bluuebunny/crossref_metadata_2025_split huggingface dataset:
A quantitative evaluation of aerosol generation during supraglottic airway insertion and removal
Authors: Shrimpton A. J. , Gregson F. K. A. , Brown J. M. , Cook T. M. , Bzdek B. R. , Hamilton F. , Reid J. P. , Pickering A. E. ,   the AERATOR study group
Published: July 2021

SummaryMany guidelines consider supraglottic airway use to be an aerosol‐generating procedure. This status requires increased levels of personal protective equipment, fallow time between cases and results in reduced operating theatre efficiency. Aerosol generation has never been quantitated during supraglottic airway use. To address this evidence gap, we conducted real‐time aerosol monitoring (0.3–10‐µm diameter) in ultraclean operating theatres during supraglottic airway insertion and removal. This showed very low background particle concentrations (median (IQR [range]) 1.6 (0–3.1 [0–4.0]) particles.l−1) against which the patient’s tidal breathing produced a higher concentration of aerosol (4.0 (1.3–11.0 [0–44]) particles.l−1, p = 0.048). The average aerosol concentration detected during supraglottic airway insertion (1.3 (1.0–4.2 [0–6.2]) particles.l−1, n = 11), and removal (2.1 (0–17.5 [0–26.2]) particles.l−1, n = 12) was no different to tidal breathing (p = 0.31 and p = 0.84, respectively). Comparison of supraglottic airway insertion and removal with a volitional cough (104 (66–169 [33–326]), n = 27), demonstrated that supraglottic airway insertion/removal sequences produced <4% of the aerosol compared with a single cough (p < 0.001). A transient aerosol increase was recorded during one complicated supraglottic airway insertion (which initially failed to provide a patent airway). Detailed analysis of this event showed an atypical particle size distribution and we subsequently identified multiple sources of non‐respiratory aerosols that may be produced during airway management and can be considered as artefacts. These findings demonstrate supraglottic airway insertion/removal generates no more bio‐aerosol than breathing and far less than a cough. This should inform the design of infection prevention strategies for anaesthetists and operating theatre staff caring for patients managed with supraglottic airways.
COVID‐19 had no impact on emergency urological admissions at an Australian tertiary hospital
Authors: Best Oliver v. , Armany David , Murthy Vinay , Handmer Marcus , Mancuso Pascal 
Published: July 2021

AbstractBackgroundsThe COVID‐19 pandemic is an unprecedented threat to health and healthcare systems. There is no published data on the impact on urological presentations in Australia.MethodsA retrospective analysis of all admissions under the urology service at Liverpool Hospital, Australia from February 1st to April 30th for 2020 and the previous 5 years.ResultsThere was a total of 397 admissions in 2020 and 438 in 2019. The mean age, proportion of male, and mean length of stay were similar. In 2020, there were 229 emergency admissions. Over the same period during the previous 5 years, there were between 195 and 218 emergency admissions. In 2019, there were 220 planned admissions and 168 in 2020. Between 2019 and 2020, there was no significant difference in the proportion of patients with admission longer than 10 days (P = 0.602), requiring intensive care unit admission (P = 0.708) or inpatient operative management (P = 0.171). Among the emergency admissions, the mean Charlson Comorbidity Index was significantly lower in 2020 compared to 2019 (P = 0.009).ConclusionsDespite the pervasive fear of the COVID‐19 pandemic and multiple, substantial alterations to hospital systems, structures and elective operating restrictions, no significant difference in numbers or acuity of emergency admissions were observed. Due to limitations in elective operating, there was an expected reduction in planned admissions. Our findings are in contrast to multiple recent studies and may be the result of our patient demographic where health‐seeking behaviours appear to have not been significantly influenced by the pandemic.
Controlling the flow balance: In vitro characterization of a pulsatile total artificial heart in preload and afterload sensitivity
Authors: Hildebrand Stephan , Diedrich Mario , Brockhaus Moritz , Finocchiaro Thomas , Cuenca Elena , De Ben Heiko , Steinseifer Ulrich , Schmitz‐Rode Thomas , Jansen Sebastian Victor 
Published: July 2021

