bluuebunny/crossref_metadata_2025_split huggingface dataset:
The right supraclavicular fossa ultrasound view for correct catheter tip positioning in right subclavian vein catheterisation: a prospective observational study
Authors: Adrian M. , Kander T. , Lundén R. , Borgquist O. 
Published: July 2021

SummaryCentral venous catheter misplacement is common (approximately 7%) after right subclavian vein catheterisation. To avoid it, ultrasound‐guided tip navigation may be used during the catheterisation procedure to help direct the guidewire towards the lower superior vena cava. We aimed to determine the number of central venous catheter misplacements when using the right supraclavicular fossa ultrasound view to aid guidewire positioning in right infraclavicular subclavian vein catheterisation. We hypothesised that the incidence of catheter misplacements could be reduced to 1% when using this ultrasound technique. One ‐hundred and three adult patients were prospectively included. After vein puncture and guidewire insertion, we used the right supraclavicular fossa ultrasound view to confirm correct guidewire J‐tip position in the lower superior vena cava and corrected the position of misplaced guidewires using real‐time ultrasound guidance. Successful catheterisation of the right subclavian vein was achieved in all patients. The guidewire J‐tip was initially misplaced in 15 patients, either in the ipsilateral internal jugular vein (n = 8) or in the left brachiocephalic vein (n = 7). In 12 patients it was possible to adjust the guidewire J‐tip to a correct position in the lower superior vena cava. All ultrasound‐determined final guidewire J‐tip positions were consistent with the central venous catheter tip positions on chest X‐ray. Three out of 103 catheters were misplaced, corresponding to an incidence (95%CI) of 2.9 (0.6–8.3) %. Although the hypothesis could not be confirmed, this study demonstrated the usefulness of the right supraclavicular fossa ultrasound view for real‐time confirmation and correction of the guidewire position in right infraclavicular subclavian vein catheterisation.
In‐depth analysis of risk factors for pseudophakic retinal detachments and retinal breaks
Authors: Gabriel Maximilian , Großpötzl Manuel , Wallisch Fabian , Djavid Daniel , Pregartner Gudrun , Haas Anton , Wedrich Andreas , Mayer‐Xanthaki Christoph 
Published: July 2021

AbstractPurposeTo provide a detailed analysis of risk factors for pseudophakic retinal detachments (PRD) and pseudophakic retinal breaks (PRB).Materials and methodsWe reviewed the medical records of cataract surgeries between 1996 and 2017 at a tertiary care hospital in Austria. A Cox proportional‐hazard regression model was used to analyse risk factors for PRD and PRB.ResultsSixty‐five thousand six hundred and sixty‐two eyes (45 043 patients) underwent phacoemulsification, and 393 eyes (cumulative incidence 0.6%) were diagnosed with PRD (327 eyes) or PRB (66 eyes) during the follow‐up (median 7.1 years, range 0–21). Calculation of adjusted hazard ratios (HR) revealed a hierarchy of risk factors for either event including (from the highest to the lowest risk) posterior capsular rupture (PCR), patient age <65 years (compared with the age group >75 years), male gender and high myopia. Diabetes mellitus was associated with a lower risk. PCR was the strongest risk factor for PRD both in patients with and without perioperative vitrectomy (i.e. vitreous loss), but time to PRD was significantly reduced only following PCR with vitrectomy.ConclusionsPosterior capsular rupture, young patient age, male gender and high myopia were risk factors for PRD, but diabetes mellitus was associated with a lower risk. PCR had the strongest association with PRD, regardless of the need for perioperative vitrectomy due to vitreous loss. Time to PRD was reduced in patients with PCR and vitrectomy compared with PCR without the need for vitrectomy or uneventful surgery.
Women doctors in female urology: current status and implications for future workforce
Authors: Pirpiris Athina , Chan Garson , O’Connell Helen E. , Gani Johan 
Published: July 2021

