bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nasal fentanyl and buccal midazolam carer administration ‘as needed’ for breakthrough symptom control in a specialist palliative care unit: a nested qualitative study
Authors: Perkins Paul , Parkinson Anne , Taylor Vanessa , Husbands Emma 
Published: November 2021

IntroductionWhen people are dying and unable to take oral medication, injectable medication is commonly used, usually administered by healthcare professionals. There may be delays to symptom relief due to travel to the person’s home. In a randomised controlled trial (RCT) previously reported, nasal fentanyl (NF) or buccal midazolam (BM) were administered by lay carers in a hospice.Objective(1) To report experiences of lay carers who administered NF and BM for symptom control and (2) To use feedback to develop guidance informing a future definitive RCT to determine whether NF and BM administered by lay carers can lead to timely, improved symptom control for people dying at home and fewer ‘emergency’ community nursing visits than standard breakthrough medication administered by healthcare professionals.Material and methodsSemistructured interviews with lay carers who gave trial medication were conducted. Interview data were analysed using a stage by stage method to code and categorise transcripts.FindingsThe six themes were: (1) Participation—lay carers welcomed the opportunity to administer medication; (2) Ease of use—lay carers found preparations easy to use; (3) How things could have been done differently—lay carers would have liked access to trial drugs at home; (4) Training—lay carers were happy with the training they received; (5) Timing—lay carers liked the immediacy of trial drugs and (6) Evaluation—assessing symptom intensity and drug efficacy.ConclusionsParticipation was acceptable to patients and lay carers, and beneficial for symptom relief. The findings will inform planning for a future community-based study.
A Machine learning model trained on dual-energy CT radiomics significantly improves immunotherapy response prediction for patients with stage IV melanoma
Authors: Brendlin Andreas Stefan , Peisen Felix , Almansour Haidara , Afat Saif , Eigentler Thomas , Amaral Teresa , Faby Sebastian , Calvarons Adria Font , Nikolaou Konstantin , Othman Ahmed E 
Published: November 2021

BackgroundTo assess the additive value of dual-energy CT (DECT) over single-energy CT (SECT) to radiomics-based response prediction in patients with metastatic melanoma preceding immunotherapy.Material and methodsA total of 140 consecutive patients with melanoma (58 female, 63±16 years) for whom baseline DECT tumor load assessment revealed stage IV and who were subsequently treated with immunotherapy were included. Best response was determined using the clinical reports (81 responders: 27 complete response, 45 partial response, 9 stable disease). Individual lesion response was classified manually analogous to RECIST 1.1 through 1291 follow-up examinations on a total of 776 lesions (6.7±7.2 per patient). The patients were sorted chronologically into a study and a validation cohort (each n=70). The baseline DECT was examined using specialized tumor segmentation prototype software, and radiomic features were analyzed for response predictors. Significant features were selected using univariate statistics with Bonferroni correction and multiple logistic regression. The area under the receiver operating characteristic curve of the best subset was computed (AUROC). For each combination (SECT/DECT and patient response/lesion response), an individual random forest classifier with 10-fold internal cross-validation was trained on the study cohort and tested on the validation cohort to confirm the predictive performance.ResultsWe performed manual RECIST 1.1 response analysis on a total of 6533 lesions. Multivariate statistics selected significant features for patient response in SECT (min. brightness, R²=0.112, padj. ≤0.001) and DECT (textural coarseness, R²=0.121, padj. ≤0.001), as well as lesion response in SECT (mean absolute voxel intensity deviation, R²=0.115, padj. ≤0.001) and DECT (iodine uptake metrics, R²≥0.12, padj. ≤0.001). Applying the machine learning models to the validation cohort confirmed the additive predictive power of DECT (patient response AUROC SECT=0.5, DECT=0.75; lesion response AUROC SECT=0.61, DECT=0.85; p<0.001).ConclusionThe new method of DECT-specific radiomic analysis provides a significant additive value over SECT radiomics approaches for response prediction in patients with metastatic melanoma preceding immunotherapy, especially on a lesion-based level. As mixed tumor response is not uncommon in metastatic melanoma, this lends a powerful tool for clinical decision-making and may potentially be an essential step toward individualized medicine.
Use of biochar for alleviating negative impact of salinity stress in corn grown in arid soil
Authors: Alotaibi Khaled D. 
Published: November 2021

