bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alternatives to remifentanil for the analgesic component of total intravenous anaesthesia: a narrative review
Authors: Hughes L. M. , Irwin M. G. , Nestor C. C. 
Published: December 2022

SummaryPropfol‐remifentanil‐based total intravenous anaesthesia has dominated recent clinical practice due to its favourable pharmacokinetic profile. Interruption in remifentanil supply has presented an opportunity to diversify or even avoid the use of opioids and consider adjuncts to propofol‐based total intravenous anaesthesia. Propofol, while a potent hypnotic, is not an effective analgesic. The administration of opioids, along with other adjuncts such as α‐2 adrenoceptor agonists, magnesium, lidocaine, ketamine and nitrous oxide provide surgical anaesthesia and avoids large doses of propofol being required. We provide an overview of both target‐control and manual infusion regimes for the alternative opioids: alfentanil, sufentanil and fentanyl. The optimal combination of hypnotic‐opioid dose, titration sequence and anticipated additional postoperative analgesia required depend on the chosen combination. In addition, we include a brief discussion on the role of non‐opioid adjuncts in total intravenous anaesthesia, suggested doses and expected reduction in propofol dose.
Recurrence and outcomes of non‐functional pancreatic neuroendocrine tumours post‐resection: an Australian retrospective, multicentre cohort study
Authors: Lim Sean , Chong Lynn , Peeroo Saania , Onasanya Olukunle , He Evelyn , Banting Simon , Croagh Daniel 
Published: December 2022

AbstractIntroductionPancreatic neuroendocrine tumours (PNETs) are heterogenous entities with variable clinical outlook. The prevalence of PNETs is increasing in Australia. Despite this, data on peri‐operative management and post‐operative prognosis for Australian patients is scant in the literature.MethodsPatients from two tertiary hospitals in Victoria were recruited. Inclusion criteria included patients who underwent curative surgical resection for primary, non‐functioning, PNETs without metastases from January 2011 to December 2021. Patients were identified via histopathological reports, CMBS and ICD‐10 codes. Data were sourced from Electronic Medical Records, outpatient notes and letters.ResultsSixty‐three patients (34 Male, 29 Female) underwent surgical resection for PNETs. Fifty‐three patients (84.1%) had a post‐operative complication, and 21 (33.3%) had severe complications. Two patients had disease recurrence. Head PNETs had higher Ki‐67% (5.33 vs. 2.72, P = 0.29), and likelihood of nodal spread (9 (36%) vs. 4 (16%), P = 0.054). Pancreatic Head resections were also associated with more frequent ICU admissions (21 (84%) vs. 18 (54.5), P = 0.024), longer ICU stays (4.05 vs. 2.17 days, P = 0.10) and hospital stays (26.76 vs. 8.27 days, P = <0.001).ConclusionWithin the limitations of this study, it demonstrates that surgical resection of PNET carries a significant morbidity with a low rate of recurrence. Additionally, Pancreatic head NETs may be associated with higher grades and increased likelihood of nodal metastases. Considering this, careful patient selection is paramount.
A first‐in‐human study of the anti‐inflammatory profibrinolytic TMS‐007, an SMTP family triprenyl phenol
Authors: Moritoyo Takashi , Nishimura Naoko , Hasegawa Keiko , Ishii Shinya , Kirihara Kenji , Takata Munenori , Svensson Akiko Kishi , Umeda‐Kameyama Yumi , Kawarasaki Shuichi , Ihara Ryoko , Sakanaka Chie , Wakabayashi Yurie , Niizuma Kuniyasu , Tominaga Teiji , Yamazaki Tsutomu , Hasumi Keiji 
Published: December 2022