ObjectiveTo objectively determine the percentage of female trainees and consultants who are interested in their career being focussed on female urology (FU) in order to facilitate the improved planning for the future of this sub‐specialty.Subjects and methodsThis was an international cross‐sectional study spanning 1 year, from December 2018 to December 2019. An anonymous, voluntary survey was generated using the online survey generator Survey monkey®. The survey was sent to urology consultants and trainees who were female from Australia, New Zealand, and Canada.ResultsThe total response rate to the survey was 61%. Up to 50% of female consultants and trainees selected a career in FU due to their gender, but up to 75% of respondents were also interested in FU of their own accord. Common concerns held by a majority of respondents included both the medical community’s and the public’s lack of awareness of FU as a component of urological expertise. Despite these concerns, most of the trainees were not concerned regarding their future work opportunities in FU, and many had intentions to pursue a fellowship in FU.ConclusionFemale urology is an increasingly popular sub‐specialisation of urology, given the steady increase in the intake of female trainees. Similar trends were identified internationally. Urology training in this area will need to continue to increase the community’s and the primary health care referrer’s awareness in order to ensure the continued success and growth of the sub‐specialty.
The distributional consequences of rent‐seeking
Authors: Angelopoulos Angelos , Angelopoulos Konstantinos , Lazarakis Spyridon , Philippopoulos Apostolis 
Published: July 2021

AbstractWe analyze the distributional effects of rent‐seeking via the financial sector in a model calibrated to US data. Rent‐seeking implies a misallocation of resources that increases wealth inequality among non‐rent‐seekers and for the whole economy. A deterioration in institutional quality implying more rent‐seeking leads to welfare losses for non‐rent‐seekers, especially for those with higher earnings and initial wealth, because they are most affected by the deterioration of the aggregate economy. On the other hand, welfare gains are larger for rent seekers with higher earnings and wealth, who have an increased resource extraction capacity.
Canals, climate, and corruption: The provisioning of public infrastructure under uncertainty
Authors: Vallury Sechindra , Leonard Bryan 
Published: July 2021

AbstractWe develop a two‐stage model to study the strategic interaction between a politician (the principal) and a bureaucrat (the agent) over the level of infrastructure provision with uncertainty about possible weather shocks. The bureaucrat chooses how much effort to contribute to infrastructure maintenance and the politician offers either a lump‐sum wage (non‐corrupt) contract or proportional bribe (corrupt) contract to induce effort. The degree of uncertainty about weather shocks, the size of the fixed wage, and the level of external monitoring to detect corruption all interact to affect (a) the politician's choice of contract and (b) whether this choice improves infrastructure outcomes. Our results suggest that curbing corruption is most likely to yield improvements in infrastructure provision when climate uncertainty is low and when bureaucratic wages are relatively high. If climate uncertainty is high, increasing monitoring has an unambiguous negative effect on infrastructure provision. Previous literature has focused either on public goods provision but not corruption or on bribery in a regulatory context that lacks public goods provision. We extend both literatures by analyzing how bribes between government officials affect a principal's ability to more effectively incentivize public goods provision by her agent.
The hemostatic and thrombotic complications of liver disease
Authors: McMurry Hannah Stowe , Jou Janice , Shatzel Joseph 
Published: July 2021

AbstractHepatic cirrhosis leads to numerous hematologic derangements resulting in a complex and tenuously rebalanced hemostatic milieu. The utility of common hematologic tests including the INR and aPTT in assessing hemostatic and thrombotic risk in patients with cirrhosis is limited, and consensus on transfusion thresholds and proper management of thrombotic complications continues to evolve. This review summarizes the pathophysiology of key derangements of hemostasis including those of platelets, von Willebrand factor, pro‐ and anticoagulation factors, and fibrin. Additionally, the pathogenesis, consequences, optimal management, and prevention of major thrombotic and bleeding complications in cirrhosis arte discussed.
Neuroprotective effects of four different fluids on cerebral ischaemia/reperfusion injury in rats through stabilization of the blood–brain barrier
Authors: Shan Reai , Zhou Hongyan , Liu Xinfang , Su Guangjun , Liu Guangsen , Zhang Xiaoli , Sun Cong , Yu Zining , Zhan Lifang , Huang Zhihua 
Published: July 2021

