bluuebunny/crossref_metadata_2025_split huggingface dataset:
Age, blood urea nitrogen, and lactate: Preoperative risk factors of laparotomy for strangulated small bowel obstruction
Authors: Hayakawa Shunsuke , Hayakawa Tetsushi , Uehara Shuhei , Miyai Hirotaka , Ogawa Ryo , Yamamoto Minoru , Tanaka Moritsugu , Takiguchi Shuji 
Published: March 2021

AbstractIntroductionDespite increasing reports of laparoscopy for strangulated small bowel obstruction (SSBO), there is no consensus on outcomes in patients with SSBO. We evaluated the safety and utility of laparoscopy for SSBO and investigated the preoperative risk factors for laparotomy.MethodsThis retrospective study included 107 patients who underwent emergency surgery for SSBO over a period of 6 years. Patients' characteristics and surgical parameters were compared between 27 patients undergoing laparoscopy alone (group L) and 80 patients undergoing laparotomy (group O, including conversion). Univariate and multivariate analyses were performed to determine risk factors for laparotomy.ResultsCompared with group L, group O had significantly shorter operation time (59 vs 115 minutes, P < .001), shorter postoperative hospital stay (6 vs 10 days, P < .001), and fewer complications (3 vs 40 cases, P < .001). Age ≥ 68 years (odds ratio [OR] 3.970, P = .021), blood urea nitrogen (BUN) ≥ 14.6 mg/dL (OR 4.360, P = .012), and lactate ≥2.80 mmol/L (OR 12.90, P = .023) were independent risk factors for laparotomy.ConclusionPrognosis was better in patients with SSBO undergoing complete laparoscopy than in patients undergoing laparotomy; however, age, BUN, and lactate were independent preoperative risk factors for laparotomy.
A comparison of faecal incontinence scoring systems
Authors: Colbran Rachel , Gillespie Christopher , Ayvaz Faruk , Warwick Andrea M. 
Published: March 2021

AbstractAimQuestionnaires designed to score the severity of faecal incontinence (FI) are widely used to provide an evaluation of symptoms across settings, studies and time. The Pelvic Floor Disorders Consortium have recommended the use of multiple questionnaires despite some overlap of questions. This study aimed to evaluate whether patient responses to these questionnaires are consistent.MethodA retrospective analysis was undertaken of patients with FI who attended a dedicated pelvic floor unit between January 2018 and December 2019 and completed the Fecal Incontinence Severity Index, Cleveland Clinic Florida Incontinence Score and St Mark's Incontinence Score simultaneously. For each questionnaire the frequency of incontinence episodes to solid stool, liquid stool and gas was divided into five categories to allow direct comparison. Answers were deemed equivalent if the allocated response was identical, slightly different if the response was in an adjacent category or very different if the response differed to a greater extent.ResultsThere were 193 patients who simultaneously completed all three FI questionnaires. There were statistically significant differences between the responses regarding frequency of solid stool, liquid stool and gas incontinence on all three questionnaires (p < 0.005). Across all domains, between 58.0% and 69.9% of responses were equivalent, 14.1%–34.0% of answers were slightly different and 8.0%–18.8% were very different.ConclusionEven when completed at the same time, and by the same person, similar questions are answered differently a significant proportion of the time. The utility of using multiple questionnaires simultaneously in the clinical setting to assess FI symptoms should be questioned.
Heart rate variability changes by non‐invasive ventilation in obesity hypoventilation syndrome
Authors: Amra Babak , Balouchianzadeh Samin , Soltaninejad Forogh , Schoebel Christoph , Fietze Ingo , Bateni Mohammad Hossein , Abdar Esfahani Morteza , Penzel Thomas 
Published: March 2021

