bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cohort study of impact on length of stay of individual enhanced recovery after surgery protocol components
Authors: Sisodia Rachel C. , Ellis Dan , Hidrue Michael , Linov Pamela , Cavallo Elena , Bryant Allison S. , Wakamatsu May , del Carmen Marcela G. 
Published: September 2021

ObjectiveThe goal of this study was to explore which enhanced recovery after surgery (ERAS) bundle items were most associated with decreased length of stay after surgery, most likely associated with decreased length of stay after surgery.DesignA cohort study.SettingLarge tertiary academic medical centre.ParticipantsThe study included 1318 women undergoing hysterectomy as part of our ERAS pathway between 1 February 2018 and 30 January 2020 and a matched historical cohort of all hysterectomies performed at our institution between 3 October 2016 and 30 January 2018 (n=1063).InterventionThe addition of ERAS to perioperative care.This is a cohort study of all patients undergoing hysterectomy at an academic medical centre after ERAS implementation on 1 February 2018. Compliance and outcomes after ERAS roll out were monitored and managed by a centralised team. Descriptive statistics, multivariate regression, interrupted time series analysis were used as indicated.Main outcome measuresImpact of ERAS process measure adherence on length of stay.ResultsAfter initiation of ERAS pathway, 1318 women underwent hysterectomy. There were more open surgeries after ERAS implementation, but cohorts were otherwise balanced. The impact of process measure adherence on length of stay varied based on surgical approach (minimally invasive vs open). For open surgery, compliance with intraoperative antiemetics (−30%, 95% CI −18% to 40%) and decreased postoperative fluid administration (−12%, 95% CI −1% to 21%) were significantly associated with reduced length of stay. For minimally invasive surgery, ambulation within 8 hours of surgery was associated with reduced length of stay (−53%, 95% CI −55% to 52%).ConclusionsWhile adherence to overall ERAS protocols decreases length of stay, the specific components of the bundle most significantly impacting this outcome remain elusive. Our data identify early ambulation, use of antiemetics and decreasing postoperative fluid administration to be associated with decreased length of stay.
A sex-related mediating effect of uric acid in the association between body composition and blood pressure in children and adolescents
Authors: Dutra Deyse M. , Zaniqueli Divanei , Alvim Rafael O. , Baldo Marcelo P. , Morra Elis A. , Faria Eliane R. , Mill José G. , Faria Carolina P. 
Published: September 2021

The increase in blood pressure (BP) during somatic growth might have direct determinants but also mediating factors. We investigated whether uric acid (UA) and other metabolic factors would mediate the association between body composition components and BP. A cross-sectional study was conducted in 928 children and adolescents (aged 6–18 years), in which body composition and blood biochemistry were evaluated. Structural equation modeling was performed to test the direct and indirect pathways between systolic blood pressure (SBP) and body composition parameters. Muscle mass (MM) showed a strong direct effect on BP, regardless of sex. In girls, a mediating pathway through UA was not significant, but the association between fat mass (FM) and MM with SBP was mediated by the cluster of metabolic factors. In boys, both MM and FM were associated with SBP through a mediating pathway via UA, but not via the cluster of metabolic factors. The association between body composition and BP in children and adolescents has a complex design and also has a sex-specific mediating component. The increase in the UA levels may affect BP levels early in boys. Also, metabolic changes elicited by FM contribute to the increase in BP at an early age in girls. Novelty: MM showed a strong direct effect on BP, regardless of sex. In girls, the association between FM and MM with SBP was mediated by the cluster of metabolic factors. In boys, both MM and FM were associated with SBP through a mediating pathway via UA.
Fuzzy membership functions tuning for speed controller of induction motor drive: performance improvement
Authors: Farah Nabil , Talib Md Hairul Nizam , Ibrahim Zulkifilie Bin , Abdullah Qazwan , Aydoğdu Ömer , Lazi Jurifa Mat , Isa Zm 
Published: September 2021

