bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhanced recovery after surgery (ERAS) in patients undergoing emergency laparotomy after trauma: a prospective, randomized controlled trial
Authors: Purushothaman Vijayan , Priyadarshini Pratyusha , Bagaria Dinesh , Joshi Mohit , Choudhary Narendra , Kumar Abhinav , Kumar Subodh , Gupta Amit , Mishra Biplab , Mathur Purva , Sagar Sushma 
Published: August 2021

BackgroundThe role of enhanced recovery after surgery (ERAS) has been established in elective operations. However, its role in emergency operations especially in trauma is under-recognized. The aim of this study was to explore the safety and efficacy of ERAS program in patients undergoing emergency laparotomy for trauma.MethodsIn this single-center study, patients who underwent emergency laparotomy after trauma were randomized to the ERAS protocol or conventional care. The ERAS protocol included early removal of catheters, early initiation of diet, use of postoperative prophylaxis and optimal usage of analgesia. The primary endpoint was duration of hospital stay. The secondary endpoints were recovery of bowel function, pain scores, complications and readmission rate.ResultsThirty patients were enrolled in each arm. The ERAS group had significant reduction in duration of hospital stay (3.3±1.3 vs. 5.0±1.7; p<0.01). Time to remove nasogastric tube (1.1±0.1 vs. 2.2±0.9; p<0.01), urinary catheter (1.1±0.1 vs. 3.5±1.6; p<0.01), and drain (1.0±0.2 vs. 3.7±1.6; p<0.01) was shorter in the ERAS group. In ERAS group, there was earlier initiation of liquid diet (1.1±0.1 vs. 2.3±1.0; p<0.01) and solid diet (2.1±0.1 vs. 3.6±1.3; p<0.01). The usage of epidural analgesia (63% vs. 30%; p=0.01), non-steroidal anti-inflammatory drugs (93% vs. 67%; p-0.02) and deep vein thrombosis prophylaxis (100% vs. 70%; p<0.01) was higher in the ERAS group. There was no difference in the recovery of bowel function (2.4±1.0 vs. 2.1±0.9; p=0.15), pain scores (3.2±1.0 vs. 3.1±1.1; p=0.87), complications (27% vs. 23%; p=0.99) and readmission rates (07% vs. 10%; p=0.99) between the two groups.ConclusionERAS protocol, when implemented in patients undergoing laparotomy for trauma, has decreased duration of hospital stay with no additional complications.Level of evidenceLevel 1, randomized controlled trial, care management.Trial registration numberClinical Trials Registry of India (CTRI/2019/06/019533).
Evaluation of horizontal submarine slide impact force on pipeline via a modified hybrid geotechnical – fluid dynamics framework
Authors: Fan Ning , Zhang Wangcheng , Sahdi Fauzan , Nian Tingkai 
Published: August 2021

There are situations in offshore energy development where potential impact forces between submarine slides and pipelines need to be estimated. The horizontal slide – pipeline impact force, parallel to the main travel direction of the sliding mass and normal to the pipeline axis, is generally dominant compared with other force components and hence of particular concern. In practice, pipelines may be suspended at varying distances above the seabed (gap) and existing methods do not consider how this will affect the horizontal slide – pipeline forces. This paper investigates the effects of pipeline–seabed gap and pipeline diameter on the horizontal slide – pipeline impact force via 181 computational fluid dynamics (CFD) simulations at Reynolds numbers of 0.36–287. Results show that variation in the pipeline–seabed gap and pipeline diameter alters the slide mass flow behaviour as it flows past the pipeline and hence the impact force when the pipeline–seabed gap is below a critical value. A modified hybrid geotechnical – fluid dynamics framework for estimating the horizontal impact force is proposed by considering the effects of the pipeline–seabed gap and pipeline diameter, which is validated with existing experimental datasets.
Australian guidelines for the prevention and treatment of posttraumatic stress disorder: Updates in the third edition
Authors: Phelps Andrea J , Lethbridge Ros , Brennan Sue , Bryant Richard A , Burns Penelope , Cooper John A , Forbes David , Gardiner Joanne , Gee Graham , Jones Kim , Kenardy Justin , Kulkarni Jayashri , McDermott Brett , McFarlane Alexander C , Newman Louise , Varker Tracey , Worth Carolyn , Silove Derrick 
Published: August 2021

