bluuebunny/crossref_metadata_2025_split huggingface dataset:
High‐flow nasal cannula versus face mask for preoxygenation in obese patients: A randomised controlled trial
Authors: Rosén Jacob , Frykholm Peter , Fors Diddi 
Published: July 2021

AbstractBackgroundPreoxygenation efficacy with high‐flow nasal cannula (HFNC) in obese patients is not clearly established. The primary aim of this study was to compare heated, humidified, high‐flow nasal cannula with face mask for preoxygenation in this population.MethodsWe conducted a single‐centre, randomised, controlled trial. Forty subjects with BMI ≥ 35 kg m−2 were randomly assigned to receive 5.0 min of preoxygenation with face mask and 7 cm H2O of PEEP (PEEP group) or HFNC at 70 L min−1 (HF group). Following induction, bag‐mask ventilation continued until laryngoscopy, whereas HFNC was maintained before and during intubation. The primary outcomes were end‐tidal fraction of oxygen (EtO2) at 2.5 and 5.0 min duration of preoxygenation. Secondary outcomes included PaO2 and PaCO2 at 2.5 and 5.0 min of preoxygenation and at intubation.ResultsMean (±SD) EtO2 was 0.89 (±0.04) versus 0.90 (±0.05) after 2.5 min (95% CI for mean difference −0.02, 0.04) and 0.93 (±0.02) versus 0.91 (±0.02) after 5.0 min of preoxygenation (95% CI for mean difference −0.03, −0.002) in the PEEP (n = 18) and HF group (n = 20), respectively. All subjects reached an EtO2 ≥ 0.85 at 5.0 min. There were no differences in mean PaO2 or PaCO2 during preoxygenation. Subjects in the HF group had a mean (±SD) apnoea time of 199 (±38) s, but no desaturation (SpO2 < 100%) occurred.ConclusionsFace mask with PEEP was superior to HFNC for preoxygenation in obese subjects. HFNC provided adequate preoxygenation quality in all subjects and may be considered as an alternative to face mask in selected patients.Trial registration#ISRCTN37375068 (www.isrctn.com).
Mental health conditions in older multimorbid patients presenting to the emergency department for acute cardiac symptoms: Cross‐sectional findings from the EMASPOT study
Authors: Figura Andrea , Kuhlmann Stella L. , Rose Matthias , Slagman Anna , Schenk Liane , Möckel Martin 
Published: July 2021

AbstractBackgroundThis study aimed to (1) examine the proportion of patients presenting to an emergency department (ED) for acute cardiac symptoms with comorbid mental health conditions (MHCs) comprising current depression, generalized anxiety disorder, and panic disorder; (2) compare cardiac patients with and without MHCs regarding sociodemographic, medical, and psychological characteristics; and (3) examine recognition and treatment rates of MHCs.MethodsMultimorbid patients, aged ≥50 years, presenting to an inner‐city ED with acute cardiac symptoms including chest pain, dyspnea, and palpitations, completed validated self‐report instruments assessing MHCs and a questionnaire collecting psychosocial and medical information. In addition, routine medical data were extracted from the electronic health record.ResultsA total of 641 patients were included in the study. Mean (±SD) age was 68.8 (±10.8) years and 41.7% were female. Based on screening instruments, 28.4% of patients were affected with comorbid MHCs. Patients reported clinically significant symptoms of depression (23.3% PHQ‐9 ≥10), generalized anxiety disorder (12.2% GAD‐7 ≥10), and panic disorder (4.7% PHQ‐PD). Patients with MHCs were more likely to be younger, female, lower educated, and unemployed. The presence of MHCs was associated with higher cardiac symptom burden and subjective treatment urgency as well as more psychosocial distress (PHQ‐stress) and impaired quality of life (SF‐12v2). Of all patients, 15.6% were identified with new or unrecognized MHCs.ConclusionsMHCs are prevalent in nearly one‐third of patients presenting with cardinal cardiac symptoms. Thus, the ED visit offers an opportunity to identify and refer patients with MHCs to appropriate and timely care after exclusion of life‐threatening conditions.
Long‐term clinical outcomes of stereotactic radiosurgery and hypofractionated stereotactic radiotherapy using the CyberKnife® robotic radiosurgery system for vestibular schwannoma
Authors: Puataweepong Putipun , Dhanachai Mantana , Swangsilpa Thiti , Sitathanee Chomporn , Ruangkanchanasetr Rawee , Hansasuta Ake , Pairat Kumuthinee 
Published: July 2021