AbstractBackgroundNon‐invasive positive pressure ventilation (NIPPV) is known to enhance hypoventilation and is particularly adopted as a treatment for patients diagnosed with obesity hypoventilation syndrome (OHS). The augmented risk of cardiovascular morbidity is known as a side effect of OHS.AimsIn this paper, this inference is examined that hypoventilation and the increased risk of morbidity can be diagnosed via the assessment of changes in heart rate variability (HRV). More specifically, the study investigates the effect of NIPPV on both HRV and hypoventilation among OHS patients. The linear relationship between different HRV measures and ventilation parameters is also examined.Materials & MethodsThe reported results are attained via an interventional clinical trial study. HRV measures are evaluated before and after treatment, in a group of patients which are newly diagnosed with OHS and receive bi‐level positive airway pressure (BiPAP) treatment for three months.ResultsThe results are compared and interpreted via statistical analysis.DiscussionThroughout the study, the relationship between hypoventilation and HRV is confirmed, as well as the effect of BiPAP on some HRV measures in both time and frequency domains. Particularly significant connections are observed between hypoventilation and low‐frequency components of HRV.ConclusionThe enhanced respiration due to the application of BiPAP can improve the performance of autonomous nervous and cardiovascular systems, in terms of HRV. Moreover, it is suggested to consider some HRV parameters to control the cardiovascular side‐effects of OHS and confine the resulting mortality rate in long term.
The non‐government alcohol and other drug workforce in Australia: Findings from a national survey
Authors: Roche Ann M. , Skinner Natalie 
Published: March 2021

AbstractIntroductionThere is growing interest in the role of the non‐government sector in the alcohol and other drug (AOD) service delivery system. This study examined the demographic profile of AOD workers in the non‐government (NGO) compared to government sector, to ascertain their professional development needs, job satisfaction, retention and turnover.MethodsThis study utilised cross‐sectional data from an Australian AOD workforce online survey that assessed participants' demographics, employment profile, professional development needs and barriers. The sample comprised 888 workers in direct client service roles.ResultsBinomial logistic regression analysis indicated that NGO workers were more likely to be younger (<35 years), have AOD lived experience and have an AOD vocational qualification. NGO workers were more likely to earn below the national average salary and report job insecurity; but nonetheless were more likely to feel respected and supported at work, believe their work was meaningful and be satisfied working in the AOD sector. Their top professional development barrier was personal financial cost. NGO workers were more likely to report employer financial costs as a professional development barrier, whereas government workers were more likely to report staff shortages.Discussion and ConclusionsAOD services in Australia rely increasingly on the NGO sector. Quality services and care pivot on the size, capability and maturity of the workforce. This study highlights the need for systemic interventions addressing structural issues, and the professional development and ongoing support needs of the NGO AOD workforce. Without such support, Australia's AOD services will be potentially jeopardised.
The urine light chain/glomerular filtration rate (GFR) quotient shows a high sensitivity and specificity to detect cast nephropathy in monoclonal light chain disease
Authors: Bergner Raoul , Hoffmann Martin , Uppenkamp Michael , Paschka Peter , Klank David 
Published: March 2021

AbstractBackgroundCast nephropathy (CN) is associated with a unfavourable outcome in monoclonal light chain (mLC) disease, but also more possible LC‐related renal diseases as well as non‐LC‐related disease can occur. Thus, it is crucial to understand the underlying renal disease. On the other hand, LC can interfere with coagulation preventing kidney biopsy as the gold standard. We sought to develop a non‐invasive algorithm to diagnose CN with a good sensitivity and specificity.MethodWe analysed data from patients with mLC disease who underwent kidney biopsy. The patients were classified in 4 groups according the renal histology: CN, AL amyloidosis, light chain deposition disease, and other renal disease. Afterwards, different algorithms were calculated for their sensitivity and specificity.ResultsCN showed a significant higher concentration of serum‐free LC and urine LC (LCu), but there was a wide and overlapping range with the other groups. The best accuracy was achieved for a LCu/GFR ratio >2 in patients with lambda LC and either a LCu/GFR > 1 and proteinuria <8 g/24 h or a LCu/GFR > 5 in patients with proteinuria >8 g/24 h in patients with kappa LC. In lambda LC, the sensitivity and specificity for CN was 94% and 90%, respectively; in kappa LC 87% and 81%, respectively.DiscussionIn patients with coagulation disturbances due to LC, a non‐invasive algorithm can separate patients with CN from other renal disease in mLC disease.
A Longitudinal Diagnostic Model with Hierarchical Learning Trajectories
Authors: Zhan Peida , He Keren 
Published: March 2021

