bluuebunny/crossref_metadata_2025_split huggingface dataset:
Healthcare professionals’ experiences with practice for managing disease‐related malnutrition in general practice and proposals for improvement: A qualitative study
Authors: Mikkelsen Sabina , Geisler Lea , Holst Mette 
Published: September 2021

AbstractBackground & AimDisease‐related malnutrition is prevalent in all healthcare settings, including general practice, and is associated with negative consequences for the individual and the community. The aim of this study was to investigate general practitioners and general practice nurses’ perceptions of how they manage disease‐related malnutrition, and their view on introducing an early intervention against disease‐related malnutrition.MethodsContent analysis was used to analyse individual semi‐structured interviews with the general practitioners (n = 9) and five focus group interviews with the general practice nurses (n = 21) from five general practices in Denmark.ResultsGeneral practice has no tradition for detection of disease‐related malnutrition and find that they rarely see patients with unintended weight loss. Nutritional guidance is to a low degree and only randomly performed. Furthermore, most of the health professionals do not have access to nutritional guidance material for patients and lack information about patients’ nutrition, when patients when patients receive treatment in the hospital. Suggestions for improvement were handouts with pictures and including nutritional status as a standard in the communication from hospital to general practice. An early intervention against unintended weight loss in specific groups was found feasible. Barriers and facilitators were seen as lack of time, lack of educational opportunities and skills. A financial incentive from the health authorities, and interventions adapted to the individual general practice were among suggested facilitators.ConclusionDisease‐related malnutrition was rarely recognised and managed in general practice. The health professionals found they lacked means to perform nutritional guidance to patients with unintended weight loss. However, the health professionals had suggestions for improvement for an early intervention including handouts for patients. Further research on implementation of early intervention against unintended weight loss in general practice is needed.
Clinical decision making is improved by BioFire Pneumonia Plus in suspected lower respiratory tract infection after lung transplantation: Results of the prospective DBATE‐IT* study
Authors: Kayser Moritz Z. , Seeliger Benjamin , Valtin Christina , Fuge Jan , Ziesing Stefan , Welte Tobias , Pletz Mathias W. , Chhatwal Patrick , Gottlieb Jens 
Published: September 2021

AbstractBackgroundLower respiratory tract infections (LRTIs) are a significant cause of morbidity and mortality in lung transplant (LTx) recipients. Timely and precise pathogen detection is vital to successful treatment. Multiplex PCR kits with short turnover times like the BioFire Pneumonia Plus (BFPPp) (manufactured by bioMérieux) may be a valuable addition to conventional tests.MethodsWe performed a prospective observational cohort study in 60 LTx recipients with suspected LRTI. All patients received BFPPp testing of bronchoalveolar lavage fluid in addition to conventional tests including microbiological cultures and conventional diagnostics for respiratory viruses. Primary outcome was time‐to‐test‐result; secondary outcomes included time‐to‐clinical‐decision and BFPPp test accuracy compared to conventional tests.ResultsBFPPp provided results faster than conventional tests (2.3 h [2–2.8] vs. 23.4 h [21–62], p < 0.001), allowing for faster clinical decisions (2.8 [2.2–44] vs. virology 28.1 h [23.1–70.6] and microbiology 32.6 h [4.6–70.9], both p < 0.001). Based on all available diagnostic modalities, 26 (43%) patients were diagnosed with viral LRTI, nine (15 %) with non‐viral LRTI, and five (8 %) with combined viral and non‐viral LRTI. These diagnoses were established by BFPPp in 92%, 78%, and 100%, respectively. The remaining 20 patients (33 %) received a diagnosis other than LRTI. Preliminary therapies based on BFPPp results were upheld in 90% of cases. There were six treatment modifications based on pathogen‐isolation by conventional testing missed by BFPPp, including three due to fungal pathogens not covered by the BFPPp.ConclusionBFPPp offered faster test results compared to conventional tests with good concordance. The absence of fungal pathogens from the panel is a potential weakness in a severely immunosuppressed population.
Population growth rates of weed species in response to herbicide programme intensity and their impact on weed community
Authors: Oreja Fernando H. , Inman Matthew D. , Jordan David L. , Leon Ramon G. 
Published: September 2021

