bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perforations of tri‐layer nitrile‐latex and natural rubber latex gloves during ex‐vivo equine intestinal anastomoses
Authors: Averay Kate , Ward Michael , Verwilghen Denis 
Published: July 2021

AbstractObjectiveTo compare perforation rates between tri‐layer nitrile‐latex and natural rubber latex surgical gloves after single‐layer end‐to‐end jejunojejunal anastomoses in equine cadavers.Study DesignProspective randomized ex‐vivo study.Sample PopulationPairs of surgical gloves (n = 46) worn during jejunojejunal anastomoses.MethodsTri‐layer nitrile‐latex and rubber latex pairs of gloves were equally but randomly allocated to a right‐handed surgeon performing 46 single‐layer end‐to‐end jejunojejunal anastomoses on cadaveric material. Number and location of perforations were determined with the water leak test after each procedure. Ten unused pairs of both glove types were tested as controls.ResultsAt least one perforation occurred in 41% (19/46) of the pairs of gloves. Glove perforations were present in 22% (5/23; 95% CI: 9–42) of tri‐layer glove pairs and 61% (14/23; 95% CI: 41–78) of the rubber glove pairs. The odds of glove perforation were 5.6 times (p = .009, 95% CI: 1.5–20.5) lower when tri‐layer rather than rubber gloves were used. The duration of procedure did not affect the risk of glove perforation (p = .679). No perforations were observed in the unused gloves.ConclusionPerforations were less common when the surgeon wore tri‐layer nitrile‐latex gloves rather than to the natural rubber latex gloves tested in this study.Clinical RelevanceTri‐layer nitrile‐latex gloves were more resistant to perforations in experimental settings; further studies may confirm that they are also superior in a clinical setting.
Study of artificial water replenishment for wetland restoration
Authors: Liu Jianwei , Zhang Qiang , Wang Zhipeng , Yang Bing , Li Yao 
Published: July 2021

AbstractThe degradation of wetlands has caused regional environment and climate problems in the Sanjiang Plain. To provide a reference for wetland protection and restoration, two artificial water replenishment schemes were designed and four indicators—water quantity, ammonia nitrogen, total nitrogen and total phosphorus—were chosen to analyse results simulated by an environmental fluid dynamics code model. Simulation results showed that the wetlands receive a suitable amount of water and reach a normal water elevation, and the concentration of most water quality indicators decreased. In addition, a fuzzy analytic hierarchy process was used to select the four indicators and 30 different combinations were designed. Following the fuzzy calculation, the comprehensive scores of 29 combinations showed that a scheme involving multiple replenishments is better than a scheme of a single replenishment. This study indicates that an effective method for restoring wetlands near or surrounding irrigation areas is rational allocation of water resources.
Mecanismos fisiopatológicos relacionados con la infección por SARS-CoV-2 en las personas expuestas durante 2019 y 2020.
Authors: Escobar Domingo María José , Escobar Domingo Daniela Paola , Moreno Correa Sandra 
Published: July 2021

La presente revisión describe los mecanismos fisiopatológicos relacionados con la infección por el Coronavirus de 2019, (COVID-19 ó SARS-CoV-2). Este virus descubierto en Wuhan-China, presentó una transmisión zoonótica y posteriormente se transmitió entre humanos a través de aerosoles y superficies contaminadas con un índice alto de contagio desatando una Pandemia. A través de búsqueda sistemática en MEDLINE Y EMBASE, se seleccionaron los estudios que apuntan al objetivo general. Se discute sobre el genoma, estructura, receptor celular, respuesta inmune y diseminación hacia otros tejidos. En conclusión, el virus analizado, presenta factores que inciden en la severidad de la manifestación clínica y en la predisposición de adultos mayores y/o con comorbilidades, a presentar fenómenos inflamatorios generalizados. La expresión del receptor celular es un factor importante en la progresión. Aunque existe evidencia de la presencia viral en SNC, se requieren estudios que profundicen la acción del virus sobre este y otros tejidos.
Fruit and vegetable consumption and the risk of type 2 diabetes: a systematic review and dose–response meta-analysis of prospective studies
Authors: Halvorsen Rine Elise , Elvestad Mathilde , Molin Marianne , Aune Dagfinn 
Published: July 2021