AbstractAimThe study aimed to evaluate the long‐term clinical outcomes of patients with vestibular schwannoma (VS) treated with stereotactic radiosurgery (SRS) and hypofractionated stereotactic radiotherapy (HSRT) with frameless robotic whole‐body radiosurgery system (CyberKnife®).MethodsThis retrospective analysis of prospectively collected data included 123 consecutive patients with VS treated at the Radiosurgery center, Ramathibodi Hospital, Bangkok, Thailand. SRS was recommended for patients with unserviceable hearing and Koos grade I–III tumors, and HSRT for patients with serviceable hearing or Koos grade III–IV tumors. Between March 2009 and December 2015, 23 patients (19%) were treated with SRS, whereas 100 (81%) received HSRT. The commonly used regimen was 12 Gy in one fraction for SRS and 18 Gy in three fractions for HSRT.ResultsAfter a median follow‐up of 72 months (range: 12–123 months), the 5‐year and 8‐year progression‐free survival (PFS) rates for the whole cohort were 96% and 92%, respectively. The PFS was not significantly different between the SRS and HSRT groups (p = 0.23). Among 28 patients with serviceable hearing in the HSRT group, the 5‐year and 8‐year hearing preservation rates were 87% and 65%, respectively. The rate of nonauditory complications was 14%. Koos grade III/IV was a predictor of disease progression and was associated with nonauditory complications.ConclusionSRS and HSRT with the CyberKnife® system provided excellent long‐term tumor control with a low rate of nonauditory complications. HSRT may result in acceptable hearing preservation rates.
The Role of the State in the Transfer of Value from Main Street to Wall Street: US Single‐Family Housing after the Financial Crisis
Authors: Christophers Brett 
Published: July 2021

AbstractAfter 2007, many US households suffered significant financial losses when their mortgages were foreclosed upon and homes repossessed. Much of this lost value ended up in the hands of institutional investors who bought repossessed homes at the bottom of the market. Using the case of the biggest such investor, Blackstone, as an exemplar, this article argues that the state was implicated in this value transfer in several crucial ways: its failure to better assist distressed borrowers ensured the availability of large numbers of homes for investors to buy; it privileged such investors over other categories of potential buyer; and its taking of action to support recovery of the housing market coincided with such investors beginning to buy at scale. The article draws on the critical macro‐finance literature to conceptualise the state’s role in terms of the “de‐risking” of financial markets that are increasingly integral to contemporary social and economic governance.
Foetal mouth movements: Effects of nicotine
Authors: Froggatt Suzanne , Reissland Nadja , Covey Judith , Kumarendran Kumar 
Published: July 2021

AbstractAimTo assess whether foetal mouth movement frequency changes across gestation and whether there are differences between cigarette and e‐cigarette exposure conditions in comparison to a non‐exposed group of foetuses.MethodPregnant women underwent 4‐dimensional (4D) foetal ultrasound scans at 32 weeks (106 scans) and 36 weeks of gestational age (87 scans) at James Cook University Hospital, UK. The 4D scans were coded using the Fetal Observable Movement System (FOMS). Measures of maternal smoking status, stress, depression, anxiety, attachment and time of scan were also collected. There were four exposure groups: non‐smokers, light smokers (<10 per day), heavy smokers (11–20 per day) and e‐cigarette users.ResultsNo significant differences in relative frequency of mouth movements between the exposure groups at 32‐ and 36 weeks of gestational age were found. Foetal mouth movements declined from 32 to 36 weeks of gestation for non‐exposed and e‐cigarette‐exposed foetuses.ConclusionDue to variability in foetal behaviour, examining mouth movements alone may not be the most appropriate method for assessing group differences. However, in line with other research, mouth movement frequency declined between 32‐ and 36 weeks of gestational age. A combination of foetal behavioural assessments is needed to assess the effects of cigarette and e‐cigarette exposure on foetal neurobehavioural development.
Effectiveness and safety of ustekinumab maintenance therapy in 103 patients with ulcerative colitis: a GETAID cohort study
Authors: Fumery Mathurin , Filippi Jérôme , Abitbol Vered , Biron Amélie , Laharie David , Serrero Melanie , Altwegg Romain , Bouhnik Yoram , Peyrin‐Biroulet Laurent , Gilletta Cyrielle , Roblin Xavier , Pineton de Chambrun Guillaume , Vuitton Lucine , Bourrier Anne , Nancey Stephane , Gornet Jean‐Marc , Nahon Stephane , Bouguen Guillaume , Viennot Stephanie , Nachury Maria , Amiot Aurelien 
Published: July 2021

