bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modified minimal‐contact COVID‐19 workflow allows for safe, remote parenteral nutrition prescribing in non–critically ill patients
Authors: Salazar Ennaliza , Poh Bee Yen , Cheang Lai Ye , Tan Lee Boo , Yong Pay Wen , Cheah Mark Chang Chuen 
Published: March 2021

AbstractBackgroundIn line with recent guidance from the American Society for Parenteral and Enteral Nutrition (ASPEN) and the European Society for Clinical Nutrition and Metabolism (ESPEN) to minimize healthcare team exposure by clustering care and relying on other providers or telehealth to collect relevant nutrition assessments, our nutrition support team has adopted a modified workflow using information technology to provide parenteral nutrition (PN) remotely in a safe and timely manner. We aim to compare our prescribing adequacy and PN‐related complications before and during the coronavirus disease 2019 (COVID‐19) outbreak using the modified workflow in non–critically ill patients.MethodsThis study reviewed a prospectively recruited cohort of adults receiving PN in the general wards or high‐dependency units from December 5, 2019, to April 15, 2020. Demographic data, nutrition assessment, PN prescriptions, blood results, electronic notes, capillary blood glucose monitoring, and catheter‐related bloodstream infection rates were reviewed for patients who received PN.ResultsWe found that patients who started PN during COVID‐19 were more malnourished with lower body mass index and higher proportion of Subjective Global Assessment B/C scores (52 [92.9%] vs 36 [73.5%], P < .005). The proportion of patients who achieved target energy amounts within 5 days was similar in both groups. Protein prescription was >1 g/kg/day in both groups, though there was a trend of higher protein prescription during COVID‐19. Complications were similar in both groups.ConclusionOur study demonstrates that minimal contact with effective multidisciplinary communication using the modified workflow can allow for safe and timely PN administration.
Dielectric heating‐assisted disinfestation of black gram and its effect on protein profile: A comparative study on radio frequency and microwave heating
Authors: Tiwari Abhinav , Shanmugasundaram Saravanan , Jaganmohan Rangarajan , Manickam Loganathan 
Published: March 2021

AbstractPulse beetle, Callosobruchus maculatus, is the major pest infesting in the stored legumes. The present study is aimed to evaluate the comparative efficacy of radio frequency (RF) and microwave (MW) heating treatments to eradicate the problem of infestation at all four life stages in blackgram (Vigna mungo). Infested blackgram kernels in a single egg, larvae, pupae, and adult stage were subjected to RF and MW irradiation at 180‐, 190‐, 200‐, and 210‐mm electrode heights for RF and at 365, 295, 250, and 230 W MW power. The lethal time for 99.99% mortality (LT99.99) was found to be 3.62 to 8.23 min for the egg stage, 4.70 to 7.27 min for larvae, and 7.10 to 8.96 min for pupae, and 5.40 to 7.73 min for adults. For MW heating treatment, the time for complete mortality of the single egg stage, larvae, pupae, and adult was found to be in the range of 5.33 to 7.83, 8.28 to 9.82, 8.87 to 10.68, and 8.86 to 10.18 min, respectively. The pupa stage was found to be the most heat tolerant in comparison with other life stages. The MW‐treated blackgram samples depicted a significant decrease in the lysine, aspartic acid, and proline content as compared with RF‐treated samples. This suggests a negative effect of the MW on the amino acids which in turn led to its deterioration. Therefore, the RF heating holds potency to disinfest legumes without affecting the major properties of legumes which was the major drawback of using the MW heating.
Reproductive Characteristics Differ in Two Invasive Populations of Blue Catfish
Authors: Nepal Vaskar , Fabrizio Mary C. 
Published: March 2021

