bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of anxiolytic premedication on vasovagal reactions and home readiness following outpatient intrathecal anaesthesia—A retrospective analysis
Authors: Gebhardt Volker , Kiefer Kevin , Weiss Christel , Schmittner Marc D. 
Published: December 2018

BackgroundVasovagal reactions during application of intrathecal anaesthesia (IA) are associated with high anxiety levels. A high percentage of patients undergoing outpatient surgery suffer from anxiety. Anxiolytic premedication in day‐surgery is suspected to delay recovery and discharge and is, therefore, not routinely used. The aim of this retrospective analysis was to detect the influence of anxiolytic premedication on the incidence of vasovagal reactions and time until discharge home.MethodsAnaesthesia records of all patients undergoing outpatient surgery under low‐dose IA from January 2008 to June 2017 were analysed. Incidences of vasovagal reactions with a decrease in blood pressure and/or heart rate and need for cardiovascular activating medications were documented. Patients were categorised as having received an anxiolytic premedication or not. The time from intrathecal injection of the local anaesthetic until readiness for discharge was recorded.ResultsThe records of 2747 patients were analysed. One thousand two hundred and ninety‐one of them received an anxiolytic premedication of 1‐2 mg midazolam intravenously. Three hundred and fourteen patients had vasovagal incidents during application of IA (no premedication n = 217 [15.0%], premedication n = 97 [7.5%], P < 0.0001). Premedication did not prolong time to achieve readiness for discharge (mepivacaine: P = 0.5886, chloroprocaine: P = 0.1555). However, in the prilocaine group, premedication led to a significantly earlier achievement of readiness for discharge (P = 0.0002).ConclusionAnxiolytic premedication significantly reduces the incidence of vasovagal reactions during the application of IA and does not affect time until readiness for discharge.
Lower short‐term mortality in ICU patients on chronic dialysis than in those requiring acute dialysis
Authors: Lohse Robin , Ibsen Michael , Wiis Jørgen , Perner Anders , Lange Theis , Damholt Mette Brimnes 
Published: December 2018

BackgroundIn ICU patients, we aimed to describe the outcomes of those with end‐stage renal disease (ESRD) as compared to those requiring acute renal replacement therapy (RRT).MethodsRetrospective analysis of all adult patients admitted to a general, university hospital ICU from 2005 to 2012. ESRD was defined as use of chronic RRT >90 days prior to admission.ResultsWe included 5927 patients of whom 1004 (17%) received acute RRT and 161 (3%) had pre‐existing ESRD requiring RRT. Thirty‐day mortality was 42% vs 28% for acute RRT vs ESRD patients (adjusted hazard ratio (aHR) 0.90 (0.61‐1.34)), and 16% for those not requiring RRT (aHR 0.91 (0.60‐1.38) compared to ESRD patients). Ninety‐day mortality was 55% vs 45% for acute RRT vs ESRD patients (aHR 0.96 (0.70‐1.31)), and 22% for those not requiring RRT (aHR 1.19 (0.84‐1.67) compared to ESRD patients). Ninety‐day ESRD survivors were younger, less severely ill and needed less vasopressor treatment than 90‐day ESRD non‐survivors. Five‐year mortality was 68% vs 69% for acute RRT vs ESRD patients (aHR 1.06 (0.81‐1.39)), and 38% for those not requiring RRT (aHR 1.31 (0.99‐1.74) compared to ESRD patients).ConclusionsThe crude mortality for patients with pre‐existing ESRD was high. Short‐term mortality was within range of those not receiving RRT when adjusted for confounders. The severity of acute illness and the burden of comorbidities may be more important than the lack of kidney function per se for the short‐term prognosis of RRT patients in the ICU.
Is there a relationship between anaesthesia and dementia?
Authors: Strand Anna‐Karin , Nyqvist Fredrik , Ekdahl Anne , Wingren Gun , Eintrei Christina 
Published: December 2018