<p>Fuzzy <span>logic controller (FLC) has gained high interest in the field of speed control of machine drives in both academic and industrial communities. This is due to the features of FLC of handling non-linearity and variations. FLC system consists of three main elements: scaling factors (SFs), membership functions (MFs), and rule-base. Fuzzy MFs can be designed with different types and sizes. For induction motor (IM) speed control, (3x3), (5x5) and (7x7) MFs are the most used MFs sizes, and normally designed based on symmetrical distribution. However, changing the width and peak position of MFs design enhance the performance. In this paper, tuning of MFs of FLC speed control of IM drives is considered. Considering (3x3), (5x5) and (7x7) MFs sizes, the widths and peak positions of these MFs are asymmetrically distributed to improve the performance of IM drive. Based on these MFs sizes, the widths and peak positions are moved toward the origin (zero), negative and positive side that produces a controller less sensitive to the small error variations. Based on simulation and performance evaluations, improvement of 5% in settling time (Ts), 0.5% in rise time and 20% of steady-state improvement achieved with the tuned MFs compared to original </span>MFs.</p>
Prognostic Implications of Left Ventricular Myocardial Work Indices in Patients With Secondary Mitral Regurgitation
Authors: Yedidya Idit , Lustosa Rodolfo P. , Fortuni Federico , van der Bijl Pieter , Namazi Farnaz , Vo Ngoc Mai , Meucci Maria Chiara , Ajmone Marsan Nina , Bax Jeroen J. , Delgado Victoria 
Published: September 2021

Background:
Assessment of left ventricular (LV) function in patients with secondary mitral regurgitation (SMR) remains challenging but is an important parameter for risk stratification. The association of LV myocardial work components (work index [GWI], constructive [GCW] and wasted [GWW] work, and work efficiency) derived from pressure-strain loops obtained with speckle tracking echocardiography, and all-cause mortality in patients with SMR was investigated.

Methods:
LV myocardial GWI, GCW, GWW, and global work efficiency were measured with speckle tracking strain echocardiography in 373 patients (72% men, median age 68 years) with various grades of SMR. All-cause mortality was the primary end point.

Results:

Mild SMR was observed in 143 patients, 128 had moderate SMR, and 102 had severe SMR. Patients with severe SMR had the largest LV volumes and the worst LV ejection fraction and LV global longitudinal strain. In patients with severe SMR, LV GWI and GCW were more impaired (500 mm Hg% versus 680 mm Hg%
P
=0.024 and 678 mm Hg% versus 851 mm Hg%
P
=0.006, respectively), while GWW was lower (130 mm Hg% versus 260 mm Hg%
P
<0.001, respectively) and global work efficiency was significantly higher (82% versus 76%,
P
=0.001) compared with patients with mild SMR. After a median follow-up of 56 months, 161 patients died. LV GWI≤500 mm Hg%, LV GCW≤750 mm Hg%, and LV GWW<300 mm Hg% were independently associated with excess mortality.

Conclusions:
Patients with severe SMR had the worst LV GWI and LV GCW but better LV GWW and global work efficiency reflecting the unloading of the LV in the low-pressure left atrial chamber. These parameters were independently associated with worse long-term survival in patients with SMR.
From Reprisals to Criminal Accountability: State Bias and the Prospects of Limiting War Through Law
Authors: Kalmanovitz Pablo 
Published: September 2021

Abstract
Over the past 25 years, criminal prosecutions for war crimes have become a central element in the long-standing project of governing hostilities in international law. According to many, the threat of criminal prosecutions can be a general deterrent against violations of the laws of war, and can contribute more broadly to the diffusion and domestic appropriation of humanitarian norms. This article discusses some unintended effects of this “anti-impunity turn” in the laws of war in the context of non-international armed conflicts. Specifically, it examines the consequences of the fact that states typically have a monopoly over the means of legitimate criminal investigation for alleged crimes committed in their territory. Far from operating on a level playing field, criminal investigations in war contexts must be undertaken under institutional conditions that tend to favor state agents over non-state opposition groups. The article spells out some implications of this form of state bias and argues that it can contribute to exacerbate conflict and prolong violence in war.
Introduction – Plausible, Norms of Warfare: Reducing the Gap Between the Normative and the Empirical
Authors: Colonomos Ariel , Beardsworth Richard 
Published: September 2021