Abstract
The management of invasive Blue Catfish Ictalurus furcatus in Chesapeake Bay tributaries is hindered by the lack of information on its reproductive biology, which is a key component of population models used to forecast abundance. We quantified and compared the reproductive traits of female Blue Catfish from two populations from the tidal reaches of the James and York River subestuaries during 2015–2017. In these systems, Blue Catfish matured between the ages of 6 and 10 years and spawned between May and July, with larger fish spawning earlier in the season. During spawning events, Blue Catfish produced 2,613–68,356 eggs, with larger and older fish producing more eggs. Fish in the more densely populated James River matured at a marginally older age but a significantly smaller size than fish in the York River, but James River fish allocated more energy to reproduction. Fish in the James River also had greater mean values of the gonadosomatic index, relative fecundity, egg organic content, and proportion of organic content in the eggs. Relative fecundity of Blue Catfish decreased with fish size, contrary to observations in most other fishes. Based on the observed variability in reproductive traits and the size dependence of relative fecundity, we recommend incorporation of population-specific reproductive rates into stock assessment models for invasive Blue Catfish.
Two‐level preconditioning for Ridge Regression
Authors: Tavernier Joris , Simm Jaak , Meerbergen Karl , Moreau Yves 
Published: March 2021

AbstractSolving linear systems is often the computational bottleneck in real‐life problems. Iterative solvers are the only option due to the complexity of direct algorithms or because the system matrix is not explicitly known. Here, we develop a two‐level preconditioner for regularized least squares linear systems involving a feature or data matrix. Variants of this linear system may appear in machine learning applications, such as ridge regression, logistic regression, support vector machines and Bayesian regression. We use clustering algorithms to create a coarser level that preserves the principal components of the covariance or Gram matrix. This coarser level approximates the dominant eigenvectors and is used to build a subspace preconditioner accelerating the Conjugate Gradient method. We observed speed‐ups for artificial and real‐life data.
The experience of continued smoking after stroke in Korean males: A qualitative study
Authors: Youn Jung Hee , Shin Sujin 
Published: March 2021

AbstractAimThis study aimed to identify the nature and meaning of continued smoking in male stroke patients based on a deep understanding of their lived experiences.DesignPhenomenological qualitative methodology.MethodsIn total, 10 male stroke patients participated in this study. We used purposive sampling for recruitment. Data collection was performed through in‐depth interviews and analysis through van Manen's methodology.ResultsFive essential themes were derived from the analyses and described participants’ experiences with continued smoking, as follows: “Natural relapse into smoking,” “Behaving like a healthy person,” “Believing that smoking will not be a problem,” “Finding consolation in smoking behaviour,” and “Consoling oneself by the rationalization of smoking behaviour.”ConclusionThe results showcased the need for the development of a smoking cessation educational programme tailored for male stroke patients who have perceptions towards being “like healthy people” after early recovery and who think that smoking is not a problematic behaviour. Participants’ reports underpinned the necessity for these programmes to have contents focused on the transformation of patients’ awareness toward their own health status.
A case of brachymetacarpia in a skeleton from a Mudejar cemetery from Spain (13th–14th century AD)
Authors: Dorado Enrique , Herrerín Jesús , Ramírez Ildefonso , Parro Loreto , Carrillo Manuel F. , Murillo Jorge 
Published: March 2021

AbstractBrachymetacarpia, a form of brachydactyly, is one of the so‐called rare diseases because of its low prevalence. Although it is a well‐known malformation today, which occasionally requires surgical correction, it is not, or hardly, reported in the palaeopathological literature. The case presented here includes an individual exhumed from the Mudejar cemetery in Uceda (Guadalajara, Spain) dated between the 13th and 14th centuries. It was in an acceptable state of preservation, except for the skull, missing except for the mandible. Its sex was determined as female and the age as a young adult. On examining the hands, the short length of both the 4th and 5th metacarpals and the shortening of the distal phalanx of one of the thumbs were noteworthy. No anomaly was observed in the bones of the feet, which were only partially recovered. Due to the characteristics of the shortening and bones affected, it was considered that the case probably corresponded to type E of brachydactyly in the Bell and Temtamy classifications and to subtype E2 in the Hertzog classification. No data were found in the bones or teeth, suggesting their inclusion in any of the multiple clinical syndromes with this abnormality.
Integrating irinotecan in standard chemotherapy: A novel dose‐density combination for high‐risk pediatric sarcomas
Authors: Bisogno Gianni , Ferrari Andrea , Tagarelli Arianna , Sorbara Silvia , Chiaravalli Stefano , Poli Elena , Scarzello Giovanni , De Corti Federica , Casanova Michela , Affinita Maria Carmen 
Published: March 2021

