bluuebunny/crossref_metadata_2025_split huggingface dataset:
Canopy damage during a natural drought depends on species identity, physiology and stand composition
Authors: Britton Travis G. , Brodribb Timothy J. , Richards Shane A. , Ridley Chantelle , Hovenden Mark J. 
Published: December 2021

Summary

Vulnerability to xylem cavitation is a strong predictor of drought‐induced damage in forest communities. However, biotic features of the community itself can influence water availability at the individual tree‐level, thereby modifying patterns of drought damage.

Using an experimental forest in Tasmania, Australia, we determined the vulnerability to cavitation (leaf P50) of four tree species and assessed the drought‐induced canopy damage of 2944 6‐yr‐old trees after an extreme natural drought episode. We examined how individual damage was related to their size and the density and species identity of neighbouring trees.

The two co‐occurring dominant tree species, Eucalyptus delegatensis and Eucalyptus regnans, were the most vulnerable to drought‐induced xylem cavitation and both species suffered significantly greater damage than neighbouring, subdominant species Pomaderris apetala and Acacia dealbata. While the two eucalypts had similar leaf P50 values, E. delegatensis suffered significantly greater damage, which was strongly related to the density of neighbouring P. apetala. Damage in E. regnans was less impacted by neighbouring plants and smaller trees of both eucalypts sustained significantly more damage than larger trees.

Our findings demonstrate that natural drought damage is influenced by individual plant physiology as well as the composition, physiology and density of the surrounding stand.
Leadless pacemaker implant guided by intracardiac echocardiography in a patient after Mustard repair
Authors: Kautzner Josef , Wunschova Hanka , Haskova Jana 
Published: December 2021

AbstractThis case report describes a successful leadless pacemaker implant (Micra VR Medtronic, Inc, Minneapolis, MN) in a 48‐year‐old patient with a history of Mustard repair. Twenty‐one years after dual‐chamber pacemaker implant, both conventional leads became dysfunctional. Lead extraction was refused by the patient and the subclavian vein was obstructed. A leadless pacemaker was selected as an alternative. Intracardiac echocardiography allowed the safe introduction of the delivery system into the nonsystemic left ventricle. Four months after implant, the pacing parameters are stable and the patient is without new complaints. A leadless pacemaker could be considered in patients with complex grown‐up congenital heart disease (GUCH).
COVID‐19 implications for pediatric anesthesia: Lessons learnt and how to prepare for the next pandemic
Authors: Afshari Arash , Disma Nicola , von Ungern‐Sternberg Britta S. , Matava Clyde 
Published: December 2021

AbstractCOVID‐19 is mainly considered an “adult pandemic,” but it also has strong implications for children and consequently for pediatric anesthesia. Despite the lethality of SARS‐CoV‐2 infection being directly correlated with age, children have equally experienced the negative impacts of this pandemic. In fact, the spectrum of COVID‐19 symptoms among children ranges from very mild to those resembling adults, but may also present as a multisystemic inflammatory syndrome. Moreover, the vast majority of children might be affected by asymptomatic or pauci‐symptomatic infection making them the “perfect” carriers for spreading the disease in the community. Beyond the clinical manifestations of SARS‐CoV‐2 infection, the COVID‐19 pandemic may ultimately have catastrophic health and socioeconomic consequences for children and adolescents, which are yet to be defined. The aim of this narrative review is to highlight how COVID‐19 pandemic has affected and changed the pediatric anesthesia practice and which lessons are to be learned in case of a future “pandemic.” In particular, the rapid evolution and dissemination of research and clinical findings have forced the scientific community to adapt and alter clinical practice on an unseen and pragmatic manner. Equally, implementation of new platforms, techniques, and devices together with artificial intelligence and large‐scale collaborative efforts may present a giant step for mankind. The valuable lessons of this pandemic will ultimately translate into new treatments modalities for various diseases but will also have the potential for safety improvement and better quality of care. However, this pandemic has revealed the vulnerability and deficiencies of our health‐care system. If not addressed properly, we may end up with a tsunami of burnout and compassionate fatigue among health‐care professionals. Pediatric anesthesia and critical care staff are no exceptions.
Sense perception in theZhuangzi莊子
Authors: Lacertosa Massimiliano 
Published: December 2021