AbstractThe adoption of dicamba‐tolerant crops has reduced the challenge of controlling glyphosate‐resistantAmaranthus palmeriin these crops. However, introducing herbicide programmes with new mechanisms of action and different intensities can favour major shifts in weed communities. This can affect not only the functionality of the agroecosystem, but also resource availability to the most problematic species. The objectives of this work were to evaluate how herbicide programme structure and intensity affect (a) weed diversity, (b) population growth rate (λ) of weed species and (c) weed community structure based on λ dynamics in a dicamba‐tolerant cotton monoculture. To achieve these objectives, a cotton field experiment was established to compare four herbicide programmes from 2011 to 2018. The herbicide programmes differed in the first 4 years (i.e. glyphosate every year, alternating glyphosate and glyphosate plus dicamba every other year, glyphosate plus dicamba every year, and residual herbicide and glyphosate plus dicamba every year). During the last 4 years, all programmes received glyphosate plus dicamba. The weed seedbank was evaluated every spring and λ calculated. Environmental variation from year to year was more important in determining weed richness than herbicide programmes, which exhibited similar richness across all treatments during the eight years of the study. Regardless of herbicide programme, most species maintained λ between zero and one. Only a few species were the exception with λ values above one, such asA.palmeri,Mollugo verticillataandEleusine indica. Although glyphosate plus dicamba reduced λ for several species, this herbicide mix was less effective in reducing λ for other weeds compared with glyphosate alone, suggesting a potential antagonism that could change weed community composition. The limited changes in λ for most species suggest the capacity of weeds to adjust reproduction and survival to overcome changes in mortality rates caused by increases in herbicide use intensity.
Mechanical ventilation in COVID‐19: A physiological perspective
Authors: Cronin John N. , Camporota Luigi , Formenti Federico 
Published: September 2021

New Findings

What is the topic of this review?
This review presents the fundamental concepts of respiratory physiology and pathophysiology, with particular reference to lung mechanics and the pulmonary phenotype associated with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection and subsequent coronavirus disease 2019 (COVID‐19) pneumonia.

What advances does it highlight?
The review provides a critical summary of the main physiological aspects to be considered for safe and effective mechanical ventilation in patients with severe COVID‐19 in the intensive care unit.

AbstractSevere respiratory failure from coronavirus disease 2019 (COVID‐19) pneumonia not responding to non‐invasive respiratory support requires mechanical ventilation. Although ventilation can be a life‐saving therapy, it can cause further lung injury if airway pressure and flow and their timing are not tailored to the respiratory system mechanics of the individual patient. The pathophysiology of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection can lead to a pattern of lung injury in patients with severe COVID‐19 pneumonia typically associated with two distinct phenotypes, along a temporal and pathophysiological continuum, characterized by different levels of elastance, ventilation‐to‐perfusion ratio, right‐to‐left shunt, lung weight and recruitability. Understanding the underlying pathophysiology, duration of symptoms, radiological characteristics and lung mechanics at the individual patient level is crucial for the appropriate choice of mechanical ventilation settings to optimize gas exchange and prevent further lung injury. By critical analysis of the literature, we propose fundamental physiological and mechanical criteria for the selection of ventilation settings for COVID‐19 patients in intensive care units. In particular, the choice of tidal volume should be based on obtaining a driving pressure < 14 cmH2O, ensuring the avoidance of hypoventilation in patients with preserved compliance and of excessive strain in patients with smaller lung volumes and lower lung compliance. The level of positive end‐expiratory pressure (PEEP) should be informed by the measurement of the potential for lung recruitability, where patients with greater recruitability potential may benefit from higher PEEP levels. Prone positioning is often beneficial and should be considered early. The rationale for the proposed mechanical ventilation settings criteria is presented and discussed.
Factores que facilitan y dificultan los procesos de reintegración de excombatientes y sus familias
Authors: Giovanni Irene , Durán Alicia del Socorro , Aponte Diego Mauricio , Laverde Diana Janneth 
Published: September 2021

