bluuebunny/crossref_metadata_2025_split huggingface dataset:
Haemodynamic effects of a prehospital emergency anaesthesia protocol consisting of fentanyl, ketamine and rocuronium in patients with trauma: a retrospective analysis of data from a Helicopter Emergency Medical Service
Authors: ter Avest Ewoud , Ragavan Dassen , Griggs Joanne , Dias Michael , Mitchinson Sophie A , Lyon Richard 
Published: December 2021

ObjectivesPrehospital rapid sequence induction (RSI) of anaesthesia is an intervention with significant associated risk. In this study, we aimed to investigate the haemodynamic response over time of a prehospital RSI protocol of fentanyl, ketamine and rocuronium in a heterogeneous population of trauma patients.Design, setting and participantWe performed a retrospective study of all trauma patients who received a prehospital RSI for trauma by a physician staffed Helicopter Emergency Medical Service in the UK between 1 June 2018 and 1 February 2020.Primary outcome measurePrimary outcome was defined as the incidence of clinically relevant hypotensive (systolic blood pressure (SBP) or mean arterial pressure (MAP) >20% below baseline, with an absolute SBP <90 mm Hg or MAP <65 mm Hg) or hypertensive (SBP or MAP >20% above baseline) episodes in the first 10 minutes post-RSI.ResultsIn total, 322 patients were included. 204 patients (63%) received a full-dose induction of 3 μg/kg fentanyl, 2 mg/kg ketamine and 1 mg/kg rocuronium, whereas 128 patients (37%) received a reduced-dose induction. Blood pressures decreased on average 12 mm Hg (95% CI 7 to 16) in the full-dose group and 6 mm Hg (95% CI 1 to 11) in the reduced-dose group, p=0.10). A hypotensive episode (mean SBP drop 53 mm Hg) was noted in 29 patients: 17 (8.3%) receiving a full dose and 12 (10.2%) receiving a reduced-dose induction, p=0.69. The blood pressure nadir was recorded on average 6–8 min after RSI. A hypertensive episode was present in 22 patients (6.8%). The highest blood pressures were recorded in the first 3 min after RSI.ConclusionPrehospital induction of anaesthesia for trauma with fentanyl, ketamine and rocuronium is not related to a significant change in haemodynamics in most patients. However, a (delayed) hypotensive response with a significant drop in SBP should be anticipated in a minority of patients irrespective of the dose regimen chosen.
ParkinSong Online: protocol for a telehealth feasibility study of therapeutic group singing for people with Parkinson’s disease
Authors: Tamplin Jeanette , Morris Meg E , Baker Felicity A , Sousa Tanara Vieira , Haines Simon , Dunn Stephen , Tull Victoria , Vogel Adam P 
Published: December 2021

IntroductionParkinson’s disease can be associated with speech deterioration and low communication confidence which in turn compromises social interaction. Therapeutic singing is an engaging method for combatting speech decline; however, face-to-face delivery can limit access to group singing. The aim of this study is to test the feasibility and acceptability of an online mode of delivery for a Parkinson’s singing intervention (ParkinSong) as well as remote data collection procedures.Methods and analysisThis ParkinSong Online feasibility trial is a single-arm, pre–post study of online singing delivery and remote data collection for 30 people living with Parkinson’s. The primary outcome measure is feasibility: recruitment, retention, attendance, safety, intervention fidelity, acceptability and associated costs. Secondary outcomes are speech (loudness, intelligibility, quality, communication-related quality of life) and wellbeing (apathy, depression, anxiety, stress, health-related quality of life). This mode of delivery aims to increase the accessibility of singing interventions.Ethics and disseminationEthics approval was obtained from The University of Melbourne Human Research Ethics Committee (2021-14465-16053-3) and the trial has been prospectively registered. Results will be presented at national and international conferences, published in a peer-reviewed journal, and disseminated to the Parkinson’s community, researchers and policymakers.Trial registration numberACTRN12621000940875.
Cash transfer during the COVID-19 pandemic: a multicentre, randomised controlled trial
Authors: Persaud Navindra , Thorpe Kevin E , Bedard Michael , Hwang Stephen W , Pinto Andrew , Jüni Peter , da Costa Bruno R 
Published: December 2021