Objective: This paper describes the development of the third edition of the National Health and Medical Research Australian Guidelines for the Prevention and Treatment of Acute Stress Disorder, posttraumatic stress disorder and Complex posttraumatic stress disorder, highlighting key changes in scope, methodology, format and treatment recommendations from the previous 2013 edition of the Guidelines. Method: Systematic review of the international research was undertaken, with GRADE methodology used to assess the certainty of the evidence, and evidence to decision frameworks used to generate recommendations. The Guidelines are presented in an online format using MAGICApp. Results: Key changes since the publication of the 2013 Guidelines include a new conditional recommendation for Child and Family Traumatic Stress Intervention for children and adolescents with symptoms within the first 3 months of trauma, and a strong recommendation for trauma-focused cognitive behaviour therapy for the child alone or with a caregiver, for those with diagnosed posttraumatic stress disorder. For adults with posttraumatic stress disorder, strong recommendations are made for specific types of trauma-focused cognitive behaviour therapy and conditional recommendations are made for five additional psychological interventions. Where medication is indicated for adults with posttraumatic stress disorder, venlafaxine is now conditionally recommended alongside sertraline, paroxetine or fluoxetine. Conclusion: These Guidelines, based on systematic review of the international literature, are intended to guide decision making for practitioners, service planners, funders and those seeking treatment for trauma related mental health concerns. For an Australian Guideline, a critical limitation is the absence of research on the treatment of Australian Aboriginal and Torres Strait Islander peoples. The new online format of the Australian posttraumatic stress disorder Guidelines means that they can be updated as sufficient new evidence becomes available.
Colonial Ideologies, Narratives, and Popular Perceptions of Ethno-racial Otherness in the Dynamics of Urban Exclusion: Debates and Evidence from Mexico, Colombia, Chile, and Argentina
Authors: Ruiz-Tagle Javier , Aguilera Carolina 
Published: August 2021

Although ethnic differentiations began with colonialism, racism was not widely addressed in Latin American social sciences until recently, since class perspectives were predominant. Within this, studies on residential segregation and urban exclusion have ignored race and ethnicity, with the exceptions of Brazil and Colombia. However, these issues have recently become crucial because of the adoption of multiculturalism, the impact of postcolonialism and postmodernism, the emergence of black and indigenous social movements, changes in state policy, and new trends in migration. A review of debates and evidence from Mexico, Colombia, Chile, and Argentina shows that persistent colonial ideologies, narratives, and popular perceptions of ethno-racial denial sustain various kinds of urban exclusion in the region. The evidence calls for a new research agenda to decolonize urban studies that adopts a critical perspective on the coloniality of power. Aunque las diferenciaciones étnicas comenzaron con el colonialismo, el racismo no se abordó ampliamente en las ciencias sociales latinoamericanas hasta hace poco, ya que predominaban las perspectivas de clase. Los estudios sobre la segregación residencial y la exclusión urbana han ignorado la raza y el origen étnico, con excepción de Brasil y Colombia. Sin embargo, estas cuestiones se han vuelto cruciales recientemente debido a la adopción del multiculturalismo, el impacto del poscolonialismo y el posmodernismo, la aparición de movimientos sociales negros e indígenas, los cambios en la política estatal y nuevas tendencias en la migración. Una revisión de los debates y evidencia en México, Colombia, Chile y Argentina muestra que las ideologías coloniales persistentes, las narrativas y las percepciones populares de la negación etnoracial sostienen varios tipos de exclusión urbana en la región. La evidencia exige una nueva agenda de investigación para descolonizar los estudios urbanos y adoptar una perspectiva crítica sobre la colonialidad del poder.
Sulfur dioxide-induced exacerbation of airway inflammation via reactive oxygen species production and the toll-like receptor 4/nuclear factor-κB pathway in asthmatic mice
Authors: Zhang Lingxiu , Yi Huilan , Sang Nan 
Published: August 2021

