bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fructooligosaccharides on inflammation, immunomodulation, oxidative stress, and gut immune response: a systematic review
Authors: Costa Graciana T , Vasconcelos Quezia D J S , Aragão Gislei F 
Published: November 2021

AbstractContextEvidence shows that fructooligosaccharides (FOSs) can modulate inflammatory, oxidative, and immune activity in the gut, possibly leading to a systemic response, improving human health.ObjectiveTo assess the present knowledge of the effects of FOSs on inflammation, immunomodulation, oxidative stress, and gut immune response.Data SourcesStudies published between December 2000 and January 2020 were systematically searched in four databases: MEDLINE, LILACS, Web of Science, and Scopus. After the screening of 1316 articles, 8 human studies and 20 animal models were included.Data ExtractionData were extracted separately by 2 reviewers. For each study, the design, population, exposures, main results, and conclusion were extracted. The research questions and the risk-of-bias information were also extracted. Additionally, the risk-of-bias were analyzed to guarantee the reliability of this review.Data AnalysisA qualitative analysis revealed that FOSs can increase bifidobacteria counts and short-chain fatty acids in the gut, stimulate IgA secretion in the colon, and decrease proinflammatory cytokines, thus influencing metabolic diseases.ConclusionStudies suggest that FOS supplementation is positively associated with an anti-inflammatory and antioxidant effect, thus enhancing the gut immune system, which may be beneficial for the host’s health.Systematic Review RegistrationPROSPERO registration nos 42020209865 and 42020220369.
Can Corporate Debt Foster Innovation and Growth?
Authors: Geelen Thomas , Hajda Jakub , Morellec Erwan 
Published: November 2021

AbstractRecent empirical studies have shown that innovative firms heavily rely on debt financing. Debt overhang implies that debt hampers innovation by incumbents. A second effect of debt is that it stimulates innovation by entrants. Using a Schumpeterian growth model with endogenous R&D and financing choices, we demonstrate that this second effect always dominates, so that debt fosters innovation and growth at the aggregate level. Our analysis suggests that the relation between debt and investment is more complex than previously acknowledged and highlights potential limitations of empirical work that solely focuses on incumbents when measuring the effects of debt on investment.Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
What is behind multiple institutional affiliations in academia?
Authors: Hottenrott Hanna , Lawson Cornelia 
Published: November 2021

Abstract
Multiple institutional affiliations (or co-affiliations) occur when an academic belongs to more than one organisation. Recent research shows an increase in academics with multiple affiliations, but evidence on how these are organised and on academics’ motivations is mainly anecdotal. In this study we develop a typology of co-affiliations, which identifies four types based on their purpose and origin. We draw on results from a unique international survey of academics in three major science nations (the UK, Germany, and Japan) to study the different factors that could explain the four types of co-affiliations. The analysis shows that academics’ motivations (networking/prestige, resources, teaching, or personal income) correlate with the observed co-affiliation type. Researcher-initiated and research-focussed co-affiliations are often motivated by networking and resource access while co-affiliations that serve other than research purposes are more often income-motivated.
Evidence of Buprenorphine-precipitated Withdrawal in Persons Who Use Fentanyl
Authors: Varshneya Neil B. , Thakrar Ashish P. , Hobelmann J. Gregory , Dunn Kelly E. , Huhn Andrew S. 
Published: November 2021

Objectives
Buprenorphine can precipitate withdrawal in opioid-dependent persons with recent fentanyl use. However, the prevalence of this phenomenon is not clinically established. We sought to evaluate the incidence of buprenorphine-precipitated withdrawal in persons who use fentanyl.

Methods
We collected self-report data on opioid withdrawal symptoms after buprenorphine use, and, as a comparator, after methadone use, in 1679 individuals seeking treatment for opioid use disorder across 49 addiction treatment centers in the United States.

Results
The odds of developing severe withdrawal symptoms significantly increased when taking buprenorphine within 24 hours after fentanyl use (OR = 5.202, 95% CI = 1.979–13.675, P = 0.001), and within 24 to 48hours after fentanyl use (OR = 3.352, 95% CI =1.237–9.089, P = 0.017). As expected, patients did not report significantly higher rates of withdrawal when taking methadone after fentanyl use. Of those who waited less than 24hours after fentanyl before using buprenorphine or methadone, 22.19% (n = 152 of 685) and 11.56% (n = 23 of 199), respectively, reported severe opioid withdrawal.