ObjectiveTo evaluate the effect of a one-time cash transfer of $C1000 in people who are unable to physically distance due to insufficient income.DesignOpen-label, multi-centre, randomised superiority trial.SettingSeven primary care sites in Ontario, Canada; six urban sites associated with St. Michael’s Hospital in Toronto and one in Manitoulin Island.Participants392 individuals who reported trouble affording basic necessities due to disruptions related to COVID-19.InterventionAfter random allocation, participants either received the cash transfer of $C1000 (n=196) or physical distancing guidelines alone (n=196).Main outcome measuresThe primary outcome was the maximum number of symptoms consistent with COVID-19 over 14 days. Secondary outcomes were meeting clinical criteria for COVID-19, SARS-CoV-2 presence, number of close contacts, general health and ability to afford basic necessities.ResultsThe primary outcome of number of symptoms reported by participants did not differ between groups after 2 weeks (cash transfer, mean 1.6 vs 1.9, ratio of means 0.83; 95% CI 0.56 to 1.24). There were no statistically significant effects on secondary outcomes of the meeting COVID-19 clinical criteria (7.9% vs 12.8%; risk difference −0.05; 95% CI −0.11 to 0.01), SARS-CoV-2 presence (0.5% vs 0.6%; risk difference 0.00 95% CI −0.02 to 0.02), mean number of close contacts (3.5 vs 3.7; rate ratio 1.10; 95% CI 0.83 to 1.46), general health very good or excellent (60% vs 63%; risk difference −0.03 95% CI −0.14 to 0.08) and ability to make ends meet (52% vs 51%; risk difference 0.01 95% CI −0.10 to 0.12).ConclusionsA single cash transfer did not reduce the COVID-19 symptoms or improve the ability to afford necessities. Further studies are needed to determine whether some groups may benefit from financial supports and to determine if a higher level of support is beneficial.Trial registration numberNCT04359264.
Impact of glucocorticoids on the incidence of lupus-related major organ damage: a systematic literature review and meta-regression analysis of longitudinal observational studies
Authors: Ugarte-Gil Manuel Francisco , Mak Anselm , Leong Joanna , Dharmadhikari Bhushan , Kow Nien Yee , Reátegui-Sokolova Cristina , Elera-Fitzcarrald Claudia , Aranow Cinthia , Arnaud Laurent , Askanase Anca D , Bae Sang-Cheol , Bernatsky Sasha , Bruce Ian N , Buyon Jill , Costedoat-Chalumeau Nathalie , Dooley Mary Ann , Fortin Paul R , Ginzler Ellen M , Gladman Dafna D , Hanly John , Inanc Murat , Isenberg David , Jacobsen Soren , James Judith A , Jönsen Andreas , Kalunian Kenneth , Kamen Diane L , Lim Sung Sam , Morand Eric , Mosca Marta , Peschken Christine , Pons-Estel Bernardo A , Rahman Anisur , Ramsey-Goldman Rosalind , Reynolds John , Romero-Diaz Juanita , Ruiz-Irastorza Guillermo , Sánchez-Guerrero Jorge , Svenungsson Elisabet , Urowitz Murray , Vinet Evelyne , van Vollenhoven Ronald F , Voskuyl Alexandre , Wallace Daniel J , Petri Michelle A , Manzi Susan , Clarke Ann Elaine , Cheung Mike , Farewell Vernon , Alarcon Graciela S. 
Published: December 2021