Sulfur dioxide (SO2) is a common air pollutant that can exacerbate asthmatic airway inflammation. The mechanisms underlying these effects are not yet fully understood. In this study, we investigated the effects of SO2 exposure (10 mg/m3) on asthmatic airway inflammation in ovalbumin-induced asthmatic mice. Our results showed that SO2 exposure alone induced slight airway injury, decreased superoxide dismutase activity, and increased nuclear factor-κB (NF-κB) expression in the lungs of mice. Moreover, SO2 exposure in asthmatic mice induced marked pathological damage, significantly increased the counts of inflammatory cells (e.g., macrophages, lymphocytes, and eosinophils) in bronchoalveolar lavage fluid, and significantly enhanced malondialdehyde and glutathione levels in the lungs. Moreover, the expression of toll-like receptor 4 (TLR4), NF-κB, pro-inflammatory cytokines (e.g., tumor necrosis factor α and interleukin-6), and type II T-helper cell (Th2) cytokines was found to be elevated in the mice exposed to SO2 and ovalbumin compared to those exposed to ovalbumin alone. These results suggest that SO2 amplifies Th2-mediated inflammatory responses, which involve reactive oxygen species and TLR4/NF-κB pathway activation; these can further enhance Th2 cytokine expression and eosinophilic inflammation. Thus, our findings provide important evidence to understand a potential mechanism through which SO2 may exacerbate airway asthmatic inflammation.
Analyzing the Administrative Burden of Competency Based Medical Education
Authors: Cheung Kevin , Rogoza Christina , Chung Andrew D. , Kwan Benjamin Yin Ming 
Published: August 2021

Purpose: Postgraduate residency programs in Canada are transitioning to a competency-based medical education (CBME) system. Within this system, resident performance is documented through frequent assessments that provide continual feedback and guidance for resident progression. An area of concern is the perception by faculty of added administrative burden imposed by the frequent evaluations. This study investigated the time spent in the documentation and submission of required assessment forms through analysis of quantitative data from the Queen’s University Diagnostic Radiology program. Methods and Materials: Data regarding time taken to complete Entrustable Professional Activities (EPA) assessments was collected from 24 full-time and part-time radiologists over a period of 18 months. This data was analyzed using SPSS to determine mean time of completion by individuals, departments, and by experience with the assessment process. Results: The average time taken to complete an EPA assessment form was 3 minutes and 6 seconds. Assuming 3 completed EPA assessment forms per week for each resident (n = 12) and equal distribution among all staff, this averaged out to an additional 18 minutes of administrative burden per staff member over a 4 week block. Conclusions: This study investigated the perception by faculty of additional administrative burden for assessment in the CBME framework. The data provided quantitative evidence of administrative burden for the documentation and submission of assessments. The data indicated that the added administrative burden may be reasonable given mandate for CBME implementation and the advantages of adoption for postgraduate medical education.
Barriers to linkage to care in hepatitis C patients with substance use disorders and dual diagnoses, despite centralized management
Authors: Grau-López Lara , Marcos-Fosch Cristina , Daigre Constanza , Palma-Alvarez Raúl Felipe , Rando-Segura Ariadna , Llaneras Jordi , Perea-Ortueta Marta , Rodriguez-Frias Francisco , Martínez-Luna Nieves , Riveiro-Barciela Mar , Ramos-Quiroga Josep Antoni , Colom Joan , Esteban Rafael , Buti María 
Published: August 2021

Background: Hepatitis C virus (HCV) management is a challenge in patients with substance use disorder (SUD). This study aimed to describe an HCV screening and linkage to care program in SUD patients, and analyze the characteristics of this population in relation to HCV infection, particularly the impact of psychiatric comorbidities (dual diagnosis). Methods: This study was a prospective clinical cohort study using a collaborative, multidisciplinary model to offer HCV care (screening, diagnosis, and therapy) to individuals with SUD attending a dedicated hospital clinic. The characteristics of the participants, prevalence of HCV infection, percentage who started therapy, and adherence to treatment were compared according to the patients’ consumption characteristics and presence of dual diagnosis. HCV screening, diagnosis, treatment initiation, and sustained virologic response were analyzed. Results: 528 individuals attended the center (November 2018–June 2019) and 401 (76%) accepted screening. In total, 112 (28%) were anti-HCV-positive and 42 (10%) had detectable HCV RNA, but only 20 of the latter started HCV therapy. Among the 253 (63%) patients with a dual diagnosis, there were no differences in HCV infection prevalence versus patients with SUD alone ( p = 0.28). Dual diagnosis did not lead to a higher risk of HCV infection or interfere with linkage to care or treatment. Conclusion: This study found a high prevalence of dual diagnosis and HCV infection in SUD patients, but dual diagnosis was not associated with an increased risk of acquiring HCV or more complex access to care. Despite use of a multidisciplinary management approach, considerable barriers to HCV care remain in this population that would need more specific focus.
Research interrupted: The impact of the COVID-19 pandemic on multiple sclerosis research in the field of rehabilitation and quality of life
Authors: Maguire Rebecca , Hynes Sinead , Seebacher Barbara , Block Valerie J , Zackowski Kathy M , Jonsdottir Johanna , Finlayson Marcia , Plummer Prue , Freeman Jennifer , Giesser Barbara , Geldern Gloria von , Ploughman Michelle 
Published: August 2021