Abstract
This special issue argues in favor of a new approach to the study of norms of warfare, which combines a normative analysis of ethical problems arising in war with an explanatory analysis of the use of force. Norms of warfare go as far back as Antiquity, and their study has followed a long historical path. In recent years, the ethics of war, mostly grounded in philosophy, has considerably expanded as a field. Notwithstanding such efforts to refine our normative knowledge of what should be just norms for the use of force, we argue that a more interdisciplinary approach is required to orient the study of the laws of war. In this Special Issue, proposals are made that, along with normative analysis, bring to the discussion not only disciplines such as political science and international relations, but also social theory, psychology and the neurosciences. We argue from a non-ideal perspective, that in order for norms to be just, they need to be ‘plausible’ for those who should abide by them. They also need to make sense in the context of democratic societies that favor a pluralistic debate on justice and ethics. Epistemically, we argue that, in order to understand if norms are plausible and just, reducing the gap between the normative and the empirical is required.
Reshaping the review of consent so we might improve participant choice
Authors: Davies Hugh 
Published: September 2021

Consent is one necessary foundation for ethical research and it’s one of the research ethics committee’s major roles to ensure that the consent process meets acceptable standards. Although on Oxford ‘A’ REC (an NHS Research Ethics Committee based in the UK) we’ve been impressed by the thought and work put into this aspect of research ethics, we’ve continued to have concerns about the suitability and effectiveness of consent processes in supporting decision making, particularly for clinical trials. There’s poor understanding of what people want to help them decide; current processes don’t provide the best grounding for informed consent and there’s inadequate public involvement. We’ve also found a lack of proportionality with researchers failing to adapt consent procedures in proportion to the burdens and consequences of the study. As a result, people are often not best helped to make an informed choice when asked to join a research study. To address these concerns, we considered how we might improve this aspect of research ethics review. Recognising the central importance of the dialogue between the volunteer and researcher, we’ve drawn up a model or flowchart of what we deem good consent practice, proposing consent should be built around four simple steps: Step 1: Introducing the study and the choices: helping the potential participants get an overview of the proposal and introducing the key issues. Step 2: Explaining all the details of the study using the detailed Participant Information Sheet. Step 3: After a gap, if necessary, reviewing and checking understanding. Step 4: Reaching agreement and recording consent. These steps, we believe, could help all involved and this article lays out ways we might improve participant choice while complying with accepted principles and current regulations.
Glenohumeral abduction contractures after residual neonatal brachial plexus injury
Authors: Alabau-Rodriguez Sergi , Romero-Larrauri Pablo , Soldado Francisco 
Published: September 2021

Glenohumeral abduction contractures are common in patients with neonatal brachial plexus injury, but little has been previously published about them. We conducted a retrospective analysis of data prospectively collected from 205 consecutive children (108 female) of mean age 9.6 years with neonatal brachial plexus injury (C5-C6, 58%; C5-C7, 29%; C5-T1, 14%). Most children (69%) showed a glenohumeral abduction contracture, it being more common in those with upper neonatal brachial plexus injury. Level of evidence: III
In-depth time-dependent analysis of the benefit of allo-HSCT for elderly patients with CR1 AML: a FILO study
Authors: Devillier Raynier , Forcade Edouard , Garnier Alice , Guenounou Sarah , Thepot Sylvian , Guillerm Gaelle , Ceballos Patrice , Hicheri Yosr , Dumas Pierre-Yves , Peterlin Pierre , Hunault-Berger Mathilde , Béné Marie-Christine , Bouvier Anne , Chevallier Patrice , Blaise Didier , Vey Norbert , Pigneux Arnaud , Récher Christian , Huynh Anne 
Published: September 2021