Conclusions
This study supports previous anecdotal reports of buprenorphine-precipitated withdrawal from fentanyl. The odds of withdrawal symptoms significantly increased when taking buprenorphine after recent (within 48 hours) fentanyl use, however, this relationship was not observed in persons taking methadone, suggesting that this effect is specific to buprenorphine. Further research is urgently needed to describe the pharmacokinetics of non-medical fentanyl use to improve buprenorphine inductions strategies.
Pharmacokinetics of Cefepime in Children on Extracorporeal Membrane Oxygenation
Authors: Thibault Céline , Moorthy Ganesh S. , Vedar Christina , Naim Maryam Y. , DiLiberto Mary Ann , Zuppa Athena F. 
Published: November 2021

Background:
Cefepime is a first-line therapy for Gram-negative infections in children on extracorporeal membrane oxygenation. Cefepime pharmacokinetics (PK) in children on extracorporeal membrane oxygenation still needs to be better established.

Methods:
This was a prospective single-center PK study. A maximum of 12 PK samples per patient were collected in children <18 years old on extracorporeal membrane oxygenation who received clinically indicated cefepime. External validation of a previously published population PK model was performed by applying the model in a new data set. The predictive performance of the model was determined by calculating prediction errors. Because of poor predictive performance, a revised model was developed using NONMEM and a combined data set that included data from both studies. Dose-exposure simulations were performed using the final model. Optimal dosing was judged based on the ability to maintain free cefepime concentrations above the minimal inhibitory concentration (MIC) for 68% and 100% of the dosing interval.

Results:
Seventeen children contributed 105 PK samples. The mean (95% CI) and median (interquartile range) prediction errors were 33.7% (19.8–47.7) and 17.5% (−22.6 to 74.4). A combined data set was created, which included 33 children contributing 310 PK samples. The final improved 2-compartment model included weight and serum creatinine on clearance and oxygenator day and blood transfusion on volume of the central compartment. At an MIC of 8 mg/L, 50 mg/kg/dose every 8 hours reached target concentrations.

Conclusions:
Dosing intervals of 8 hours were needed to reach adequate concentrations at an MIC of 8 mg/L. Longer dosing intervals were adequate with higher serum creatinine and lower MICs.
Management of late in-the-bag IOL dislocation with exchange and scleral fixation of IOL with the transfixion technique
Authors: Pineda-Fernández Angel A. , Chen Yan 
Published: November 2021

Introduction:
Late in-the-bag intraocular lens (IOL) dislocation is a serious complication of cataract surgery.

Patient and clinical findings:
A 70-year-old woman with a history of left eye cataract surgery presented with progressively decreasing vision that had worsened over the past 6 months. In the left eye, the uncorrected distance visual acuity (UDVA) was counting fingers at 5 m, the corrected distance visual acuity (CDVA) was 20/25 (+12.25 −1.25 × 180), and the intraocular pressure was normal. An anterior segment examination revealed severe inferior dislocation of the IOL-capsular bag complex.

Diagnosis, intervention, and outcomes:
The patient was diagnosed with late in-the-bag IOL dislocation and underwent IOL–capsular bag complex explantation with sulcus-sutured IOL implantation using a new scleral fixation technique that included transfixion of a foldable acrylic IOL with polytetrafluoroethylene suture. The postoperative outcome was good; the UDVA was 20/70, and the CDVA was 20/25, and there were no postoperative complications such as infection, suture erosion, iritis, uveitis, vitreous hemorrhage, or retinal detachment.

Conclusions:
Late in-the-bag IOL dislocation was safely managed with IOL–capsular bag complex explantation and scleral fixation of a foldable posterior chamber IOL. This transfixion technique can be used for scleral fixation in patients with late in-the-bag IOL dislocation.
Labor Participation of Retirement-Aged Workers
Authors: Yuan Bocong , Li Jiannan , Lan Junbang 
Published: November 2021

Background:
Delayed retirement initiative is taken as one of the proposed solutions to population aging. Rare research attention has been paid to determinants in decisions-making of late retirement.

Method:
This study applies data from CHARLS survey (2018) that traces the health status among older adults in China, and implements the stepwise multiple regression analysis adjusted with robust standard errors on individual level.