AbstractIn learning diagnostic assessments, the attribute hierarchy specifies a sequential network of interrelated attribute mastery processes, which makes a test blueprint consistent with the cognitive theory. One of the most important functions of attribute hierarchy is to guide or limit the developmental direction of students and then form a hierarchical learning trajectory. To address the issue that the existing longitudinal learning diagnosis models cannot track the development of hierarchical attributes, this study proposes a new hierarchical longitudinal learning diagnostic modeling approach and two sample models. Compared to the longitudinal learning diagnosis models that do not consider the attribute hierarchy, the proposed models, by taking the sequential mastery tree into account, can accommodate various attribute hierarchies and simultaneously track an individual's learning developmental trajectory. An empirical study was conducted to illustrate the advantages of the proposed model. The results mainly indicated that the proposed model can properly diagnose the development of hierarchical attributes in longitudinal assessments. A simulation study was further conducted to explore the model parameter recovery of the proposed models.
Risk of requiring a walking aid after 6.5 years of ocrelizumab treatment in patients with relapsing multiple sclerosis: Data from the OPERA I and OPERA II trials
Authors: Giovannoni Gavin , Kappos Ludwig , de Seze Jerome , Hauser Stephen L. , Overell James , Koendgen Harold , Manfrini Marianna , Wang Qing , Wolinsky Jerry S. 
Published: March 2021

AbstractBackground and purposeRequiring a walking aid is a fundamental milestone in multiple sclerosis (MS), represented by an Expanded Disability Status Scale (EDSS) score ≥6.0. In the present study, we assess the effect of ocrelizumab (OCR) on time to EDSS score ≥6.0 in relapsing MS.MethodsTime to EDSS score ≥6.0 confirmed for ≥24 and ≥48 weeks was assessed over the course of 6.5 years (336 weeks) in the double‐blind period (DBP) and open‐label extension (OLE) period of the OPERA I (NCT01247324) and OPERA II (NCT01412333) studies.ResultsTime to reach EDSS score ≥6.0 was significantly delayed in those initially randomized to OCR versus interferon. Over 6.5 years, the risk of requiring a walking aid confirmed for ≥24 weeks was 34% lower among those who initiated OCR earlier versus delayed treatment (average hazard ratio [HR] DBP + OLE 0.66, 95% confidence interval [CI] 0.45–0.95; p = 0.024); the risk of requiring a walking aid confirmed for ≥48 weeks was 46% lower (average HR DBP+OLE 0.54, 95% CI 0.35–0.83; p = 0.004).ConclusionThe reduced risk of requiring a walking aid in earlier initiators of OCR demonstrates the long‐term implications of earlier highly effective treatment.
Effect of bioactive glass air‐abrasion on Fusobacterium nucleatum and Porphyromonas gingivalis biofilm formed on moderately rough titanium surface
Authors: Abushahba Faleh , Gürsoy Mervi , Hupa Leena , Närhi Timo O. 
Published: March 2021

AbstractThis aim of this study was to investigate the effects of three types of air‐abrasion particles on dual‐species biofilms of Fusobacterium nucleatum and Porphyromonas gingivalis, both of which were cultured on sandblasted and acid‐etched (SA) titanium discs. Out of 24 SA discs with biofilm, 18 were exposed to either air‐abrasion using Bioglass 45S5 (45S5 BG; n = 6), novel zinc (Zn)‐containing bioactive glass (Zn4 BG; n = 6), or inert glass (n = 6). The efficiency of biofilm removal was evaluated using scanning electron microscopy (SEM) imaging and culturing techniques. Air‐abrasion using 45S5 BG or Zn4 BG demonstrated a significant decrease in the total number of viable bacteria compared to discs air‐abraded with inert glass or intact biofilm without abrasion. Moreover, P. gingivalis could not be detected from SEM images nor culture plates after air‐abrasion with 45S5 BG or Zn4 BG. The present study showed that air‐abrasion with 45S5 or Zn4 bioactive glasses can successfully eradicate dual‐biofilm of F. nucleatum and P. gingivalis from sandblasted and acid‐etched titanium discs.
No leading‐edge effect in North Atlantic harbor porpoises: Evolutionary and conservation implications
Authors: Ben Chehida Yacine , Loughnane Roisin , Thumloup Julie , Kaschner Kristin , Garilao Cristina , Rosel Patricia E. , Fontaine Michael C. 
Published: March 2021