AimsTMS‐007, an SMTP family member, modulates plasminogen conformation and enhances plasminogen‐fibrin binding, leading to promotion of endogenous fibrinolysis. Its anti‐inflammatory action, mediated by soluble epoxide hydrolase inhibition, may contribute to its efficacy. Evidence suggests that TMS‐007 can effectively treat experimental thrombotic and embolic strokes with a wide time window, while reducing haemorrhagic transformation. We aim to evaluate the safety, pharmacokinetics and pharmacodynamics of TMS‐007 in healthy volunteers.MethodsThis was a randomized, placebo‐controlled, double blind, dose‐escalation study, administered as a single intravenous infusion of TMS‐007 in cohorts of healthy male Japanese subjects. Six cohorts were planned, but only five were completed. In each cohort (n = 8), individuals were randomized to receive one of five doses of TMS‐007 (3, 15, 60, 180 or 360 mg; n = 6) or placebo (n = 2).ResultsTMS‐007 was generally well tolerated, and no serious adverse events were attributed to the drug. A linear dose‐dependency was observed for plasma TMS‐007 levels. No symptoms of bleeding were observed on brain MRI analysis, and no bleeding‐related responses were found on laboratory testing. The plasma levels of the coagulation factor fibrinogen and the anti‐fibrinolysis factor α2‐antiplasmin levels were unchanged after TMS‐007 dosing. A slight increase in the plasma level of plasmin‐α2‐antiplasmin complex, an index of plasmin formation, was observed in the TMS‐007 group in cohort 2.ConclusionsTMS‐007 is generally well tolerated and exhibits favourable pharmacokinetic profiles that warrant further clinical development.
Customised acoustic therapy delivered through a web‐based platform—An innovative approach to tinnitus treatment
Authors: Connell James Thomas , Bassiouni Ahmed , Harrison Ella , Laden Stephanie , O'Brien Sinead , Sahota Raguwinder , Carney A. Simon , Foreman Andrew , Krishnan Suren , Hodge John‐Charles 
Published: December 2022

AbstractObjectivesCustomised acoustic therapy aims to moderate the neural pathways implicated in the pathophysiology of tinnitus. This study aimed to assess the efficacy of customised acoustic therapy administered via a web‐based treatment platform.DesignClinical trial with prospective recruitment. Fifty‐eight participants underwent 6 weeks of customised acoustic therapy.SettingTreatment was delivered for 2 h each day using a smartphone, tablet or computer. Treatment was integrated into usual daily activities.ParticipantsParticipants with subjective tinnitus were recruited through public and private otolaryngology clinics and electronic and print media.Main Outcomes MeasuredFiveQ, a novel 5 question tinnitus questionnaire, was measured at baseline and each week of treatment. Statistical analyses, including Wilcoxon, Mann–Whitney and mixed linear regression, were used to assess treatment efficacy and identify factors associated with treatment response.Results39/58 participants (67.2%) had an improvement in symptom severity scores, 4 had no change (6.9%) and 15 had a decline from baseline (25.9%). Mean FiveQ scores improved by 22.9% from 40.8 (SD = 21.4) at baseline to 31.5 (SD = 21.3) following 6 weeks of treatment (p < 0.001). With the exception of the slight tinnitus group, all other groups (from mild to catastrophic) demonstrated a treatment response. Participants with low frequency tinnitus (<2000 Hz) had a significantly greater treatment response (p < 0.001).ConclusionCustomised acoustic therapy administered via a web‐based platform demonstrated encouraging efficacy. At least mild symptoms at baseline and low frequency tinnitus were associated with a greater treatment response. Customised acoustic therapy offers accessible and efficacious tinnitus treatment, however longer term clinical studies are required to confirm the observed initial benefit is maintained.
Myofibroblast stroma differentiation in infiltrative basal cell carcinoma is accompanied by regulatory T‐cells
Authors: Ressler Julia Maria , Zila Nina , Korosec Ana , Yu Josef , Silmbrod Rita , Bachmayr Victoria , Tittes Julia , Strobl Johanna , Lichtenberger Beate Maria , Hoeller Christoph , Petzelbauer Peter 
Published: December 2022