AbstractProtecting the blood–brain barrier (BBB) is a potential strategy to treat cerebral ischaemic injury. We previously reported that hypertonic sodium chloride hydroxyethyl starch 40 (HSH) treatment alleviates brain injury induced by transient middle cerebral artery occlusion (tMCAO). However, other fluids, including 20% mannitol (MN), 3% hypertonic sodium chloride (HTS) and hydroxyethyl starch 130/0.4 solution (HES), have the same effect as HSH in cerebral ischaemia/reperfusion injury (CI/RI) remains unclear. The present study evaluated the protective effects of these four fluids on the BBB in tMCAO rats. Sprague–Dawley (SD) rats were randomly assigned to six groups. A CI/RI rat model was established by tMCAO for 120 min followed by 24 h of reperfusion. The sham and tMCAO groups were treated with normal saline (NS), whereas the other four groups were treated with the four fluids. After 24 h of reperfusion, neurological function, brain oedema, brain infarction volume, permeability of the BBB, cortical neuron loss and protein and mRNA expression were assessed. The four fluids (especially HSH) alleviated neurological deficits and decreased the infarction volume, brain oedema, BBB permeability and cortical neuron loss induced by tMCAO. The expression levels of GFAP, IL‐1β, TNF‐α, MMP‐9, MMP‐3, AQP4, MMP‐9, PDGFR‐β and RGS5 were decreased, whereas the expression levels of laminin and claudin‐5 were increased. These data suggested that small‐volume reperfusion using HSH, HES, MN and HTS ameliorated CI/RI, probably by attenuating BBB disruption and postischaemic inflammation, with HSH exerting the strongest neuroprotective effect.
Decision support system for major depression detection using spectrogram and convolution neural network with EEG signals
Authors: Loh Hui Wen , Ooi Chui Ping , Aydemir Emrah , Tuncer Turker , Dogan Sengul , Acharya U. Rajendra 
Published: July 2021

AbstractThe number of Major Depressive Disorder (MDD) patients is rising rapidly these days following the incidence of COVID‐19 pandemic. It is challenging to detect MDD through personal interviews and by observing electroencephalogram (EEG) signals. Hence, an automated MDD detection system developed using deep learning techniques can help reduce the workload of clinicians by diagnosing MDD accurately. In this study, we have proposed a novel deep learning model based on Convolutional Neural Network (CNN) and spectrogram images. In this work, Short‐Time Fourier Transform (STFT) is first applied to the EEG signals to obtain spectrogram images of MDD patients and healthy subjects. These spectrogram images are then fed to the CNN model for automated detection of MDD patients and healthy subjects. The EEG signals used in this study were obtained from public database with 34 MDD patients and 30 healthy subjects. The highest classification accuracy, precision, sensitivity, specificity, and F1‐score of 99.58%, 99.40%, 99.70%, 99.48%, and 99.55% respectively were obtained with hold‐out validation. Our MDD detection model is highly accurate and needs to be validated with more diverse MDD database before it can be used in clinical settings. Also, we plan to use our developed prototype to detect depression using other physiological signals like electrocardiogram (ECG) and speech signals for accurate and faster diagnosis.
Targeting cannabinoid receptor 2 (CB2) limits collagen production—An in vitro study in a primary culture of human fibroblasts
Authors: Correia‐Sá Inês , Carvalho Cláudia , A. Machado Vera , Carvalho Sofia , Serrão Paula , Marques Marisa , Vieira‐Coelho Maria A. 
Published: July 2021

AbstractPrevious studies showed that cannabinoid 2 (CB2) receptor is involved in skin inflammation, fibrogenesis and re‐epithelialization in mice, indicating that this receptor may be implicated in wound healing. Thus, topical use of cannabinoids may have a role in local fibrotic and wound healing diseases such as scars or keloids. We investigate the effect of the CB2 selective receptor agonist (6aR,10aR)‐3‐(1,1‐Dimethylbutyl)‐6a,7,10,10a‐tetrahydro‐6,6,9‐trimethyl‐6H‐dibenzo[b,d]pyran (JWH133) and the CB2 selective receptor antagonist (6‐Iodo‐2‐methyl‐1‐[2‐(4‐morpholinyl)ethyl]‐1H‐indol‐3‐yl)(4‐methoxyphenyl)‐methanone (AM630), on primary cultures of human fibroblasts. Primary cultures of adult human fibroblasts were obtained from abdominal human skin samples. Fibroblasts pretreated with JWH133 and/or AM630 were stimulated with TGF‐β (10 ng/ml). Fibroblast activation into myofibroblasts was quantified by the expression of alpha‐smooth muscle actin (α‐SMA) using Immunocytochemistry and Western Blot assays. Collagen content was quantified with the Sirius red staining assay. Upon human fibroblasts stimulation with TGF‐β, a significant increase on α‐SMA and CB2 receptor expression was observed. In these cells, JWH133 decreased α‐SMA expression and collagen content. However, this effect was not observed in resting human fibroblasts. AM630 decreased α‐SMA expression and collagen content in both resting and activated fibroblasts. This effect was time‐ and concentration‐dependent with an IC50 value of 11 μM. The CB2 receptor appears to be involved in fibroblast repair during skin wound healing in humans, as TGF‐β increases CB2 receptor expression and JWH133 produces an anti‐fibrotic effect in human fibroblasts. AM630 also showed an anti‐fibrotic effect hypothesizing that other cannabinoid receptors, such as TRPV, may be involved in this response.
Spatial variation in direct and indirect effects of climate and productivity on species richness of terrestrial tetrapods
Authors: Barreto Elisa , Rangel Thiago F. , Coelho Marco Túlio P. , Cassemiro Fernanda A. S. , Zimmermann Niklaus E. , Graham Catherine H. 
Published: July 2021