Tremendous benefits of biochar (BC) amendment to soil have been reported, including their role in alleviating the impact of salinity stress in plants. The aim of this study was to evaluate the effects of BC produced at 300 °C (BC300) and 700 °C (BC700) on the germination rate (GR) and selected growth characteristics of corn plants irrigated with salinized water over a growth period of 6 weeks. The experimental treatments included three biochar treatments: BC0 (control, without biochar addition), BC300, and BC700. The treatments also included three salinity levels of irrigation water: 0, 3, and 6 dS·m−1. The biochar was applied at a rate of 3%. The GR decreased with increasing salinity level, which was more evident in the first week. This stress impact was reduced when treated with the BC700 relative to the saline treatments without BC. Both BC treatments demonstrated contrasting effects on corn growth, nutrient uptake, and Na+ and K+ content in plant tissue. The effect of BC700 treatment on plant height and root length was limited, but the impact of salinity stress on chlorophyll meter readings, chlorophyll fluorescence parameter (Fv/Fm), dry matter yield, and N and P uptake were largely mitigated. It also increased K+ and decreased Na+ content in plant tissue. However, the BC300 treatment adversely affected plant growth parameters at each salinity level. Overall, the BC produced at a higher temperature significantly alleviated the impact of salinity stress on plant growth characteristics, which is probably attributed to their higher surface area and porosity, enhancing their salt ion sorption capacity.
Performance of the ReD TPC, a novel double-phase LAr detector with silicon photomultiplier readout
Authors: Agnes P. , Albergo S. , Albuquerque I. , Arba M. , Ave M. , Boiano A. , Bonivento W. M. , Bottino B. , Bussino S. , Cadeddu M. , Caminata A. , Canci N. , Cappello G. , Caravati M. , Cariello M. , Castellano S. , Catalanotti S. , Cataudella V. , Cereseto R. , Cesarano R. , Cicalò C. , Covone G. , de Candia A. , De Filippis G. , De Rosa G. , Davini S. , Dionisi C. , Dolganov G. , Fiorillo G. , Franco D. , Giovanetti G. K. , Galbiati C. , Gulino M. , Ippolito V. , Kemmerich N. , Kochanek I. , Korga G. , Kuss M. , La Commara M. , La Delfa L. , Leyton M. , Li X. , Lissia M. , Mari S. M. , Martoff C. J. , Masone V. , Matteucci G. , Musico P. , Oleynikov V. , Pallavicini M. , Pandola L. , Razeto A. , Rescigno M. , Rode J. , Rossi N. , Sablone D. , Sanfilippo S. , Scapparone E. , Sosa A. , Suvorov Y. , Testera G. , Tricomi A. , Tuveri M. , Wada M. , Wang H. , Wang Y. , Westerdale S. 
Published: November 2021

AbstractA double-phase argon Time Projection Chamber (TPC), with an active mass of 185 g, has been designed and constructed for the Recoil Directionality (ReD) experiment. The aim of the ReD project is to investigate the directional sensitivity of argon-based TPCs via columnar recombination to nuclear recoils in the energy range of interest (20–$$200\,\hbox {keV}_{nr}$$200keVnr) for direct dark matter searches. The key novel feature of the ReD TPC is a readout system based on cryogenic Silicon Photomultipliers (SiPMs), which are employed and operated continuously for the first time in an argon TPC. Over the course of 6 months, the ReD TPC was commissioned and characterised under various operating conditions using$$\gamma $$γ-ray and neutron sources, demonstrating remarkable stability of the optical sensors and reproducibility of the results. The scintillation gain and ionisation amplification of the TPC were measured to be$$g_1 = (0.194 \pm 0.013)$$g1=(0.194±0.013)photoelectrons/photon and$$g_2 = (20.0 \pm 0.9)$$g2=(20.0±0.9)photoelectrons/electron, respectively. The ratio of the ionisation to scintillation signals (S2/S1), instrumental for the positive identification of a candidate directional signal induced by WIMPs, has been investigated for both nuclear and electron recoils. At a drift field of 183 V/cm, an S2/S1 dispersion of 12% was measured for nuclear recoils of approximately 60–$$90\,\hbox {keV}_{nr}$$90keVnr, as compared to 18% for electron recoils depositing 60 keV of energy. The detector performance reported here meets the requirements needed to achieve the principal scientific goals of the ReD experiment in the search for a directional effect due to columnar recombination. A phenomenological parameterisation of the recombination probability in LAr is presented and employed for modeling the dependence of scintillation quenching and charge yield on the drift field for electron recoils between 50–500 keV and fields up to 1000 V/cm.
3D multi-scale modelling of plasma-based seeded soft X-ray lasers
Authors: Oliva Eduardo , Fernández-Tello Elisa V. , Cotelo Manuel , Martínez Gil Pablo , Moreno José Antonio , Velarde Pedro 
Published: November 2021