BackgroundThe association between intake of fruit and vegetables and their subtypes, and the risk of type 2 diabetes has been investigated in several studies, but the results have been inconsistent.ObjectiveWe conducted an updated systematic review and dose–response meta-analysis of prospective studies on intakes of fruit and vegetables and fruit and vegetable subtypes and the risk of type 2 diabetes.DesignPubMed and Embase databases were searched up to 20 October 2020. Prospective cohort studies of fruit and vegetable consumption and type 2 diabetes mellitus were included. Summary relative risks (RRs) and 95% CIs were estimated using a random effects model.ResultsWe included 23 cohort studies. The summary RR for high versus low intake and per 200 g/day were 0.93 (95% CI: 0.89 to 0.98, I2=0%, n=10 studies) and 0.98 (95% CI: 0.95 to 1.01, I2=37.8%, n=7) for fruit and vegetables combined, 0.93 (95% CI: 0.90 to 0.97, I2=9.3%, n=20) and 0.96 (95% CI: 0.92 to 1.00, I2=68.4%, n=19) for fruits and 0.95 (95% CI: 0.88 to 1.02, I2=60.4%, n=17) and 0.97 (95% CI: 0.94 to 1.01, I2=39.2%, n=16) for vegetables, respectively. Inverse associations were observed for apples, apples and pears, blueberries, grapefruit and grapes and raisins, while positive associations were observed for intakes of cantaloupe, fruit drinks, fruit juice, brussels sprouts, cauliflower and potatoes, however, most of these associations were based on few studies and need further investigation in additional studies.ConclusionsThis meta-analysis found a weak inverse association between fruit and vegetable intake and type 2 diabetes risk. There is indication of both inverse and positive associations between intake of several fruit and vegetables subtypes and type 2 diabetes risk, however, further studies are needed before firm conclusions can be made.
Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care
Authors: Sajid Imran Mohammed , Parkunan Anand , Frost Kathleen 
Published: July 2021

ObjectivesThe largest proportion of general practitioner (GP) magnetic resonance imaging (MRI) is musculoskeletal (MSK), with consistent annual growth. With limited supporting evidence and potential harms from early imaging overuse, we evaluated practice to improve pathways and patient safety.MethodsCohort evaluation of routinely collected diagnostic and general practice data across a UK metropolitan primary care population. We reviewed patient characteristics, results and healthcare utilisation.ResultsOf 306 MSK-MRIs requested by 107 clinicians across 29 practices, only 4.9% (95% CI ±2.4%) appeared clearly indicated and only 16.0% (95% CI ±4.1%) received appropriate prior therapy. 37.0% (95% CI ±5.5%) documented patient imaging request. Most had chronic symptoms and half had psychosocial flags. Mental health was addressed in only 11.8% (95% CI ±6.3%) of chronic sufferers with psychiatric illness, suggesting a solely pathoanatomical approach to MSK care. Only 7.8% (95% CI ±3.0%) of all patients were appropriately managed without additional referral. 1.3% (95% CI ±1.3%) of scans revealed diagnoses leading to change in treatment (therapeutic yield). Most imaged patients received pathoanatomical explanations to their symptoms, often based on expected age or activity-related changes. Only 16.7% (95% CI ±4.2%) of results appeared correctly interpreted by GPs, with spurious overperception of surgical targets in 65.4% (95% CI ±5.3%) who suffered ‘low-value’ (ineffective, harmful or wasteful) post-MRI referral cascades due to misdiagnosis and overdiagnosis. Typically, 20%–30% of GP specialist referrals convert to a procedure, whereas MRI-triggered referrals showed near-zero conversion rate. Imaged patients experienced considerable delay to appropriate care. Cascade costs exceeded direct-MRI costs and GP-MSK-MRI potentially more than doubles expenditure compared with physiotherapist-led assessment services, for little-to-no added therapeutic yield, unjustifiable by cost–consequence or cost–utility analysis.ConclusionUnfettered GP-MSK-MRI use has reached unaccceptable indication creep and disutility. Considerable avoidable harm occurs through ubiquitous misinterpretation and salient low-value referral cascades for two-thirds of imaged patients, for almost no change in treatment. Any marginally earlier procedural intervention for a tiny fraction of patients is eclipsed by negative consequences for the vast majority. Only 1–2 patients need to be scanned for one to suffer mismanagement. Direct-access imaging is neither clinically, nor cost-effective and deimplementation could be considered in this setting. GP-MSK-MRI fuels unnecessary healthcare utilisation, generating nocebic patient beliefs and expectations, whilst appropriate care is delayed and a high burden of psychosocial barriers to recovery appear neglected.
Prognosis palliative care study, palliative prognostic index, palliative prognostic score and objective prognostic score in advanced cancer: a prospective comparison
Authors: Lee Seung Hun , Lee Jeong Gyu , Choi Young Jin , Seol Young Mi , Kim Hyojeong , Kim Yun Jin , Yi Yu Hyeon , Tak Young Jin , Kim Gyu Lee , Ra Young Jin , Lee Sang Yeoup , Cho Young Hye , Park Eun Ju , Lee Youngin , Choi Jungin , Lee Sae Rom , Kwon Ryuk Jun , Son Soo Min 
Published: July 2021