AbstractThe benefit of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for patients with acute myeloid leukemia (AML) aged &gt;60 years remains a matter of debate, notably when performed in first complete remission (CR1). To clarify this issue, the French Innovative Leukemia Organization (FILO) performed a 10-year real-world time-dependent analysis. The study enrolled patients between 60 and 70 years of age with AML in CR1 after intensive chemotherapy with intermediate (IR) or unfavorable (UR) risk according to the European LeukemiaNet (ELN) 2010 classification. The impact of allo-HSCT was analyzed through three models: (1) time-dependent Cox; (2) multistate for dynamic prediction; and (3) super landmark. The study enrolled 369 (73%) IR and 138 (27%) UR patients with AML, 203 of whom received an allo-HSCT. Classical multivariate analysis showed that allo-HSCT significantly improved relapse-free survival (RFS; hazard ratio [HR] [95% confidence interval (CI)], 0.47 [0.35-0.62]; P &lt; .001) and overall survival (OS; HR [95% CI], 0.56 [0.42-0.76]; P &lt; .001), independently of the ELN risk group. With the multistate model, the predicted 5-year probability for IR and UR patients to remain in CR1 without allo-HSCT was 8% and 1%, respectively. Dynamic predictions confirmed that patients without allo-HSCT continue to relapse over time. Finally, the super landmark model showed that allo-HSCT significantly improved RFS (HR [95% CI], 0.47 [0.36-0.62]; P &lt; .001) and OS (HR [95% CI], 0.54 [0.40-0.72]; P &lt; .001). allo-HSCT in CR1 is reported here as significantly improving the outcome of fit older patients with AML. Long-term RFS without allo-HSCT is very low (&lt;10%), supporting allo-HSCT as being the best curative option for these patients.
Saline and alkaline stresses alter soil properties and composition and structure of gene-based nitrifier and denitrifier communities in a calcareous desert soil
Authors: Guo Jiaxin , Zhou Yongxue , Guo Huijuan , Min Wei 
Published: September 2021

Abstract
Background
Saline and alkaline stresses damages the health of soil systems. Meanwhile, little is known about how saline or alkaline stress affects soil nitrifier and denitrifier communities. Therefore, we compared the responses of gene-based nitrifier and denitrifier communities to chloride (CS), sulfate (SS), and alkaline (AS) stresses with those in a no-stress control (CK) in pots with a calcareous desert soil.

Results
Compared with CK, saline and alkaline stress decreased potential nitrification rate (PNR) and NO3-N; increased pH, salinity, water content, and NH4-N; and decreased copy numbers of amoA-AOA and amoA-AOB genes but increased those of denitrifier nirS and nosZ genes. Copies of nirK increased in SS and AS but decreased in CS. There were more copies of amoA-AOB than of amoA-AOA and of nirS than of nirK or nosZ. Compared with CK, SS and AS decreased operational taxonomic units (OTUs) of amoA-AOB but increased those of nirS and nosZ, whereas CS decreased nirK OTUs but increased those of nosZ. The numbers of OTUs and amoA-AOB genes were greater than those of amoA-AOA. There were positive linear relations between PNR and amoA-AOA and amoA-AOB copies. Compared with CK, the Chao 1 index of amoA-AOA and amoA-AOB decreased in AS, that of nirK increased in CS and SS, but that of nirS and nosZ increased in all treatments. The Shannon index of amoA-AOB decreased but that of nirS increased in CS and SS, whereas the index of nirK decreased in all treatments. Saline and alkaline stress greatly affected the structure of nitrifier and denitrifier communities and decreased potential biomarkers of nirS-type; however, AS increased those of nirK- and nosZ-type, and SS decreased those of nosZ-type. Soil water content, pH, and salinity were important in shaping amoA-AOA and denitrifier communities, whereas soil water and pH were important to amoA-AOB communities.

Conclusion
These results indicate that the nitrifier and denitrifier communities respond to saline and alkaline stresses conditions. Communities of amoA-AOA and amoA-AOB contribute to nitrification in alluvial gray desert soil, and those of nirS are more important in denitrification than those of nirK or nosZ.
NRXN1α+/- is associated with increased excitability in ASD iPSC-derived neurons
Authors: Avazzadeh Sahar , Quinlan Leo R. , Reilly Jamie , McDonagh Katya , Jalali Amirhossein , Wang Yanqin , McInerney Veronica , Krawczyk Janusz , Ding Yicheng , Fitzgerald Jacqueline , O’Sullivan Matthew , Forman Eva B. , Lynch Sally A. , Ennis Sean , Feerick Niamh , Reilly Richard , Li Weidong , Shen Xu , Yang Guangming , Lu Yin , Peeters Hilde , Dockery Peter , O’Brien Timothy , Shen Sanbing , Gallagher Louise 
Published: September 2021