BackgroundLong‐term cognitive problems are common among elderly patients after surgery, and it has been suggested that inhalation anaesthetics play a role in the development of dementia. This study aims to investigate the hypothesis that patients with dementia have been more exposed to surgery and inhalational anaesthetics than individuals without dementia.MethodsUsing 457 cases from a dementia‐registry and 420 dementia‐free controls, we performed a retrospective case‐control study. The medical records were reviewed to determine exposure to anaesthesia occurring within a 20‐year timeframe before the diagnosis or inclusion in the study. Data were analysed using multivariate logistic regression and propensity score analysis.ResultsAdvanced age (70 years and older, with the highest risk in ages 80‐84 years) and previous head trauma were risk factors for dementia. History of exposure to surgery with anaesthesia was a risk factor for dementia (OR = 2.23, 95% CI 1.66‐3.00, P < 0.01). Exposure to inhalational anaesthetics with halogenated anaesthetics was associated with an increased risk of dementia, compared to no exposure to anaesthesia (OR = 2.47, 95% CI 1.17‐5.22, P = 0.02). Exposure to regional anaesthesia was not significantly associated with increased risk of dementia (P = 0.13).ConclusionIn this 20‐year retrospective case‐control study, we found a potential association between dementia and prior anaesthesia. Exposure to general anaesthetics with halogenated anaesthetic gases was associated with an increased risk of dementia.
Endorsement of clinical practice guidelines by the Scandinavian Society of Anaesthesiology and Intensive Care Medicine
Authors: Rehn Marius , Chew Michelle S. , Olkkola Klaus T. , Örn Sverrison Kristinn , Yli‐Hankala Arvi , Møller Morten Hylander 
Published: December 2018

AbstractClinical practice guidelines from other organizations or societies with assumed clinical and contextualized relevance for Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI) members, may trigger a formal evaluation by The Clinical Practice Committee (CPC) for possible SSAI endorsement. This avoids unnecessary duplicate processes and minimizes resource‐waste. Identified guidelines are assessed for endorsement using the Appraisal of Guidelines for REsearch and Evaluation (AGREE) II instrument. The SSAI CPC utilizes the AGREE II online coordinated group appraisal platform to assess the methodological rigor and transparency in which the guideline was developed. The results of the assessment, including the decision to endorse or not, are presented to the SSAI Board for sanctioning. This document briefly outlines the process for evaluation of non‐SSAI guidelines by the CPC for possible SSAI endorsement.
Drosophila insulin‐like peptide dilp1 increases lifespan and glucagon‐like Akh expression epistatic to dilp2
Authors: Post Stephanie , Liao Sifang , Yamamoto Rochele , Veenstra Jan A. , Nässel Dick R. , Tatar Marc 
Published: December 2018

AbstractInsulin/IGF signaling (IIS) regulates essential processes including development, metabolism, and aging. The Drosophila genome encodes eight insulin/IGF‐like peptide (dilp) paralogs, including tandem‐encoded dilp1 and dilp2. Many reports show that longevity is increased by manipulations that decrease DILP2 levels. It has been shown that dilp1 is expressed primarily in pupal stages, but also during adult reproductive diapause. Here, we find that dilp1 is also highly expressed in adult dilp2 mutants under nondiapause conditions. The inverse expression of dilp1 and dilp2 suggests these genes interact to regulate aging. Here, we study dilp1 and dilp2 single and double mutants to describe epistatic and synergistic interactions affecting longevity, metabolism, and adipokinetic hormone (AKH), the functional homolog of glucagon. Mutants of dilp2 extend lifespan and increase Akh mRNA and protein in a dilp1‐dependent manner. Loss of dilp1 alone has no impact on these traits, whereas transgene expression of dilp1 increases lifespan in dilp1 − dilp2 double mutants. On the other hand, dilp1 and dilp2 redundantly or synergistically interact to control circulating sugar, starvation resistance, and compensatory dilp5 expression. These interactions do not correlate with patterns for how dilp1 and dilp2 affect longevity and AKH. Thus, repression or loss of dilp2 slows aging because its depletion induces dilp1, which acts as a pro‐longevity factor. Likewise, dilp2 regulates Akh through epistatic interaction with dilp1. Akh and glycogen affect aging in Caenorhabditis elegans and Drosophila. Our data suggest that dilp2 modulates lifespan in part by regulating Akh, and by repressing dilp1, which acts as a pro‐longevity insulin‐like peptide.
MicroclimOz – A microclimate data set for Australia, with example applications
Authors: Kearney Michael R. 
Published: December 2018