BackgroundPredicting how long a patient with far advanced cancer has to live is a significant part of hospice and palliative care. Various prognostic models have been developed, but have not been fully compared in South Korea.ObjectivesWe aimed to compare the accuracy of the Prognosis in Palliative Care Study (PiPS), Palliative Prognostic Index (PPI), Palliative Prognostic Score (PaP) and Objective Prognostic Score (OPS) for patients with far advanced cancer in a palliative care unit in South Korea.MethodsThis prospective study included patients with far advanced cancer who were admitted to a single palliative care unit at the National University Hospital. Variables for calculating the prognostic models were recorded by a palliative care physician. The survival rate was estimated using the Kaplan-Meier method. The sensitivity, specificity, positive predictive value and negative predictive value of each model were calculated.ResultsA total of 160 patients participated. There was a significant difference in survival rates across all groups, each categorised through the five prognostic models. The overall accuracy (OA) of the prognostic models ranged between 54.5% and 77.6%. The OA of clinicians’ predictions of survival ranged between 61.9% and 81.3%.ConclusionThe PiPS, PPI, PaP and OPS were successfully validated in a palliative care unit of South Korea. There was no difference in accuracy between the prognostic models, and OA tended to be lower than in previous studies.
Virtual reality in hospice: improved patient well-being
Authors: Lloyd Anna , Haraldsdottir Erna 
Published: July 2021

BackgroundVirtual reality (VR) technology as a therapeutic intervention has been gaining attention in healthcare settings in recent years. Studies suggest that using the technology can help alleviate symptoms such as pain and anxiety and induce positive emotions for people in hospital. Managing symptoms and promoting emotional and psychological well-being are core palliative care goals of relieving suffering of people with life-limiting illness. Accordingly, VR may be highly beneficial for use in hospice care yet remains underdeveloped in such settings. This qualitative study aimed to trial the technology and consider what benefits may emerge for hospice in patients.MethodsA one-off VR session was offered to patients at a hospice in Scotland. Sessions were observed by a researcher and followed by qualitative semi-structured interviews to discuss the experience with those who took part. Interviews were audio recorded, transcribed and thematically analysed.ResultsNineteen hospice patients successfully tried an immersive VR experience. VR sessions were acceptable for people within the hospice environment. The majority of participants enjoyed the experience. Many expressed joy and delight at the process. VR holds possibilities for relieving symptoms such as pain and anxiety frequently experienced by people in hospices. Furthermore, the technology offers the capacity to reconnect with a previous sense of self and to allow respite through the capacity to transcend current reality and connect with another meaningful reality. This exploratory study offers a starting point for larger studies to investigate the utility of VR for hospice patients.
STING agonist loaded lipid nanoparticles overcome anti-PD-1 resistance in melanoma lung metastasis via NK cell activation
Authors: Nakamura Takashi , Sato Takanori , Endo Rikito , Sasaki Shun , Takahashi Naomichi , Sato Yusuke , Hyodo Mamoru , Hayakawa Yoshihiro , Harashima Hideyoshi 
Published: July 2021