AbstractIntroductionThe implications of infiltrative compared to non‐infiltrative growth of cutaneous basal cell carcinoma (BCC) on the tumor stroma and immune cell landscape are unknown. This is of clinical importance, because infiltrative BCCs, in contrast to other BCC subtypes, are more likely to relapse after surgery and radiotherapy.Materials and MethodsThis descriptive cross‐sectional study analyzed 38 BCCs collected from 2018 to 2021. In the first cohort (n = 28), immune cells were characterized by immunohistochemistry and multiplex immunofluorescence staining for CD3, CD8, CD68, Foxp3, and α‐SMA protein expression. In the second cohort (n = 10) with matched characteristics (age, sex, location, and BCC subtype), inflammatory parameters, including TGF‐β1, TGF‐β2, ACTA2, IL‐10, IL‐12A, and Foxp3, were quantified via RT‐qPCR after isolating mRNA from BCC tissue samples and perilesional skin.ResultsInfiltrative BCCs showed significantly increased levels of α‐SMA expression in fibroblasts (p = 0.0001) and higher levels of Foxp3+ (p = 0.0023) and CD3+ (p = 0.0443) T‐cells compared to non‐infiltrative BCCs. CD3+ (p = 0.0171) and regulatory T‐cells (p = 0.0026) were significantly increased in α‐SMA‐positive tumor stroma, whereas CD8+ T‐cells (p = 0.1329) and CD68+ myeloid cells (p = 0.2337) were not affected. TGF‐β1 and TGF‐β2 correlated significantly with ACTA2/α‐SMA mRNA expression (p = 0.020, p = 0.005).ConclusionInfiltrative growth of BCCs shows a myofibroblastic stroma differentiation and is accompanied by an immunosuppressive tumor microenvironment.
Home monitoring of haemoglobin A1c in diabetes: A systematic review and narrative synthesis on accuracy, reliability and patient acceptability
Authors: Colley Jack , Dambha‐Miller Hajira , Stuart Beth , Bartholomew Jazz , Benton Madeleine , Baykoca Jeni , Price Hermione 
Published: December 2022

AbstractAimIn the UK people with diabetes who do not attend annual review appointments often have higher haemoglobin A1c (HbA1c) levels. We aim to determine the acceptability of self‐collected posted capillary blood samples, and if they produce accurate and reliable HbA1c results.MethodsWe include adult studies comparing capillary blood to venous blood for measuring HbA1c. We exclude methods not suitable for postage. Electronic databases of MEDLINE, Embase, CINAHL, Web of Science, Google Scholar and OpenGrey were searched from inception to September 2021, as well as relevant conference abstracts. Two reviewers performed study selection, data extraction and risk of bias assessment independently. Narrative synthesis was performed.ResultsOur search retrieved 3747 records. Following de‐duplication and screening 30 articles were included. The mean difference (MD) and limits of agreement (LoA) between capillary and venous HbA1c were smaller and narrower respectively when micro/capillary tubes (micro/cap) were used for capillary blood storage compared to dried blood spots (capDBS) (micro/cap MD range −0.4 to 1.4 mmol/mol vs. capDBS MD range −4.3 to 7.2 mmol/mol, micro/cap LoA width 2.4 to 6 mmol/mol vs. capDBS LoA width 11.7 to 16.8 mmol/mol). After using self‐collection kits, 83%–96% of participants reported satisfaction, 87%–99% found it easy and 69%–94% reported they would use it again.ConclusionMicrotubes/capillary tubes look promising as a method of self‐collecting and posting capillary blood samples for the measurement of HbA1c based on the accuracy and reliability findings presented. DBS samples demonstrated comparatively poorer accuracy. Data on acceptability were limited and further research is needed.
Shura council election in Qatar: Influences that shape how voters select candidates
Authors: Al‐Thani Hessa , Al‐Ahmadi Aisha , Al‐Emadi Ahmed 
Published: December 2022

AbstractQatar, a small Gulf Arab nation with a de facto absolute monarchy, held its first general elections ever for 30 Shura Council seats on October 2, 2021. This marked the first time in Qatar's history that citizens played a more direct role in government, moving beyond symbolic elections. This study aimed to examine the factors likely to have influenced voters' selection of candidates, the key issues that are significant to Qatari citizens, and the possible characteristics of candidates that are deemed essential. While informal conversations are the main method of data collection for this study, social identity theory, specifically group‐based models, was used to understand the influences that shape Qatari voters' choices of candidates. Findings indicate that tribe‐related and family‐connected attributes constitute important influences on voters' choice decisions. Moreover, voters were concerned about candidates' characteristics and the issues and policies candidates deemed important. Discussion and recommendations are provided.
Blockchain‐based multi‐layered federated extreme learning networks in connected vehicles
Authors: Rajan Durga , Eswaran Poovammal , Srivastava Gautam , Ramana Kadiyala , Iwendi Celestine 
Published: December 2022

