thrombosis of the lungs as the major COVID‐19 pathogenesis, likewise for SARS. Since then (June–August 2020), no targeted early therapy considering this pathogenetic issue was approached. The patients treated with early anti‐inflammatory, anti‐platelet, anticoagulant and antibiotic therapy confirmed that COVID‐19 was an endothelial inflammation with immuno‐thrombosis. Patients not treated or scarcely treated with the most proper and appropriate therapy and in the earliest, increased the hospitalization rate in the intensive care units and also mortality, due to immune‐thrombosis from the pulmonary capillary district and alveoli. The disease causes widespread endothelial inflammation, which can induce damage to various organs and systems. Therapy must be targeted in this consideration, and in this review, we demonstrate how early anti‐inflammatory therapy may treat endothelia inflammation and immune‐thrombosis caused by COVID‐19, by using drugs we are going to recommend in this paper.
Structural and molecular determinants of mineralocorticoid receptor signalling
Authors: Grossmann Claudia , Almeida‐Prieto Brian , Nolze Alexander , Alvarez de la Rosa Diego 
Published: November 2021

During the past decades, the mineralocorticoid receptor (MR) has evolved from a much‐overlooked member of the steroid hormone receptor family to an important player, not only in volume and electrolyte homeostasis but also in pathological changes occurring in an increasing number of tissues, especially the renal and cardiovascular systems. Simultaneously, a wealth of information about the structure, interaction partners and chromatin requirements for genomic signalling of steroid hormone receptors became available. However, much of the information for the MR has been deduced from studies of other family members and there is still a lack of knowledge about MR‐specific features in ligand binding, chromatin remodelling, co‐factor interactions and general MR specificity‐conferring mechanisms that can completely explain the differences in pathophysiological function between MR and its closest relative, the glucocorticoid receptor. This review aims to give an overview of the current knowledge of MR structure, signalling and co‐factors modulating its activity.LINKED ARTICLESThis article is part of a themed issue on Emerging Fields for Therapeutic Targeting of the Aldosterone‐Mineralocorticoid Receptor Signaling Pathway. To view the other articles in this section visithttp://onlinelibrary.wiley.com/doi/10.1111/bph.v179.13/issuetoc
Diagnostic accuracy outcomes of office‐based (outpatient) biopsies in patients with laryngopharyngeal lesions: A systematic review
Authors: Owusu‐Ayim Mervyn , Ranjan Sushil R. , Lim Alison E. , Rogers Alexander D. G. , Montgomery Jenny , Flach Susanne , Manickavasagam Jaiganaesh 
Published: November 2021

AbstractBackgroundIn‐office biopsies (IOB) using local anaesthetic for laryngopharyngeal tumours has become an increasingly popular approach since the advent of distal chip endoscopes. Although a wide range of studies advocate use in clinical practice, the widespread application of the procedure is hampered by concerns regarding diagnostic accuracy.ObjectiveTo assess the diagnostic accuracy of IOB performed via flexible endoscopy. In addition, to analyse modifiable factors that may affect diagnostic accuracy of IOB.DesignA systematic review following the PRISMA guidelines was conducted. PubMed, EMBASE, the Cochrane Library, Web of Science and CINAHL were used in the literature database search. Quality assessment of included studies was perfomed using the Newcastle‐Ottawa Scale.ResultsA total of 875 studies were identified, 16 of which were included into the systematic review; 1572 successful biopsies were performed using flexible endoscopy; 1283 cases were accurately diagnosed in the outpatient setting (81.6%) and 289 samples did not provide an accurate diagnosis (18.4%). The median sensitivity of IOB was 73%, and the specificity was 96.7%. Analysis of variable factors did not show any significant differences in method of approach, size of equipment (forceps) and additional lighting system or learning curve.ConclusionIOB are a viable tool for diagnostic workup of laryngopharyngeal tumours. Clinicians should be wary of reported limitations of IOB when benign or pre‐malignant diagnoses are made. In cases suspicious of malignancy, confirmatory investigation should be conducted.
Sorafenib attenuates liver fibrosis by triggering hepatic stellate cell ferroptosis via HIF‐1α/SLC7A11 pathway
Authors: Yuan Siyu , Wei Can , Liu Guofang , Zhang Lijun , Li Jiahao , Li Lingling , Cai Shiyi , Fang Ling 
Published: November 2021

AbstractObjectivesEvidences demonstrate that sorafenib alleviates liver fibrosis via inhibiting HSC activation and ECM accumulation. The underlying mechanism remains unclear. Ferroptosis, a novel programmed cell death, regulates diverse physiological/pathological processes. In this study, we aim to investigate the functional role of HSC ferroptosis in the anti‐fibrotic effect of sorafenib.Materials and MethodsThe effects of sorafenib on HSC ferroptosis and ECM expression were assessed in mouse model of liver fibrosis induced by CCl4. In vitro, Fer‐1 and DFO were used to block ferroptosis and then explored the anti‐fibrotic effect of sorafenib by detecting α‐SMA, COL1α1 and fibronectin proteins. Finally, HIF‐1α siRNA, plasmid and stabilizers were applied to assess related signalling pathway.ResultsSorafenib attenuated liver injury and ECM accumulation in CCl4‐induced fibrotic livers, accompanied by reduction of SLC7A11 and GPX4 proteins. In sorafenib‐treated HSC‐T6 cells, ferroptotic events (depletion of SLC7A11, GPX4 and GSH; accumulation iron, ROS and MDA) were discovered. Intriguingly, these ferroptotic events were not appeared in hepatocytes or macrophages. Sorafenib‐elicited HSC ferroptosis and ECM reduction were abrogated by Fer‐1 and DFO. Additionally, both HIF‐1α and SLC7A11 proteins were reduced in sorafenib‐treated HSC‐T6 cells. SLC7A11 was positively regulated by HIF‐1α, inactivation of HIF‐1α/SLC7A11 pathway was required for sorafenib‐induced HSC ferroptosis, and elevation of HIF‐1α could inhibit ferroptosis, ultimately limited the anti‐fibrotic effect.ConclusionsSorafenib triggers HSC ferroptosis via HIF‐1α/SLC7A11 signalling, which in turn attenuates liver injury and fibrosis.
Changing Chinese Diets to Achieve a Win–Win Solution for Health and the Environment
Authors: Sheng Fangfang , Wang Jingjing , Chen Kevin Z. , Fan Shenggen , Gao Haixiu 
Published: November 2021

AbstractDiets are key determinants of nutrition and health and play a significant role in the environment. In this article, we aim to (i) describe dietary transitions and health in China and the consequent environmental challenges; (ii) identify differences between current Chinese diets and healthy reference diets; (iii) conduct a systematic review assessing the health impacts of four reference diets on the Chinese population, and (iv) simulate changes in greenhouse gas emissions under different diet scenarios. The results show differences between the Chinese diets and reference diets, with the current Chinese diet including mainly grains (especially refined rice), excessive meat consumption, and insufficient consumption of fruit and milk. If all Chinese consumers adopt one of the healthy reference diets all the time, the incidence of diet‐related chronic disease and mortality would be significantly reduced. Such dietary shifts would also reduce greenhouse gas emissions by 146–202 million tons (18–25 percent) compared with the projected emissions level in 2030.