AbstractModelling plasma-based seeded soft X-ray lasers from the creation of the plasma to the propagation of a femtosecond high-order harmonic (HOH) seed throughout several millimetres of inhomogeneous plasma is a complex challenge. Different spatio-temporal scales from the hydrodynamic evolution of the plasma (hundreds of micrometres and nanoseconds) to the propagation of pulses through the plasma (millimetres and tens of picoseconds), electron collisions (picoseconds or even shorter) and the evolution of the envelope of the seeded HOH (tens of femtoseconds) must be tackled in order to fully understand these systems. In this paper, we will present the multi-scale computational paradigm that we have used to perform a full ab initio simulation of a dense, Ni-like Krypton plasma amplifier of soft X-rays. Results of the modelling and expected future applications will also be shown.
Qualitative Diagnosis of Liver Tumors Based on Ultrasound-Guided Automatic Biopsy
Authors: Peng Bin 
Published: November 2021

The goal of this study was to see if automatic biopsy guided by ultrasound could be used to provide a qualitative diagnosis of a liver tumor. Methods. A total of 40 patients (101 focuses) were treated with automatic liver parenchyma biopsy under ultrasound guidance, and the correlation between pathological outcomes and ultrasound images was investigated. The lesion size in the observation group was compared to that in the control group using conventional ultrasound (

P

> 0.05), and there was no significant difference. Under contrast-enhanced ultrasound (CEUS), there was no statistically significant difference in lesion size between the observation and control groups (

P

> 0.05). The difference in lesion size between the conventional ultrasonography and CEUS observation groups was statistically significant (

P

0.05). Conclusion. Ultrasound-guided automated biopsy of the liver parenchyma is a simple and effective procedure with fewer problems and a high diagnostic rate, and it deserves to be promoted clinically.
Factors Influencing Reintervention Following Ductal Artery Stent Implantation for Ductal-Dependent Pulmonary Blood Flow: Results From the Congenital Cardiac Research Collaborative
Authors: Shahanavaz Shabana , Qureshi Athar M. , Petit Christopher J. , Goldstein Bryan H. , Glatz Andrew C. , Bauser-Heaton Holly D. , McCracken Courtney E. , Kelleman Michael S. , Law Mark A. , Nicholson George T. , Zampi Jeffrey D. , Pettus Joelle , Meadows Jeffery 
Published: November 2021

Background:
Stenting of the patent ductus arteriosus (PDA) is an established palliative option for infants with ductal-dependent pulmonary blood flow. Following initial palliation, reintervention on the PDA stent is common, but risk factors have not been characterized.

Methods:
Infants with ductal-dependent pulmonary blood flow palliated with PDA stent between 2008 and 2015 were reviewed within the Congenital Cardiac Research Collaborative. Rates and risk factors for reintervention were analyzed.

Results:
Among 105 infants who underwent successful PDA stenting, 41 patients (39%) underwent a total of 53 reinterventions on the PDA stent, with all but one occurring within 6 months of the initial intervention. Stent redilation constituted the majority of reintervention (n=35; 66%) followed by additional stent placement (n=11; 21%) and surgical shunt placement (n=7; 13%). The majority of reintervention was nonurgent, and there were no deaths during the reintervention procedure. All but one reintervention occurred within 6 months of the initial procedure. On univariate analysis, risk factors for reintervention included anticipated single-ventricle physiology, lack of prior balloon pulmonary valvuloplasty, use of drug-eluting stent, and increased ductal tortuosity.

