bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trust your gut: Effect of a pharmacist-driven pilot project to decrease alvimopan use past gastrointestinal recovery in postsurgical patients
Authors: Shtoyko Ashley N , Cwikla Gregory M , Feldman Elizabeth A , Darko William , Miller Christopher D , Seabury Robert W 
Published: May 2021

Abstract

Purpose
Alvimopan is a peripherally acting opioid receptor antagonist indicated to accelerate gastrointestinal (GI) recovery following surgery, but its benefits past GI recovery are unknown and evidence suggests that it may increase risk for myocardial infarction. The purpose of this study was to evaluate the efficacy of a pilot alvimopan stewardship program aimed at intervening to discontinue alvimopan use following GI recovery.

Methods
This was a retrospective, observational study examining the first 5 months of the alvimopan stewardship pilot program. During this initial period, a pharmacy resident assessed whether each patient met criteria for GI recovery, defined as solid food toleration and first bowel movement or flatus. If a patient met the criteria for GI recovery, the resident intervened and recommended that the primary team discontinue alvimopan. Primary outcomes were the percentage of patients with alvimopan continued past GI recovery and the percentage of patients for whom alvimopan ordered past GI recovery was discontinued following intervention by stewardship. Secondary outcomes included the percentage of accepted recommendations to discontinue alvimopan following GI recovery and the number of alvimopan doses ordered following GI recovery.

Results
In total, 73 patients were included in the study analysis, all of whom underwent abdominal and/or urologic surgery. Alvimopan was ordered to be administered in 35.6% (26/73) of patients after GI recovery. The stewardship program intervened and recommended discontinuation on 50% (13/26) of the alvimopan doses ordered past GI recovery. Recommendations were accepted by the primary team for 92.3% (12/13) of the patients. A total of 51 doses of alvimopan were ordered for administration past GI recovery, with an average of 2 doses per patient.

Conclusion
A pilot pharmacy-driven alvimopan stewardship program was able to identify and intervene on alvimopan orders continued past GI recovery. Interventions decreasing alvimopan use past GI recovery could be of benefit by minimizing potential risk and decreasing potential costs without a negative impact on patient outcomes.
Performance of Asbestos Enclosure Ventilation: Laboratory Evaluation of Complex Configuration
Authors: Kulmala Ilpo , Linnainmaa Markku , Kokkonen Anna , Heinonen Kimmo , Kanerva Tomi , Säämänen Arto 
Published: May 2021

Abstract
The aim of the study was to find out good practices for effective air distribution inside a complex shaped asbestos enclosure and for control of pressure differences between the enclosure and the surroundings. In addition, sufficient pressure difference for asbestos containment was tested. The effect of air distribution was studied in laboratory conditions by constructing an L-shaped asbestos enclosure and connecting it to a negative pressure unit. The efficiency of six different ventilation configurations was compared using a tracer decay method and the local air change indexes as the performance indicator. The sufficient negative pressure for containment was assessed by simulating person traffic to and from the enclosure and recording the pressure difference continuously. The effect of a pressure controller unit in maintaining the target pressure difference was also tested by simulating filter loadings of the negative pressure unit causing changes in the air flow rate. The results showed that high nominal air change rates alone do not guarantee good air distribution. Effective air distribution within an asbestos enclosure can be arranged by locating additional air supply openings far away from the air exhaustion point, using recirculation air with a pressure controller, or extending the exhaust location to the poorly ventilated areas. A pressure difference of at least −10 Pa is recommended to ensure a sufficient margin of safety in practical situations.
Reproductive aging and pace-of-life syndromes: more active females age faster
Authors: Han Chang S , Yang Gawon 
Published: May 2021

Abstract
A common pattern of reproductive aging is that reproductive performance increases during early life and reaches a peak, followed by a decline with age. Such quadratic reproductive aging patterns can differ among individuals. Moreover, if individual differences in reproductive aging patterns reflect individual-specific life-history trade-off strategies, they are also predicted to be associated with behavior according to the pace-of-life syndrome. For example, more active, aggressive, or bolder individuals may invest more in early reproduction, resulting in more rapid reproductive aging. In this study, we estimated individual differences in quadratic reproductive aging patterns and the relationship between reproductive aging and the activity of the virgin female bean bug (Riptortus pedestris) in the absence of mating costs. We found that the egg production of virgin females followed a parabolic trajectory with age and that individuals varied significantly in their quadratic reproductive aging patterns. In addition, we found that females that were relatively more active during early life invested in egg production more heavily at a young age and suffered from a sharper decline in egg production later in life. Thus, our results indicate that individual reproductive aging patterns may be a key component in the study of pace-of-life syndromes. We suggest that within-individual plastic characteristics of life-history traits such as reproductive aging patterns may explain the mixed results from multiple studies on pace-of-life syndromes.
Origins of Galápagos’ land-locked vertebrates: what, whence, when, how?
Authors: Ali Jason R , Fritz Uwe 
Published: May 2021