AbstractThe objective of this study is to identify the preload and afterload sensitivity of the ReinHeart TAH 2.0. For adequate left‐right flow balance, the concept of a reduced right stroke volume (by about 10%) and active adaption of the right diastole duration are evaluated concerning the controllability of the flow balance. This study used an active mock circulation loop to test a wide range of preload and afterload conditions. Preload sensitivity was tested at atrial pressures (APs) between 4 and 20 mm Hg. Left afterload was varied in a range of 60‐140 mm Hg mean aortic pressure (MAP), right afterload was simulated between 15 and 40 mm Hg. Four scenarios were developed to verify that the flow difference fully covers the defined target range of 0‐1.5 L/min. Although a positive correlation between inlet pressure and flow is identified for the right pump chamber, the left pump chamber already fills completely at an inlet pressure of 8‐10 mm Hg. With increasing afterload, both the left and right flow decrease. A positive flow balance (left flow exceeds right flow) is achieved over the full range of tested afterloads. At high APs, the flow difference is limited to a maximum of 0.7 L/min. The controllability of flow balance was successfully evaluated in four scenarios, revealing that a positive flow difference can be achieved over the full range of MAPs. Under physiological test conditions, the linear relationship between flow and heart rate was confirmed, ensuring good controllability of the TAH.
Risk factors for haemodynamic instability and its prolongation during laparoscopic adrenalectomy for pheochromocytoma
Authors: Takeda Toshikazu , Hakozaki Kyohei , Yanai Yoshinori , Masuda Tsukasa , Yasumizu Yota , Tanaka Nobuyuki , Matsumoto Kazuhiro , Morita Shinya , Kosaka Takeo , Mizuno Ryuichi , Kurihara Isao , Asanuma Hiroshi , Itoh Hiroshi , Oya Mototsugu 
Published: July 2021

AbstractObjectivePheochromocytoma is a rare neuroendocrine tumour that secretes catecholamines and originates in the adrenal gland. Although surgical resection is the only curative therapy for pheochromocytoma, it is associated with a risk of haemodynamic instability (HDI), such as extremely high blood pressure and/or post tumour removal hypotension and shock. We investigated the risk factors for HDI during pheochromocytoma surgery.Design and PatientsEighty‐two patients who underwent laparoscopic adrenalectomy for pheochromocytoma between July 2002 and February 2020 were examined. We excluded 3 patients with bilateral disease and 11 without detailed 24 h urinary data. We defined HDI as systolic blood pressure ≥ 200 or <80 mmHg. We investigated the risk factors for HDI during laparoscopic adrenalectomy for pheochromocytoma.ResultsThere were 29 males and 39 females with a median age of 50.5 years. Tumours were localised on the right adrenal gland in 28 patients and on the left in 40. The median tumour diameter was 37.5 mm and the median pneumoperitoneum time was 93.5 min. Twenty‐five out of sixty‐eight patients (37%) developed HDI. A multivariate analysis identified diabetes mellitus (DM; odds ratio: 3.834; 95% confidence interval: 1.062–13.83; p = .04) as an independent predictor of HDI. In terms of hormonal data, median 24 h urinary epinephrine levels (p = .04) and metanephrine levels (p = .01) were significantly higher in the HDI group. DM was also considered as a risk factor for prolonged HDI (p = .02).ConclusionSurgeons and anaesthesiologists need to be aware of the risk of HDI and its prolongation during laparoscopic adrenalectomy for pheochromocytoma for DM patients.
Introduction: The Right to the City in Latin America
Authors: Rayner Jeremy , Zamorano Villareal Claudia 
Published: July 2021

AbstractThis article provides an introduction to the theoretical and substantive issues raised by the four articles collected here and places them in the context of the evolving debates over right to the city in the Latin American region. We assess some of the commonalities and differences between the articles, with regard to the right to the city as both a language of struggle and a theoretical framework. We also consider the rapidly changing context of the right to the city in the region and possibilities for future research and action.
The growing trend for no primary surgery in colorectal cancer
Authors: Peponis Thomas , Stafford Caitlin , Cusack James , Cauley Christy , Goldstone Robert , Berger David , Bordeianou Liliana , Kunitake Hiroko , Francone Todd , Ricciardi Rocco 
Published: July 2021