Results:
The difficulty in instrumental activities of daily living (IADLs) and chronic conditions could increase the intention of retirement-aged workers to withdraw from late career participation; and the overlay of both would interact to reinforce such intention. Besides, the employment-related social pension participation could further strengthen the jointly contributing effect of both on withdrawal from late career participation.

Conclusion:
The triple interaction mechanism in retirement-aged workers’ decisions of late retirement needs considering in the policy formulation of delayed retirement initiative.
Deterioration of Lipid Metabolism Despite Fitness Improvements in Wildland Firefighters
Authors: Rosales Alejandro M. , Dodds Patrick S. , Hailes Walter S. , Sol Joseph A. , Coker Robert H. , Quindry John C. , Ruby Brent C. 
Published: November 2021

Objective:Determine serum lipid and general health/fitness alterations following a 5-month wildfire suppression season.Methods:We recruited 100 wildland firefighters (WLFFs) to a 5-month pre- to post-season observational study. Nude body mass, blood pressure (BP), grip strength, and steptest heart rate (HR) were recorded. Blood samples were collected for lipid panel analysis (total cholesterol, high density lipoproteins (HDL)-cholesterol, low density lipoproteins-cholesterol, very low density lipoproteinscholesterol, triglycerides, triglyceride:HDL-cholesterol ratio). Two-tailed dependentttests determined statistical significance (P < 0.05).Results:There were pre- to post-season changes in nude body mass (+2 ± 4%,P = 0.001), systolic BP (−2 ± 10%,P = 0.01), step-test HR (−5 ± 10%,P < 0.001), and all serum lipids (total cholesterol: +5 ± 14%,P = 0.02, HDL-cholesterol: = 1 ± 17%,P = 0.04, low density lipoproteins-cholesterol: +8 ± 22%,P = 0.02, very low density lipoproteins-cholesterol: +31 ± 49%,P < 0.001, triglycerides: +30 ± 49%,P < 0.001, triglyceride:HDL-cholesterol ratio: +37 ± 58%,P < 0.001). Pre- to post-season diastolic BP (P = 0.12) and grip strength (P = 0.60) remained stable.Conclusions:WLFFs demonstrate maladaptive serum lipids and body mass alterations despite subtle aerobic fitness improvements.
Impact of Peer-Assisted Learning on Ultrasound
Authors: Garvick Sarah , Smith Ian , Carter Jason , El Tannir Ziad , Gentile Anthony , Jones Geoff , Rogers Lauren , Gillette Chris 
Published: November 2021

Purpose
The aim of this study was to understand how peer-assisted learning (PAL) could be utilized by physician assistant (PA) students in an ultrasound student interest group (USIG) as a means of developing cognitive confidence and practical competence with the imaging modality.

Methods
An observational study that included 3 USIG workshops was designed. Pre- and postworkshop surveys were administered. All first-year PA students, regardless of participation in the USIG workshops, were asked to complete the voluntary and anonymous surveys.

Results
A statistically significant difference between those who attended at least one workshop and those who did not attend any workshops on their postworkshop scores (p = 0.02) was seen. There was a statistically significant association between the number of workshops attended and the postworkshop difference (p = 0.03).

Conclusion
Results show that, in the context of social cognitive theory, PAL is an efficacious learning modality that enhances learner and tutor performance in ultrasound.
Multicenter Results With an Active Transcutaneous Bone Conduction Implant in Patients With Single-sided Deafness
Authors: Huber Alexander M. , Strauchmann Bernd , Caversaccio Marco D. , Wimmer Wilhelm , Linder Thomas , De Min Nicola , Hempel John-Martin , Pollotzek Marlene , Frenzel Henning , Hanke Frauke , Röösli Christof 
Published: November 2021

Objective:
To evaluate the audiological and subjective benefit from hearing rehabilitation with an active bone conduction implant in subjects with single-sided sensorineural deafness (SSD).

Study Design:
Prospective, multicenter, single-subject repeated measures.

Setting:
Tertiary referral center, five clinics in Germany and Switzerland.

Patients:
Seventeen subjects aged 18 years and older with severe to profound unilateral sensorineural hearing loss and contralateral normal hearing were followed up for 24 months.

Intervention:
Active bone conduction implant.

Main Outcome Measures:
Speech understanding in noise was assessed in three situations: with signal from front, deaf, or normal hearing side (with noise from front in all set-ups). Subjective benefit was evaluated using the Speech, Spatial, and Qualities of Hearing (SSQ-B) and Bern Benefit in Single-Sided Deafness (BBSS) questionnaire.