ObjectiveIn systemic lupus erythematosus (SLE), disease activity and glucocorticoid (GC) exposure are known to contribute to irreversible organ damage. We aimed to examine the association between GC exposure and organ damage occurrence.MethodsWe conducted a literature search (PubMed (Medline), Embase and Cochrane January 1966–October 2021). We identified original longitudinal observational studies reporting GC exposure as the proportion of users and/or GC use with dose information as well as the occurrence of new major organ damage as defined in the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. Meta-regression analyses were performed. Reviews, case-reports and studies with <5 years of follow-up, <50 patients, different outcomes and special populations were excluded.ResultsWe selected 49 articles including 16 224 patients, 14 755 (90.9%) female with a mean age and disease duration of 35.1 years and of 37.1 months. The mean follow-up time was 104.9 months. For individual damage items, the average daily GC dose was associated with the occurrence of overall cardiovascular events and with osteoporosis with fractures. A higher average cumulative dose adjusted (or not)/number of follow-up years and a higher proportion of patients on GC were associated with the occurrence of osteonecrosis.ConclusionsWe confirm associations of GC use with three specific damage items. In treating patients with SLE, our aim should be to maximise the efficacy of GC and to minimise their harms.
Obstructive sleep apnea confers lower mortality risk in acute ischemic stroke patients treated with endovascular thrombectomy: National Inpatient Sample analysis 2010–2018
Authors: Lapow Justin M , Dicpinigaitis Alis J , Pammal Rajkumar S , Coghill Griffin A , Rechester Osher , Feldstein Eric , Nuoman Rolla , Maselli Kristina , Kodi Shyla , Bauerschmidt Andrew , Rosenberg Jon B , Yaghi Shadi , Kaur Gurmeen , Kurian Christeen , Chong Ji Y , Mayer Stephan A , Gandhi Chirag D , Al-Mufti Fawaz 
Published: December 2021

BackgroundObstructive sleep apnea (OSA) portends increased morbidity and mortality following acute ischemic stroke (AIS). Evaluation of OSA in the setting of AIS treated with endovascular mechanical thrombectomy (MT) has not yet been evaluated in the literature.MethodsThe National Inpatient Sample from 2010 to 2018 was utilized to identify adult AIS patients treated with MT. Those with and without OSA were compared for clinical characteristics, complications, and discharge disposition. Multivariable logistic regression analysis and propensity score adjustment (PA) were employed to evaluate independent associations between OSA and clinical outcome.ResultsAmong 101 093 AIS patients treated with MT, 6412 (6%) had OSA. Those without OSA were older (68.5 vs 65.6 years old, p<0.001), female (50.5% vs 33.5%, p<0.001), and non-caucasian (29.7% vs 23.7%, p<0.001). The OSA group had significantly higher rates of obesity (41.4% vs 10.5%, p<0.001), atrial fibrillation (47.1% vs 42.2%, p=0.001), hypertension (87.4% vs 78.5%, p<0.001), and diabetes mellitus (41.2% vs 26.9%, p<0.001). OSA patients treated with MT demonstrated lower rates of intracranial hemorrhage (19.1% vs 21.8%, p=0.017), treatment of hydrocephalus (0.3% vs 1.1%, p=0.009), and in-hospital mortality (9.7% vs 13.5%, p<0.001). OSA was independently associated with lower rate of in-hospital mortality (aOR 0.76, 95% CI 0.69 to 0.83; p<0.001), intracranial hemorrhage (aOR 0.88, 95% CI 0.83 to 0.95; p<0.001), and hydrocephalus (aOR 0.51, 95% CI 0.37 to 0.71; p<0.001). Results were confirmed by PA.ConclusionsOur findings suggest that MT is a viable and safe treatment option for AIS patients with OSA.
Synthesis of 3D Hollow Structured MnCo2O4/CNTs Nanocomposite and Its Magnetic Properties
Authors: Yousf Nehad , Elzwawy Amir , Ouda Emtinan , Mansour S. A. , Duraia El Shazly M. 
Published: December 2021