El presente artículo se propone como objetivo describir factores que facilitan y dificultan los procesos de reintegración de excombatientes desmovilizados de Grupos Armados Organizados (GAO) en Colombia, al igual que los de sus familias, vinculados a la Agencia Colombiana para la Reincorporación y Normalización (ARN), con el fin de generar información que permita ampliar la comprensión de sus características y necesidades, dadas las complejidades del conflicto armado del que provienen. Esta es una investigación cualitativa que utilizó el método de teoría fundamentada. Dentro de los resultados más significativos se encontraron la necesidad de acompañar procesos de crianza para evitar la repetición de patrones intergeneracionales violentos, así como la importancia de fortalecer procesos comunicacionales dentro del sistema familiar. Así mismo, se hizo evidente lo fundamental de abordar la sensación de estigmatización y desarraigo de los excombatientes y sus familias durante todo el proceso de reintegración. Finalmente, la investigación resaltó la necesidad del trabajo con las comunidades receptoras, pues estas son un elemento esencial para el proceso de ajuste de los excombatientes y sus familias y la necesidad de construir el sentido de la reintegración con sus participantes.
Task-Level Dexterous Manipulation With Multifingered Hand Under Modeling Uncertainties
Authors: Caldas Alex , Grossard Mathieu , Makarov Maria , Rodriguez-Ayerbe Pedro 
Published: September 2021

Abstract
This article presents an approach to efficiently control grippers/multifingered hands for dexterous manipulation according to a task, i.e., a predefined trajectory in the object space. The object motion is decomposed using a basis of predefined object motions equivalent to object-level coordinate couplings and leading to the definition of the task-level space. In the proposed approach, the decomposition of the motion in the task space is associated with a robust control design based on linear matrix inequalities (LMIs) and bilinear matrix inequalities (BMIs). Eigenvalue placement ensures the robustness of the system to geometric uncertainties and eigenvector placement decouples the system according to task specifications. A practical evaluation of the proposed control strategy is provided with a two-fingers' and six degrees-of-freedom robotic system manipulating an object in the horizontal plane. Results show a better trajectory tracking and the robustness of the control law according to geometric uncertainties and the manipulation of various objects.
Hip Abductor Rate of Torque Development as Opposed to Isometric Strength Predicts Peak Knee Valgus During Landing: Implications for Anterior Cruciate Ligament Injury
Authors: Stearns-Reider Kristen M. , Straub Rachel K. , Powers Christopher M. 
Published: September 2021

Peak knee valgus has been shown to predict anterior cruciate ligament injury. The purpose of the current study was to compare peak rate of torque development (RTD) to peak isometric torque as a predictor of peak knee valgus during landing. Twenty-three healthy females participated. Hip abductor muscle performance was quantified using 2 types of isometric contractions: sustained and rapid. Peak isometric torque was calculated from the sustained isometric contraction. Peak RTD was calculated from the rapid isometric contraction (0–50 and 0–200 ms after force initiation). Kinematic data were collected during the deceleration phase of a double-leg drop jump task. Linear regression was used to assess the ability of hip abductor muscle performance variables to predict peak knee valgus. Increased peak RTD during the 0 to 50 milliseconds window after force initiation was found to significantly predict lower peak knee valgus (P = .011, R2 = .32). In contrast, neither peak RTD from 0 to 200 milliseconds after force initiation window (P = .45, R2 = .03) nor peak isometric torque (P = .49, R2 = .03) predicted peak knee valgus. The inability of the hip abductors to rapidly generate muscular force may be more indicative of “at-risk” movement behavior in females than measures of maximum strength.
Propagating uplift controls on high-elevation, low-relief landscape formation in the southeast Tibetan Plateau
Authors: Yuan X.P. , Huppert K.L. , Braun J. , Shen X. , Liu-Zeng J. , Guerit L. , Wolf S.G. , Zhang J.F. , Jolivet M. 
Published: September 2021

