bluuebunny/crossref_metadata_2025_split huggingface dataset:
Histopathological effects of electrosurgical interventions in an in vivo porcine model of colonic endoscopic mucosal resection
Authors: Whitfield Anthony M , Burgess Nicholas G , Bahin Farzan F , Kabir Sharir , Pellisé María , Sonson Rebecca , Subramanian Vishnu , Mahajan Hema , McLeod Duncan , Byth Karen , Bourke Michael J 
Published: June 2021

ObjectiveEndoscopic mucosal resection (EMR) in the colon has been widely adopted, but there is limited data on the histopathological effects of the differing electrosurgical currents (ESCs) used. We used an in vivo porcine model to compare the tissue effects of ESCs for snare resection and adjuvant margin ablation techniques.DesignStandardised EMR was performed by a single endoscopist in 12 pigs. Two intersecting 15 mm snare resections were performed. Resections were randomised 1:1 using either a microprocessor-controlled current (MCC) or low-power coagulating current (LPCC). The lateral margins of each defect were treated with either argon plasma coagulation (APC) or snare tip soft coagulation (STSC). Colons were surgically removed at 72 hours. Two specialist pathologists blinded to the intervention assessed the specimens.Results88 defects were analysed (median 7 per pig, median defect size 29×17 mm). For snare ESC effects, 156 tissue sections were assessed. LPCC was comparable to MCC for deep involvement of the colon wall. For margin ablation, 172 tissue sections were assessed. APC was comparable to STSC for deep involvement of the colon wall. Islands of preserved mucosa at the coagulated margin were more likely with APC compared with STSC (16% vs 5%, p=0.010).ConclusionFor snare resection, MCC and LPCC did not produce significantly different tissue effects. The submucosal injectate may protect the underlying tissue, and technique may more strongly dictate the depth and extent of final injury. For margin ablation, APC was less uniform and complete compared with STSC.
Investigation of post-trial access views among study participants and stakeholders using photovoice and semistructured interviews
Authors: Ngwenya Nothando , Iwuji Collins , Petersen Nabeel , Myeni Nompilo , Nxumalo Samukelisiwe , Ngema Ursula , Seeley Janet 
Published: June 2021

PurposeWe examine the levels of post-trial responsibility ascribed to different stakeholders, following a community-based clinical trial and how the ‘responsibility’ is understood.MethodsWe employed photovoice, unstructured observations and key informant interviews to gain insights into contexts of access to care following transition to the public health system post trial. We used an inductive narrative analysis to explore experiences and understandings of post-trial access (PTA).ResultsIn their photovoice stories, many participants expressed a sense of abandonment after the trial. This was viewed as a contributing factor to failing to re-engage with care available in the public health system. This led to the experiences of loss as some trial participants defaulted and died. Research investigators, department of health participants and sponsor agreed that PTA was especially important for communities in resource-limited settings. The government has an obligation towards its citizens while researchers have a responsibility to ensure a smooth transition of patients to public clinics. Sponsors have a responsibility to ensure that the trial is conducted in accordance with the protocol and post-trial agreements are in place and adhered to. Research partnerships among stakeholders were affected by power imbalances making it difficult to negotiate and plan for post-trial care responsibilities.ConclusionsThe research community still struggles with understanding the scope of PTA responsibilities. Power dynamics between public health actors and research sponsors need to be managed to ensure that government involvement is not tokenistic. The responsibility of trial participants and ethics committees needs to be investigated further.
Bronchoscopic needle-based confocal laser endomicroscopy (nCLE) as a real-time detection tool for peripheral lung cancer
Authors: Kramer Tess , Wijmans Lizzy , de Bruin Martijn , van Leeuwen Ton , Radonic Teodora , Bonta Peter , Annema Jouke T 
Published: June 2021