Background The COVID-19 pandemic has likely had a negative impact on rehabilitation and quality of life (QoL) research in multiple sclerosis (MS). Method We explored perceived barriers to research among 87 researchers, representing 18 countries, both prior to and since COVID-19. Results A Wilcoxon signed-rank test found that significantly more researchers reported experiencing barriers to research since the onset of the pandemic compared to pre-COVID-19 (p < .001), with 78% of respondents reporting at least some barriers since COVID-19. The most commonly-cited barriers related to participant access (n = 38) and interruptions/delays to projects (n = 19). Although no gender differences were found in the number of barriers reported, female respondents were more likely to cite time or competing demands as barriers to research. Females were also more likely to perceive being negatively impacted by the pandemic compared to other genders (p = .007). Conclusions Implications for the future landscape of rehabilitation research in MS are discussed.
Usability, functionality, and efficacy of a custom myoelectric elbow-wrist-hand orthosis to assist elbow function in individuals with stroke
Authors: Hoppe-Ludwig Shenan , Armitage Jodi , Turner Kristi L , O’Brien Megan K , Mummidisetty Chaithanya K , Koch Lori McGee , Kocherginsky Masha , Jayaraman Arun 
Published: August 2021

Introduction After stroke, upper limb impairment affects independent performance of activities of daily living. We evaluated the usability, functionality, and efficacy of a myoelectric elbow-wrist-hand orthosis to provide support, limit unsafe motion, and enhance the functional motion of paralyzed or weak upper limbs. Methods Individuals with stroke participated in a single-session study to evaluate the device. Ability to activate the device was tested in supported and unsupported shoulder position, as well as the elbow range of motion, ability to maintain elbow position, and ability to lift and hold a range of weights while using the device. Results No adverse events were reported. 71% of users were able to operate the device in all three active myoelectric activation modes (Biceps, Triceps, Dual) during testing. Users were able to hold a range of wrist weights (0.5–2 lbs) for 10–120 seconds, with the largest percentage of participants able to hold weights with the device in Biceps Mode. Conclusions The myoelectric elbow-wrist-hand orthosis improved range of motion during use and was efficacious at remediating upper extremity impairment after stroke. All users could operate the device in at least one mode, and most could lift and hold weights representative of some everyday objects using the device.
Impact of Potentially Unwarranted Intravenous Antibiotics Targeting Pulmonary Infections in Acute Decompensated Heart Failure
Authors: Wu Sara , Alikhil Maryam , Forsyth Rochelle , Allen Bryan 
Published: August 2021

Background Acute decompensated heart failure (ADHF) can present similarly to pulmonary infections. The additional volume and sodium received from intravenous antibiotics (IVAB) can be counterproductive, especially when strong evidence of infection is lacking. Objective The objective was to evaluate the impact of potentially unwarranted IVAB on clinical outcomes in patients with ADHF. Methods This multicenter, retrospective, cohort study evaluated adults admitted with ADHF, a chest radiograph within 24 hours, B-natriuretic peptide >100 pg/mL, and either received no IVAB or IVAB for at least 48 hours. Subjects with recent antibiotics, justification for antibiotics, or transferred to the intensive care unit (ICU) within 24 hours of admission were excluded. The primary outcome was hospital length of stay (LOS). Secondary outcomes included utilization of loop diuretics, administration of fluid and sodium, mortality, and 30-day readmissions. Results Out of 240 subjects included, 120 received IVAB. LOS was significantly longer in the IVAB group (5.12 days vs 3.73 days; P < .001). LOS remained significantly longer in the IVAB group in a propensity score matched cohort (5.26 days vs 3.70 days; P < .001). The IVAB group received more volume and sodium from intravenous fluids ( P < .001). ICU admission greater than 24 hours after admission was higher with IVAB (20% vs 7.5%; P = .049). No significant differences in total loop diuretics, intubation rate, mortality, and 30-day readmissions were identified. Conclusion ADHF patients who received potentially unwarranted IVAB had longer hospital LOS and were more likely to be admitted to the ICU after 24 hours of hospitalization.
5-Azacytidine depletes HSCs and synergizes with an anti-CD117 antibody to augment donor engraftment in immunocompetent mice
Authors: Bankova Andriyana K. , Pang Wendy W. , Velasco Brenda J. , Long-Boyle Janel R. , Shizuru Judith A. 
Published: August 2021