Results:
When the signal was coming from the deaf side the mean improvement of the speech reception threshold in noise ranged from 1.5 up to 2.2 dB with the device and was statistically and clinically significant at all tested timepoints. No significant difference between the aided and unaided situation was found when signal and noise were coming from the front. With the signal from the normal hearing side no clinically significant difference, that is, greater than 1 dB between the aided and unaided situation was found. The SSQ-B and BBSS questionnaire showed an overall improvement with no significant difference between time points.

Conclusions:
The study demonstrates long-term efficacy and benefit of the device in adults with SSD. Patients reported substantial and persistent subjective benefit from the active bone conduction implant.
Perceptions of Live Streaming Compared With an In-Person Nursing Conference
Authors: Overbay Devorah , Bigand Teresa , Springer Gale 
Published: November 2021

OBJECTIVE
The aim of this study was to understand registered nurses' (RNs') perceptions of attending a live streaming versus in-person continuing education event.

BACKGROUND
During the COVID-19 global pandemic, in-person continuing education events for healthcare providers required conversion to digital platforms. Literature is sparse regarding healthcare providers' perceptions on attending a live streaming continuing education event.

METHODS
Registered nurses completed a survey after a live streaming research conference from a large US healthcare system. Likert-scale survey items were analyzed using descriptive statistics and open-ended questions with content analysis and thematic coding.

RESULTS
A total of 219 RNs participated. The RNs reported an overall positive experience with the live streaming event and indicated a preference for this platform for the future. Three benefits emerged: savings, self-care and safety, and user-friendly. Perceived drawbacks were coded with 3 themes: technical issues, impaired focus, and social/networking challenges.

CONCLUSIONS
Despite challenges, live streaming conferences may be satisfying and preferable for nurses.
Arthroscopic Synovectomy of the Wrist in Patients With Rheumatoid Arthritis
Authors: d'Ailly Philip N. , Mulders Marjolein A. M. , Bisoendial Radjesh J. , Kuijper T. Martijn , Coert J. Henk , Schep Niels W. L. 
Published: November 2021

Background
Rheumatoid arthritis (RA) of the wrist can lead to loss of wrist function and progressive joint destruction if inadequately treated. Arthroscopic synovectomy of the wrist may prove a valuable treatment for local inflammation.

Objective
The aim of this study was to perform a systematic review evaluating functional outcomes and pain following arthroscopic synovectomy of the wrist in RA patients.

Methods
A systematic review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) guidelines. MEDLINE, EMBASE, The Cochrane Library, Web of Science, and Google Scholar were searched for studies describing pain or functional outcomes following arthroscopic synovectomy of the wrist in RA patients (CRD42021270846). Risk of bias was assessed using the Methodological Index for Non-Randomized Studies. Data collection included patient characteristics, pain scores, wrist function questionnaires, secondary surgery, and complications.

Results
Six noncomparative cohort studies were included, with a total of 153 arthroscopic synovectomies. Disease duration of RA ranged from 32 to 89 months, and radiographic progression was mild to moderate. The Methodological Index for Non-Randomized Studies scores ranged from 8 to 10 out of 16. Mean follow-up ranged from 21 to 95 months. Improvements were seen in pooled mean visual analog scale pain score (from 7.7 to 2.2, p < 0.05), pooled mean Modified Mayo Wrist Score (from 43.3 to 70.4, p < 0.05), and the Disability of the Arm, Shoulder, and Hand (from 67.5 to 36.5, p < 0.05). Two complications occurred, and 5 patients required secondary surgery.

Conclusions
There is limited evidence suggesting that arthroscopic synovectomy of the wrist improves wrist function and pain in patients with RA, with few complications. In centers with arthroscopic expertise, it can be considered as a treatment option.
Impact of Body Mass Index on Major Complications, Multiple Complications, In-hospital Mortality, and Failure to Rescue After Esophagectomy for Esophageal Cancer
Authors: Hirano Yuki , Kaneko Hidehiro , Konishi Takaaki , Itoh Hidetaka , Matsuda Satoru , Kawakubo Hirofumi , Uda Kazuaki , Matsui Hiroki , Fushimi Kiyohide , Itano Osamu , Yasunaga Hideo , Kitagawa Yuko 
Published: November 2021

Objective:
To examine the association of BMI with mortality and related outcomes after oncologic esophagectomy.