IntroductionDiagnosing peripheral lung cancer with the bronchoscope is challenging with near miss of the target lesion as major obstacle. Needle-based confocal laser endomicroscopy (nCLE) enables real-time microscopic tumour visualisation at the needle tip (smart needle).AimTo investigate feasibility and safety of bronchoscopic nCLE imaging of suspected peripheral lung cancer and to assess whether nCLE imaging allows real-time discrimination between malignancy and airway/lung parenchyma.MethodsPatients with suspected peripheral lung cancer based on (positron emission tomography-)CT scan underwent radial endobronchial ultrasound (rEBUS) and fluoroscopy-guided flexible bronchoscopy. After rEBUS lesion detection, an 18G needle loaded with the CLE probe was inserted in the selected airway under fluoroscopic guidance. The nCLE videos were obtained at the needle tip, followed by aspirates and biopsies. The nCLE videos were reviewed and compared with the cytopathology of the corresponding puncture and final diagnosis. Five blinded raters validated nCLE videos of lung tumours and airway/lung parenchyma twice.ResultsThe nCLE imaging was performed in 26 patients. No adverse events occurred. In 24 patients (92%) good to high quality videos were obtained (final diagnosis; lung cancer n=23 and organising pneumonia n=1). The nCLE imaging detected malignancy in 22 out of 23 patients with lung cancer. Blinded raters differentiated nCLE videos of malignancy from airway/lung parenchyma (280 ratings) with a 95% accuracy. The inter-observer agreement was substantial (κ=0.78, 95% CI 0.70 to 0.86) and intra-observer reliability excellent (mean±SD κ=0.81±0.05).ConclusionBronchoscopic nCLE imaging of peripheral lung lesions is feasible, safe and allows real-time lung cancer detection. Blinded raters accurately distinguished nCLE videos of lung cancer from airway/lung parenchyma, showing the potential of nCLE imaging as real-time guidance tool.
Sex- and tissue-dependent creatine uptake in response to different creatine monohydrate doses in male and female Sprague–Dawley rats
Authors: Dunham Tyler C. , Murphy Jensen E. , MacPherson Rebecca E.K. , Fajardo Val Andrew , Ward Wendy E. , Roy Brian D. 
Published: June 2021

Sprague–Dawley rats (n = 32) underwent 8-weeks of creatine monohydrate (CM) supplementation (0, 2.5, 5, and 10 g/L). Total creatine (TCr) concentrations in female white fibre-dominant gastrocnemius (WGAS) and cardiac muscle (HRT) were significantly higher compared with males (p < 0.05). CM supplementation increased TCr concentrations in female WGAS (p < 0.05) and HRT (p < 0.01) and in male red fibre-dominant gastrocnemius muscle (RGAS) (p < 0.05). Future research should further investigate sex-differences in basal levels of TCr and the response to CM supplementation. Novelty: There is a sex- and tissue-dependant response to CM supplementation in rats.
Geographic patterns of genetic diversity in North American trees: a continent-wide analysis
Authors: Gougherty Andrew V. 
Published: June 2021

In the Northern Hemisphere, many species have been reported to have greater genetic diversity in southern populations than northern populations — ostensibly due to migration northward following the last glacial maximum. The generality of this pattern, while well-established for some taxa, remains unclear for North American trees. To address this issue, I collected published population genetics data for 73 North American tree species and tested whether genetic diversity was associated with latitude or longitude and whether geographic trends were associated with dispersal traits, range, or study characteristics. I found there were no general geographic patterns in genetic diversity and the strength of the geographic gradients was not associated with any species or study characteristics. The northern and western regions of North America tended to have more species with genetic diversity that declined with latitude, but most species had no significant trend. This work shows that North American trees have complex and individualistic patterns of genetic diversity that may negate explanation by any particular dispersal trait or range characteristic.
Tree establishment on post-mining waste soils: species, density, and mixture effects
Authors: Asmara Degi Harja , Allaire Suzanne , van Noordwijk Meine , Khasa Damase P. 
Published: June 2021