AbstractBased on a synthesis of new molecular phylogenetic data, a detailed review is presented for the origins of the Galápagos’ native land-locked vertebrates [42 species; 11 clades: geckos (3), lava lizards (2), giant tortoises (1), iguanas (1), racer snakes (1) and oryzomyine rodents (3)]. Nine groups have roots in coastal Ecuador and Peru and would have been transported to the archipelago on rafts, many on the Humboldt Current. Inferring the sources of the giant tortoises, which probably floated over unaided, and the iguanas is more challenging because their closest living relatives occupy ground remote from the Pacific. Acknowledging uncertainties with the age-dating of both the phylogenetic tree nodes and the landmass emergences, seven, probably eight, of the colonizations likely involved beachings on the modern-day islands within the last 4 Myr. Three, possibly four, of the earlier arrivals may have been on now-submerged landmasses that were created by the Galápagos volcanic hotspot. Alternatively, the true sister taxa of the Galápagos species could be extinct and these colonizations, too, are more recent. This is likely for the giant tortoises. The assembled data set hints at the oldest/youngest clades showing the highest/lowest levels of diversification, although other factors also exert an influence.
Digital Pitfalls: The Politics of Digitalization in Bangladesh
Authors: Aziz Abdul 
Published: May 2021

Abstract
The state-led investment in digital infrastructure under the ruling party’s political agenda of “Digital Bangladesh” has given rise to scholarly and policy debates, especially around issues of digital surveillance and media censorship. Such concerns have intensified during the COVID-19 pandemic. This article analyzes contemporary Bangladesh in the context of emerging trends related to the digitalization of society. In particular, I employ the concept of “digital pitfalls” to explore the state’s use of surveillance and the politics of fear to limit freedom of expression and silence critical voices in the digital age.
Health of Asylees Compared to Refugees in the United States Using Domestic Medical Examination Data, 2014–2016: A Cross-Sectional Analysis
Authors: Kumar Gayathri S , Pezzi Clelia , Payton Colleen , Mamo Blain , Urban Kailey , Scott Kevin , Montour Jessica , Cabanting Nuny , Aguirre Jenny , Ford Rebecca , Hughes Stephen E , Kawasaki Breanna , Kennedy Lori , Jentes Emily S 
Published: May 2021

Abstract

Background
Between 2008 and 2018, persons granted asylum (asylees) increased by 168% in the United States. Asylees are eligible for many of the same domestic benefits as refugees under the US Refugee Admissions Program (USRAP), including health-related benefits such as the domestic medical examination. However, little is known about the health of asylees to guide clinical practice.

Methods
We conducted a retrospective cross-sectional analysis of domestic medical examination data from 9 US sites from 2014 to 2016. We describe and compare demographics and prevalence of several infectious diseases such as latent tuberculosis infection (LTBI), hepatitis B and C virus (HBV, HCV), and select sexually transmitted infections and parasites by refugee or asylee visa status.

Results
The leading nationalities for all asylees were China (24%) and Iraq (10%), while the leading nationalities for refugees were Burma (24%) and Iraq (19 %). Approximately 15% of asylees were diagnosed with LTBI, and 52% of asylee adults were susceptible to HBV infection. Prevalence of LTBI (prevalence ratio [PR] = 0.8), hepatitis B (0.7), hepatitis C (0.5), and Strongyloides (0.5) infections were significantly lower among asylees than refugees. Prevalence of other reported conditions did not differ by visa status.