Abstract
In the present contribution, the 3D hollow structure of manganese cobalt oxide/carbon nanotubes (MnCo2O4/CNTs) nanocomposite was successfully synthesized through a co-precipitation procedure followed by post-heat treatment. The as-prepared samples were characterized by X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), Field Emission Scanning Electron Microscopy (FESEM), Transmission electron microscopy (TEM), and vibrating sample magnetometer (VSM). Based on the obtained results, the surface of carbon nanotubes was coated uniformly in radial directions by manganese oxide (MnO2) nanosheets forming a flower-shaped structure. In the next step, cobalt oxide precursor was introduced to form MnCo2O4/CNTs nanocomposite. The XRD data confirms the formation of MnCo2O4/CNTs. The estimated values of the strain and the crystallite size based on the Williamson-Hall (W-H) method are calculated as 5.326×10-4 and 16 nm respectively. The fingerprint area of FTIR suggests the successful incorporation of MnO2 and cobalt oxide onto CNTs’ surfaces. The flower-shaped structure in the nanoscale is verified by the FESEM and TEM devices. Furthermore, the magnetic specifications revealed the paramagnetic with a small ferromagnetic component of the aforementioned MnCo2O4/CNTs nanocomposite.
Study on the Impact of Online Courses for Pregnant and Lying-In Women on Maternal and Infant Health during the Epidemic
Authors: Shi Liangfang , Yuan Ling , Zhou Lin , Zhang Shuixian , Lei Xia 
Published: December 2021

The sudden outbreak of the new crown pneumonia has brought online learning from a supporting role to the center of the teaching stage in an instant. On the basis of the feasibility analysis and demand analysis of the microcourse learning system, this paper uses Sina cloud server to build the WeChat public platform learning online course and designs and implements the microcourse learning system function based on the microcourse public platform. We completed the recording, editing, publishing, and testing of microclass courses and provided services for teachers and pregnant women's microclass learning in order to achieve better learning results. A total of 151 people regularly participate in maternity school courses, accounting for 30.4%. There are 190 people who have never attended the maternity school course, accounting for 38.2%. There are 156 people who occasionally participate in maternity school courses, accounting for 31.4%. The top five sources of health information during pregnancy are books, maternity schools, experience of elders, the Internet, and television. The results of one-way analysis of variance showed that pregnant women of different ages had statistically different scores in the dimensions of knowledge and ideas (

P

< 0.05). There are statistical differences in the scores of pregnant women with different economic incomes in this dimension (

P

< 0.05). The women with economic income ≥5000 yuan/month have the highest scores, and those with economic income ≥5000 yuan/month have the lowest scores. The scores of pregnant women who participated in the maternity school were significantly higher than those who did not participate in the maternity school (

P

< 0.05). There are statistical differences in the scores of maternal and child health basic skills among pregnant women of different age groups (

P

< 0.05). The women aged ≥35 years old have the highest scores, and those aged 20–24 years old have the lowest scores. The differences in the scores of pregnant women with different economic incomes in this dimension are statistically significant (

P

＜0.05). The women with economic income ≥5000 yuan/month have the highest score, and those with economic income<2000 yuan/month have the lowest score. Participation in maternity schools has an impact on the scores of this dimension. Pregnant women who regularly participate in maternity schools have the highest average scores, and those who do not participate in maternity schools have the lowest average scores.
Hemosiderin-Laden Macrophages in Bronchoalveolar Lavage: Predictive Role for Acute Exacerbation of Idiopathic Interstitial Pneumonias
Authors: Arai Toru , Kagawa Tomoko , Sasaki Yumiko , Sugawara Reiko , Sugimoto Chikatoshi , Tachibana Kazunobu , Fujita Yoshiki , Hayashi Seiji , Inoue Yoshikazu 
Published: December 2021

Background. Hemosiderin-laden macrophages (HLMs) have been identified in the bronchoalveolar lavage fluid (BALF) of patients with idiopathic pulmonary fibrosis (IPF). This retrospective study examined the ability of HLMs in BALF to predict the acute exacerbation (AE) of chronic idiopathic interstitial pneumonias (IIPs). Methods. Two hundred and twenty-one patients with IIP diagnosed by bronchoscopy were enrolled in the study (IPF, n = 87; IIPs other than IPF, n = 134). Giemsa stain was used to detect HLMs in BALF specimens. Prussian blue stain was used to quantify HLMs in BALF, and a hemosiderin score (HS) was given to the specimens containing HLMs. Results. Twenty-four patients had a positive HS (range: 7‒132). The receiver-operating characteristic curve analysis identified the cutoff HS value for predicting the AE of IIPs to be 61.5. Seven cases had a higher HS (≥61.5) and 214 had a lower HS. AE occurred significantly earlier in the higher HS group (4/7 cases) than in the lower HS group (41/214 cases) during a median observation period of 1239 days (log-rank test,