Tree establishment to restore degraded boreal post-mining lands is challenged by low soil productivity, a harsh microclimate, and potentially high contaminant levels. The use of mixed vegetation can facilitate the microclimate but increase competition for soil resources. A statistical accounting of plant–plant interactions and adaptation to multispecies conditions is hard to achieve in field experiments; trials under controlled conditions can distinguish effects of planting density and species interactions in the early stages of plant establishment. A greenhouse trial was established in containers (“mesocosms”) with waste rock or fine tailings from gold mines. Pregerminated (1-week-old) seedlings (Alnus viridis subsp. crispa, Picea glauca, Populus tremuloides, Salix arbusculoides) were planted using a Nelder density gradient design, modified for species combinations. A relative competition effect was estimated as a competitiveness index for each species combination, calculated as a ratio of α coefficients in the Holliday growth equation. The specific leaf area (SLA) was measured to indicate plant water stress adaptation. All species grew better in monoculture on fine tailings, while only P. tremuloides grew better in all mixtures on waste rock. Although net positive effects of density on SLA increment during early growth suggested microclimate improvement on fine tailings, no mixture provided advantages for both species in paired combinations.
Combination of Terrestrial and Satellite Gravity Data for the Characterization of the Southwestern Coastal Region of Cameroon: Appraisal for Hydrocarbon Exploration
Authors: Kamto Paul Gautier , Lemotio Willy , Tokam Alain-Pierre Kamga , Yap Loudi 
Published: June 2021

The southwestern coastal region of Cameroon is an area of interest because of its hydrocarbon potential (gas and oil). Terrestrial and satellite gravity data were combined and analyzed to provide a better precision in determining the structure of the study area. Firstly, the two gravity databases (in situ and satellite) have been coupled and validated using the least square collocation technique. Then, spectral analysis was applied to the combined Bouguer anomaly map to evaluate the thickness of sediments in some localities. We found that the sedimentary cover of the southwestern coastal region of Cameroon has a thickness that varies laterally from

1.68
±
0.08

to

2.95
±
0.15

km

, especially in the western part. This result confirms that our target area is a potential site for hydrocarbon exploration. The horizontal gradient method coupled with the upward continuation at variable heights has been used to highlight several lineaments and their directions (N-S, E-W, SW-NE, and SSW-NNE). Lineaments trending in an N-S orientation are predominant. The Euler deconvolution method was also applied to the Bouguer anomaly map to determine the position, orientation, and depth of the different superficial faults of the study area. It appears that the majority of superficial faults have an N-S and SSW-NNE orientation. These directions are correlated with those previously highlighted by the maxima of horizontal gradient. The structural map could be used for a better identification of the direction of fluid flow within the subsurface or to update the geological map of our study area.
Cardiac Troponin Thresholds and Kinetics to Differentiate Myocardial Injury and Myocardial Infarction
Authors: Wereski Ryan , Kimenai Dorien M. , Taggart Caelan , Doudesis Dimitrios , Lee Kuan Ken , Lowry Matthew T.H. , Bularga Anda , Lowe David J. , Fujisawa Takeshi , Apple Fred S. , Collinson Paul O. , Anand Atul , Chapman Andrew R. , Mills Nicholas L. 
Published: June 2021

Background:
Although the 99th percentile is the recommended diagnostic threshold for myocardial infarction, some guidelines also advocate the use of higher troponin thresholds to rule in myocardial infarction at presentation. It is unclear whether the magnitude or change in troponin concentration can differentiate causes of myocardial injury and infarction in practice.

Methods:
In a secondary analysis of a multicenter randomized controlled trial, we identified 46 092 consecutive patients presenting with suspected acute coronary syndrome without ST-segment–elevation myocardial infarction. High-sensitivity cardiac troponin I concentrations at presentation and on serial testing were compared between patients with myocardial injury and infarction. The positive predictive value and specificity were determined at the sex-specific 99th percentile upper reference limit and rule-in thresholds of 64 ng/L and 5-fold of the upper reference limit for a diagnosis of type 1 myocardial infarction.

Results:

Troponin was above the 99th percentile in 8188 patients (18%). The diagnosis was type 1 or type 2 myocardial infarction in 50% and 14% and acute or chronic myocardial injury in 20% and 16%, respectively. Troponin concentrations were similar at presentation in type 1 (median [25th–75th percentile] 91 [30–493] ng/L) and type 2 (50 [22–147] ng/L) myocardial infarction and in acute (50 [26–134] ng/L) and chronic (51 [31–130] ng/L) myocardial injury. The 99th percentile and rule-in thresholds of 64 ng/L and 5-fold upper reference limit gave a positive predictive value of 57% (95% CI, 56%–58%), 59% (58%–61%), and 62% (60%–64%) and a specificity of 96% (96%–96%), 96% (96%–96%), and 98% (97%–98%), respectively. The absolute, relative, and rate of change in troponin concentration were highest in patients with type 1 myocardial infarction (
P
<0.001 for all). Discrimination improved when troponin concentration and change in troponin were combined compared with troponin concentration at presentation alone (area under the curve, 0.661 [0.642–0.680] versus 0.613 [0.594–0.633]).