AbstractIn this essay I explore the controversial issue of sense perception in theZhuangzi莊子. Although scholars have not explicitly addressed this aspect of the Chinese text, a common assumption is that theZhuangziproposes a mysticism that undermines sense perception in favour of a transcendent self. After an overview of this interpretation, and after analysing some key passages of the text that deal with heart fasting (xinzhai心齋), sitting and forgetting (zuowang坐忘) and skill mastery, I demonstrate that some interpreters of theZhuangziread the text as if it has a metaphysical bent, recommending that sense perception be transcended as a prerequisite to perfection. In contrast, my thesis is that the text does not propose a withdrawal from the senses and from the world, but rather warns about the danger of abiding to doctrinal knowledge, which has the consequence of a person losing their responsive awareness. Indeed, in theZhuangzi, sense perception is not an impediment on the way to a supersensible reality, but an integral part of one's own being in the world. Through my analysis, I object to the idea that theZhuangziproposes a mystical union with something not immediately available, which moreover needs to be achieved by transcending the lived world that is encountered through sense perception. My view is that such a move not only postulates union with a transcendent entity, it also forces a dualism between a person's capacities. This is problematic because theZhuangzidoes not point to another world–in a two worlds theory–where one must ideally attain the condition of a transcendent self. On the contrary, in rejecting a univocalethos, the text suggests one should keep responding to changing circumstances without turning one's perceptual awareness into entrenched habits. Thus, theZhuangzishows how sense perception should be seen, not as a “problem” but as an ethical possibility through which the univocity of doctrinal knowledge can be undermined.
Many‐objective land use planning using a hypercube‐based NSGA‐III algorithm
Authors: Maleki Jamshid , Masoumi Zohreh , Hakimpour Farshad , Coello Coello Carlos A. 
Published: December 2021

AbstractDue to the many objectives and constraints involved in urban land use planning (ULUP), this is considered as a many‐objective and complex optimization problem that needs a variety of geographical analyses. In this article, the main target is improving NSGA‐III as an advanced many‐objective optimization algorithm for solving the ULUP problem. In this study, five objective functions (i.e., consistency, dependency, compactness, suitability, and per capita violation of land uses) are considered for their simultaneous optimization for allocation. The proposed algorithm is tested using the spatial data of region 7, district 1 of Tehran using a vector format. To evaluate the results, two more real datasets were implemented. The performance of the improved algorithm is compared concerning NSGA‐II and NSGA‐III in the main case study area and two other instances. The comparison results show that the improved algorithm increases the convergence and diversity of the generated solutions in ULUP concerning the results obtained by these two other algorithms. The results of the optimization with these methods can help decision‐makers toward sustainable development in the construction of new cities, new towns, and smart cities.
Energy Cost of Running in Well-Trained Athletes: Toward Slope-Dependent Factors
Authors: Lemire Marcel , Remetter Romain , Hureau Thomas J. , Geny Bernard , Lonsdorfer Evelyne , Favret Fabrice , Dufour Stéphane P. 
Published: December 2021