AbstractAimWe aimed to dissect the spatial variation of the direct and indirect effects of climate and productivity on global species richness of terrestrial tetrapods.LocationGlobal.Time periodPresent.Major taxa studiedTerrestrial tetrapods.MethodsWe used a geographically weighted path analysis to estimate and map the direct and indirect effects of temperature, precipitation and primary productivity on species richness of terrestrial tetrapods across the globe.ResultsWe found that all relationships shift in magnitude, and even in direction, among taxonomic groups, geographical regions and connecting paths. Direct effects of temperature and precipitation are generally stronger than both indirect effects mediated by productivity and direct effects of productivity.Main conclusionsRichness gradients seem to be driven primarily by effects of climate on organismal physiological limits and metabolic rates rather than by the amount of productive energy. Reptiles have the most distinct relationships across tetrapods, with a clear latitudinal pattern in the importance of temperature versus water.
Efficacy and safety of apararenone (MT‐3995) in patients with nonalcoholic steatohepatitis: A randomized controlled study
Authors: Okanoue Takeshi , Sakamoto Michiie , Harada Kenichi , Inagaki Masaya , Totsuka Naoko , Hashimoto Gaia , Kumada Hiromitsu 
Published: July 2021

AbstractAimTo evaluate the efficacy, safety, and tolerability of apararenone 10 mg/day in patients with nonalcoholic steatohepatitis (NASH).MethodsIn this multicenter, randomized, double‐blind, placebo‐controlled phase II study, patients received apararenone 10 mg or placebo once daily for 72 weeks. The primary efficacy end‐point was percent change in serum alanine aminotransferase (ALT) from baseline to 24 weeks after randomization. Secondary efficacy end‐points included changes in liver fibrosis markers. Adverse drug reactions (ADRs) and serum potassium levels were evaluated.ResultsForty‐eight patients were randomly assigned to treatment (placebo, 23; apararenone, 25). The percent change in ALT at 24 weeks was −3.0% and −13.7% with placebo and apararenone, respectively (p = 0.308). The apararenone group showed greater reductions from baseline in fibrosis markers (type IV collagen 7S and procollagen‐3 N‐terminal peptide) and noninvasive tests of fibrosis (enhanced liver fibrosis score and Fibrosis‐4 index) at all time points versus placebo. The percentage of patients with improvement of 1 point or more in fibrosis stage/without nonalcoholic fatty liver disease activity score worsening was 41.7% with apararenone and 26.1% with placebo (p = 0.203). Adverse drug reactions were reported in three (13.0%) and three (12.5%) patients in the placebo and apararenone groups, respectively. Serum potassium levels increased in the apararenone group during the study and decreased to near baseline after the end of treatment.ConclusionsIn patients with NASH, apararenone 10 mg/day for 72 weeks was effective in decreasing ALT levels, improved multiple potential fibrosis markers, and was safe and well tolerated. Pathological findings showed anti‐inflammatory and antifibrotic effects of apararenone.
Barriers and facilitators of shared decision making in acutely ill inpatients with schizophrenia—Qualitative findings from the intervention group of a randomised‐controlled trial
Authors: Becher Stefanie , Holzhüter Fabian , Heres Stephan , Hamann Johannes 
Published: July 2021

