bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and clinical features of bile acid diarrhea in patients with chronic diarrhea
Authors: Costa Stefania , Gattoni Serena , Nicolardi Maria Luisa , Costetti Martina , Maimaris Stiliano , Schiepatti Annalisa , Biagi Federico 
Published: January 2021

ObjectiveBile acid diarrhea is a form of chronic diarrhea caused by excessive bile reaching the colon. Conditions involving the terminal ileum and cholecystectomy are predisposing factors but an idiopathic form of bile acid diarrhea has also been described. In this study we aimed to evaluate the prevalence of bile acid diarrhea in patients consecutively evaluated for chronic diarrhea in an Outpatient Gastroenterology Clinic.MethodsMedical records of all patients admitted for chronic diarrhea (>4 weeks) between June 2018 and April 2019 were retrospectively reviewed. Bile acid diarrhea was suspected in patients with ileal disease, cholecystectomy or post‐prandial diarrhea. Patients’ age at diagnosis, sex, presenting symptoms, results of main test and examinations, final diagnoses and date of last follow‐up visit were also collected. Exclusion of chronic diarrhea of other causes and a 6‐month clinical improvement with cholestyramine treatment confirmed the diagnosis of bile acid diarrhea.ResultsIn total, 139 patients aged 46 ± 20 years (76 women and 63 men) were included. Diarrhea due to an organic cause was diagnosed in 16 patients. A clinical response to cholestyramine persisting for more than 6 months led to a diagnosis of bile acid diarrhea in 39 (aged 52 ± 19 years) out of the remaining 123 patients with functional forms of diarrhea. Therefore, the prevalence of bile acid diarrhea was 28.1% (95% confidence interval 19.9%‐38.4%) in patients with chronic diarrhea.ConclusionsBile acid diarrhea is a very common, yet under‐recognized cause of chronic functional diarrhea. A therapeutic trial of cholestyramine is a valid diagnostic strategy.
Metabolic energy conservation for fermentative product formation
Authors: Folch Pauline L. , Bisschops Markus M.M. , Weusthuis Ruud A. 
Published: January 2021

SummaryMicrobial production of bulk chemicals and biofuels from carbohydrates competes with low‐cost fossil‐based production. To limit production costs, high titres, productivities and especially high yields are required. This necessitates metabolic networks involved in product formation to be redox‐neutral and conserve metabolic energy to sustain growth and maintenance. Here, we review the mechanisms available to conserve energy and to prevent unnecessary energy expenditure. First, an overview of ATP production in existing sugar‐based fermentation processes is presented. Substrate‐level phosphorylation (SLP) and the involved kinase reactions are described. Based on the thermodynamics of these reactions, we explore whether other kinase‐catalysed reactions can be applied for SLP. Generation of ion‐motive force is another means to conserve metabolic energy. We provide examples how its generation is supported by carbon‐carbon double bond reduction, decarboxylation and electron transfer between redox cofactors. In a wider perspective, the relationship between redox potential and energy conservation is discussed. We describe how the energy input required for coenzyme A (CoA) and CO2 binding can be reduced by applying CoA‐transferases and transcarboxylases. The transport of sugars and fermentation products may require metabolic energy input, but alternative transport systems can be used to minimize this. Finally, we show that energy contained in glycosidic bonds and the phosphate‐phosphate bond of pyrophosphate can be conserved. This review can be used as a reference to design energetically efficient microbial cell factories and enhance product yield.
A large genome with chromosome‐scale assembly sheds light on the evolutionary success of a true toad (Bufo gargarizans)
Authors: Lu Bin , Jiang Jianping , Wu Hua , Chen Xiaohong , Song Xiaowei , Liao Wenbo , Fu Jinzhong 
Published: January 2021