Conclusions:
In infants with ductal-dependent pulmonary blood flow palliated with PDA stent implantation, reintervention is common, can be performed safely, and is associated with both anatomic/procedural factors and anticipated final physiology.
VE-Cadherin Is Required for Cardiac Lymphatic Maintenance and Signaling
Authors: Harris Natalie R. , Nielsen Natalie R. , Pawlak John B. , Aghajanian Amir , Rangarajan Krsna , Serafin D. Stephen , Farber Gregory , Dy Danielle M. , Nelson-Maney Nathan P. , Xu Wenjing , Ratra Disha , Hurr Sophia H. , Qian Li , Scallan Joshua P. , Caron Kathleen M. 
Published: November 2021

Background:
The adherens protein VE-cadherin (vascular endothelial cadherin) has diverse roles in organ-specific lymphatic vessels. However, its physiological role in cardiac lymphatics and its interaction with lymphangiogenic factors has not been fully explored. We sought to determine the spatiotemporal functions of VE-cadherin in cardiac lymphatics and mechanistically elucidate how VE-cadherin loss influences prolymphangiogenic signaling pathways, such as adrenomedullin and VEGF (vascular endothelial growth factor)-C/VEGFR3 (vascular endothelial growth factor receptor 3) signaling.

Methods:

Cdh5

flox/flox

;Prox1CreER

T2

mice were used to delete VE-cadherin in lymphatic endothelial cells across life stages, including embryonic, postnatal, and adult. Lymphatic architecture and function was characterized using immunostaining and functional lymphangiography. To evaluate the impact of temporal and functional regression of cardiac lymphatics in
Cdh5

flox/flox

;Prox1CreER

T2

mice, left anterior descending artery ligation was performed and cardiac function and repair after myocardial infarction was evaluated by echocardiography and histology. Cellular effects of VE-cadherin deletion on lymphatic signaling pathways were assessed by knockdown of VE-cadherin in cultured lymphatic endothelial cells.

Results:

Embryonic deletion of VE-cadherin produced edematous embryos with dilated cardiac lymphatics with significantly altered vessel tip morphology. Postnatal deletion of VE-cadherin caused complete disassembly of cardiac lymphatics. Adult deletion caused a temporal regression of the quiescent epicardial lymphatic network which correlated with significant dermal and cardiac lymphatic dysfunction, as measured by fluorescent and quantum dot lymphangiography, respectively. Surprisingly, despite regression of cardiac lymphatics,
Cdh5

flox/flox

;Prox1CreER

T2

mice exhibited preserved cardiac function, both at baseline and following myocardial infarction, compared with control mice. Mechanistically, loss of VE-cadherin leads to aberrant cellular internalization of VEGFR3, precluding the ability of VEGFR3 to be either canonically activated by VEGF-C or noncanonically transactivated by adrenomedullin signaling, impairing downstream processes such as cellular proliferation.

Conclusions:
VE-cadherin is an essential scaffolding protein to maintain prolymphangiogenic signaling nodes at the plasma membrane, which are required for the development and adult maintenance of cardiac lymphatics, but not for cardiac function basally or after injury.
Improvement in Surgical Quality Following Pancreaticoduodenectomy With Increasing Case Volume in a Rural Hospital
Authors: Mitsakos Anastasios T. , Vohra Nasreen A. , Fitzgerald Timothy L. , Buccini Peter , Parikh Alexander A. , Snyder Rebecca A. , Zervos Emmanuel E. 
Published: November 2021

Background The literature is replete with studies that define the nexus of quantity and quality in complex surgical operations. These observations have heralded a call for centralization of care to high-volume centers. The purpose of this study was to chronicle improvements in quality associated with pancreaticoduodenectomy (PD) as a rural hospital matures from a low- to very high-volume center. Methods A retrospective review of a prospective pancreatic surgery database was undertaken from July 2007 to June 2020. Annual periods were characterized as low (≤12/year), high (13-29/year), and very high volume (≥30/year). Data for the following quality benchmarks were aggregated and compared: length of stay (LOS), 30-day readmissions, 30-day mortality, and 1- and 3-year survival. A subgroup analysis was undertaken in those patients undergoing PD for adenocarcinoma detailing margin status and number of lymph nodes harvested. Outcomes were compared using the Fisher’s exact and Student’s t-test. Results 375 PD were completed over the 13-year period; 62.1% were undertaken for ductal adenocarcinoma. There was a significant decrease in LOS and 30-day readmissions as the institution matured toward very high volume. There were no significant differences in 30-day mortality, 1- and 3-year survival, or margin negativity rates associated with volume. Extent of lymph node harvest significantly improved as institutional experience increased. Discussion Our pancreatic surgery program matured rapidly from low to very high volume with institutional commitment and dedicated resources. As the institution matured, operational efficiencies and surgical quality improved. Not unexpectedly, biology trumped volume as reflected in 1- and 3-year survival rates.
Admitting Service and Outcome for Small Bowel Obstruction
Authors: Thacker Christopher , Lauer Claire , Nealon Kathleen , Walker Charles , Factor Matthew 
Published: November 2021