AbstractBackgroundShared decision making (SDM) is appreciated as a promising model of communication between clinicians and patients. However, in acute mental health settings, its implementation is still unsatisfactory.ObjectiveThe aim of this study is to examine barriers and facilitators of SDM with acutely ill inpatients with schizophrenia.DesignA qualitative interview study was performed.Setting and ParticipantsThe analysis is based on interviews with participants (patients and staff members) of the intervention group of the randomised‐controlled SDMPLUS trial that demonstrated a significant improvement of SDM measures for patients with schizophrenia on acute psychiatric wards.Main Variables StudiedInterviews addressed treatment decisions made during the current inpatient stay. The interviews were analysed using qualitative content analysis.ResultsA total of 40 interviews were analysed and 131 treatment decisions were identified. According to the interviewees, SDM had taken place in 29% of the decisions, whereas 59% of the decisions were made without SDM. In 16%, a clear judgement could not be made. Barriers and facilitators of SDM were categorised into patient factors, clinician factors, setting factors and others. Clinicians mostly reported patient factors (e.g., symptoms) as barriers towards SDM, which were not mirrored on the patients' side. Facilitators included patient as well as clinician behaviour during consultations.ConclusionEven in the context of a successful SDM intervention, the implementation of SDM for patients in the very acute stages of schizophrenia is often not possible. However, strong facilitators for SDM have also been identified, which should be used for further implementation of SDM.Patient or Public ContributionDuring the development of the study protocol, meetings with user representatives were held.
Kojic acid and tea polyphenols inactivate Escherichia coli O157:H7 in vitro and on salmon fillets by inflicting damage on cell membrane and binding to genomic DNA
Authors: Wang Ruifei , Fang Meimei , Hu Xinyi , Yu Yigang , Xiao Xinglong 
Published: July 2021

SummaryThe development of effective natural antibacterial agents is important due to the insecurity of synthetic antimicrobial agents and consumer preferences. In this study, kojic acid (KA) and tea polyphenols (TP) were found to exhibit synergistic inhibitory effect against Escherichia coli O157:H7 with a fractional inhibitory concentration index of 0.25. KA combined with TP at 25% of their minimum inhibitory concentrations (MICs) completely inactivated E. coli O157:H7 within 4 h. Subsequently, propidium iodide uptake tests, genomic DNA interaction analysis, molecular docking, field emission scanning electron microscopy and biofilm formation assay were conducted to understand the synergistic antibacterial mechanism of KA‐TP. The results demonstrated that KA‐TP attacked the cell membrane cooperatively, thus disturbing membrane integrity and cell structure, and KA could bind to the genomic DNA to affect the biofilm formation of E. coli O157:H7. Moreover, the contamination of E. coli O157:H7 on raw salmon fillets was eliminated to varying degrees after soaking treatments with KA and/or TP for 30 min. The depuration effect was further enhanced when KA combined with TP, and more than 2‐log reduction of E. coli O157:H7 was obtained under the treatment of KA‐TP at 2 MIC, suggesting that KA‐TP may serve as a natural compound disinfectant for ready‐to‐eat aquatic products.
Efficacy of Lactobacillus vaginal suppositories for the prevention of recurrent cystitis: A phase II clinical trial
Authors: Sadahira Takuya , Wada Koichiro , Araki Motoo , Mitsuhata Ritsuko , Yamamoto Masumi , Maruyama Yuki , Iwata Takehiro , Watanabe Masami , Watanabe Toyohiko , Kariyama Reiko , Nasu Yasutomo , Ishii Ayano 
Published: July 2021

ObjectivesTo prospectively assess the efficacy and safety of Lactobacillus vaginal suppositories for the prevention of recurrent cystitis.MethodsIn this single‐arm, open‐label, phase II clinical trial, participants used vaginal suppositories containing the GAI 98322 strain of Lactobacillus crispatus for 1 year either every 2 days or three times per week. The primary end‐point was the response rate, as assessed by the number of episodes of recurrent cystitis during the year of administration. The secondary end‐points were the response rate, as assessed by episodes of recurrent cystitis during the 1 year after completion of the administration period; the total number of episodes of recurrent cystitis before, during and after administration; adverse events; and changes in urine bacteria and the vaginal microbiome.ResultsA total of 28 women were enrolled, and 21 completed the study. A total of 18 patients achieved an effective response (86%) during administration. The suppressive effects of Lactobacillus vaginal suppositories on episodes of cystitis continued up to 1 year after the last suppository was administered. There was a significant reduction in the mean number of episodes of cystitis, both during and after administration of Lactobacillus vaginal suppositories. No treatment‐related adverse events were observed. Amplicon sequencing analysis of the vaginal microbiome showed that Lactobacillus species colonized the vagina during the periods when episodes of cystitis were absent.ConclusionsVaginal suppositories containing the GAI 98322 strain of Lactobacillus crispatus effectively prevent episodes of recurrent cystitis, both during administration and for at least 1 year after administration.