BackgroundResistance to an immune checkpoint inhibitor (ICI) is a major obstacle in cancer immunotherapy. The causes of ICI resistance include major histocompatibility complex (MHC)/histocompatibility locus antigen (HLA) class I loss, neoantigen loss, and incomplete antigen presentation. Elimination by natural killer (NK) cells would be expected to be an effective strategy for the treatment of these ICI-resistant tumors. We previously demonstrated that a lipid nanoparticle containing a stimulator of an interferon gene (STING) agonist (STING-LNP) efficiently induced antitumor activity via the activation of NK cells. Thus, we evaluated the potential of reducing ICI resistance by STING-LNPs.MethodsLung metastasis of a B16-F10 mouse melanoma was used as an anti-programmed cell death 1 (anti-PD-1)-resistant mouse model. The mice were intravenously injected with the STING-LNP and the mechanism responsible for the improvement of anti-PD-1 resistance by the STING-LNPs was analyzed by RT-qPCR and flow cytometry. The dynamics of STING-LNP were also investigated.ResultsAlthough anti-PD-1 monotherapy failed to induce an antitumor effect, the combination of the STING-LNP and anti-PD-1 exerted a synergistic antitumor effect. Our results indicate that the STING-LNP treatment significantly increased the expression of CD3, CD4, NK1.1, PD-1 and interferon (IFN)-γ in lung metastases. This change appears to be initiated by the type I IFN produced by liver macrophages that contain the internalized STING-LNPs, leading to the systemic activation of NK cells that express PD-1. The activated NK cells appeared to produce IFN-γ, resulting in an increase in the expression of the PD ligand 1 (PD-L1) in cancer cells, thus leading to a synergistic antitumor effect when anti-PD-1 is administered.ConclusionsWe provide a demonstration to show that a STING-LNP treatment can overcome PD-1 resistance in a B16-F10 lung metastasis model. The mechanism responsible for this indicates that NK cells are activated by stimulating the STING pathway which, in turn, induced the expression of PD-L1 on cancer cells. Based on the findings reported herein, the STING-LNP represents a promising candidate for use in combination therapy with anti-PD-1-resistant tumors.
Abstract 447: Deep Transcriptomic Analysis of Human Vascular Cells Identifies Risk Genes for Common Vascular Diseases
Authors: Nurnberg Sylvia T , Park YoSon , Vaquero-Garcia Jordi , Pjanic Milos , Elwyn Susanna , Pluta John , Zhao Wei , Testa Stephanie , Barash Yoseph , Brown Christopher , Quertermous Thomas , Rader Daniel 
Published: July 2021

The most recent Genome-wide Association Study (GWAS) meta-analysis has reported a total of 58 genomic loci to be statistically significantly associated with genetic susceptibility to Coronary Artery Disease (CAD) (Consortium, 2015). Many of these loci also associate with other phenotypes, with the majority being lipid traits (Tada et al., 2014). But also hypertension, stroke (Dichgans et al., 2014) and migraine (Pickrell et al., 2016) appear to share genetic determinants with CAD.
To functionally annotate the genomic loci harboring these association SNPs we sequenced the transcriptomes of 20 same donor human coronary artery endothelial (EC) and smooth muscle cell (SMC) lines. Deep RNA-Sequencing was used to assess Differential Gene Expression, Differential Splicing and Allele-Specific Expression. Focusing on GWAS loci for vascular phenotypes (CAD, stroke, migraine) we identified genes which display allele-specific differences in mRNA expression or splicing. We propose these genes as suitable targets for follow up studies.
Consortium, C.A.D. (2015). A comprehensive 1000 Genomes-based genome-wide association meta-analysis of coronary artery disease. Nature genetics 47, 1121-1130.
Tada, H., Won, H.H., Melander, O., Yang, J., Peloso, G.M., and Kathiresan, S. (2014). Multiple associated variants increase the heritability explained for plasma lipids and coronary artery disease. Circulation Cardiovascular genetics 7, 583-587.
Dichgans, M., Malik, R., Konig, I.R., Rosand, J., Clarke, R., Gretarsdottir, S., Thorleifsson, G., Mitchell, B.D., Assimes, T.L., Levi, C., et al. (2014). Shared genetic susceptibility to ischemic stroke and coronary artery disease: a genome-wide analysis of common variants. Stroke; a journal of cerebral circulation 45, 24-36.
Pickrell, J.K., Berisa, T., Liu, J.Z., Segurel, L., Tung, J.Y., and Hinds, D.A. (2016). Detection and interpretation of shared genetic influences on 42 human traits. Nature genetics 48, 709-717.
Abstract 568: Lipidomic Comparison of Hyperglycemic and Normal Subjects Using Absolute Quantitation of >700 Lipid Species
Authors: Rees Jon , Kuklenyik Susan , Gardner Michael , Schieltz David , Parks Bryan A , Jones Jeffrey , Toth Christopher , McWilliams Lisa , Andrews Michael , Barr John R 
Published: July 2021