AbstractHigh-elevation, low-relief surfaces are widespread in many mountain belts. However, the origin of these surfaces has long been debated. In particular, the southeast Tibetan Plateau has extensive low-relief surfaces perched above deep valleys and in the headwaters of three of the world's largest rivers (Salween, Mekong, and Yangtze Rivers). Various geologic data and geodynamic models show that many mountain belts grow first to a certain height and then laterally in an outward propagation sequence. By translating this information into a kinematic propagating uplift function in a landscape evolution model, we propose that the high-elevation, low-relief surfaces in the southeast Tibetan Plateau are simply a consequence of mountain growth and do not require a special process to form. The propagating uplift forms an elongated river network geometry with broad high-elevation, low-relief headwaters and interfluves that persist for tens of millions of years, consistent with the observed geochronology. We suggest that the low-relief interfluves can be long-lived because they lack the drainage networks necessary to keep pace with the rapid incision of the large main-stem rivers. The propagating uplift also produces spatial and temporal exhumation patterns and river profile morphologies that match observations. Our modeling therefore reconciles geomorphic observations with geodynamic models of uplift of the southeast Tibetan Plateau, and it provides a simple mechanism to explain the low-relief surfaces observed in several mountain belts on Earth.
Activity of Energy and Carbohydrate Metabolism Enzymes in the Juvenile Pink Salmon Oncorhynchus gorbuscha (Walb.) during the Transition from Freshwater to a Marine Environment
Authors: Churova M. V. , Shulgina N. S. , Krupnova M. Yu. , Efremov D. A. , Nemova N. N. 
Published: September 2021

AbstractBiochemical adaptations of energy metabolism and some pathways of glucose oxidation during a change in salinity of the environment in larvae and smolts of the pink salmonOncorhynchus gorbuscha(Walb.) inhabiting the White Sea were studied. We assayed the activity of energy and carbohydrate metabolism enzymes (cytochromecoxidase (COХ), lactate dehydrogenase (LDH), glucose-6-phosphate dehydrogenase (G6PDH), 1-glycerophosphate dehydrogenase (1-GPDH), and aldolase) in pink salmon larvae in a short-term aquarium experiment and in pink salmon smolts in a long-term cage experiment simulating the transition of juveniles from freshwater to a marine environment. A decrease in the activity of COX, LDH, 1‑GPDH, and aldolase already in the first hour after the transfer of larvae to seawater was shown. Smolts kept in the estuary and in the sea had low levels of activity of 1-GPDH and aldolase in comparison with individuals from the river. Most likely, in the salmon juveniles studied, there was a redistribution of carbohydrates between the reactions of aerobic and anaerobic metabolism in favor of anaerobic ATP synthesis. No changes in the enzyme activity of the pentose phosphate pathway, G-6-PDH, were found in either larvae or smolts compared with the individuals kept in freshwater. Maintenance of the required levels of anaerobic metabolism and of the pentose phosphate pathway is probably one of the mechanisms of biochemical adaptation of pink salmon to changes in salinity.
Patient and caregiver factors in ambulatory incident reports: a mixed-methods analysis
Authors: Sharma Anjana E , Huang Beatrice ,   Stakeholder Research Advisory Council, Del Rosario Jan Bing , Yang Janine , Boscardin W John , Sarkar Urmimala 
Published: September 2021

ObjectivesPatients and caregivers are the primary stakeholders in ambulatory safety, given they perform daily chronic disease self-management, medication administration and outpatient follow-up. However, little attention has been given to their role in adverse events. We identified themes related to patient and caregiver factors and challenges in ambulatory safety incident reports from a Patient Safety Organization.MethodsWe conducted a mixed-methods analysis of ambulatory incident reports submitted to the Collaborative Healthcare Patient Safety Organization, including 450 hospitals or clinic members in 13 US states. We included events that had patient and/or caregiver behavioural, socioeconomic and clinical factors that may have contributed to the event. Two members of the team independently coded patient/caregiver factors, with dual coding of 20% of events. We then conducted a ‘frequent item set’ analysis to identify which factors most frequently co-occurred. We applied inductive analysis to the most frequent sets to interpret themes. Our team included a diverse stakeholder advisory council of patients, caregivers and healthcare staff.ResultsWe analysed 522 incident reports and excluded 73 for a final sample of 449 events. Our co-occurrence analysis found the following three themes: (1) clinical advice may conflict with patient priorities; (2) breakdowns in communication and patient education cause medication adverse events and (3) patients with disabilities are vulnerable to the external environment.ConclusionsAmbulatory safety reports capture both structural and behavioural factors contributing to adverse events. Actionable takeaways include the following: improving clinician counselling of patients to convey medical advice to elicit priorities, enhanced education regarding medication adverse events and expanding safety precautions for patients with disabilities at home. Ambulatory safety reporting must include patients in reporting and event review for better mitigation of future harm.
COVID-19 is associated with distinct myopathic features in the diaphragm of critically ill patients
Authors: Shi Zhonghua , Bogaards Sylvia J P , Conijn Stefan , Onderwater Yeszamin , Espinosa Pedro , Bink Diewertje I , van den Berg Marloes , van de Locht Martijn , Bugiani Marianna , van der Hoeven Hans , Boon Reinier A , Heunks Leo , Ottenheijm Coen A C 
Published: September 2021