AbstractUnderstanding species responses to past environmental changes can help forecast how they will cope with ongoing climate changes. Harbor porpoises are widely distributed in the North Atlantic and were deeply impacted by the Pleistocene changes with the split of three subspecies. Despite major impacts of fisheries on natural populations, little is known about population connectivity and dispersal, how they reacted to the Pleistocene changes, and how they will evolve in the future. Here, we used phylogenetics, population genetics, and predictive habitat modeling to investigate population structure and phylogeographic history of the North Atlantic porpoises. A total of 925 porpoises were characterized at 10 microsatellite loci and one quarter of the mitogenome (mtDNA). A highly divergent mtDNA lineage was uncovered in one porpoise off Western Greenland, suggesting that a cryptic group may occur and could belong to a recently discovered mesopelagic ecotype off Greenland. Aside from it and the southern subspecies, spatial genetic variation showed that porpoises from both sides of the North Atlantic form a continuous system belonging to the same subspecies (Phocoena phocoena phocoena). Yet, we identified important departures from random mating and restricted dispersal forming a highly significant isolation by distance (IBD) at both mtDNA and nuclear markers. A ten times stronger IBD at mtDNA compared with nuclear loci supported previous evidence of female philopatry. Together with the lack of spatial trends in genetic diversity, this IBD suggests that migration–drift equilibrium has been reached, erasing any genetic signal of a leading‐edge effect that accompanied the predicted recolonization of the northern habitats freed from Pleistocene ice. These results illuminate the processes shaping porpoise population structure and provide a framework for designing conservation strategies and forecasting future population evolution.
Genomic consequences of human‐mediated translocations in margin populations of an endangered amphibian
Authors: De Cahsan Binia , Westbury Michael V. , Paraskevopoulou Sofia , Drews Hauke , Ott Moritz , Gollmann Günter , Tiedemann Ralph 
Published: March 2021

AbstractDue to their isolated and often fragmented nature, range margin populations are especially vulnerable to rapid environmental change. To maintain genetic diversity and adaptive potential, gene flow from disjunct populations might therefore be crucial to their survival. Translocations are often proposed as a mitigation strategy to increase genetic diversity in threatened populations. However, this also includes the risk of losing locally adapted alleles through genetic swamping. Human‐mediated translocations of southern lineage specimens into northern German populations of the endangered European fire‐bellied toad (Bombina bombina) provide an unexpected experimental set‐up to test the genetic consequences of an intraspecific introgression from central population individuals into populations at the species range margin. Here, we utilize complete mitochondrial genomes and transcriptome nuclear data to reveal the full genetic extent of this translocation and the consequences it may have for these populations. We uncover signs of introgression in four out of the five northern populations investigated, including a number of introgressed alleles ubiquitous in all recipient populations, suggesting a possible adaptive advantage. Introgressed alleles dominate at the MTCH2 locus, associated with obesity/fat tissue in humans, and the DSP locus, essential for the proper development of epidermal skin in amphibians. Furthermore, we found loci where local alleles were retained in the introgressed populations, suggesting their relevance for local adaptation. Finally, comparisons of genetic diversity between introgressed and nonintrogressed northern German populations revealed an increase in genetic diversity in all German individuals belonging to introgressed populations, supporting the idea of a beneficial transfer of genetic variation from Austria into North Germany.
A sunny spot: habitat management through vegetation cuts increases oviposition in abandoned fields in an endemic Mediterranean butterfly
Authors: Cini Alessandro , Benetello Fulvia , Platania Leonardo , Bordoni Adele , Boschi Sara , Franci Emiliano , Ghisolfi Gea , Pasquali Lorenzo , Negroni Riccardo , Dapporto Leonardo 
Published: March 2021