Conclusions:
Although we observed important differences in the kinetics, cardiac troponin concentrations at presentation are insufficient to distinguish type 1 myocardial infarction from other causes of myocardial injury or infarction in practice and should not guide management decisions in isolation.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT01852123.
Effects of Sodium‐Glucose Linked Transporter 2 Inhibition With Ertugliflozin on Mitochondrial Function, Energetics, and Metabolic Gene Expression in the Presence and Absence of Diabetes Mellitus in Mice
Authors: Croteau Dominique , Luptak Ivan , Chambers Jordan M. , Hobai Ion , Panagia Marcello , Pimentel David R. , Siwik Deborah A. , Qin Fuzhong , Colucci Wilson S. 
Published: June 2021

Background
Inhibitors of the sodium‐glucose linked transporter 2 improve cardiovascular outcomes in patients with or without type 2 diabetes mellitus, but the effects on cardiac energetics and mitochondrial function are unknown. We assessed the effects of sodium‐glucose linked transporter 2 inhibition on mitochondrial function, high‐energy phosphates, and genes encoding mitochondrial proteins in hearts of mice with and without diet‐induced diabetic cardiomyopathy.

Methods and Results

Mice fed a control diet or a high‐fat, high‐sucrose diet received ertugliflozin mixed with the diet (0.5 mg/g of diet) for 4 months. Isolated mitochondria were assessed for functional capacity. High‐energy phosphates were assessed by
31
P nuclear magnetic resonance spectroscopy concurrently with contractile performance in isolated beating hearts. The high‐fat, high‐sucrose diet caused myocardial hypertrophy, diastolic dysfunction, mitochondrial dysfunction, and impaired energetic response, all of which were prevented by ertugliflozin. With both diets, ertugliflozin caused supernormalization of contractile reserve, as measured by rate×pressure product at high work demand. Likewise, the myocardial gene sets most enriched by ertugliflozin were for oxidative phosphorylation and fatty acid metabolism, both of which were enriched independent of diet.

Conclusions
Ertugliflozin not only prevented high‐fat, high‐sucrose–induced pathological cardiac remodeling, but improved contractile reserve and induced the expression of oxidative phosphorylation and fatty acid metabolism gene sets independent of diabetic status. These effects of sodium‐glucose linked transporter 2 inhibition on cardiac energetics and metabolism may contribute to improved structure and function in cardiac diseases associated with mitochondrial dysfunction, such as heart failure.
Risk of Fractures in Stroke Patients Treated With a Selective Serotonin Reuptake Inhibitor: A Systematic Review and Meta-Analysis
Authors: Jones Joshua S. , Kimata Rina , Almeida Osvaldo P. , Hankey Graeme J. 
Published: June 2021

Background and Purpose:
Stroke survivors have an increased risk of depression and bone fractures. Selective serotonin reuptake inhibitors (SSRIs) have been associated with an increased risk of fractures in observational studies. Several randomized controlled trials (RCTs) reporting the effect of SSRIs on the risk of fractures in stroke survivors have been published recently but have not been subject to a meta-analysis. We aimed to determine the risk of fractures associated with the use of SSRIs, and the risk of falls, seizures, and recurrent strokes as possible mediators of fractures, in stroke survivors.

Methods:
We conducted a systematic review and meta-analysis of RCTs of SSRIs in stroke survivors according to a protocol registered in PROSPERO (CRD42020192632). Web of Science, EMBASE, PsycINFO, and Ovid Medline/PubMed bibliographic databases, clinical trial registers, and grey literature sources were searched. RCTs of SSRIs versus placebo or no intervention that report the risk of fractures in adult survivors of hemorrhagic or ischemic stroke were included. Two reviewers independently screened search results and extracted data. Meta-analyses were conducted for each outcome using the Mantel-Haenszel random-effects models.