Abstract
Depletion of hematopoietic stem cells (HSCs) is used therapeutically in many malignant and nonmalignant blood disorders in the setting of a hematopoietic cell transplantation (HCT) to eradicate diseased HSCs, thus allowing donor HSCs to engraft. Current treatments to eliminate HSCs rely on modalities that cause DNA strand breakage (ie, alkylators, radiation) resulting in multiple short-term and long-term toxicities and sometimes even death. These risks have severely limited the use of HCT to patients with few to no comorbidities and excluded many others with diseases that could be cured with an HCT. 5-Azacytidine (AZA) is a widely used hypomethylating agent that is thought to preferentially target leukemic cells in myeloid malignancies. Here, we reveal a previously unknown effect of AZA on HSCs. We show that AZA induces early HSC proliferation in vivo and exerts a direct cytotoxic effect on proliferating HSCs in vitro. When used to pretreat recipient mice for transplantation, AZA permitted low-level donor HSC engraftment. Moreover, by combining AZA with a monoclonal antibody (mAb) targeting CD117 (c-Kit) (a molecule expressed on HSCs), more robust HSC depletion and substantially higher levels of multilineage donor cell engraftment were achieved in immunocompetent mice. The enhanced effectiveness of this combined regimen correlated with increased apoptotic cell death in hematopoietic stem and progenitor cells. Together, these findings highlight a previously unknown therapeutic mechanism for AZA which may broaden its use in clinical practice. Moreover, the synergy we show between AZA and anti-CD117 mAb is a novel strategy to eradicate abnormal HSCs that can be rapidly tested in the clinical setting.
Ultrasound-guided fine needle aspiration cytology of Para-aortic lymph node metastasis in uterine cervical cancer: diagnostic accuracy and impact on clinical decision making
Authors: Liu Junping , Liu Xin , Guo Zhengying , Lv Xiaojuan , Mao Weimin , Xu Dong , Wang Lijing 
Published: August 2021

Abstract
Objective
The main aim of this study was to ascertain the effectiveness of ultrasound-guided fine needle aspiration cytology (US-FNAC) in the diagnosis of para-aortic lymph node (PALN) metastasis in uterine cervical cancer and to establish its potential impact on clinical therapeutic decision making.

Methods
We retrospectively reviewed clinical data from 92 patients diagnosed with cervical cancer with PALN enlargement between 2010 and 2018. Cytological results obtained with US-FNAC were classified by the same experienced cellular pathologists. Diagnostic indicators were determined on the basis of biopsy, imaging and clinical follow-up results. Univariate and multivariate analyses were used to assess the differences of influencing factors. The effect of US-FNAC on clinical decision making was evaluated.

Results
Cytological results of US-FNAC were categorized as malignancy (n = 62; 67.4%), suspicious malignancy (n = 11; 12.0%), undetermined (n = 5; 5.4%), benign (n = 10; 10.9%), and inadequate (n = 4; 4.3%). Satisfactory biopsy samples were obtained from 95.7% of PALNs sampled (88/92). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FNAC in distinguishing benign from malignant cases were 90.1% (95% CI: 0.809–0.953), 100% (95% CI: 0.561–1), 100% (95% CI: 0.938–1), 46.7% (95% CI: 0.223–0.726) and 90.9% (95% CI: 0.848–0.970), respectively. Univariate analysis indicated significant differences in experience of puncture physicians (radiologists) between the correct and wrong diagnosis groups (P < 0.05), which was further confirmed as an independent predictor of diagnostic accuracy in multivariate analysis (p = 0.031, OR = 0.077, 95% CI: 0.354–0.919). All patients tolerated the US-FNAC procedure well and only nine presented slight abdominal discomfort. The therapeutic strategies for 74 patients (80.4%) were influenced by US-FNAC findings.

Conclusions
US-FNAC was a relatively safe and effective technique for examination of enlarged para-aortic lymph nodes and may therefore serve as a routine diagnostic tool to guide clinical decision making for management of cervical cancer.