Purpose: This study aimed to determine the contribution of metabolic, cardiopulmonary, neuromuscular, and biomechanical factors to the energy cost (ECR) of graded running in well-trained runners. Methods: Eight men who were well-trained trail runners (age: 29 [10] y, mean [SD]; maximum oxygen consumption: 68.0 [6.4] mL·min−1·kg−1) completed maximal isometric evaluations of lower limb extensor muscles and 3 randomized trials on a treadmill to determine their metabolic and cardiovascular responses and running gait kinematics during downhill (DR: −15% slope), level (0%), and uphill running (UR: 15%) performed at similar O2 uptake (approximately 60% maximum oxygen consumption). Results: Despite similar O2 demand, ECR was lower in DR versus level running versus UR (2.5 [0.2] vs 3.6 [0.2] vs 7.9 [0.5] J·kg−1·m−1, respectively; all P < .001). Energy cost of running was correlated between DR and level running conditions only (r2 = .63; P = .018). Importantly, while ECR was correlated with heart rate, cardiac output, and arteriovenous O2 difference in UR (all r2 > .50; P < .05), ECR was correlated with lower limb vertical stiffness, ground contact time, stride length, and step frequency in DR (all r2 > .58; P < .05). Lower limb isometric extension torques were not related to ECR whatever the slope. Conclusion: The determining physiological factors of ECR might be slope specific, mainly metabolic and cardiovascular in UR versus mainly neuromuscular and mechanical in DR. This possible slope specificity of ECR during incline running opens the way for the implementation of differentiated physiological evaluations and training strategies to optimize performance in well-trained trail runners.
Appearance and disappearance rates of Phanerozoic marine animal paleocommunities
Authors: Muscente A.D. , Martindale Rowan C. , Prabhu Anirudh , Ma Xiaogang , Fox Peter , Hazen Robert M. , Knoll Andrew H. 
Published: December 2021

AbstractEcological observations and paleontological data show that communities of organisms recur in space and time. Various observations suggest that communities largely disappear in extinction events and appear during radiations. This hypothesis, however, has not been tested on a large scale due to a lack of methods for analyzing fossil data, identifying communities, and quantifying their turnover. We demonstrate an approach for quantifying turnover of communities over the Phanerozoic Eon. Using network analysis of fossil occurrence data, we provide the first estimates of appearance and disappearance rates for marine animal paleocommunities in the 100 stages of the Phanerozoic record. Our analysis of 124,605 fossil collections (representing 25,749 living and extinct marine animal genera) shows that paleocommunity disappearance and appearance rates are generally highest in mass extinctions and recovery intervals, respectively, with rates three times greater than background levels. Although taxonomic change is, in general, a fair predictor of ecologic reorganization, the variance is high, and ecologic and taxonomic changes were episodically decoupled at times in the past. Extinction rate, therefore, is an imperfect proxy for ecologic change. The paleocommunity turnover rates suggest that efforts to assess the ecological consequences of the present-day biodiversity crisis should focus on the selectivity of extinctions and changes in the prevalence of biological interactions.
ARCADIA study protocol: a phase II, randomised, double-blind, placebo-controlled clinical trial to assess the safety and efficacy of AZD1656 in patients with diabetes hospitalised with suspected or confirmed COVID-19
Authors: McCafferty Kieran , Hollowood Zoe , Allan Michelle , Lockhart Donna , Chorlton Jamie , Martin John 
Published: December 2021

IntroductionCOVID-19, caused by SARS-CoV-2, remains a global pandemic that has affected more than 100 million people worldwide with over 4.8 million deaths as of October 2021. Patients with diabetes have both an increased susceptibility to SARS-CoV-2 infection, enhanced disease severity and increased risk of mortality. The challenge presented in these patients is both to improve glycaemic control—which itself may confer a survival advantage—and to help maintain or restore immunological homeostasis. The specific glucokinase activator AZD1656 may address both of these challenges via its glucose-lowering effect and its immunological mechanism of action. The aim of theAlleviation of cardioRespiratory complications in patients withCOVID-19AndDIAbetes (ARCADIA) trial is to investigate this hypothesis and determine whether AZD1656 can improve clinical outcomes for these patients.Methods and analysisARCADIA is a double-blind, placebo-controlled, interventional study of AZD1656 in 150 patients with either type 1 or type 2 diabetes who have been admitted to hospital with COVID-19. Eligible, consented patients will be randomised in a 1:1 manner to receive either active drug or matched placebo tablets while they are in hospital. All patients will receive the usual and current standard of care for patients with COVID-19 in that hospital. Clinical and laboratory data will be collected and assessed at baseline and throughout their participation in the study. Data will be captured in the case report form, which will be electronically archived at the end of the trial in the trial master file. The WHO 8-point Ordinal Scale for Clinical Improvement will be used to measure clinical outcome for the primary endpoint of the trial.Ethics and disseminationEthical approval has been obtained from the East Midlands-Leicester South Ethics Committee (REC 20/EM/0198) in the UK, from the National Bioethics Committee of Medicines and Medical Devices in Bucharest, Romania, and from the Ethics Committee IKEM a TN in Prague, Czech Republic. All study-related data will be used by the sponsor in accordance with local data protection law. In the UK, all patient identifiable data will be stored on a password-protected National Health Service N3 network with full audit trail. Anonymised data will be stored in an ISO27001 certificated data warehouse.Trial registration numberEudraCT 2020-002211-21,NCT04516759.
Risk of infections and mortality in Danish patients with cancer diagnosed with bone metastases: a population-based cohort study
Authors: Hjelholt Thomas Johannesson , Rasmussen Thomas Bøjer , Seesaghur Anouchka , Hernandez Rohini K , Marongiu Andrea , Obel Niels , Sørensen Henrik Toft , Pedersen A B 
Published: December 2021

