bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pre‐emptive remifentanil alleviates pain associated with tracheal suctioning in patients under mechanical ventilation and goal‐directed sedation: A randomized controlled feasibility trial
Authors: Deng Peng , Hao Liqun , Deng Yan , Yao Rong , Cao Yu 
Published: January 2021

AbstractAimsTo investigate the efficacy of pre‐emptive remifentanil in alleviating pain during tracheal suctioning in patients under mechanical ventilation.BackgroundGoal‐directed sedation is recommended for patients under mechanical ventilation by the current guidelines. Whether goal‐directed sedation can prevent pain during tracheal suctioning in these patients is unknown.DesignThis was a two‐centre, randomized, crossover, single‐blind trial conducted between August and October 2019.MethodsPatients under mechanical ventilation received low‐dose remifentanil, high‐dose remifentanil or placebo prior to each tracheal suctioning in a random order. The primary outcomes were evaluated using the critical‐care pain observation tool and Richmond agitation–sedation scale after tracheal suctioning. Adverse events were also documented.ResultsA total of 39 patients who underwent 117 tracheal suctions were enrolled. After the tracheal suction, changes in the critical‐care pain observation tool and Richmond agitation–sedation scale scores were significantly lower in the low‐dose and high‐dose groups than in the placebo group (P < 0.001). A non‐significant increase in the absence of spontaneous breathing was observed in the high‐dose group compared to that in the placebo group.ConclusionA pre‐emptive remifentanil bolus of 0.5 μg/kg can mitigate the pain associated with tracheal suctioning.
Migrant health professionals’ systemic human rights vulnerabilities
Authors: Breakey Hugh , Ransome William , Sampford Charles 
Published: January 2021

AbstractThis article investigates whether the methods by which states implement citizens’ human rights possess serious weaknesses for ensuring migrant health professionals’ rights. Stemming from the discipline of normative philosophy, the moral approach to human rights sees rights as implemented through multiple waves of duties delivered by state‐managed integrity systems. We argue that this otherwise comparatively reliable method can fail to deliver adequate outcomes to migrant health professionals. These professionals can encounter problems stemming from the following: their lack of political priority as non‐citizens; the challenges to effective monitoring of migrant health professional pathways and outcomes; the incapacity of federal lawmakers to impact on key policy levers; the ever‐present threat of “pathways to nowhere”; and state‐enabled employee exploitation. The findings provide a philosophically grounded foundation for acknowledging the human rights concerns of even high‐skilled migrants, and show why special regimes for rights protection, facilitation and monitoring are necessary for migrant health professionals.
The evolutionary history of sedges (Cyperaceae) in Madagascar
Authors: Larridon Isabel , Spalink Daniel , Jiménez‐Mejías Pedro , Márquez‐Corro José Ignacio , Martín‐Bravo Santiago , Muasya Muthama , Escudero Marcial 
Published: January 2021

AbstractAimMadagascar is renowned for its unparalleled biodiversity and endemism. With many ecosystems under threat, research is urgently needed on its unique plant diversity. This applies both to Madagascar's forests and treeless vegetation types. Sedges (Cyperaceae) are among the top 10 species‐richest angiosperm families in Madagascar (310 native species, 38% endemic), of which two‐thirds occur in open habitats. We aimed to infer the evolutionary history of sedges in Madagascar, by estimating the number, age and origins of endemic lineages, and how they diversified on the island. We tested contrasting hypotheses of (a) few colonizations but important in situ radiations against (b) a high number of anagenetic colonizations.LocationMadagascar and the surrounding Indian Ocean islands, integrated within a global dataset.TaxonSedge family Cyperaceae.MethodsWe estimated time‐calibrated molecular phylogenies encompassing a large proportion of Madagascar's known sedge flora (incl. 55% of native species), integrating sequence data for 1,382 accessions representing almost 25% of the c. 5,600 sedge species worldwide, combined with ancestral area reconstruction, diversification analyses and Bayesian stochastic mapping.ResultsCyperaceae lineages arrived in Madagascar from c. 40 Mya with many arriving more recently. About 20 endemic lineages of Cyperaceae occur on the island, of which only six encompass more than five species. All except one of the endemic lineages that diversified in Madagascar use the C3 photosynthetic pathway. The main biogeographical links of Madagascar's sedge flora are to Southern and Tropical Africa.Main conclusionsThe biogeographical history of Cyperaceae in Madagascar is a chronicle of relatively recent multiple in and out processes of long‐distance dispersal colonizations constrained by distance. Also, the Madagascar region is not only a ‘sink’ for immigrant taxa, in situ diversification and dispersal to other regions also occurred. Some of the most diverse endemic lineages show clear adaptation to local environments.
Food Insecurity Among Older Adults: 10‐Year National Trends and Associations with Diet Quality
Authors: Leung Cindy W. , Wolfson Julia A. 
Published: January 2021