p

= 0.026). Multivariate Cox proportional hazard regression analysis showed that a higher HS was a significant predictor of AE in addition to IPF, percent predicted forced vital capacity, and modified Medical Research Council score. The C-statistics for the prediction of AE did not significantly improve by all the above parameters with HS as compared without HS. Conclusions. A higher HS was a significant predictor of AE in IIPs but did not significantly improve the predictive ability of other parameters.
Bifurcation and Stabillity Analysis of HIV Transmission Model with Optimal Control
Authors: Cheneke Kumama Regassa , Rao Koya Purnachandra , Edessa Geremew Kenassa 
Published: December 2021

A mathematical model of HIV transmission is built and studied in this paper. The system’s equilibrium is calculated. A next-generation matrix is used to calculate the reproduction number. The novel method is used to examine the developed model’s bifurcation and equilibrium stability. The stability analysis result shows that the disease-free equilibrium is locally asymptotically stable if

0
<

R

0

<
1

but unstable if

R

0

>
1

. However, the endemic equilibrium is locally and globally asymptotically stable if

R

0

>
1

and unstable otherwise. The sensitivity analysis shows that the most sensitive parameter that contributes to increasing of the reproduction number is the transmission rate

β

2

of HIV transmission from HIV individuals to susceptible individuals and the parameter that contributes to the decreasing of the reproduction number is identified as progression rate

η

of HIV-infected individuals to AIDS individuals. Furthermore, it is observed that as we change

η

from

0.1

to

1

, the reproduction number value decreases from 1.205 to 1.189, where the constant value of

β

2

=
0.1

. On the other hand, as we change the value of

β

2

from

0.1

to

1

, the value of the reproduction number increases from 0.205 to 1.347, where the constant value of

η
=
0.1

. Further, the developed model is extended to the optimal control model of HIV/AIDS transmission, and the cost-effectiveness of the control strategy is analyzed. Pontraygin’s Maximum Principle (PMP) is applied in the construction of the Hamiltonian function. Moreover, the optimal system is solved using forward and backward Runge–Kutta fourth-order methods. The numerical simulation depicts the number of newly infected HIV individuals and the number of individuals at the AIDS stage reduced as a result of taking control measures. The cost-effectiveness study demonstrates that when combined and used, the preventative and treatment control measures are effective. MATLAB is used to run numerical simulations.
Plasticity of Extrachromosomal and IntrachromosomalBRAFAmplifications in Overcoming Targeted Therapy Dosage Challenges
Authors: Song Kai , Minami Jenna K. , Huang Arthur , Dehkordi Siavash R. , Lomeli Shirley H. , Luebeck Jens , Goodman Mark H. , Moriceau Gatien , Krijgsman Oscar , Dharanipragada Prashanthi , Ridgley Trevor , Crosson William P. , Salazar Jesus , Pazol Eli , Karin Gabriel , Jayaraman Rachana , Balanis Nikolas G. , Alhani Salwan , Sheu Kyle , ten Hoeve Johanna , Palermo Amelia , Motika Stephen E. , Senaratne T. Niroshi , Paraiso Kim H. , Hergenrother Paul J. , Rao P. Nagesh , Multani Asha S. , Peeper Daniel S. , Bafna Vineet , Lo Roger S. , Graeber Thomas G. 
Published: December 2021