SummaryBackgroundPhase III trials have demonstrated the efficacy and safety of ustekinumab in ulcerative colitis (UC), but few real‐life long‐term data are currently available.AimsTo assess the real‐world effectiveness and safety of ustekinumab in patients with UC.MethodsFrom January to September 2019, all consecutive patients with active UC treated with ustekinumab in a GETAID centre were included. Patients were evaluated at week 52. Remission was defined as a partial Mayo Clinic score ≤2.ResultsWe included 103 patients with UC (62 men; mean age: 41.2 ± 16.2 years; 52% pancolitis E3) with an insufficient response to immunosuppressants, anti‐TNFs and/or vedolizumab. At week 52, 45 (44%) patients had discontinued ustekinumab mainly due to lack of effectiveness (n = 41). The cumulative probabilities of ustekinumab persistence were 96.1%, 81.6%, 71.7% and 58.4% after 3, 6, 9 and 12 months respectively. The overall steroid‐free clinical remission rate at week 52 was 32% of whom 71% had subscores of null for rectal bleeding and stool frequency. Ten patients underwent colectomy within a median of 6.7 [4.3‐10.6] months. Adverse effects were observed in 15 (16.9%) patients; 4 (4.5%) were severe, including one patient who died from a myocardial infarction.ConclusionAfter 52 weeks, over one‐half of patients with refractory UC were still treated by ustekinumab and one‐third were in steroid‐free clinical remission.
Effect of dipeptide on intestinal peptide transporter 1 gene expression: An evaluation using primary cultured chicken intestinal epithelial cells
Authors: Tokutake Yukako , Taciak Marcin , Sato Kan , Toyomizu Masaaki , Kikusato Motoi 
Published: July 2021

AbstractPeptide transporter 1 (PepT1) is a transporter responsible for absorbing dipeptide and tripeptide in enterocytes and is upregulated by dipeptide in mammals. It has not been certain whether intestinal PepT1 expression is responsive to dipeptides in chickens because of the lack of in vitro study using the cultured enterocytes. This study established a primary culture model of chicken intestinal epithelial cells (IECs) in two‐dimensional monolayer culture using collagen gel by which the response of chicken PepT1 gene expression to dipeptide stimuli was evaluated. The cultured chicken IECs showed the epithelial‐like morphology attached in a patch‐manner and exhibited positive expression of cytokeratin and epithelial cadherin, specific marker proteins of epithelial cells. Moreover, the chicken IECs exhibited the gene expression of intestinal cell type‐specific marker, villin1, mucin 2, and chromogranin A, suggesting that the cultured IECs were composed of enterocytes as well as goblet and enteroendocrine cells. PepT1 gene expression was significantly upregulated by synthetic dipeptide, glycyl‐l‐glutamine, in the cultured IECs. From the results, we herein suggested that dipeptide is a factor upregulating PepT1 gene expression in chicken IECs.
Learning from remote decentralised clinical trial experiences: A qualitative analysis of interviews with trial personnel, patient representatives and other stakeholders
Authors: Coyle Joanne , Rogers Amy , Copland Rachel , De Paoli Giorgia , MacDonald Thomas M. , Mackenzie Isla S. ,   of the Trials@Home Consortium
Published: July 2021