AbstractBackgroundIrinotecan is a drug active against pediatric sarcomas with a toxicity profile that theoretically allows for its association with more myelotoxic drugs. We examined the feasibility of a dose‐density strategy integrating irinotecan in standard chemotherapy regimens for patients with high‐risk sarcomas.MethodsBetween November 2013 and January 2020, 23 patients ≤25 years old were included in the study. Eleven patients newly diagnosed with metastatic disease received nine cycles of IrIVA (irinotecan‐ifosfamide‐vincristine‐actinomycin D; ifosfamide 3 g/m2 on days 1 and 2, vincristine 1.5 mg/m2 on day 1, actinomycin D 1.5 mg/m2 on day 1, irinotecan 20 mg/m2 for 5 consecutive days starting on day 8) as first‐line therapy. Two relapsed patients received IrIVA and 10 IrVAC (irinotecan‐vincristine‐actinomycin D‐cyclophosphamide; cyclophosphamide 1.5 g/m2 on day 1 instead of ifosfamide). Feasibility was assessed in terms of toxicity and time to complete the treatment.ResultsSeventeen rhabdomyosarcomas, four Ewing sarcomas, two desmoplastic small round cell tumors received a total of 181 cycles (range 2–10). Grade 4 neutropenia occurred in 62.4% of the cycles. Thirteen patients had febrile neutropenia. Diarrhea occurred in 14 cycles. The median time to complete the treatment was 195 days (range 170–231), 83.4% of cycles were administered on time or with a delay <1 week. With a median follow‐up of 2.6 years (range 0.2–5.0), 12 patients are alive, nine complete remissions, three with the disease.ConclusionsA dose‐density strategy combining irinotecan with standard chemotherapy is feasible. This approach will be investigated in the next trial coordinated by the European pediatric Soft tissue sarcoma Study Group.
Racial/ethnic, socioeconomic, and geographic survival disparities in adolescents and young adults with primary central nervous system tumors
Authors: Puthenpura Vidya , Canavan Maureen E. , Poynter Jenny N. , Roth Michael , Pashankar Farzana D. , Jones Beth A. , Marks Asher M. 
Published: March 2021

AbstractBackgroundDisparities in survival by race/ethnicity, socioeconomic status (SES), and geography in adolescent and young adult (AYA) patients with central nervous system (CNS) tumors have not been well studied.ProcedureA retrospective cohort study utilizing the Surveillance, Epidemiology, and End Results (SEER) database was conducted for AYA patients diagnosed with primary CNS tumors. Adjusted hazard ratios (aHR) were calculated using a multivariate Cox proportional hazard model to evaluate the association between race/ethnicity, SES, rurality, and hazard of death.ResultsAll minority groups showed an increased hazard of death with greatest disparities in the high‐grade glioma cohort. Lower SES was associated with an increased hazard of death in non‐Hispanic White (NHW) patients (aHR 1.12; 95% confidence interval [CI] 1.01–1.24), non‐Hispanic Black (NHB) patients (aHR 1.34; 95% CI 1.00–1.80), and patients aged 25–29 years (aHR 1.29; 95% CI 1.07–1.55). Mediation analysis showed an indirect effect of SES on the effect of race/ethnicity on the hazard of death only among NHB patients, with SES accounting for 33.7% of the association between NHB and hazard of death. Rurality was associated with an increased hazard of death for patients in the lowest SES tertile (aHR 1.31; 95% CI 1.08–1.59) and NHW patients (aHR 1.20; 95% CI 1.08–1.34).ConclusionsPatients identified as a racial/ethnic minority, patients with a lower SES, and patients residing in rural areas had an increased hazard of death. Further studies are needed to understand and address the biological, psychosocial, societal, and economic factors that impact AYA neuro‐oncology patients at highest risk of experiencing poorer outcomes.
A novel “video‐game” simulator for training fetoscopic laser coagulation of anastomoses in twin‐to‐twin transfusion syndrome
Authors: Windrim Rory , Young Alexander , LeBouthillier Francis , Ryan Greg , Van Mieghem Tim , Abbasi Nimrah , Keunen Johannes , D'Souza Rohan , Kfouri Julia 
Published: March 2021

Key Points/Highlights

We have developed a high‐fidelity interactive “video‐game” simulator in order to teach fetoscopic laser ablation of placental anastomoses for twin‐twin transfusion syndrome

This simulator may be used by teachers in order to provide metrics‐based simulator education to multiple trainees, in both hands‐on and distanced learning settings

What is already known about this topic?