Abstract
Background
NRXN1 deletions are identified as one of major rare risk factors for autism spectrum disorder (ASD) and other neurodevelopmental disorders. ASD has 30% co-morbidity with epilepsy, and the latter is associated with excessive neuronal firing. NRXN1 encodes hundreds of presynaptic neuro-adhesion proteins categorized as NRXN1α/β/γ. Previous studies on cultured cells show that the short NRXN1β primarily exerts excitation effect, whereas the long NRXN1α which is more commonly deleted in patients involves in both excitation and inhibition. However, patient-derived models are essential for understanding functional consequences of NRXN1α deletions in human neurons. We recently derived induced pluripotent stem cells (iPSCs) from five controls and three ASD patients carrying NRXN1α+/- and showed increased calcium transients in patient neurons.

Methods
In this study we investigated the electrophysiological properties of iPSC-derived cortical neurons in control and ASD patients carrying NRXN1α+/- using patch clamping. Whole genome RNA sequencing was carried out to further understand the potential underlying molecular mechanism.

Results
NRXN1α﻿﻿+﻿﻿/﻿﻿- cortical neurons were shown to display larger sodium currents, higher AP amplitude and accelerated depolarization time. RNASeq analyses revealed transcriptomic changes with significant upregulation glutamatergic synapse and ion channels/transporter activity including voltage-gated potassium channels (GRIN1, GRIN3B, SLC17A6, CACNG3, CACNA1A, SHANK1), which are likely to couple with the increased excitability in NRXN1α﻿﻿+﻿﻿/﻿﻿- cortical neurons.

Conclusions
Together with recent evidence of increased calcium transients, our results showed that human NRXN1α﻿﻿+﻿﻿/﻿﻿- isoform deletions altered neuronal excitability and non-synaptic function, and NRXN1α﻿﻿+﻿﻿/﻿﻿- patient iPSCs may be used as an ASD model for therapeutic development with calcium transients and excitability as readouts.
Towards cross-Canada monitoring of the unregulated street drug supply
Authors: Biggar Emily , Papamihali Kristi , Leclerc Pascale , Hyshka Elaine , Graham Brittany , Taylor Marliss , Payer Doris , Maloney-Hall Bridget , Buxton Jane A. 
Published: September 2021

Abstract
Background
The well-being of people who use drugs (PWUD) continues to be threatened by substances of unknown type or quantity in the unregulated street drug supply. Current efforts to monitor the drug supply are limited in population reach and comparability. This restricts capacity to identify and develop measures that safeguard the health of PWUD. This study describes the development of a low-barrier system for monitoring the contents of drugs in the unregulated street supply. Early results for pilot sites are presented and compared across regions.

Methods
The drug content monitoring system integrates a low-barrier survey and broad spectrum urine toxicology screening to compare substances expected to be consumed and those actually in the drug supply. The system prototype was developed by harm reduction pilot projects in British Columbia (BC) and Montreal with participation of PWUD. Data were collected from harm reduction supply distribution site clients in BC, Edmonton and Montreal between May 2018–March 2019. Survey and urine toxicology data were linked via anonymous codes and analyzed descriptively by region for trends in self-reported and detected use.

Results
The sample consisted of 878 participants from 40 sites across 3 regions. Reported use of substances, their detection, and concordance between the two varied across regions. Methamphetamine use was reported and detected most frequently in BC (reported: 62.8%; detected: 72.2%) and Edmonton (58.3%; 68.8%). In Montreal, high concordance was also observed between reported (74.5%) and detected (86.5%) cocaine/crack use. Among those with fentanyl detected, the percentage of participants who used fentanyl unintentionally ranged from 36.1% in BC, 78.6% in Edmonton and 90.9% in Montreal.

Conclusions
This study is the first to describe a feasible, scalable monitoring system for the unregulated drug supply that can contrast expected and actual drug use and compare trends across regions. The system used principles of flexibility, capacity-building and community participation in its design. Results are well-suited to meet the needs of PWUD and inform the local harm reduction services they rely on. Further standardization of the survey tool and knowledge mobilization is needed to expand the system to new jurisdictions.