ObjectivesRisk of infections in patients with solid cancers and bone metastases (BM) and the subsequent impact on prognosis is unclear. We examined the risk of infections among patients with cancer diagnosed with BM and the subsequent impact of infections on mortality.DesignPopulation-based cohort study.SettingDanish medical databases holding information on all hospital contacts in Denmark.ParticipantsAdult patients with solid cancers and BM between 1 January 1994 and 30 November 2013.Outcome measuresIn the risk analyses, the outcome was time to hospitalisation for common severe infections, pneumonia, sepsis and urinary tract infections. In the mortality analysis, we used Cox regression to compute HRs of death, modelling infection as time-varying exposure, stratifying for primary cancer type and adjusting for age, sex and comorbidities.ResultsAmong 23 336 patients with cancer and BM, cumulative incidences of common severe infections were 4.6%, 14.0% and 20.0% during 1 month, 1 year and 10 years follow-up. The highest incidence was observed for pneumonia, followed by urinary tract infections and sepsis. Infection was a strong predictor of 1 month mortality (adjusted HR: 2.1 (95% CI 1.8 to 2.3)) and HRs increased after 1 and 10 years: 2.4 (95% CI 2.3 to 2.6) and 2.4 (95% CI 2.4 to 2.6). Sepsis and pneumonia were the strongest predictors of death. Results were consistent across cancer types.ConclusionPatients with cancer and BM were at high risk of infections, which was associated with a more than twofold increased risk of death for up to 10 years of follow-up. The findings underscore the importance of preventing infections in patients with cancer and BM.
Odds of return: a prospective study using provider assessment to predict short-term patient return visits to the emergency department
Authors: Fruhan Scott , Bills Corey B 
Published: December 2021

ObjectivePrevious studies have assessed patient-level characteristics associated with emergency department (ED) return visits, but none have used provider assessment. We prospectively investigate whether clinical providers could accurately predict ED return visits.MethodsProspective cohort study.SettingSingle academically affiliated urban county hospital.ParticipantsDischarged ED patients over a 14-month period with a provider assessment of the likelihood of patient return within 7 days of ED discharge.Main outcome measuresThe primary outcome of interest was a return visit to the ED within 7 days. Additional outcome measures included a return visit within 72 hours and a return visit resulting in admission. We also measured the accuracy of provider gestalt, and provide measures of sensitivity, specificity, predictive values, and likelihood ratios.ResultsOf the 11 922 ED discharges included in this study, providers expected 2116 (17.7%) to result in a return visit within 7 days. Providers were much more likely to perceive a return visit if the patient left against medical advice (OR: 5.97, 95% CI: 4.67 to 7.62), or was homeless (OR: 5.69, 95% CI: 5.14 to 6.29). Patients who actually returned were also more likely to be homeless, English speaking and to have left the ED against medical advice on the initial encounter. The strongest predictor of a return visit at both 72 hours and 7 days in multivariable modelling was provider assessment (OR: 3.77, 95% CI: 3.25 to 4.37; OR: 3.72, 95% CI: 3.29 to 4.21, respectively). Overall sensitivity and specificity of provider gestalt as a measure of patient return within 7 days were 47% and 87%, respectively. The positive and negative likelihood ratios were 3.51 and 0.61, respectively.ConclusionsClinician assessment was the strongest predictor of a return visit in this dataset. Clinician assessment may be used as a way to screen patients during the index visit and enrol them in efforts to decrease return visits.
Mental burden and perception of the study situation among undergraduate students during the COVID-19 pandemic: a cross-sectional study and comparison of dental and medical students
Authors: Guse Jennifer , Weegen Annabel Susan , Heinen Ines , Bergelt Corinna 
Published: December 2021