Abstract
The abandonment of agricultural land and the afforestation of grassland habitats represent major threats for butterflies in European and Mediterranean areas. A crucial goal for Lepidoptera conservation is to maintain and/or restore habitat quality by targeted management. Nevertheless, there are few experimental studies allowing to derive data‐driven strategies to protect butterflies of open grasslands in the Mediterranean region.
We developed a habitat management strategy for the conservation of the Italian endemic butterfly Zerynthia cassandra by adopting a three‐step procedure: (i) characterising which environmental and host plant features influence oviposition on plants; (ii) identifying and testing the effect of a data‐driven habitat management intervention; (iii) understanding which micro‐habitat features promote Z. cassandra oviposition in restored places to optimise the intervention.
Both patch (areas of 1 m radius hosting Aristolochia shoots) and plant features affect oviposition, with the strongest positive effects showed by high irradiation of the patch and plant quality (high number of flowers and leaves). Accordingly, the management consisted in vegetation cuts to increase irradiation, and 2 years of monitoring demonstrated that this procedure significantly increased oviposition (average increase of about 2 eggs per plant) and larval presence. Micro‐habitat sampling demonstrated that the maximum oviposition differed between vegetation structures, highlighting the importance of a local fine‐tuning before the intervention.
We provided a data‐driven, effective, and sustainable management strategy to increase habitat suitability and oviposition for an endemic and endangered Mediterranean butterfly. Our framework can drive management strategies for other species with similar ecological requirements and subjected to similar threats.
Rapport management in the opening sequence of African and Asian doctors in South Africa
Authors: Fawole Adebola Abosede , Rammala Johannes Ratsitana 
Published: March 2021

AbstractCommunication issues occur when foreign doctors from different cultural backgrounds have to treat local patients and attempt to establish rapport across cultures in order to diagnose correctly and advise treatment in a way that is acceptable to the patient. This paper reports on strategies used by Iranian and Nigerian medical doctors in public hospitals in Limpopo, South Africa, to establish and manage rapport in the opening sequence of their first meetings with local rural patients. The study used a conversation analysis method to examine the interaction of Iranian and Nigerian doctors with local South African patients against the background of Spencer‐Oatey's rapport management framework and cultural maxims of greetings and forms of address in the two countries. Recordings of opening sequences of consultations were examined to provide an understanding of the doctors’ linguistic behavior. Consultations conducted by six doctors were recorded, transcribed, translated where necessary and analyzed against the background of the Rapport Management Framework. All the Iranian doctors were found to adopt different strategies from the Nigerian doctors even though both countries are classified as high‐context cultures and would be expected to use similar communication strategies. The findings have implications for the induction of foreign medical doctors in South Africa.
Presenting symptoms of COVID‐19 and clinical outcomes in hospitalised older adults
Authors: Gregorevic Kate , Maier Andrea , Miranda Roeisa , Loveland Paula , Miller Katherine , Buising Kirsty , Marshall Caroline , O'Gorman Bronwyn , Tan Amanda , Staggard Kylie , O'Halloran Tessa , Nguyen Huong Xuan Thi , Disler Jessica , Crotty Frances , Lim Kai , Cianter Joseph , Kelly Cate , Lim Kwang 
Published: March 2021

AbstractBackgroundIn July 2020, a COVID‐19 outbreak was recognised in the geriatric wards at a subacute campus of the Royal Melbourne Hospital affecting patients and staff. Patients were also admitted to this site after diagnosis in residential care.AimsTo describe the early symptoms and the outcomes of COVID‐19 in older adults.MethodsPatients diagnosed with COVID‐19 at the facility in July or August 2020 were identified and their medical records were examined to identify symptoms present before and after their diagnosis and to determine their outcomes.ResultsOverall, 106 patients were identified as having COVID‐19, with median age of 84.3 years (range 41–104 years); 64 were diagnosed as hospital inpatients after a median length of stay of 49 days, 31 were transferred from residential aged care facilities with a known diagnosis and 11 were diagnosed after discharge. There were 95 patients included in an analysis of symptom type and timing onset. Overall, 61 (64.2%) were asymptomatic at the time of diagnosis of COVID‐19, having been diagnosed through screening initiated on site. Of these, 88.6% developed symptoms of COVID‐19 within 14 days. The most common initial symptom type was respiratory, but there was wide variation in presentation, including fever, gastrointestinal and neurological symptoms, many initially not recognised as being due to COVID‐19. Of 104 patients, 32 died within 30 days of diagnosis.ConclusionsCOVID‐19 diagnosis is challenging due to the variance in symptoms. In the context of an outbreak, asymptomatic screening can identify affected patients early in the disease course.