AbstractWe present a high‐quality genome assembly for the Asiatic toad (Bufo gargarizans) and explore the evolution of several large gene families in amphibians. With a large genome assembly size of 4.55 Gb, the chromosome‐scale assembly includes 747 scaffolds with an N50 of 539.8 Mb and 1.79% gaps. Long terminal repeats (LTRs) constitute a high proportion of the genome and their expansion is a key contributor to the inflated genome size in this species. This is very different from other small amphibian genomes, but similar to that of the enormous axolotl genome. The genome retains a large number of duplicated genes, with tandem (TD) and proximal duplications (PD) the predominant mode of duplication. A total of 122 gene families have undergone significant expansion and were mainly enriched in sensory perception of smell and bitter taste. The CYP2C subfamily, which plays an important role in metabolic detoxification, specifically expanded via TD and PD in the Asiatic toad and the cane toad (true toads). Most of Na+/K+‐ATPase genes experienced accelerated evolution along Bufonid lineages and two amino acid sites involving toad‐toxin resistance were found to experience positive selection. We also revealed a dynamic evolution of olfactory and vomeronasal receptor gene families which was likely driven by the water‐to‐land transition. The high‐quality genome of the Asiatic toad will provide a solid foundation to understand the genetic basis of its many biological processes.
Mapping forest leaf area density from multiview terrestrial lidar
Authors: Béland Martin , Kobayashi Hideki 
Published: January 2021

Abstract

Terrestrial lidar data are known to be useful for estimating the three‐dimensional (3D) distribution of leaf area in forests. This type of product holds great potential for modelling canopy reflectance and light interception to study the links between structure and function. However, little is currently known about its potential and limits in dense forests. Higher leaf area density implies that more laser pulses emitted by the ground‐based instrument are intercepted in lower canopy levels, and the implications of such occlusion effects on radiative transfer simulations are unknown. Occlusion effects can be minimized by increasing the number of locations lidar data is acquired from; how many locations are required for a forest with a given structure? This paper aims to address these knowledge gaps.

We acquired terrestrial lidar data using a very high density of scanning positions (5 m between positions) over four dense forest 60 m × 60 m plots along a structural gradient. Occlusion effects were quantified, and the 3D distribution of leaf area density was mapped using voxels (cubic volumes) for four different scan densities (one original and three downsampled). The voxel arrays were then input into a radiative transfer model to simulate bidirectional reflectance factors and vertical fraction of absorbed radiation.

We found that the summation of leaf area estimates for all voxels within the plot provided leaf area index (LAI) values close to LAI values estimated using traditional methods at each site. Occluded areas occurred mostly at the top of bottom heavy canopies. Radiative transfer simulations suggest that modelling small scale (<1 m) bidirectional reflectance factors (BRF) and light interception requires the highest scan position density used (5 m between scan positions), particularly at bottom heavy sites, and that 10 m between scan positions can be used for plot scale BRF simulations in forests with foliage density and vertical profiles similar to those tested here.

This work establishes some initial guidelines for establishing terrestrial lidar survey protocols for mapping leaf area density in forests. The leaf area density voxel arrays derived are among the most accurate plot‐level 3D characterizations of foliage arrangement produced to date.
Nursing diagnoses of the self‐perception domain in women in the puerperium
Authors: Farias Danielly Gama Lima Malheiros , Mota Maria Eduarda Wanderley , Carneiro Marília Cabral Pinheiro , de Almeida Bárbara Guedes , Pessoa Natália Ramos Costa , Frazão Cecília Maria Farias de Queiroz 
Published: January 2021

AbstractPurposeDuring puerperium, women experience changes that may be responsible for disorders in the phenomenon of self‐perception. Thus, the present study aims to analyze the nursing diagnoses of the self‐perception domain of NANDA International Taxonomy II in puerperal women.MethodsDescriptive, cross‐sectional, and quantitative study. The sample consisted of 153 women on puerperium followed in a University Hospital in a Brazilian capital. Data were collected through interviews with the application of an instrument. Data analysis was performed using descriptive and inferential statistics. The study was approved by the Research Ethics Committee (CAAE: 02849818.0. 0000.5208).FindingsThe most prevalent Nursing Diagnosis of the self‐concept class was Readiness for enhanced self‐concept, which presented statistically significant associations with two defining characteristics. The risk for situational low self‐esteem was the most prevalent Nursing Diagnosis in the Self‐esteem class and presented associations to two risk factors. The Nursing Diagnosis Disrupted body image, present in the Body Image class, showed associations with 11 significant defining characteristics.ConclusionsThe analysis of the Nursing Diagnosis of the Self‐Perception domain can assist in planning interventions directed to the specific needs of women in the puerperium.Implications for nursing practiceThis study may contribute to the development of specific interventions to the reality of the puerperal, encouraging the nursing professional to implement the Nursing Process in the clinical practice. It may also contribute to the refinement of the NANDA‐II taxonomy and the advancement of nursing research, in addition to providing safe clinical practice grounded in scientific knowledge for planning educational actions in puerperal women in order to minimize the negative perceptions experienced by them.
The swedish covid‐19 intensive care cohort: Risk factors of ICU admission and ICU mortality
Authors: Ahlström Björn , Frithiof Robert , Hultström Michael , Larsson Ing‐Marie , Strandberg Gunnar , Lipcsey Miklos 
Published: January 2021