AbstractMany problems in pure and applied ecology require the quantification of above‐ and below‐ground microclimates. Here I describe a data set of hourly microclimates for the Australian continent, simulated from the years 1990 to 2017 across a grid of 1893 locations approx. 60 km apart. The data were generated with the NicheMapR microclimate model, driven by 0.05° gridded daily meteorological forcing data (air temperature, wind speed, humidity, cloud cover, rainfall), 0.025° elevation and 0.008° soil texture data. The above‐ground microclimate variables include horizontal plane solar radiation, solar zenith angle, sky temperature (from which down‐welling longwave radiation can be computed), air temperature, relative humidity and wind speed at 1 and 120 cm height, and snow depth. The below‐ground variables include soil temperature, pore humidity, soil moisture and soil water potential for 0, 2.5, 5, 10, 15, 20, 30, 50, 100 and 200 cm below‐ground. The computations are for four shade levels (0%, 50%, 70% and 90%). The data set can be used for a wide variety of applications, including the computation of heat and water budgets of organisms, the potential for vegetation growth, and the computation of stress and growth indices. The use of daily forcing data also allows assessments of the consequences of extreme events including heat waves. Example applications are provided for computing plant growth potential, grasshopper egg development, lizard body temperature and mammalian energy and water requirements.
Preventing Prevention
Authors: Gailmard Sean , Patty John W. 
Published: December 2018

AbstractPreventing climate change and damage from natural disasters typically requires policies with up‐front costs that promise a flow of benefits over time. Why has obtaining such policies in a competitive electoral democracy proved so intractable? We develop a formal model of electoral accountability in this context, in which politicians have private information about their motivations. The model shows why fully rational voters, though certain that incumbents spend less on disaster prevention than is good for them, reelect incumbents at very high rates. In addition, in such equilibria, voters would punish incumbents who spent more on disaster prevention. This equilibrium is consistent with (and implies) some of the major empirical regularities observed in the literature on voting and disaster prevention. We discuss some implications of our analysis for advancing public debates about disaster and climate change mitigation.
Do egalitarians always help the disadvantaged more than the advantaged? Testing a value‐norm conflict hypothesis in Malaysia
Authors: Owuamalam Chuma Kevin , Matos Andrea Soledad 
Published: December 2018

Do egalitarians always express greater compassion toward the disadvantaged than toward the advantaged? A closer look at existing scholarship on the topic suggests that they likely do. Here, we investigated whether such tendency is also apparent within interdependent, high power distance cultures where the high‐status privilege prevails. Given the emphasis on harmony in social relations in interdependent cultures, we reasoned that egalitarians might experience a dissonance between their private equity values and a societal norm prescribing high‐status privilege, which we refer to as the value‐norm conflict. We therefore proposed and found evidence in Malaysia (N = 273) that egalitarians succumbed to the normative high‐status privilege in their culture: They displayed greater compassion towards higher than lower status victims, but only when the political cost of doing so was low. Interestingly, anti‐egalitarians displayed equitable levels of compassion for high‐ and low‐status victims, but only when the political cost for taking such action also was low. Hence, we show that even egalitarians can, at times, favor the privileged and that anti‐egalitarians can act equitably, so long as the political cost of doing so is trivial for them.
Lactate clearance in infants undergoing surgery for congenital heart disease
Authors: Desplanque Laetitia , Hamaide‐Defrocourt Florent , Berkia Ilham , Tourneur Tiffany , Albinni Souha , Bojan Mirela 
Published: December 2018