The use of simulation improves training of the fetoscopic laser techniques utilized in the treatment of twin‐twin transfusion syndrome

A number of mannequins have been developed to aid this education

What does this study add?

Two new simulators are described for twin‐twin transfusion syndrome training—silicone and digital

The digital simulator is a novel digital video game virtual format

This new format has enhanced interactivity and has the potential to enable distance learning
How abnormal is the normal? Clinical characteristics of CF patients with normal FEV1
Authors: Cohen‐Cymberknoh Malena , Ben Meir Elad , Gartner Silvia , Reiter Joel , Spangenberg Angeles , Garriga Laura , Eisenstadt Iris , Israeli Tomer , Tsabari Reuven , Shoseyov David , Gileles‐Hillel Alex , Breuer Oded , Simanovsky Natalia , Kerem Eitan 
Published: March 2021

AbstractBackgroundNormal values (>80%) of Forced Expiratory Volume in one second (FEV1) in patients with cystic fibrosis (CF) may lead to the interpretation that there is no lung disease. This study is a comprehensive analysis of lung involvement in CF patients having normal FEV1.MethodsPatients were recruited from two CF centers: Hadassah Medical Center, Jerusalem and Vall d' Hebron Hospital, Barcelona. Lung disease was assessed by lung clearance index (LCI), chest CT‐Brody score, respiratory cultures, number of pulmonary exacerbations (PEx), and days of antibiotic treatment in the year before the assessment.ResultsOf the 247 patients, 89 (36%) had FEV1 ≥80% and were included in the study (mean age, 17.6; range, 4.25–49 years). Chronic Pseudomonas aeruginosa infection was found in 21%, and 31% had at least one major PEx in the year before the study. Abnormally elevated LCI was found in 86% of patients, ranging between 7.52 and 18.97, and total Brody score (TBS) was abnormal in 92% (range, 5.0–96.5). Patients with chronic P. aeruginosa had significantly higher LCI (p = .01) and TBS (p = .02) which were associated with more major PEx (p < .01 and p = .01, respectively) and more days of intravenous (IV) antibiotic treatment in the preceding year (p = .03 and p = .001, respectively).ConclusionsMost CF patients with normal FEV1 have already physiological and structural lung abnormalities which were associated with more PEx and IV antibiotic treatment. Further studies are needed to determine if better adherence to the currently used therapies and the new cystic fibrosis transmembrane modulators will prevent the progression of lung disease.
Augmented renal clearance in critically ill patients with cancer (ARCCAN Study): A prospective observational study evaluating prevalence and risk factors
Authors: Nazer Lama H. , AbuSara Aseel K. , Kamal Yasmeen 
Published: March 2021