BackgroundSeveral studies have recently addressed factors associated with severe Coronavirus disease 2019 (COVID‐19); however, some medications and comorbidities have yet to be evaluated in a large matched cohort. We therefore explored the role of relevant comorbidities and medications in relation to the risk of intensive care unit (ICU) admission and mortality.MethodsAll ICU COVID‐19 patients in Sweden until 27 May 2020 were matched to population controls on age and gender to assess the risk of ICU admission. Cases were identified, comorbidities and medications were retrieved from high‐quality registries. Three conditional logistic regression models were used for risk of ICU admission and three Cox proportional hazards models for risk of ICU mortality, one with comorbidities, one with medications and finally with both models combined, respectively.ResultsWe included 1981 patients and 7924 controls. Hypertension, type 2 diabetes mellitus, chronic renal failure, asthma, obesity, being a solid organ transplant recipient and immunosuppressant medications were independent risk factors of ICU admission and oral anticoagulants were protective. Stroke, asthma, chronic obstructive pulmonary disease and treatment with renin‐angiotensin‐aldosterone inhibitors (RAASi) were independent risk factors of ICU mortality in the pre‐specified primary analyses; treatment with statins was protective. However, after adjusting for the use of continuous renal replacement therapy, RAASi were no longer an independent risk factor.ConclusionIn our cohort oral anticoagulants were protective of ICU admission and statins was protective of ICU death. Several comorbidities and ongoing RAASi treatment were independent risk factors of ICU admission and ICU mortality.
Age‐related changes in hippocampal‐dependent synaptic plasticity and memory mediated by p75 neurotrophin receptor
Authors: Wong Lik‐Wei , Chong Yee Song , Lin Wei , Kisiswa Lilian , Sim Eunice , Ibáñez Carlos F. , Sajikumar Sreedharan 
Published: January 2021

AbstractThe plasticity mechanisms in the nervous system that are important for learning and memory are greatly impacted during aging. Notably, hippocampal‐dependent long‐term plasticity and its associative plasticity, such as synaptic tagging and capture (STC), show considerable age‐related decline. The p75 neurotrophin receptor (p75NTR) is a negative regulator of structural and functional plasticity in the brain and thus represents a potential candidate to mediate age‐related alterations. However, the mechanisms by which p75NTRaffects synaptic plasticity of aged neuronal networks and ultimately contribute to deficits in cognitive function have not been well characterized. Here, we report that mutant mice lacking the p75NTRwere resistant to age‐associated changes in long‐term plasticity, associative plasticity, and associative memory. Our study shows that p75NTRis responsible for age‐dependent disruption of hippocampal homeostatic plasticity by modulating several signaling pathways, including BDNF, MAPK, Arc, and RhoA‐ROCK2‐LIMK1‐cofilin. p75NTRmay thus represent an important therapeutic target for limiting the age‐related memory and cognitive function deficits.
CEO decision horizon and corporate R&D investments: an explanation based on managerial myopia and risk aversion
Authors: Li Yaoqin , Xu Xixiong , Zhu Yushu , Haq Mamiza 
Published: January 2021