AbstractMeasurement of lactate concentrations during cardiac surgery with cardiopulmonary bypass (CPB) is a reliable monitoring tool for the assessment of the adequacy of perfusion, and a predictor of poor outcome. However, increased lactate production, which is multifactorial (anaerobic metabolism, hyperglycemia), increased lactate load by packed red blood cell (PRBC) transfusions, and decreased lactate clearance may all result in hyperlactatemia. The aim of this study was to estimate the clearance of lactate in infants undergoing surgery with CPB, using the lactate load from the PRBCs transfusions received during CPB. Retrospective cohort of infants <1 year of age with repeated lactate measurements during CPB, and a known lactate concentration in the PRBCs used during CPB were evaluated. All patients received PRBCs in the prime and during CPB to maintain hematocrit >35% and venous saturation >70%. Lactate kinetics were estimated across several time intervals between two lactate measurements, using a single compartment model. The lactate load was calculated as the product: PRBC‐lactate concentration * volume. The rate of endogenous lactate production was assumed to be unchanged (maintenance of high oxygen deliveries and normoglycemia throughout CPB). Overall, 87 calculations were performed in 27 patients, then averaged per patient. The mean lactate half‐life was 12.36 min [10.67–14.06], the mean clearance was 0.09 L/min [0.06–0.11], the indexed lactate clearance was 0.36 L/min/m2 [0.28–0.44]. Lactate clearance increased significantly with age. The half‐life of lactate in infants is comparable with that reported in adults with CPB, and lactate clearance is higher. Knowing the high lactate content of PRBCs, lactate clearance rather than absolute concentration is potentially a better indicator of the adequacy of perfusion during CPB in infants.
Role of erythrocytes in short‐term rewarming kidney perfusion after cold storage
Authors: Minor Thomas , von Horn Charlotte , Paul Andreas 
Published: December 2018

AbstractShort term normothermic reconditioning by machine perfusion after cold storage has shown beneficial effects in renal transplantation models. Systematic investigations concerning the inclusion of washed erythrocytes as oxygen carriers are lacking in this context. Porcine kidneys were subjected to 20 h of static cold storage. Prior to reperfusion, grafts were put on a machine for 2 h of oxygenated (95% O2; 5% CO2) rewarming perfusion. In one group (n = 6) washed erythrocytes were added to the perfusate after temperature has reached 20°C; the other group (n = 6) was run without additives. Control kidneys (n = 6) were immediately reperfused without treatment. Upon reperfusion in vitro, a more than twofold improvement of renal clearance of creatinine, urinary protein loss, fractional excretion of sodium, efficiency of oxygen utilization (TNa/VO2) and a significant reduction of innate immune activation (HMGB1, tenascin C, expression of TLR4) was seen after machine perfusion, compared with the controls. However, no advantage could be obtained by the addition of erythrocytes and inner cortical tissue pO2 always remained above normal values during cell‐free machine perfusion. Our data strongly argue in favor of a rewarming perfusion of cold stored donor kidneys but do not substantiate an indication for adding oxygen carriers in this particular setting.
A standardized recession of the inferior oblique extraocular muscle – a safe and self‐grading surgical procedure for trochlear nerve palsy: a 10‐year material
Authors: Haugen Olav H. , Nepstad Lise 
Published: December 2018

AbstractPurposeTo evaluate the results of surgical treatment in a large group of patients with trochlear nerve palsy, with emphasis on the self‐grading effect of a standardized recession of the ipsilateral inferior oblique muscle.MethodsAll patients who underwent first‐time surgery for trochlear nerve palsy in the period 2005–2014 in our department (n = 114) were retrospectively evaluated regarding pre‐ and postoperative data, surgical procedure, and the need for reoperations. Mean follow‐up time was 8.5 ± 13.8 months.ResultsAmong the 114 patients, 73 (64.0%) had a congenital palsy, 31 (27.2%) an acquired palsy, while in 10 cases (8.8%) the type of palsy was uncertain. A standardized recession of the ipsilateral inferior oblique muscle with reattachment at the lateral border of the inferior rectus muscle was carried out in 97.3% of the congenital palsies and in 80.5% of the acquired/uncertain group. In the total patient material, further surgery was needed in 15.8%. Among the patients who underwent a single standardized recession of the inferior oblique muscle, a significant correlation between preoperative vertical angle of deviation and the postoperative change in deviation was demonstrated (correlation coefficient −0.70, p < 0.001), confirming the self‐grading nature of this procedure. Subjectively, 97.1% in the congenital and 91.4% in the acquired/uncertain group reported complete/near complete resolution or significant improvement of their symptoms at the final control examination.ConclusionIn the majority of patients with trochlear nerve palsy, a favourable outcome may be achieved after a single, standardized recession of the ipsilateral inferior oblique muscle.
Cognitive dysfunction in Malaysian patients with major depressive disorder: A subgroup analysis of a multicountry, cross‐sectional study
Authors: Zainal Nor Zuraida , Kalita Pranab , Herr Keira Joann 
Published: December 2018