Conclusions
Compared to refugees, asylees included in our dataset were less likely to be infected with some infectious diseases but had similar prevalence of other reported conditions. The Centers for Disease Control and Prevention’s Guidance for the US Domestic Medical Examination for Newly Arrived Refugees can also assist clinicians in the care of asylees during the routine domestic medical examination.
Outcome analysis of the Gore Conformable Thoracic Stent Graft with active control system for the treatment of arch and descending thoracic aortic disease
Authors: Böckler Dittmar , Bischoff Moritz S , Kronsteiner Dorothea , Skrypnik Denis , Meisenbacher Katrin 
Published: May 2021

Abstract

OBJECTIVES
The aim of this study was to evaluate technical/clinical outcomes of the Gore TAG Conformable Thoracic Stent Graft with Active Control System (CTAG with ACS) in thoracic aortic disease since its introduction in Europe in 2017.

METHODS
Patients undergoing thoracic endovascular aortic repair (TEVAR) with the device between 2017 and 2020 were identified from a prospectively maintained single-centre database and retrospectively analysed. Predominant indications were aortic dissection (n = 46), thoracic/thoraco-abdominal aneurysm (n = 20/n = 7), penetrating ulcer (n = 14) and intramural haematoma (n = 12). Emergency procedures were performed in 47% (54/115). The primary outcome was technical success. Secondary outcomes were clinical success, serious adverse events and procedure-related reintervention. ACS was assessed regarding angulation, accuracy and apposition. The median follow-up was 8.46 months (interquartile range: 3.18–16.89 months).

RESULTS
A total of 115 consecutive patients (82 males, median age 63; interquartile range: 53–74 years) have been included. Technical success was achieved in 95.7% (110/115). Clinical success rate was 80.9% (93/115); mostly due to procedure-related death (n = 14). Overall mortality was 19.1% (22/115), with significant differences between elective/emergency procedures (log-rank: P &lt; 0.001). Procedure-related serious adverse event rate was 44.3% (51/115). Procedure-related reintervention was performed in 20.9% (24/115). The cumulative incidence for reintervention differed significantly between elective/emergency cases (Gray’s test: P = 0.0033). Angulation was used in 40.9% of patients (47/115), mostly in type II arches (52.7%). Deployment accuracy was 87.8% (101/115). Sufficient apposition was present in 93.0% (107/115).

CONCLUSIONS
This single-centre study shows encouraging performance of the CTAG with ACS in an array of aortic pathologies. Although longer-term data must be awaited, ACS leads to overall favourable device placement. Despite ongoing advances in device technology, TEVAR remains challenging and is associated with significant burden inherent to the underlying disease.
Right ventricular function as a predictor of appropriate therapy of implantable cardioverter defibrillator
Authors: Chiba T , Kajiyama T , Sugawara M , Kitagawa M , Takahira H , Ito R , Nakano M , Nakano M , Kondo Y , Kobayashi Y 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Aim
The purpose of this study was to evaluate the association of RV function and appropriate therapy of ICD.Methods: This study was a single-center retrospective cohort study. Consecutive patients who underwent ICD implantation for any diseases were enrolled except for non-dilated phase hypertrophic cardiomyopathy and channelopathy. Transthoracic echocardiographic parameters including left ventricular ejection fraction (LVEF), RV basal diameter, RV end-diastolic area, and right ventricular fractional area change (RVFAC) were evaluated. RV systolic dysfunction was defined as RVFAC &lt;35%. Cox regression analysis was used to analyze the effects of those parameters on appropriate ICD therapy after the implantation.

Results
In total, 151 patients (60.9 ± 13.6 years, 117 males) consisting of 67 old myocardial infarction, 34 dilated cardiomyopathy, 19 cardiac sarcoidosis, and 31 others were enrolled. Eighty patients received an ICD as a secondary prophylaxis. Mean LVEF and RVFAC were 37.8 ± 13.9% and 33.2 ± 10.8%, respectively. RV systolic dysfunction was present in 86 (57.0%) patients, which was significantly associated with ICD therapy (odds ratio 2.313; 95% confidence interval 1.067-5.014; P = 0.034) according to a univariate analysis. There was no correlation between RVFAC and LVEF (correlation coefficient =0.064). Regarding the subjects LVEF &gt; 35%, RV systolic dysfunction was an independent predictor of ICD therapy in a multivariate analysis.