Background/ObjectivesFood insecurity has emerged as a critical health issue for older adults. Food insecurity has been shown to disrupt healthy eating patterns, but these associations have not been widely studied among older adults. The objectives of the present study were to: (1) examine national trends in food insecurity across a 10‐year period, and (2) evaluate the associations between food insecurity and multiple diet quality indices in a recent and nationally representative sample of adults aged 60 or older.DesignCross‐sectional analysis of the 2007–2016 National Health and Nutrition Examination Surveys.SettingNationally representative sample of the United States.ParticipantsThe analytic sample was comprised of 5,097 adults aged 60 or older, with household incomes at or below 300% of the federal poverty level.MeasurementsHousehold food security was measured using the 18‐item US Household Food Security Survey Module. Diet was assessed using two 24‐hour dietary recalls. Multivariate linear and logistic regression models examined the associations between household food security and three evidence‐based diet quality indices, adjusting for sociodemographic and health characteristics.ResultsAcross the 10‐year period, food insecurity increased significantly from 5.5% to 12.4% among older adults; this increase was more pronounced among lower‐income older adults. From the linear regression models, food insecurity was associated with lower scores on the Healthy Eating Index (β = −1.90, 95% confidence interval (CI) = −3.70, −0.09), the Alternate Healthy Eating Index‐2010 (β = −1.47, 95% CI = −2.51, −0.44), and the Mediterranean Diet Score (β = −0.54, 95% CI = −1.06, −0.01) after multivariate adjustment. Further adjustment for the presence of chronic medical conditions did not attenuate these results.ConclusionFood insecurity is associated with lower overall diet quality among older adults, supporting the need for clinical efforts to identify those at risk of food insecurity and public health efforts to alleviate food insecurity and promote healthy eating behaviors among older adults.
Intrapartum fetal heart rate patterns and perinatal outcome in chorioamnionitis at or beyond 34 weeks of gestation
Authors: Muraoka Junsuke , Kodama Yuki , Ohashi Masanao , Goto Tomoko , Sameshima Hiroshi 
Published: January 2021

AbstractAimTo investigate intrapartum fetal heart rate (FHR) patterns in women with chorioamnionitis at or beyond 34 weeks of gestation in relation to neonatal outcome and to compare clinical and subclinical chorioamnionitis.MethodsA retrospective questionnaire survey on deliveries during 2015 was conducted by the Perinatology Committee of the Japan Society of Obstetrics and Gynecology from 2016 to 2018. A total of 498 singleton births complicated by chorioamnionitis delivered at ≥34 weeks of gestation without major congenital malformations were included. The subjects were divided into clinical and subclinical chorioamnionitis groups based on Lencki's criteria. Poor perinatal outcome was defined as death or brain damage. We analyzed clinical features, FHR patterns in the last 2 h before delivery, gestational age, birthweight, Apgar score, umbilical arterial blood gas analysis, and infant's outcome.ResultsIncidence of chorioamnionitis at ≥34 weeks of gestation was 0.59% (522/87827). Clinical and subclinical chorioamnionitis comprised 240 and 258 cases, respectively. Abnormal FHR patterns (late deceleration or decreased baseline variability) were significantly associated with poor perinatal outcome. Combined late deceleration and decreased variability showed low positive predictive value (12.8%) and high negative predictive value (99.5%), and was significantly associated with long‐term poor outcome in clinical chorioamnionitis only (odds ratio: 29.4, p < 0.01). Poor perinatal outcome showed no significant difference between the clinical and subclinical chorioamnionitis groups.ConclusionsCombined late deceleration and decreased variability could predict poor perinatal outcome in clinical chorioamnionitis. Poor perinatal outcome occurred in infants born to mothers with clinical and subclinical chorioamnionitis.
Prevalence and 6‐month recovery of olfactory dysfunction: a multicentre study of 1363 COVID‐19 patients
Authors: Lechien J. R. , Chiesa‐Estomba C. M. , Beckers E. , Mustin V. , Ducarme M. , Journe F. , Marchant A. , Jouffe L. , Barillari M. R. , Cammaroto G. , Circiu M. P. , Hans S. , Saussez S. 
Published: January 2021