AbstractIntroductionCognitive dysfunction has been significantly associated with functional impairment in patients with major depressive disorder (MDD).MethodsThis is a subgroup analysis of 211 Malaysian patients recruited from the multicountry, multicenter, cross‐sectional Cognitive Dysfunction in Asian patients with Depression (CogDAD) study. Depression severity, cognitive dysfunction, and functional disability were assessed and compared with the overall CogDAD study population. Factors associated with functional disability were also evaluated in this Malaysian patient population.ResultsApproximately half of the Malaysian patients were in their first depressive episode, with the majority being treated for mild‐to‐moderate depression. Furthermore, Malaysian patients experienced cognitive dysfunction, with self‐reported Perceived Deficits Questionnaire (PDQ‐D) scores falling within the third quartile of PDQ‐D severity. Malaysian patients also reported functional disability evidenced by a mean total Sheehan Disability Scale (SDS) score of 11.47 ± 6.68, with the highest SDS score reported in the “Social Life/Leisure Activities” domain. Compared with the overall CogDAD study population, the Malaysian patient population had comparable patient demographics in terms of marital and working status; outcome scores for PHQ‐9 (9‐item Patient Health Questionnaire for self‐reported depression severity), PDQ‐D and SDS; and worst perceived cognitive dysfunction reported in the “Attention/Concentration” domain. Factors found to be significantly associated with functional disability were PDQ‐D score, sick leave taken, and antidepressant treatment (P < 0.05).DiscussionFindings from this subgroup analysis highlight the significance of treating cognitive dysfunction in patients with MDD and its correlation to functional disability.
Reliability and validity of the short‐version instrument to measure health promotion for Korean cancer survivors
Authors: Lim Jung‐won 
Published: December 2018

AbstractPurposeThe current study tests the validity and reliability of the short version of the Health Promoting Lifestyle Profile II (HPLP‐II) when used to measure health promotion for Korean cancer survivors.MethodsThe survey data were collected from 175 Korean cancer survivors who were diagnosed with breast or colorectal cancer in South Korea. The confirmatory factor analysis (CFA) and structural equation modeling were conducted to examine the construct and criterion validity of the Korean version of the HPLP‐II.ResultsFindings demonstrated that excluding nutrition and stress management, four subscales showed good internal consistency. The three competing models of the HPLP‐II were tested to determine the factor structure of the HPLP‐II for Korean cancer survivors: (a) the original 6‐factor, (b) the modified 4‐factor, and (c) the modified 5‐factor. The five‐factor solution with 23 items was selected for the final model. The criterion‐related validity based on the relationships between health promotion and HRQOL was demonstrated.DiscussionThis study makes an important contribution to understanding the health promotion measure used by Korean cancer survivors. Specifically, this study provides a rationale to investigate the validity of a measure before such measures are used in the different language and cultural groups.
Substantial red wolf genetic ancestry persists in wild canids of southwestern Louisiana
Authors: Murphy Sean M. , Adams Jennifer R. , Cox John J. , Waits Lisette P. 
Published: December 2018

AbstractConcerns over red wolf (Canis rufus) extinction caused by hybridization with coyotes (C. latrans) led to the capture and removal of remnant wild wolves from southwestern Louisiana and southeastern Texas, United States, during the 1970s. Here we show that despite decades of unmitigated hybridization, and declaration of endangered red wolves as functionally extinct in the wild, red wolf mitochondrial or nuclear DNA ancestry persists in ∼55% of contemporary wild canids sampled in southwestern Louisiana. Surprisingly, one individual had 78–100% red wolf ancestry, which is within the range for 75% red wolf, red wolf backcross, or putative red wolf, depending on estimation method. Our findings bolster support for designation of red wolves as a distinct species, demonstrate a critical need for the United States Government to consider adopting an existing but unimplemented hybrid policy, and suggest that immediate reassessment of canid management and taxonomic designation in southwestern Louisiana may be warranted.