Conclusion
RV systolic dysfunction was independently associated with increased ICD therapy despite of relatively preserved LVEF.
Understanding Aging in Place: Home and Community Features, Perceived Age-Friendliness of Community, and Intention Toward Aging in Place
Authors: Choi Yeon Jin 
Published: May 2021

Abstract

Background and Objectives
Promoting age-friendliness of communities and supporting aging in place (AIP) are of great importance. Based on processes of belonging and agency, which suggest that person–environment interactions influence residents’ evaluations and behaviors related to the environment, this study aims to examine the interrelationship between the availability of age-friendly features, perceived age-friendliness of community, and intention toward AIP.

Research Design and Methods
This study used the 2015 AARP Age-Friendly Community Survey, which includes 66 home and neighborhood features under the 8 domains specified by the World Health Organization’s Age-Friendly Cities Guidelines. A series of regression and mediational analyses were conducted to test hypotheses.

Results
Overall, a greater availability of age-friendly features was positively associated with perceived age-friendliness of community and AIP intention. The relationship between age-friendly features and AIP intention was mediated by perceived age-friendliness of community (50.3%–96% of the total effects). When perceived age-friendliness of community was introduced to models, the direct effects of housing, outdoor spaces and buildings, and transportation domains remained significant.

Discussion and Implications
Findings suggest that a greater availability of age-friendly features influences older adults’ perception on their community, leading to the development of a desire to age in place, supporting processes of belonging and agency. Domains of housing, outdoor spaces and buildings, and transportation may be the most important features in promoting age-friendliness of community and the key determinants of AIP. Policymakers and practitioners may need to prioritize promoting an age-friendly built environment before the social environment in building age-friendly communities.
Universal Features in Panarthropod Inter-Limb Coordination during Forward Walking
Authors: Nirody Jasmine A 
Published: May 2021

Synopsis
Terrestrial animals must often negotiate heterogeneous, varying environments. Accordingly, their locomotive strategies must adapt to a wide range of terrain, as well as to a range of speeds to accomplish different behavioral goals. Studies in Drosophila have found that inter-leg coordination patterns (ICPs) vary smoothly with walking speed, rather than switching between distinct gaits as in vertebrates (e.g., horses transitioning between trotting and galloping). Such a continuum of stepping patterns implies that separate neural controllers are not necessary for each observed ICP. Furthermore, the spectrum of Drosophila stepping patterns includes all canonical coordination patterns observed during forward walking in insects. This raises the exciting possibility that the controller in Drosophila is common to all insects, and perhaps more generally to panarthropod walkers. Here, we survey and collate data on leg kinematics and inter-leg coordination relationships during forward walking in a range of arthropod species, as well as include data from a recent behavioral investigation into the tardigrade Hypsibius exemplaris. Using this comparative dataset, we point to several functional and morphological features that are shared among panarthropods. The goal of the framework presented in this review is to emphasize the importance of comparative functional and morphological analyses in understanding the origins and diversification of walking in Panarthropoda.
Introduction
The Dendrite Arbor of Purkinje Cells Is Altered Following to Tail Regeneration in the Leopard Gecko
Authors: Bradley Stefanie S , Howe Erika , Bailey Craig D C , Vickaryous Matthew K 
Published: May 2021

Abstract
Purkinje cells of the cerebellum have a complex arborized arrangement of dendrites and are among the most distinctive cell types of the nervous system. Although the neuromorphology of Purkinje cells has been well described for some mammals and teleost fish, for most vertebrates less is known. Here we used a modified Golgi–Cox method to investigate the neuromorphology of Purkinje cells from the lizard Eublepharis macularius, the leopard gecko. Using Sholl and Branch Structure Analyses, we sought to investigate whether the neuromorphology of gecko Purkinje cells was altered in response to tail loss and regeneration. Tail loss is an evolved mechanism commonly used by geckos to escape predation. Loss of the tail represents a significant and sudden change in body length and mass, which is only partially recovered as the tail is regenerated. We predicted that tail loss and regeneration would induce a quantifiable change in Purkinje cell dendrite arborization. Post hoc comparisons of Sholl analyses data showed that geckos with regenerated tails have significant changes in dendrite diameter and the number of dendrite intersections in regions corresponding to the position of parallel fiber synapses. We propose that the neuromorphological alterations observed in gecko Purkinje cells represent a compensatory response to tail regrowth, and perhaps a role in motor learning.
Dual antiplatelet therapy is under-prescribed in patients with surgically treated acute myocardial infarction
Authors: Roberto Marco , Radovanovic Dragana , Buttà Carmelo , Tersalvi Gregorio , Krüll Joël , Erne Paul , Rickli Hans , Pedrazzini Giovanni Battista , Moccetti Marco 
Published: May 2021

Abstract

OBJECTIVES
Despite guideline recommendations, previous reports, coming mainly from outside Europe, showed low rates of prescriptions for dual antiplatelet therapy (DAPT) in patients with acute myocardial infarction (AMI) undergoing surgical revascularization. The present study assesses this issue in the era of potent P2Y12 inhibitors in Switzerland.