AbstractObjectiveTo investigate prevalence and recovery of olfactory dysfunction (OD) in COVID‐19 patients according to the disease severity.MethodsFrom 22 March to 3 June 2020, 2581 COVID‐19 patients were identified from 18 European hospitals. Epidemiological and clinical data were extracted at baseline and within the 2‐month post‐infection.ResultsThe prevalence of OD was significantly higher in mild form (85.9%) compared with moderate‐to‐critical forms (4.5–6.9%; P = 0.001). Of the 1916 patients with OD, 1363 completed the evaluations (71.1%). A total of 328 patients (24.1%) did not subjectively recover olfaction 60 days after the onset of the dysfunction. The mean duration of self‐reported OD was 21.6 ± 17.9 days. Objective olfactory evaluations identified hyposmia/anosmia in 54.7% and 36.6% of mild and moderate‐to‐critical forms, respectively (P = 0.001). At 60 days and 6 months, 15.3% and 4.7% of anosmic/hyposmic patients did not objectively recover olfaction, respectively. The higher baseline severity of objective olfactory evaluations was strongly predictive of persistent OD (P < 0.001).ConclusionOD is more prevalent in mild COVID‐19 forms than in moderate‐to‐critical forms. OD disappeared in 95% of patients regarding objective olfactory evaluations at 6 months.
Thermal Comfort in School Classes in the Era of Global Warming: A Prospective Multicenter Study
Authors: Golshan Taylor , Lande Sarah , Nickfardjam Kaitlyn , Cohensedgh Sabrina , Roitblat Yulia , Nehuliaieva Liliia , Khabie David , Stillman Ruby , Volynsky‐Lauson Anna , Mametov Kadri , Shterenshis Michael 
Published: January 2021

ABSTRACTBACKGROUNDWe investigated adolescents' feelings of thermal comfort during the educational process in various geographical locations far apart and present recommendations for the adjustment of the thermal environment in schools.METHODSThe prospective international multicenter study took place in 8 locations on different continents. The survey in the form of a questionnaire was carried out among 2800 healthy high school students. The study was divided into “cold season survey,” “warm‐season survey,” and heat wave survey.RESULTSThe statistically significant difference between the “cold season survey” score of 4.04 (discomfort) and “warm‐season survey” score of 3.47 (slight discomfort) (p = .04) indicates that students feel more thermal discomfort during winter months in all 8 locations. The heat wave survey score was 4.53 (discomfort). During the cold season, 29.24% of high school students felt themselves in full thermal comfort and 76.48% of the students felt themselves relatively comfortable (slightly cool—comfortable—slightly warm).CONCLUSIONSEven during the ongoing process of climate change, the cold season discomfort remains the main problem for students in classes. This tendency is present in different continents as a universal problem. We recommend keeping an entrance hall and classroom temperatures at different levels and to advise students about proper clothing.
Switching from entecavir to tenofovir alafenamide for chronic hepatitis B patients with low‐level viraemia
Authors: Li Zhong‐Bin , Li Le , Niu Xiao‐Xia , Chen Song‐Hai , Fu Yi‐Ming , Wang Chun‐Yan , Liu Yan , Shao Qing , Chen Guofeng , Ji Dong 
Published: January 2021