IntroductionThe diaphragm is the main muscle of inspiration, and its dysfunction contributes to adverse clinical outcomes in critically ill patients. We recently reported the infiltration of SARS-CoV-2, and the development of fibrosis, in the diaphragm of critically ill patients with COVID-19. In the current study, we aimed to characterise myofiber structure in the diaphragm of critically ill patients with COVID-19.MethodsDiaphragm muscle specimens were collected during autopsy from patients who died of COVID-19 in three academic medical centres in the Netherlands in April and May 2020 (n=27). We studied diaphragm myofiber gene expression and structure and compared the findings obtained to those of deceased critically ill patients without COVID-19 (n=10).ResultsMyofibers of critically ill patients with COVID-19 showed on average larger cross-sectional area (slow-twitch myofibers: 2441±229 vs 1571±309 µm2; fast-twitch myofibers: 1966±209 vs 1225±222 µm2). Four critically ill patients with COVID-19 showed extremely large myofibers, which were splitting and contained many centralised nuclei. RNA-sequencing data revealed differentially expressed genes involved in muscle regeneration.ConclusionDiaphragm of critically ill patients with COVID-19 has distinct myopathic features compared with critically ill patients without COVID-19, which may contribute to the ongoing dyspnoea and fatigue in the patients surviving COVID-19 infection.
Prognostic value of admission high-sensitivity troponin in patients with ST-elevation myocardial infarction
Authors: Coelho-Lima Jose , Georgiopoulos Georgios , Ahmed Javed , Adil Syeda E R , Gaskin David , Bakogiannis Constantinos , Sopova Kateryna , Ahmed Fareen , Ahmed Haaris , Spray Luke , Richardson Gavin , Bagnall Alan J , Stellos Konstantinos , Stamatelopoulos Kimon , Spyridopoulos Ioakim 
Published: September 2021

Background and aimAlthough the diagnostic usefulness of high-sensitivity cardiac troponin T (hs-cTnT) is well established in ST-segment elevation myocardial infarction (STEMI), its prognostic relevance in risk stratification of patients with STEMI remains obscure. This study sought to determine the prognostic value of pre-reperfusion (admission) and post-reperfusion (12-hour) hs-cTnT in patients with STEMI treated with primary percutaneous coronary intervention (PPCI).MethodsRetrospective observational longitudinal study including consecutive patients with STEMI treated with PPCI at a university hospital in the northeast of England. hs-cTnT was measured at admission to the catheterisation laboratory and 12 hours after PPCI. Clinical, procedural and laboratory data were prospectively collected during patient hospitalisation (June 2010–December 2014). Mortality data were obtained from the UK Office of National Statistics. The study endpoints were in-hospital and overall mortality.ResultsA total of 3113 patients were included. Median follow-up was 53 months. Admission hs-cTnT >515 ng/L (fourth quartile) was independently associated with in-hospital mortality (HR=2.53 per highest to lower quartiles; 95% CI: 1.32 to 4.85; p=0.005) after multivariable adjustment for a clinical model of mortality prediction. Likewise, admission hs-cTnT >515 ng/L independently predicted overall mortality (HR=1.27 per highest to lower quartiles; 95% CI: 1.02 to 1.59; p=0.029). Admission hs-cTnT correctly reclassified risk for in-hospital death (net reclassification index (NRI)=0.588, p<0.001) and overall mortality (NRI=0.178, p=0.001). Conversely, 12-hour hs-cTnT was not independently associated with mortality.ConclusionAdmission, but not 12-hour post-reperfusion, hs-cTnT predicts mortality and improves risk stratification in the PPCI era. These results support a prognostic role for admission hs-cTnT while challenge the cost-effectiveness of routine 12-hour hs-cTnT measurements in patients with STEMI.