METHODS
All patients with a diagnosis of AMI included in the Acute Myocardial Infarction in Switzerland Plus Registry from January 2014 to December 2019 were screened; 9050 patients undergoing either percutaneous (8727, 96.5%) or surgical (323, 3.5%) revascularization were included in the analysis.

RESULTS
Surgically treated patients were significantly less likely to receive DAPT at discharge (56.3% vs 96.7%; P &lt; 0.001). Even when discharged with a prescription for DAPT, those patients were significantly less likely to receive a regimen containing a new P2Y12 inhibitor (67/182 [36.8%] vs 6945/8440 [83.2%]; P &lt; 0.001). At multivariate analysis, surgical revascularization was independently associated with a lower likelihood of receiving a prescription for DAPT at discharge (odds ratio 0.03, 95% confidence interval 0.02–0.06).

CONCLUSIONS
DAPT prescriptions for patients with AMI undergoing surgical revascularization are not in line with current guideline recommendations. Efforts are necessary to clarify the role of DAPT for secondary prevention in these patients and increase the confidence of treating physicians in guideline recommendations.

Clinical trial registration
Acute Myocardial Infarction in Switzerland Plus Registry; registration number at ClinicalTrials.gov: NCT01305785.
Excess all-cause mortality and COVID-19-related mortality: a temporal analysis in 22 countries, from January until August 2020
Authors: Achilleos Souzana , Quattrocchi Annalisa , Gabel John , Heraclides Alexandros , Kolokotroni Ourania , Constantinou Constantina , Pagola Ugarte Maider , Nicolaou Nicoletta , Rodriguez-Llanes Jose Manuel , Bennett Catherine Marie , Bogatyreva Ekaterina , Schernhammer Eva , Zimmermann Claudia , Costa Antonio Jose Leal , Lobato Jackeline Christiane Pinto , Fernandes Ngibo Mubeta , Semedo-Aguiar Ana Paula , Jaramillo Ramirez Gloria Isabel , Martin Garzon Oscar Dario , Mortensen Laust Hvas , Critchley Julia A , Goldsmith Lucy P , Denissov Gleb , Rüütel Kristi , Le Meur Nolwenn , Kandelaki Levan , Tsiklauri Shorena , O’Donnell Joan , Oza Ajay , Kaufman Zalman , Zucker Inbar , Ambrosio Giuseppe , Stracci Fabrizio , Hagen Terje P , Erzen Ivan , Klepac Petra , Arcos González Pedro , Fernández Camporro Ángel , Burström Bo , Pidmurniak Nataliia , Verstiuk Olesia , Huang Qian , Mehta Neil Kishor , Polemitis Antonis , Charalambous Andreas , Demetriou Christiana A 
Published: May 2021

Abstract

Background
This study aimed to investigate overall and sex-specific excess all-cause mortality since the inception of the COVID-19 pandemic until August 2020 among 22 countries.

Methods
Countries reported weekly or monthly all-cause mortality from January 2015 until the end of June or August 2020. Weekly or monthly COVID-19 deaths were reported for 2020. Excess mortality for 2020 was calculated by comparing weekly or monthly 2020 mortality (observed deaths) against a baseline mortality obtained from 2015–2019 data for the same week or month using two methods: (i) difference in observed mortality rates between 2020 and the 2015–2019 average and (ii) difference between observed and expected 2020 deaths.

Results
Brazil, France, Italy, Spain, Sweden, the UK (England, Wales, Northern Ireland and Scotland) and the USA demonstrated excess all-cause mortality, whereas Australia, Denmark and Georgia experienced a decrease in all-cause mortality. Israel, Ukraine and Ireland demonstrated sex-specific changes in all-cause mortality.

Conclusions
All-cause mortality up to August 2020 was higher than in previous years in some, but not all, participating countries. Geographical location and seasonality of each country, as well as the prompt application of high-stringency control measures, may explain the observed variability in mortality changes.