AbstractBackground and AimsAbout 20% of patients receiving nucleos(t)ide analogues treatment experienced low‐level viraemia (LLV), which is associated with progression of liver fibrosis and high risk of hepatocellular carcinoma. We aimed to evaluate the effectiveness and safety of switching from entecavir (ETV) to tenofovir alafenamide fumarate (TAF) in ETV‐treated patients with LLV.MethodsIn this prospective study, ETV‐treated patients with LLV, presented to our hospital from December 2018 to October 2019, were enrolled. Switching to TAF or continuing ETV was given. The primary effectiveness endpoint was complete virological response (CVR) at 24 weeks, and the safety endpoint was the first occurrence of any clinical adverse event during the treatment.ResultsTotally, 211 patients were recruited and propensity score matching (PSM) generated 75 patients in either TAF or ETV group. After PSM, baseline characteristics were balanced in two groups. After 24‐week treatment, the CVR and ALT normalization in TAF group were 62.7% and 47.6%, which were higher than 9.3% and 10.5% in ETV group (OR 16.4, 95% CI 6.6‐40.0, P < .001) respectively. Subgroup analysis showed that switching to TAF achieved favours CVR regardless of the status of sex, age, CHB family history, HBV DNA, HBeAg and cirrhosis, whereas alcohol consumption and diabetes mellitus might compromise the CVR of switching to TAF. Both therapies were well tolerated and had satisfying renal safety.ConclusionsFor ETV‐treated patients with LLV, switching to TAF is safe enough and superior compared with continuing ETV monotherapy regarding both virological and biochemical benefits.
Conceptual changes in ameloblastoma: Suggested re‐classification of a "veteran" tumor
Authors: Zlotogorski‐Hurvitz Ayelet , Soluk Tekkeşin Merva , Passador‐Santos Fabricio , Martins Montalli Victor Angelo , Salo Tuula , Mauramo Matti , Kats Lazar , Buchner Amos , Vered Marilena 
Published: January 2021

AbstractObjectivesThe merging of ameloblastoma (AM) with mural unicystic ameloblastoma (UAM‐M) was suggested by the 2017 WHO based on similar treatment needs. In an international multicenter study, we investigated the characteristics of their merged product (merged‐AM) and raised the possibility of unifying AM and UAM (total‐AM).Materials and methodsAM and UAM (luminal/intraluminal/mural), separate and combined, were analyzed for demographic/clinical/radiological features. ANOVA and chi‐square tests were followed by univariate and multivariate analyses, and significance was set at p < .05.ResultsThe patients’ mean age was 39.6 ± 20.3 years in merged‐AM (147 AM, 76 UAM‐M), 45.1 ± 19.4 years in AM (p = .009). Merged‐AM comprised 51.3% multilocular/48.7% unilocular tumors, AM comprised 72.5%/27.5%, respectively (p < .001). Merged‐AM was associated with impacted teeth in 30.8%, AM in 18% (p = .023). The probability of merged‐AM for multilocularity increased by 2.4% per year of age (95%CI 0.6–4.2, p = .009). Association with impacted teeth decreased by 7.9% per year of age (95%CI 1.9–14.39, p = .009). Merged‐AM did not differ from total‐AM (p > .05).ConclusionsMerged‐AM partially differed from AM, but differences appeared to diminish in an age/time‐wise manner. Merged‐AM and total‐AM were nearly indistinguishable. Therefore, AM and UAM may be considered a continuous spectrum of one type of tumor, further necessitating revision of the treatment approaches.
Clinical and pathological findings of chronic actinic dermatitis
Authors: Lin Naiyu , Huang Xiaobao , Ma Chunguang , Han Jiande 
Published: January 2021