The presence of diabetes mellitus in patients significantly increases the risk of cardiovascular disease, among many negative health outcomes. Several research groups have reported lipid species anomalies in subjects showing insulin resistance, including higher concentrations of sphingomyelin species relative to normal controls. Advances in lipidomic methodologies has allowed for the profiling of numerous lipid species in a single extraction and analytical run. We used the SCIEX Lipidyzer platform to determine the absolute concentration of 770 distinct lipid species from 52 subjects categorized into hyperglycemic (n=30) and normal subjects (n=22). Lipid species were determined from the following classes: cholesterol esters (CE), ceramides (CER), diacylglycerols (DAG), dihydroceramide (DCER), free fatty acids (FFA), hexosylceramides (HCER), lactosylceramides (LCER), lysophosphatidylcholines (LPC), lysophosphatidylethanolamines (LPE), phosphatidylcholines (PC), phosphatidylethanolamines (LPE), sphingomyelins (SM), and triacylglycerols (TAG).
After normalizing by the sum of total apolipoprotein A and apolipoprotein B (to account for the possibility of reduced particle number due to medicinal intervention), lipids both by class and species were compared using one way analysis of variance. On a class level, relative to normal subjects, hyperglycemic patients showed increased levels of CER and FFA. Individual lipid species of these classes that were higher in hyperglycemic patients include CER(18:0), CER(20:0), CER(24:1), FFA(16:0), FFA(16:1), FFA(18:0), FFA(18:1), FFA(18:2), FFA(18:3), and FFA(20:3) Differences were also found in SM concentrations between hyperglycemic and normal patients resulting in a higher the SM/PC ratio, indicating changes in the lipid fluidity of the shell in lipoprotein particles of hyperglycemic patients. On a species level, SM(16:0), SM(18:1), and SM(24.1), were elevated in hyperglycemic subjects relative to normal subjects. This finding of elevated unsaturated SM species in hyperglycemic patients is at odds with other studies where it was found that the saturated SM moieties were elevated in insulin resistant subjects.
Abstract 585: Mathematical Modelling of Monocytes and Monocyte-Derived Cells in Inflammation Shows Cholesterol Biomagnification as a Determinant of Atherosclerotic Plaque Fate
Authors: Ford Hugh 
Published: July 2021

Efferocytosis recycles substances, such as cholesterol, from apoptotic monocytes and monocyte-derived macrophages (Mo/Mphi) back into the Mo/Mphi population. Without net removal, these substances will concentrate within successive generations of Mo/Mphis --- a biomagnification process seldom explored in inflammation. We propose that biomagnification of cholesterol within the Mo/Mphi population is an important feature of atherosclerotic plaque progression by gradually enhancing inflammation and necrosis over time.
We have developed a mathematical model of Mo/Mphi in inflammation where a population of Mo/Mphi is modelled with a distribution of internalised lipids in the population. We use this to explore the relationship between cholesterol accumulation and plaque fate. Although the number of Mo/Mphis in the plaque remains stable when the rates of recruitment and proliferation are balanced by apoptosis and egress, lipid dynamics (such as cholesterol bioaccumulation) within this system may change. The model can be used to investigate the conditions when lipids are and are not stably trafficked between Mo/Mphi and apoptotic Mo/Mphi. Destabilisation of lipid dynamics results in a continuous throughput of material from Mo/Mphi and apoptotic Mo/Mphi to the necrotic core. These conditions include the amount of modified LDL relative to HDL, the propensity of Mo/Mphi to replicate and to leave the plaque. Surprisingly Mo/Mphi proliferation provides a highly protective mechanism by halving accumulated cholesterol between two daughter cells and doubling the phagocytic capacity of the parent cell. Overall the technique of mathematical modelling offers novel insights into both plaque pro- and regression. We will conclude with a discussion on how the theory of biomagnification extends to all innate inflammatory systems.