AbstractAimIn colorectal cancer (CRC), surgery of the primary site is commonly curative. Our aim was to determine estimates of ‘no surgery’ for primary CRC while identifying common reasons for no surgery.MethodWe identified all patients with a diagnosis of colorectal adenocarcinoma from the National Cancer Database between January 2004 and December 2016. Then, we identified patients who did not undergo surgery on the primary tumour and their demographic, tumour and institutional characteristics. Kaplan–Meier and logistic regression analyses were used to evaluate specific factors associated with overall survival as related to no surgery and recommendations against operative management.ResultsA total of 1,208,878 patients with CRC were identified, 14.5% of whom had no surgery of the primary cancer. No surgery was more common in rectal cancer than in colon cancer. Despite a steady incidence of CRC diagnoses, the likelihood of no surgery grew by 170% over the study period. Metastatic disease was noted in 53.7% of the no surgery cohort. Nine per cent of the no surgery patient cohort received a recommendation against surgery despite the absence of metastatic disease, 7.5% refused surgery and only 2% underwent palliative surgery. On multivariable analysis, patients who were not recommended to have surgery were more likely to be older, uninsured, comorbid and receive care at a single hospital. The no surgery patients had significantly lower overall survival.ConclusionA substantial proportion of patients with CRC do not have surgery. Interventions aimed at expanding access and promoting second opinions at other cancer hospitals might reduce the growing rate of no surgery in CRC.
Driven by data: Improved protected area effectiveness in Royal Manas National Park, Bhutan
Authors: Wangmo Singye , Wangdi Sonam , Wyatt Alexander , Tenzin Kuenley , Lhendup Jampel , Singh Rohit 
Published: July 2021

AbstractThe necessity of rangers and other frontline staff for ensuring the protection and effective management of protected areas is well documented. The Spatial Monitoring and Reporting Tool (SMART) was developed as a law enforcement monitoring tool with the aim of assisting management in the allocation of resources and strategic deployment of ranger patrols. The ability of SMART to contribute to improved protection depends heavily on effective application through an adaptive management framework. Royal Manas National Park (RMNP), Bhutan, presents an opportunity to review the use of a protected area law enforcement monitoring tool for improving the detection and reduction of illegal activities within a protected area through effective ranger patrols. Results from the analysis of 5 years of monitoring data collected by rangers indicates a marked improvement in patrol effort in RMNP and suggests that the effective deployment of law enforcement monitoring tools, when used as part of an adaptive management framework, can improve the detectability of poaching related threats, potentially resulting in an overall reduction of poaching threats through enabling the informed and targeted allocation of staff and resources.
Atlas of the vascular flora of the Iberian Peninsula biodiversity hotspot (AFLIBER)
Authors: Ramos‐Gutiérrez Ignacio , Lima Herlander , Pajarón Santiago , Romero‐Zarco Carlos , Sáez Llorenç , Pataro Luciano , Molina‐Venegas Rafael , Rodríguez Miguel Á. , Moreno‐Saiz Juan Carlos 
Published: July 2021

AbstractMotivationWe accessed published and unpublished floristic sources to compile a comprehensive species list of the Iberian–Balearic terrestrial vascular flora and generate AFLIBER, an accurate floristic database of georeferenced plant occurrence records.Main type of variable containedSpecies distribution data totalling 1,824,549 plant occurrence records corresponding to 6,456 species and subspecies.Spatial location and grainThe western Mediterranean, including inland territories of Spain, Portugal and Andorra and the adjacent archipelagos of Berlengas, Columbretes and the Balearic Islands, covered by 6,316 UTM quadrangular grid cells of 10 km resolution.Time periodAll distributional trustable records were considered to create the AFLIBER database, most of them dating from the 1960s onwards.Major taxa and level of measurementTerrestrial vascular plant species and subspecies.Software formatData are supplied as comma‐separated text (csv) files.
The human amniotic fluid stem cell secretome triggers intracellular Ca2+ oscillations, NF‐κB nuclear translocation and tube formation in human endothelial colony‐forming cells
Authors: Balducci Valentina , Faris Pawan , Balbi Carolina , Costa Ambra , Negri Sharon , Rosti Vittorio , Bollini Sveva , Moccia Francesco 
Published: July 2021