AbstractBackgroundChronic actinic dermatitis (CAD) is a recurrent photosensitive disease occurs predominantly in elderly men on sun‐exposed areas, which seriously affect the patient's life quality. The etiology of CAD remains unknown.MethodsSixty‐six CAD patients, 66 atopic dermatitis (AD) patients, and 46 healthy people were enrolled into this study. Patient‐level data were obtained from the electronic medical record and laboratory databases. We also obtained 29 tissue samples including 16 lichenoid lesions, 7 minimal erythematous dose (MED) analysis induced lesions, and 6 normal skin samples. Histopathologic and immunohistochemical analysis were performed.ResultsIn the clinical characteristics, albumin was lower and uric acid was higher significantly in patients diagnosed as CAD. The infection rate of CAD patient after skin biopsy was considerably high (23.3%). The serum allergen test was prone to be negative in CAD patients. Lymphocytes were the dominate infiltrating cells in early and late CAD lesions, while more CD4+, CD8+, CD69+, and CD103 + cells were found in the late lesions. There is no difference in CD4+/CD8 + ratio and CD69+/CD103 + ratio among groups. More mast cells were observed in the early‐stage lesions, and more dendritic cell was observed in the late‐stage lesions.ConclusionsCAD patients have certain oxidative stress and are prone to be infected after skin biopsy. Serum allergen detection is of little significance for CAD diagnosis. Mast cells may be involved in the early process of CAD, while dendritic cells and tissue‐resident memory T cell (TRM) may be related to the chronic process of the disease.
Bayesian Semi-parametric G-computation For Causal Inference in a Cohort Study with Mnar Dropout and Death
Authors: Josefsson Maria , Daniels Michael J. 
Published: January 2021

Abstract
Causal inference with observational longitudinal data and time-varying exposures is often complicated by time-dependent confounding and attrition. The G-computation formula is one approach for estimating a causal effect in this setting. The parametric modelling approach typically used in practice relies on strong modelling assumptions for valid inference and moreover depends on an assumption of missing at random, which is not appropriate when the missingness is missing not at random (MNAR) or due to death. In this work we develop a flexible Bayesian semi-parametric G-computation approach for assessing the causal effect on the subpopulation that would survive irrespective of exposure, in a setting with MNAR dropout. The approach is to specify models for the observed data using Bayesian additive regression trees, and then, use assumptions with embedded sensitivity parameters to identify and estimate the causal effect. The proposed approach is motivated by a longitudinal cohort study on cognition, health and ageing and we apply our approach to study the effect of becoming a widow on memory. We also compare our approach to several standard methods.
Tribology of an assembly of hairs: Influence of multiscale surface chemistry and structure on sensorial tactile properties
Authors: Galliano Anthony , Fougere Maxime , Wolfram Leszek , Maibach Howard I. , Luengo Gustavo S. 
Published: January 2021

AbstractBackgroundHair fibers may be either oriented in a common direction or randomly arranged. Fiber arrangement as well as cosmetic treatment control the sensorial perception. The present study explores the respective influence of these two aspects by predicting the product performance in terms of tactile perception.Materials and MethodsFriction forces between hair swatches of different curl patterns using a finger‐like probe have been measured to better mimic real‐life hair/finger contact. Measurements of fiber alignment, hair diameter (thickness), and compression tests were performed on natural and treated swatches to assess the respective weight of these parameters.ResultsConditioned hair exhibit an adhesive behavior measured at the start of the frictional movement. Conversely, natural hair is influenced by fiber reorientation. After a few seconds, friction‐related signals stabilize. Thus, the averaged friction forces do not only depend on hair thickness, but increase with a decreased alignment of the fibers.ConclusionsIntrinsic (diameter/curliness) and external (orientation/ friction/compression) characteristics allow to define a model of "macroscopic" roughness linked to the sensorial characterization. As friction of hair swatches depends upon fiber alignment and coating, this combined approach is potentially a very useful in vitro test, as an alternative or complementary method to sensory tests.
Experiences and Strategies Influencing Older Adults to Continue Playing Walking Football
Authors: Cholerton Rachel , Quirk Helen , Breckon Jeff , Butt Joanne 
Published: January 2021

Adults aged 55+ years are most likely to be inactive, despite research suggesting that older adults experience multiple benefits when participating in physical activity and sport. Limited research focuses on long-term continuation of sport participation in this population, especially in “adapted sports” like walking football. This study explored the experiences of walking football maintenance in 55- to 75-year-old players. Semistructured interviews were conducted, with 17 older adults maintaining walking football play over 6 months. The inductive analysis revealed five higher-order themes representing maintenance influences and two higher-order themes relating to maintenance mechanisms (i.e., the conscious process by which players maintain). Influences when maintaining walking football included individual- and culture-level influences (e.g., perceived benefits of maintenance and ability acceptance). Maintenance mechanisms included cognitions and behaviors (e.g., scheduling sessions and redefining physical activity expectations). Findings highlight novel implications for policy and practice, which are important to consider when delivering walking football to older adults.