Introduction Small bowel obstruction (SBO) is a common admission diagnosis. Prior research has shown improved length of stay and time to operation for SBO patients on surgical services (SS) compared to medical services (MS). This study evaluates the impact of admitting service on readmission and mortality. Methods A 12-year retrospective cohort study of patients ≥18 years old, admitted with SBO to either a MS or SS within one health care system was performed. Clinicodemographic characteristics and admission details were extracted and reviewed. Statistical analyses performed included the Student’s t-test, chi-square, and multivariable regression. Results The study included 7921 patients, of which 3862 (48.8%) were admitted to a SS. No significant clinicodemographic differences existed between the groups except SS patients were more likely to have cancer (23.3% vs 15.2%, P < .0001) and to be within a 30-day post-operative period (9.4% vs 1.8%, P < .0001). On multivariable analysis, admission to a SS was associated with a decreased admission mortality (OR .70), 30-day mortality (OR .42), and 180-day mortality (OR .42). 30-day readmissions (OR .54) and 180-day readmission (OR .43) were also significantly decreased for SS patients. In patients requiring a procedure during admission, there was significantly decreased admission mortality (OR .684), 30-day mortality (OR .470), 180-day mortality (OR .431), 30-day readmission (OR .63), and 180-day readmission (OR .50). Conclusion In patients with SBO, admission to a SS confers decreased odds of readmission and mortality compared to MS. Future studies are needed to understand the management decisions potentially underlying these differences. These findings may help better define admission pathways and improve outcomes.
Entrapment and escape: Exploring the relationship between suicide and emigration in a post-communist country
Authors: B Erdos Marta , Javor Rebeka 
Published: November 2021

Background: Suicide rate in Hungary was nearly the highest in the world in the decades preceding the transition of the social system. Shortly after the transition in 1989, a radical decrease in fatal suicides occurred, parallel with a marked increase in emigration. Methods: We analyzed the data published by the Hungarian Central Statistical Office to detect if there was an association between the remarkable drop in suicide rates and the changes in emigration rates from 1995 to 2019. Results: The results of a brief statistical analysis on the correlation between suicide rate and emigration confirmed a strong negative relationship ( r = −.855, p = .00). For more precise results, we applied linear regression analysis, which showed that the emigration rate predicted 73.2% of suicide rate variances with a high predictive value (β = −.983). Conclusion: The study provides a possible explanation through a phenomenological analysis on major life transformations. Relating the arrested flight/cry of pain theory, the theory of rites of passage and double-bind communication resulted a comprehensive and coherent, but not exhaustive explanation on the relationship between suicide and emigration.
An exploration of the relationship between adverse events on the farm and suicidal ideation in farmers
Authors: Phalp Laura , Corcoran Rhiannon , Eames Catrin , Naik Aarun 
Published: November 2021

Background: The risk of suicide for agricultural workers in parts of the United Kingdom (UK) is almost twice the national average. Existing literature has suggested that adverse farming events, where failure is determined by uncontrollable and unpredictable forces, may be to blame. Yet, the impact of such events on farmer suicidality has not been explicitly explored. Aims: The present paper therefore aimed to investigate the relationship between adverse farming events and suicidal ideation in farmers. Methods: A cross-sectional questionnaire battery was disseminated between July 2018 and February 2019, and completed by 170 adult farmers. Results: Over a 12-month period, 88.8% reported that they had experienced an adverse farming event and 32.9% said that they had experienced suicidal thoughts. Correlational analysis revealed a relationship between these variables. Conclusions: The high prevalence of suicidal ideation within farmers demonstrates a critical need for intervention. Likewise, the prevalence of adverse farming events suggests that interventions need to be appropriately tailored, with greater understanding about the impact of such events on the mental wellbeing of farmers.