AimsThe aim of the study was to identify actionable learning points from stakeholders in remote decentralised clinical trials (RDCTs) to inform their future design and conduct.MethodsSemistructured interviews were carried out with a purposive sample of stakeholders, including senior managers, trial managers, technology experts, principal investigators, clinical investigators, research scientists, research nurses, vendors, patient representatives and project assistants. The interview data were coded using a thematic approach, identifying similarities, differences and clustering to generate descriptive themes. Further refinement of themes was guided by empirical phenomenology, grounding explanation in the meanings that interviewees gave to their experiences.ResultsForty‐eight stakeholders were interviewed. Actionable learning points were generated from the thematic analysis. Patient involvement and participant engagement were seen as critical to the success of RDCTs where in‐person contact is minimal or nonexistent. Involving patients in identifying the research question, creating recruitment materials, apps and websites, and providing ongoing feedback to trial participants were regarded as facilitating recruitment and engagement. Building strong relationships early with trial partners was thought to support RDCT conduct. Multiple modes of capturing information, including patient‐reported outcomes (PROs) and routinely collected data, were felt to contribute to data completeness. However, RDCTs may transfer trial activity burden onto participants and remote‐working research staff, therefore additional support may be needed.ConclusionRDCTs will continue to face challenges in implementing novel technologies. However, maximising patient and partner involvement, reducing participant and staff burden, and simplifying how participants and staff interact with the RDCT may facilitate their implementation.
Concentration‐QT modelling shows no evidence of clinically significant QT interval prolongation with capivasertib at expected therapeutic concentrations
Authors: Voronova Veronika , Cullberg Marie , Delff Philip , Parkinson Joanna , Dota Corina , Schiavon Gaia , Maroj Brijesh , Rekić Dinko , Cheung S. Y. Amy 
Published: July 2021

Pharmacokinetics‐matched digital electrocardiogram data (n = 503 measurements from 180 patients) collected in a first‐in‐human, multi‐part, dose‐escalation (from 80 to 800 mg) and dose expansion (at 480 mg) phase 1 study in patients with advanced solid malignancies, were used to assess potential risk of QT prolongation associated with the AKT inhibitor capivasertib. The relationship between plasma drug concentrations and baseline‐adjusted Fridericia‐corrected QT (ΔQTcF) values was estimated using a prespecified linear mixed‐effects model. The model provided an unbiased reproduction of the experimental data set, estimating a small but positive correlation between capivasertib concentration and ΔQTcF. At the expected therapeutic dose (400 mg twice daily) the predicted mean ΔQTcF at the steady state maximum concentration was 3.97 ms with an upper limit of the 90% CI of 5.07 ms; below the 10 ms limit proposed by ICH E14 guidance. This analysis suggests that capivasertib is not expected to present a clinically significant risk for QT prolongation that is associated with pro‐arrhythmic effects.
Prophylactic corticosteroid use in patients receiving axicabtagene ciloleucel for large B‐cell lymphoma
Authors: Oluwole Olalekan O. , Bouabdallah Krimo , Muñoz Javier , De Guibert Sophie , Vose Julie M. , Bartlett Nancy L. , Lin Yi , Deol Abhinav , McSweeney Peter A. , Goy Andre H. , Kersten Marie José , Jacobson Caron A. , Farooq Umar , Minnema Monique C. , Thieblemont Catherine , Timmerman John M. , Stiff Patrick , Avivi Irit , Tzachanis Dimitrios , Kim Jenny J. , Bashir Zahid , McLeroy Jeff , Zheng Yan , Rossi John M. , Johnson Lisa , Goyal Lovely , van Meerten Tom 
Published: July 2021

SummaryZUMA‐1 (NCT02348216) examined the safety and efficacy of axicabtagene ciloleucel (axi‐cel), an autologous CD19‐directed chimaeric antigen receptor (CAR)‐T cell therapy, in refractory large B‐cell lymphoma. To reduce treatment‐related toxicity, several exploratory safety management cohorts were added to ZUMA‐1. Specifically, cohort 6 investigated management of cytokine release syndrome (CRS) and neurologic events (NEs) with prophylactic corticosteroids and earlier corticosteroid and tocilizumab intervention. CRS and NE incidence and severity were primary end‐points. Following leukapheresis, patients could receive optional bridging therapy per investigator discretion. All patients received conditioning chemotherapy (days −5 through −3), 2 × 106 CAR‐T cells/kg (day 0) and once‐daily oral dexamethasone [10 mg, day 0 (before axi‐cel) through day 2]. Forty patients received axi‐cel. CRS occurred in 80% of patients (all grade ≤2). Any grade and grade 3 or higher NEs occurred in 58% and 13% of patients respectively. Sixty‐eight per cent of patients did not experience CRS or NEs within 72 h of axi‐cel. With a median follow‐up of 8·9 months, objective and complete response rates were 95% and 80% respectively. Overall, prophylactic corticosteroids and earlier corticosteroid and/or tocilizumab intervention resulted in no grade 3 or higher CRS, a low rate of grade 3 or higher NEs and high response rates in this study population.
Perivascular fat imaging by computed tomography (CT): a virtual guide
Authors: Kotanidis Christos P. , Antoniades Charalambos 
Published: July 2021