AbstractAugmented renal clearance (ARC) is a phenomenon that has been associated with enhanced excretion of renally eliminated drugs, such as antimicrobials, which may result in subtherapeutic levels and potentially therapeutic failure. There has been limited data on ARC in critically ill patients with cancer. This study aimed to evaluate the prevalence of ARC and to identify risk factors associated with ARC in this patient population. This was a prospective study at an oncologic intensive care unit (ICU) which included adult patients with normal renal function, defined as serum creatinine ≤1 mg/dl and urine output >0.5 ml/kg/hr. The 24‐hour creatinine clearance (ClCr) study was used to determine ClCr, starting on day 1 of ICU admission, for 5 days or until ICU transfer or death. ARC was defined as ClCr >130 ml/min/1.73 m2. Univariate and multivariate logistic regression analyses were performed to identify risk factors for ARC. Over the study period, 363 patients were enrolled who completed an average of 2.8 ± 1.5(SD) days in the study and contributed 977 ClCr measurements. The mean age was 52 ± 16(SD) years old, the majority had solid tumors (n = 264, 73%), mean APACHE II was 21 ± 8(SD), and the major admission diagnosis was respiratory failure (n = 165, 45%). ARC was reported in 116 (32%) patients on at least one of the study days. Over the study period, the incidence of ARC ranged between 15.6% and 24.3%. Age was the only risk factor significantly associated with ARC (OR 1.028, 95% CI 1.005–1.051).
Complete lung collapse as a rare complication of sarcoidosis‐associated mediastinal lymphadenopathy
Authors: Rishi Abdul R. , Zurob Adel , Williams Christopher , Al‐Sharif Hussam , Zaied Ali , Trivedi Vipul , Rishi Muhammad A. 
Published: March 2021

Key messageComplete lung collapse associated with sarcoidosis is exceedingly rare. Although lymphoma should be ruled out when patients with mediastinal lymphadenopathy develop lung collapse, sarcoidosis should be considered in the differential, especially when associated with fibrosing mediastinitis.
Keyed shear connections with looped U‐bars subjected to normal and shear forces Part II—rigid‐plastic modeling of the ultimate capacity
Authors: Sørensen Jesper Harrild , Hoang Linh Cao , Poulsen Peter Noe 
Published: March 2021

AbstractWhen the structural capacity of precast concrete structures is to be determined, reliable and practical models for estimation of the ultimate load carrying capacity of the structural connections are essential. In this paper, rigid‐plastic upper bound solutions for the load carrying capacity of keyed shear connections subjected to shear and normal forces are derived and compared to experimental results. The solutions are based on two idealized failure mechanisms involving complete key cut off and local key corner shearing, respectively. The solutions furnish a tool to design connections for the most ductile failure mode, which according to experimental observations is the one with local key corner shearing. Comparison with test results shows that satisfactory overall agreement is found, when appropriate material parameters are adopted. This includes an effectiveness factor, which in this study has been taken from previous studies of similar problems, and an internal angle of friction for mortar in the range of 30°–34°. The agreement is better for combinations of shear and compression, whereas the case of shear combined with large tension forces (i.e., half the yield capacity of the U‐bars) is overestimated by the solutions. Based on the results, it can be recommended that the solutions may be applied in practice using the lower limit for the internal angle of friction, and provided that precaution are taken in cases where the connections are utilized to transfer tension.
Trimetazidine improved adriamycin‐induced cardiomyopathy by downregulating TNF‐α, BAX, and VEGF immunoexpression via an antioxidant mechanism
Authors: Eid Basma G. , El‐Shitany Nagla Abd El‐Aziz , Neamatallah Thikryat 
Published: March 2021

AbstractFew studies have reported a prophylactic effect of the anti‐ischemic trimetazidine (TRI) against cardiac toxicity caused by adriamycin (ADR). However, the mechanism of action of TRI remained incomplete. The cardioprotective mechanism(s) of TRI against ADR‐induced cardiotoxicity was investigated in this study. Cardiotoxicity was induced in three groups of Wistar rats by injecting a single dose of ADR (10 mg/kg, i.p.). TRI was administered in two doses regimen, low (L) (2.5 mg/kg, i.p.) and high (H) (10 mg/kg, i.p.). The results of the study showed that both TRI L and H doses improved cardiac enzymes and pathology, while only the TRI H dose improved the electrocardiogram. Both TRI L and H doses decreased malondialdehyde and increased reduced glutathione and superoxide dismutase. Only TRI H dose increased glutathione peroxidase and catalase. Both TRI L and H doses decreased interleukin‐1 beta and tumor necrosis factor‐alpha (TNF‐α). Both TRI L and H doses downregulated TNF‐α, BAX, and vascular endothelial growth factor cardiac protein expression. The data obtained in this study provided evidence that TRI opposed ADR‐induced cardiotoxicity. The mechanism could be due to improved antioxidant levels as well as inhibition of inflammation and programmed cell death.