Results:
The searches yielded 683 records, of which 4 RCTs of 6 months duration with a total of 6549 participants were included in the meta-analysis: 3 studies of fluoxetine and 1 study of citalopram. Treatment with an SSRI for 6 months increased the risk of fractures with a risk ratio of 2.36 (95% CI, 1.64–3.39) compared with placebo. The risk of falls, seizures, and recurrent stroke was not statistically significantly increased. Only studies of fluoxetine and citalopram were available for inclusion in the review, and hence the generalizability of the findings to other SSRIs is uncertain.

Conclusions:
Based on available RCTs of fluoxetine and citalopram, SSRIs used for 6 months doubled the risk of fractures in stroke survivors.

Registration:

URL:
https://www.crd.york.ac.uk/prospero/
; Unique identifier: CRD42020192632.
Some Costs & Benefits of Cost-Benefit Analysis
Authors: Sunstein Cass R. 
Published: June 2021

Abstract
The American administrative state has become a cost-benefit state, at least in the sense that prevailing executive orders require agencies to proceed only if the benefits justify the costs. Some people celebrate this development; others abhor it. For defenders of the cost-benefit state, the antonym of their ideal is, alternately, regulation based on dogmas, intuitions, pure expressivism, political preferences, or interest-group power. Seen most sympathetically, the focus on costs and benefits is a neo-Benthamite effort to attend to the real-world consequences of regulations, and it casts a pragmatic, skeptical light on modern objections to the administrative state, invoking public-choice theory and the supposedly self-serving decisions of unelected bureaucrats. The focus on costs and benefits is also a valuable effort to go beyond coarse arguments, from both the right and the left, that tend to ask this unhelpful question: “Which side are you on?” In the future, however, there will be much better ways, which we might consider neo-Millian, to identify those consequences: 1) by relying less on speculative ex ante projections and more on actual evaluations; 2) by focusing directly on welfare and not relying on imperfect proxies; and 3) by attending closely to distributional considerations–on who is helped and who is hurt.
Early Vernacular Medical Advice Books and Their Popular Appeal in Early Modern Italy
Authors: Cavallo Sandra 
Published: June 2021

Abstract
The essay considers the explosion of medical advice publications in the vernacular thatcharacterises the first two centuries of printing, and in particular their chronology and the different textual genres that made up this literature in early modern Italy. It shows that, in spite of the almost exclusive focus on recipe books in recent scholarship, the composition of this literature was much more varied and regimens of health, food regimens, books about the medicinal properties of naturalia, and compendia of medical information of various kinds (diagnostic, preventative and therapeutic) matched and sometimes exceeded the fortune of recipe books. It then goes on to ask what made some vernacular medical advice books particularly appealing to a wide non-professional and non-Latinate audience,while apparently similar publications attracted little interest. To this end it pays unprecedented attention to the full range of elements that determined the appeal of a book: its physical and typographical features, its contents and implicit functions, its author, patron, publisher and geographical reach.
The Reception, Consumption and Broader Context of a French Vernacular Plague Tract Printed in 1495
Authors: Brenner Elma 
Published: June 2021

Abstract
This article focuses on the physician Thomas Le Forestier’s French vernacular plague tract published in Rouen in 1495, to explore how medical advice on epidemic illness was consumed and disseminated in Normandy and further afield in the later fifteenth and sixteenth centuries. While plague was an urgent issue facing all people at this time, and the publication of this text in the vernacular ostensibly made its advice more accessible than material in Latin, the article finds that it was probably read above all by physicians or other medical practitioners, including those from a monastic or ecclesiastical context, rather than by a more diverse range of readers. These medical readers sometimes assembled personalised Sammelbände (volumes in which separately produced printed and/or manuscript works were bound together), gathering together a range of health-related texts that could be read alongside each other. Although the extant copies of Le Forestier’s tract do not appear to have travelled beyond France, continental plague printings in Latin were annotated by English readers, indicating the transnational dissemination of such material in the scholarly language shared across Europe.