AbstractCombining the views of managerial myopia and risk aversion, we argue that a short decision horizon could divert corporate investments away from R&D investments. We devise an industry‐adjusted measurement combining CEO’s expected tenure and age as a proxy for CEO decision horizon and find a positive relationship between the horizon and corporate R&D investments. The relationship is stronger among firms with lower industry‐level income volatility and lower firm‐level performance pressure. The results also show that CEO age is more important than CEO tenure in affecting the decision horizon. Further analyses indicate that risk aversion determines the studied relationship.
A genome‐wide association study for the number of teats in European rabbits (Oryctolagus cuniculus) identifies several candidate genes affecting this trait
Authors: Bovo S. , Schiavo G. , Utzeri V. J. , Ribani A. , Schiavitto M. , Buttazzoni L. , Negrini R. , Fontanesi L. 
Published: January 2021

SummaryIn the European rabbit (Oryctolagus cuniculus), a polytocous livestock species, the number of teats indirectly impacts the doe reproduction efficiency and, in turn, the sustainable production of rabbit meat. In this study, we carried out a genome‐wide association study (GWAS) for the total number of teats in 247 Italian White does included in the Italian White rabbit breed selection program, by applying a selective genotyping approach. Does had either 8 (n = 121) or 10 teats (n = 126). All rabbits were genotyped with the Affymetrix Axiom OrcunSNP Array. Genomic data from the two extreme groups of rabbits were also analysed with the single‐marker fixation index statistic and combined with the GWAS results. The GWAS identified 50 significant SNPs and the fixation index analysis identified a total of 20 SNPs that trespassed the 99.98th percentile threshold, 19 of which confirmed the GWAS results. The most significant SNP (P = 4.31 × 10−11) was located on OCU1, close to the NUDT2 gene, a breast carcinoma cells proliferation promoter. Another significant SNP identified as candidate gene NR6A1, which is well known to play an important role in affecting the correlated number of vertebrae in pigs. Other significant markers were close to candidate genes involved in determining body length in mice. Markers associated with increased number of teats could be included in selection programmes to speed up the improvement for this trait in rabbit lines that need to increase maternal performances.
Local anaesthetic adjuncts for peripheral regional anaesthesia: a narrative review
Authors: Desai N. , Kirkham K. R. , Albrecht E. 
Published: January 2021

SummaryModerate‐to‐severe postoperative pain persists for longer than the duration of single‐shot peripheral nerve blocks and hence continues to be a problem even with the routine use of regional anaesthesia techniques. The administration of local anaesthetic adjuncts, defined as the concomitant intravenous or perineural injection of one or more pharmacological agents, is an attractive and technically simple strategy to potentially extend the benefits of peripheral nerve blockade beyond the conventional maximum of 8–14 hours. Historical local anaesthetic adjuncts include perineural adrenaline that has been demonstrated to increase the mean duration of analgesia by as little as just over 1 hour. Of the novel local anaesthetic adjuncts, dexmedetomidine and dexamethasone have best demonstrated the capacity to considerably improve the duration of blocks. Perineural dexmedetomidine and dexamethasone increase the mean duration of analgesia by up to 6 hour and 8 hour, respectively, when combined with long‐acting local anaesthetics. The evidence for the safety of these local anaesthetic adjuncts continues to accumulate, although the findings of a neurotoxic effect with perineural dexmedetomidine during in‐vitro studies are conflicting. Neither perineural dexmedetomidine nor dexamethasone fulfils all the criteria of the ideal local anaesthetic adjunct. Dexmedetomidine is limited by side‐effects such as bradycardia, hypotension and sedation, and dexamethasone slightly increases glycaemia. In view of the concerns related to localised nerve and muscle injury and the lack of consistent evidence for the superiority of the perineural vs. systemic route of administration, we recommend the off‐label use of systemic dexamethasone as a local anaesthetic adjunct in a dose of 0.1–0.2 mg.kg−1 for all patients undergoing surgery associated with significant postoperative pain.
The role of peripheral nerve stimulation in the era of ultrasound‐guided regional anaesthesia
Authors: Gadsden J. C. 
Published: January 2021