ObjectivesTo investigate levels of distress, depression, anxiety, stress and perception of their current study situation during the COVID-19 pandemic among undergraduate dental and medical students.DesignObservational, cross-sectional study including two consecutive surveys (May and July 2020).SettingA large medical school in Germany.ParticipantsAll first year dental and medical students were invited. 132 participating first year students (44 dental, 88 medical) from the first survey and 150 students (50 dental, 100 medical) from the second were included in our analyses.Primary and secondary outcome measuresMental burden (distress thermometer, Patient Health Questionnaire-4, Perceived Stress Scale-4) and self-reported changes in mental health and perception of study situation during the COVID-19 pandemic (self-developed items) were compared. Open-ended questions were analysed by conventional content analyses.ResultsA considerable proportion of students (t1: May 2020: 84.1%; t2: July 2020: 77.3%) reported distress levels above cut-off. In July 2020, dental students reported significantly higher distress scores than medical students (dental: M=7.0, SD=2.3; medical: M=5.7; SD=2.1; p<0.001). More dental than medical students reported mild, moderate and severe levels of anxiety and depression symptoms. The majority stated that their mental health and study motivation had not changed during the pandemic. Logistic regression showed that being a dental student was significantly associated with a higher likelihood for serious worries regarding the study situation during COVID-19 at t1 (OR 4.0; 95% CI 1.1 to 14.2). At t2 higher distress was significantly associated with a higher likelihood for experiencing serious worries (OR 1.8; 95% CI 1.3 to 2.5). Regarding current concerns related to the pandemic, students most frequently reported difficulties with self-regulated learning (15.2%), study-related worries and uncertainty (14.4%), missing feedback of students and lecturers (11.4%) and lack of practical training (9.8%).ConclusionThe results suggest that high mental burden and the lack of practical training among medical and dental students is an increasing problem, with a possibly even higher urgency in dental students. Tailored psychological and educational support offers during and after the COVID-19 pandemic might help them as they progress through (medical and) dental school.
Models for predicting venous thromboembolism in ambulatory patients with lung cancer: a systematic review protocol
Authors: Yan Ann-Rong , Samarawickrema Indira , Naunton Mark , Peterson Gregory M , Yip Desmond , Mortazavi Reza 
Published: December 2021

IntroductionVenous thromboembolism (VTE) is a common complication in patients with cancer and has a determining role in the disease prognosis. The risk is significantly increased with certain types of cancer, such as lung cancer. Partly due to difficulties in managing haemorrhage in outpatient settings, anticoagulant prophylaxis is only recommended for ambulatory patients at high risk of VTE. This requires a precise VTE risk assessment in individual patients. Although VTE risk assessment models have been developed and updated in recent years, there are conflicting reports on the effectiveness of such risk prediction models in patient management. The aim of this systematic review is to gain a better understanding of the available VTE risk assessment tools for ambulatory patients with lung cancer and compare their predictive performance.Methods and analysisA systematic review will be conducted using MEDLINE, Cochrane Library, CINAHL, Scopus and Web of Science databases from inception to 30 September 2021, to identify all reports published in English describing VTE risk prediction models which have included adult ambulatory patients with primary lung cancer for model development and/or validation. Two independent reviewers will conduct article screening, study selection, data extraction and quality assessment of the primary studies. Any disagreements will be referred to a third researcher to resolve. The included studies will be assessed for risk of bias and applicability. The Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies will be used for data extraction and appraisal. Data from similar studies will be used for meta-analysis to determine the incidence of VTE and the performance of the risk models.Ethics and disseminationEthics approval is not required. We will disseminate the results in a peer-reviewed journal.PROSPERO registration numberCRD42021245907.