AbstractSecond trimester foetal human amniotic fluid‐derived stem cells (hAFS) have been shown to possess remarkable cardioprotective paracrine potential in different preclinical models of myocardial injury and drug‐induced cardiotoxicity. The hAFS secretome, namely the total soluble factors released by cells in their conditioned medium (hAFS‐CM), can also strongly sustain in vivo angiogenesis in a murine model of acute myocardial infarction (MI) and stimulates human endothelial colony‐forming cells (ECFCs), the only truly recognized endothelial progenitor, to form capillary‐like structures in vitro. Preliminary work demonstrated that the hypoxic hAFS secretome (hAFS‐CMHypo) triggers intracellular Ca2+ oscillations in human ECFCs, but the underlying mechanisms and the downstream Ca2+‐dependent effectors remain elusive. Herein, we found that the secretome obtained by hAFS undergoing hypoxic preconditioning induced intracellular Ca2+ oscillations by promoting extracellular Ca2+ entry through Transient Receptor Potential Vanilloid 4 (TRPV4). TRPV4‐mediated Ca2+ entry, in turn, promoted the concerted interplay between inositol‐1,4,5‐trisphosphate‐ and nicotinic acid adenine dinucleotide phosphate‐induced endogenous Ca2+ release and store‐operated Ca2+ entry (SOCE). hAFS‐CMHypo‐induced intracellular Ca2+ oscillations resulted in the nuclear translocation of the Ca2+‐sensitive transcription factor p65 NF‐κB. Finally, inhibition of either intracellular Ca2+ oscillations or NF‐κB activity prevented hAFS‐CMHypo‐induced ECFC tube formation. These data shed novel light on the molecular mechanisms whereby hAFS‐CMHypo induces angiogenesis, thus providing useful insights for future therapeutic strategies against ischaemic‐related myocardial injury.
The N‐ and C‐terminal carbohydrate recognition domains of galectin‐9 from Carassius auratus contribute differently to its immunity functions to Aeromonas hydrophila and Staphylococcus aureus
Authors: Wang Li , Wang Qiuxia , Wang Lei , Wu Shixiu , Yu Yan , Zhang Yanhong , Gao Pei , Kong Xianghui , Ma Jinyou 
Published: July 2021

AbstractGalectin‐9, an important pathogen recognition receptor (PRR), could recognize and bind pathogen‐associated molecular patterns (PAMPs) on the surface of invading microorganisms, initiating the innate immune responses. A galectin‐9 was identified from Qihe crucian carp Carassius auratus and designated as CaGal‐9. The predicted CaGal‐9 protein contained two non‐identical carbohydrate recognition domains (CRDs), namely, N‐CRD and C‐CRD. The recombinant proteins (rCaGal‐9, rN‐CRD and rC‐CRD) were purified from Escherichia coli BL21 (DE3) and exhibited strong agglutinating activity with erythrocytes of rabbit. The haemagglutination was inhibited by D‐galactose, α‐lactose and N‐acetyl‐D‐galactose. Results of microbial agglutination assay showed that three recombinant proteins agglutinated Gram‐negative bacterium Aeromonas hydrophila and Gram‐positive bacterium Staphylococcus aureus. With regard to the binding activity, each recombinant protein could bind to LPS, PGN and the examined microorganisms (A. hydrophila and S. aureus) with different binding affinities. The integrated analyses suggested that CaGal‐9 with two CRD domains could play an important role in immune defence against pathogenic microorganisms for C. auratus.
Pharmacist‐led interventions to improve medication adherence in older adults: A meta‐analysis
Authors: Marcum Zachary A. , Jiang Shangqing , Bacci Jennifer L. , Ruppar Todd M. 
Published: July 2021