AbstractFocal amplifications (FA) can mediate targeted therapy resistance in cancer. Understanding the structure and dynamics of FAs is critical for designing treatments that overcome plasticity-mediated resistance. We developed a melanoma model of dual MAPK inhibitor (MAPKi) resistance that bears BRAFV600 amplifications through either extrachromosomal DNA (ecDNA)/double minutes (DM) or intrachromosomal homogenously staining regions (HSR). Cells harboring BRAFV600E FAs displayed mode switching between DMs and HSRs, from both de novo genetic changes and selection of preexisting subpopulations. Plasticity is not exclusive to ecDNAs, as cells harboring HSRs exhibit drug addiction–driven structural loss of BRAF amplicons upon dose reduction. FA mechanisms can couple with kinase domain duplications and alternative splicing to enhance resistance. Drug-responsive amplicon plasticity is observed in the clinic and can involve other MAPK pathway genes, such as RAF1 and NRAS. BRAF FA-mediated dual MAPKi–resistant cells are more sensitive to proferroptotic drugs, extending the spectrum of ferroptosis sensitivity in MAPKi resistance beyond cases of dedifferentiation.Significance:Understanding the structure and dynamics of oncogene amplifications is critical for overcoming tumor relapse. BRAF amplifications are highly plastic under MAPKi dosage challenges in melanoma, through involvement of de novo genomic alterations, even in the HSR mode. Moreover, BRAF FA-driven, dual MAPKi–resistant cells extend the spectrum of resistance-linked ferroptosis sensitivity.This article is highlighted in the In This Issue feature, p. 873
Cancer Induces a Stress Ileopathy Depending on β-Adrenergic Receptors and Promoting Dysbiosis that Contributes to Carcinogenesis
Authors: Yonekura Satoru , Terrisse Safae , Alves Costa Silva Carolina , Lafarge Antoine , Iebba Valerio , Ferrere Gladys , Goubet Anne-Gaëlle , Fahrner Jean-Eudes , Lahmar Imran , Ueda Kousuke , Mansouri Gibrail , Pizzato Eugénie , Ly Pierre , Mazzenga Marine , Thelemaque Cassandra , Fidelle Marine , Jaulin Fanny , Cartry Jérôme , Deloger Marc , Aglave Marine , Droin Nathalie , Opolon Paule , Puget Angélique , Mann Fanny , Neunlist Michel , Bessard Anne , Aymeric Laetitia , Matysiak-Budnik Tamara , Bosq Jacques , Hofman Paul , Duong Connie P.M. , Ugolini Sophie , Quiniou Valentin , Berrard Sylvie , Ryffel Bernhard , Kepp Oliver , Kroemer Guido , Routy Bertrand , Lordello Leonardo , Bani Mohamed-Amine , Segata Nicola , Yengej Fjodor Yousef , Clevers Hans , Scoazec Jean-Yves , Pasolli Edoardo , Derosa Lisa , Zitvogel Laurence 
Published: December 2021

Abstract

Gut dysbiosis has been associated with intestinal and extraintestinal malignancies, but whether and how carcinogenesis drives compositional shifts of the microbiome to its own benefit remains an open conundrum. Here, we show that malignant processes can cause ileal mucosa atrophy, with villous microvascular constriction associated with dominance of sympathetic over cholinergic signaling. The rapid onset of tumorigenesis induced a burst of REG3γ release by ileal cells, and transient epithelial barrier permeability that culminated in overt and long-lasting dysbiosis dominated by Gram-positive Clostridium species. Pharmacologic blockade of β-adrenergic receptors or genetic deficiency in Adrb2 gene, vancomycin, or cohousing of tumor bearers with tumor-free littermates prevented cancer-induced ileopathy, eventually slowing tumor growth kinetics. Patients with cancer harbor distinct hallmarks of this stress ileopathy dominated by Clostridium species. Hence, stress ileopathy is a corollary disease of extraintestinal malignancies requiring specific therapies.

Significance:
Whether gut dysbiosis promotes tumorigenesis and how it controls tumor progression remain open questions. We show that 50% of transplantable extraintestinal malignancies triggered a β-adrenergic receptor–dependent ileal mucosa atrophy, associated with increased gut permeability, sustained Clostridium spp.–related dysbiosis, and cancer growth. Vancomycin or propranolol prevented cancer-associated stress ileopathy.
This article is highlighted in the In This Issue feature, p. 873