Summary Background Data:
Previous studies showed that high BMI was a risk factor for anastomotic leakage and low BMI was a risk factor for respiratory complications after esophagectomy. However, the association between BMI and in-hospital mortality after oncologic esophagectomy remains unclear.

Methods:
Data for patients who underwent esophagectomy for esophageal cancer between July 2010 and March 2019 were extracted from a Japanese nationwide inpatient database. Multivariate regression analyses and restricted cubic spline analyses were used to investigate the associations between BMI and short-term outcomes, adjusting for potential confounders.

Results:
Among 39,406 eligible patients, in-hospital mortality, major complications, and multiple complications (≥2 major complications) occurred in 1069 (2.7%), 14,824 (37.6%), and 3621 (9.2%), respectively. Compared with normal weight (18.5–22.9 kg/m2), severe underweight (<16.0 kg/m2), mild/moderate underweight (16.0–18.4 kg/m2), and obese (≥27.5 kg/m2)were significantly associated with higher in-hospital mortality [odds ratio 2.20 (95% confidence interval 1.65–2.94), 1.25 (1.01–1.49), and 1.48 (1.05–2.09), respectively]. BMI showed U-shaped dose-response associations with mortality, major complications, and multiple complications. BMI also showed a reverse J-shaped association with failure to rescue (death after major complications).

Conclusions:
Both high BMI and low BMI were associated with mortality, major complications and multiple complications after esophagectomy for esophageal cancer. Patients with low BMI were more likely to die once a major complication occurred. The present results can assist with risk stratification in patients undergoing oncologic esophagectomy.
The Beirut Port Explosion Injuries and Lessons Learned
Authors: Gebran Anthony , Abou Khalil Elissa , El Moheb Mohamad , Albaini Obey , El Warea Mohamad , Ibrahim Rand , Karam Karin , El Helou Mohamad Othman , Ramly Elie P. , El Hechi Majed , Matar Ayah , Zeineddine Jana , Dabar George , Al Hajj Assem , Abi Saad George , Hoballah Jamal , Safadi Bassem , Kaafarani Haytham M. A. 
Published: November 2021

Objective:
This multicenter study aims to describe the injury patterns, emergency management and outcomes of the blast victims, recognize the gaps in hospital disaster preparedness, and identify lessons to be learned.

Summary Background Data:
On August 4th, 2020, the city of Beirut, Lebanon suffered the largest urban explosion since Hiroshima and Nagasaki, resulting in hundreds of deaths and thousands of injuries.

Methods:
All injured patients admitted to four of the largest Beirut hospitals within 72 hours of the blast, including those who died on arrival or in the emergency department (ED), were included. Medical records were systematically reviewed for: patient demographics and comorbidities; injury severity and characteristics; prehospital, ED, operative, and inpatient interventions; and outcomes at hospital discharge. Lessons learned are also shared.

Results:
An estimated total of 1818 patients were included, of which 30 died on arrival or in the ED and 315 were admitted to the hospital. Among admitted patients, the mean age was 44.7 years (range: 1 week–93 years), 44.4% were female, and the median injury severity score (ISS) was 10 (5, 17). ISS was inversely related to the distance from the blast epicenter (r = -−0.18, P = 0.035). Most injuries involved the upper extremities (53.7%), face (42.2%), and head (40.3%). Mildly injured (ISS <9) patients overwhelmed the ED in the first 2 hours; from hour 2 to hour 8 post-injury, the number of moderately, severely, and profoundly injured patients increased by 127%, 25% and 17%, respectively. A total of 475 operative procedures were performed in 239 patients, most commonly soft tissue debridement or repair (119 patients, 49.8%), limb fracture fixation (107, 44.8%), and tendon repair (56, 23.4%). A total of 11 patients (3.5%) died during the hospitalization, 56 (17.8%) developed at least 1 complication, and 51 (16.2%) were discharged with documented long-term disability. Main lessons learned included: the importance of having key hospital functions (eg, laboratory, operating room) underground; the nonadaptability of electronic medical records to disasters; the ED overwhelming with mild injuries, delay in arrival of the severely injured; and the need for realistic disaster drills.

Conclusions:
We, therefore, describe the injury patterns, emergency flow and trauma outcome of patients injured in the Beirut port explosion. The clinical and system-level lessons learned can help prepare for the next disaster.