AbstractBackground/objectiveAs pharmacists work to ensure reimbursement for chronic disease management services on the national level, evidence of their impact on important health metrics, such as medication adherence, is needed. However, summative evidence is lacking on the effectiveness of pharmacists to improve medication adherence in older adults. The objective was to assess the effectiveness of pharmacist‐led interventions on medication adherence in older adults (65+ years).Design/setting/participantsUsing a systematic review and meta‐analytic approach, a comprehensive search of publications in PubMed, Scopus, CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Google Scholar was conducted through April 2, 2020 for randomized clinical trials of pharmacist‐led interventions to improve medication adherence in older adults. A standardized mean difference effect size (Cohen's d) was calculated for medication adherence in each study. Study effect sizes were pooled using a random‐effects model, with effect sizes weighted by inverse of its total variance.MeasurementsMedication adherence using any method of measurement.ResultsAmong 40 unique randomized trials of pharmacist‐led interventions with data from 8822 unique patients (mean age, range: 65–85 years), the mean effect size was 0.57 (k = 40; 95% Confidence Interval [CI]: 0.38–0.76). When two outlier studies were excluded from the analysis, the mean effect size reduced to 0.41 (k = 38; 95% CI: 0.27–0.54). A sensitivity analysis of medication adherence outcome by time point resulted in a mean effect size of 0.64 at 3 months (k = 12; 95% CI: 0.32–0.97), 0.30 at 6 months (k = 13; 95% CI: 0.11–0.48), 0.22 at 12 months (k = 12; 95% CI: 0.08–0.37), and 0.36 for outcome time points beyond 12 months (k = 5; 95% CI: 0.02–0.70).ConclusionThis meta‐analysis found a significant improvement in medication adherence among older adults receiving pharmacist‐led interventions. Implementation of pharmacist‐led interventions supported by Medicare reimbursement could ensure older adults' access to effective medication adherence support.
GTPase ROP6 negatively modulates phosphate deficiency through inhibition of PHT1;1 and PHT1;4 in Arabidopsis thaliana
Authors: Gao Huiling , Wang Tian , Zhang Yanting , Li Lili , Wang Chuanqing , Guo Shiyuan , Zhang Tianqi , Wang Cun 
Published: July 2021

AbstractPhosphorus, an essential macroelement for plant growth and development, is a major limiting factor for sustainable crop yield. The Rho of plant (ROP) GTPase is involved in regulating multiple signal transduction processes in plants, but potentially including the phosphate deficiency signaling pathway remains unknown. Here, we identified that the rop6 mutant exhibited a dramatic tolerant phenotype under Pi‐deficient conditions, with higher phosphate accumulation and lower anthocyanin content. In contrast, the rop6 mutant was more sensitive to arsenate (As(V)) toxicity, the analog of Pi. Immunoblot analysis displayed that the ROP6 protein was rapidly degraded through ubiquitin/26S proteasome pathway under Pi‐deficient conditions. In addition, pull‐down assay using GST‐RIC1 demonstrated that the ROP6 activity was decreased obviously under Pi‐deficient conditions. Strikingly, protein–protein interaction and two‐voltage clamping assays demonstrated that ROP6 physically interacted with and inhibited the key phosphate uptake transporters PHT1;1 and PHT1;4 in vitro and in vivo. Moreover, genetic analysis showed that ROP6 functioned upstream of PHT1;1 and PHT1;4. Thus, we conclude that GTPase ROP6 modulates the uptake of phosphate by inhibiting the activities of PHT1;1 and PHT1;4 in Arabidopsis.
Improving flood disaster preparedness of hospitals in Central Thailand: Hospital personnel perspectives
Authors: Rattanakanlaya Kanittha , Sukonthasarn Achara , Wangsrikhun Suparat , Chanprasit Chawapornpan 
Published: July 2021

AbstractAimTo improve hospitals disaster preparedness during floods.BackgroundThe Thai flood disaster in 2011 struck several sectors, including hospitals. It is necessary to build a disaster preparedness system that ensures that hospitals have the capacity to respond effectively to any kind of disaster.MethodsThis qualitative study was conducted using content analysis. Purposive sampling was used to select 15 participants, including doctors, nurses and other staff involved in disaster preparedness, and semi‐structured interviews were conducted with them. The study was reported according to COREQ guidelines.ResultsHealthcare personnel identified several ways in which flood disaster preparedness of hospitals may be enhanced. Three themes and eight subthemes were identified during the data analysis. The three themes were as follows: 1) ongoing efforts for flood prevention and mitigation at a national level; 2) developing operational guidelines to effectively prevent and resolve flood problems at provincial levels; and 3) increasing the levels of flood readiness at the hospital level.ConclusionsThe results of this study indicate strategies to help policymakers and health personnel enhance flood disaster preparedness measures at hospitals based on the experiences of hospital personnel involved in one of the worst flood disasters worldwide.Relevance to clinical practiceHospitals alone cannot deal with unpredictable events; they need additional assistance in disaster preparedness. There are three levels at which improving hospital flood disaster preparedness can take place: national, provincial and hospital levels. Nursing professionals participate in hospital disaster preparedness and work with multidisciplinary teams to provide services. Nurses should be prepared for such participation, as their involvement, through tailored services for hospital disaster preparedness, can expand the literature on nursing knowledge to improve clinical outcomes.