Imaging in medicine has been revolutionised by technological, computational and research advances over the past decades. Computed tomography (CT), in particular, has seen rapid evolution especially in the field of cardiovascular non‐invasive imaging. It is being recognised as the first‐line tool for the assessment of stable and unstable disease with diagnostic, prognostic and re‐stratification potential. Vascular inflammation is a key component of the atherosclerotic process and has been shown to induce molecular, transcriptional and structural changes to perivascular adipose tissue (PVAT). Being a diverse structure itself, PVAT surrounds the human vessels and is characterised by a highly rich secretome, including, amongst others, adipokines, cytokines, gaseous messengers and miRNAs It is implicated in a bidirectional interplay with the adjacent vascular wall, affecting and being affected by aspects of its biology, mainly inflammation. In this review, we discuss the current status of cardiac CT in imaging vascular inflammation through PVAT phenotyping.LINKED ARTICLESThis article is part of a themed issue on Molecular imaging ‐ visual themed issue. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v178.21/issuetoc
Vertical stratification of dung beetles in young secondary forests of Singapore
Authors: Abdul Rahman Ita Liana , Yap Sean , Goh Thary Gazi , Toh Kai Xin , Yee Qian Qi Hillary , Puniamoorthy Nalini 
Published: July 2021

AbstractIn tropical rain forests where resources are present at different spatial scales, niche partitioning could affect biodiversity. For instance, insects inhabiting the arboreal strata often differ drastically from those in the ground strata. In this study, we investigated the vertical distribution of dung beetles in young secondary forests of Singapore by comparing their biodiversity from both ground and canopy traps. In total, we sampled 2242 individuals from four genera. Species composition significantly differed between canopy and ground traps, with Onthophagus cf. crassicollis, Onthophagus cf. deliensis, Onthophagus cf. leusermontis, and Onthophagus cf. babirussa contributing most differences. We report the presence of Onthophagus. cf. deliensis—an abundant, widespread arboreal specialist. Species richness and diversity were significantly lower in canopy traps, indicative of ephemeral dung present. When comparing Shannon diversity differences between stratum, temperature and humidity did not have significant effects. Morphological analyses suggested that arboreal dung beetles are smaller with greater wing loading, exposed eye ratio and leg size, which improve flight, vision, and dung manipulation. This study is a first step toward documenting vertical stratification of dung beetles in young secondary forests of Singapore; detecting morphological differences between ground and arboreal specialists, that are likely adaptations to divergent niches.
Just a business decision? Debarment in public procurement in Canada and the United States
Authors: Acorn Elizabeth 
Published: July 2021

AbstractThe Canadian government is considering changes to its Integrity and Suspension Policy, particularly the rules governing debarment and when an individual or corporation can be precluded from public contracting due to misconduct. The reforms would bring Canada’s policy closer to that of the US. This article compares federal debarment policies in Canada and the US and examines the consequences of these distinct policies by considering their role in anti‐foreign bribery enforcement. This discussion reveals a disjuncture between Canada’s policy goals and practice, which suggests that the proposed reforms to Canada’s debarment policy are not as significant as they first appear.
La préséance de la rationalité budgétaire sur les autres dimensions de l’intérêt public en droit québécois des contrats publics
Authors: Pellerin Antoine 
Published: July 2021

SommaireLes contrats publics ont pour finalité l’intérêt public. C’est ce qui les distingue des contrats privés et fait en sorte qu’on leur applique des règles juridiques spécifiques. La loi ne dit cependant pas ce que signifie l’intérêt public lorsque vient le temps pour l’État d’exercer son pouvoir contractuel. Nous avons donc examiné le cadre juridique applicable aux contrats publics québécois pour voir si une conception particulière de l’intérêt public s’en dégage. L’analyse menée révèle que le droit québécois des contrats publics est caractérisé par une conception essentiellement budgétaire de l’intérêt public. Cet article explique en quoi cela pose problème.