SummaryWith the widespread use of ultrasound for localising nerves during peripheral nerve blockade, the value of electrical nerve stimulation of evoked motor responses has been questioned. Studies continue to show that, compared with nerve stimulation, ultrasound guidance alone leads to: significantly improved block success; decreased need for rescue analgesia; decreased procedural pain; and lower rates of vascular puncture. Nerve stimulation combined with ultrasound does also not appear to improve block success rates, apart from those blocks where the nerves are challenging to view, such as the obturator nerve. The role of nerve stimulation has changed in the last 15 years from a technique to locate nerves to that of an adjunct to ultrasound. Nerve stimulation can serve as a monitor against needle‐nerve contact and may be useful in avoiding nerves that are in the needle trajectory during specific ultrasound guided techniques. Nerve stimulation is also a useful adjunct in teaching novices ultrasound‐guided regional anaesthesia, especially when the position and or appearance of nerves may be variable. In this review, the changing role of nerve stimulation in contemporary regional anaesthetic practice is presented and discussed.
Incidence of accidental awareness during general anaesthesia in obstetrics: a multicentre, prospective cohort study
Authors: Odor P. M. , Bampoe S. , Lucas D. N. , Moonesinghe S. R. , Andrade J. , Pandit J. J. ,   Pan‐London Peri‐operative Audit and Research Network (PLAN), for the DREAMY Investigators Group
Published: January 2021

SummaryGeneral anaesthesia for obstetric surgery has distinct characteristics that may contribute towards a higher risk of accidental awareness during general anaesthesia. The primary aim of this study was to investigate the incidence, experience and psychological implications of unintended conscious awareness during general anaesthesia in obstetric patients. From May 2017 to August 2018, 3115 consenting patients receiving general anaesthesia for obstetric surgery in 72 hospitals in England were recruited to the study. Patients received three repetitions of standardised questioning over 30 days, with responses indicating memories during general anaesthesia that were verified using interviews and record interrogation. A total of 12 patients had certain/probable or possible awareness, an incidence of 1 in 256 (95%CI 149–500) for all obstetric surgery. The incidence was 1 in 212 (95%CI 122–417) for caesarean section surgery. Distressing experiences were reported by seven (58.3%) patients, paralysis by five (41.7%) and paralysis with pain by two (16.7%). Accidental awareness occurred during induction and emergence in nine (75%) of the patients who reported awareness. Factors associated with accidental awareness during general anaesthesia were: high BMI (25–30 kg.m‐2); low BMI (<18.5 kg.m‐2); out‐of‐hours surgery; and use of ketamine or thiopental for induction. Standardised psychological impact scores at 30 days were significantly higher in awareness patients (median (IQR [range]) 15 (2.7–52.0 [2–56]) than in patients without awareness 3 (1–9 [0–64]), p = 0.010. Four patients had a provisional diagnosis of post‐traumatic stress disorder. We conclude that direct postoperative questioning reveals high rates of accidental awareness during general anaesthesia for obstetric surgery, which has implications for anaesthetic practice, consent and follow‐up.
The Anaesthesia Case Report (ACRE) checklist: a tool to promote high‐quality reporting of cases in peri‐operative practice
Authors: Shelton C. L. , Klein A. A. , Bailey C. R. , El‐Boghdadly K. 
Published: January 2021

SummaryCase reports have fulfilled an important role in the development of anaesthesia and continue to be highly relevant to modern practice. Despite this, they are sometimes criticised for being insufficiently rigorous to meaningfully inform clinical practice or research design. Reporting checklists are a useful tool to improve rigour in research and, although case report checklists have previously been developed, no existing checklist focuses on the peri‐operative setting. In order to address the need for a case reports checklist that better accommodates peri‐operative care, we used an established tool as the basis for developing the 12‐item Anaesthesia Case Report checklist. This was refined using an iterative approach through feedback from journal editors with experience of handling case reports, patient and public involvement, and trialling its use on Anaesthesia Reports submissions. The Anaesthesia Case Report checklist differs from existing checklists by aligning with peri‐operative practice; it places less emphasis on making diagnoses and focuses on the way in which clinical challenges, for example, related to the patient’s comorbidities or operative interventions, are addressed. Adopting a standardised approach to the content of case reports presents clear benefits to authors, editors and peer reviewers through streamlining the processes involved in writing and publication. The Anaesthesia Case Report checklist provides a pragmatic framework for comprehensive and transparent reporting. We hope it will facilitate the authorship of high‐quality case reports with the potential to further improve the quality and safety of peri‐operative care.