AbstractIntelligent and networked vehicles help build an efficient vehicular network's infrastructure. The widespread use of electronic software exposes these networks to cyber‐attacks. Intrusion detection systems (IDS) are useful for preventing vehicle network assaults. IDS have been customized using machine and deep learning networks for greater real‐time performance. Current learning‐based intrusion detection systems demand substantial processing capabilities to train and update intricate training models in vehicular devices, resulting in decreased efficiency and ability to defend against assaults. This study presents Blockchain‐based Multi‐Layer Federated Extreme Learning Machines (MLFEM) enabled IDS (BEF‐IDS) for safe data transfers. The proposed IDS leverages federated learning to generate Multi‐Layered Extreme Learning Machines, which are offloaded to dispersed vehicular edge devices such as Road‐Side Units (RSU) and connected vehicles. This federated strategy decreases resource use without sacrificing security. Blockchain technology records and shares training models, assuring network security. Using real‐time data sets, the suggested algorithm's performance under different attack scenarios were extensively tested. The suggested method obtained 98% accuracy and Recall, 97.9% Precision, and 97.9% F1 Score performance, which suggests it's incredibly secure and costs very little to transmit.
Effect of prior cyclic damage on rock failure exposed to triaxial multistage unloading confining pressure and cyclic loads
Authors: Wang Yu , Han Jianqiang , Li Peng , Cai Meifeng 
Published: December 2022

AbstractA series of triaxial alternative unloading and damage‐controlled cyclic loading tests were conducted on deeply buried granodiorite. The testing results reveal that the prior cyclic loading damage influences rock volumetric deformation, stiffness degradation, damage evolution, and failure modes. Rock volumetric deformation and hysteresis ratio increase with increasing prior cyclic damage, and the subsequent damage propagation is the most severe for a sample subjected to high cyclic damage. A larger hysteresis ratio indicates large plastic deformation and energy loss. In addition, a damage evolution model was proposed based on the irreversible radial strain, and it well describes the damage propagation at the respective cyclic loading stage (CLS) and unloading confining pressure stage (UCPS). Moreover, as prior damage increases, the dominant failure mode changes from shear failure to mixed shear–tensile failure and then to tensile failure. It is suggested that rock failure is cyclic damage dependent; damage fully develops under high cyclic damage.
Prevalence of Bleeding Symptoms in Denmark Using the Patient‐administered Bleeding Assessment Tool (self‐BAT)
Authors: Hansen Rasmus Søgaard , Vinholt Pernille Just 
Published: December 2022

AbstractIntroductionThe patient‐administered bleeding assessment tool (self‐BAT) is a screening tool developed to identify individuals in need of work‐up for bleeding disorders. Nonetheless, large studies on self‐BAT scores on healthy individuals according to gender and age are lacking.AimDetermine cut‐offs for abnormal total score of self‐BAT and investigate the prevalence of bleeding symptoms in blood donors and individuals representative of the general Danish population.MethodsBlood donors, 15,600 children (<18 years) and 18,200 adults from the general Danish population, were invited to complete a Danish version of the self‐BAT. To determine cut‐offs for abnormal total self‐BAT score, findings from healthy young children (0–11 years old), healthy adolescents (12–17 years old), healthy adult women and healthy adult men were used.ResultsAmong healthy young children (244 girls, 260 boys), healthy adolescents (58 girls, 83 boys), healthy women (n = 437) and healthy men (n = 278) from the general population, along with healthy blood donors (116 women, 176 men), the 95th percentile for total score was two for young girls, three for young boys, four for adolescent girls, three for adolescent boys, eight for women and four for men.ConclusionOur findings indicate that the abnormal total self‐BAT score is ≥3 for girls aged 0–11 years old, ≥4 for boys aged 0–11 years old, ≥5 for girls aged 12—17 years old, ≥4 for boys aged 12–17 years old, ≥9 for women and ≥5 for men. To establish the accuracy of these cut‐offs for diagnosing bleeding disorders, further studies are needed.
Evaluation of tribological behavior of silicon carbide and silicon nitride ceramics under different conditions
Authors: Matzke Caleb , Singh Mrityunjay , Gupta Surojit 
Published: December 2022

AbstractA comparative analysis of the tribological behavior of commercially available sintered silicon carbide (SiC) and three different types of silicon nitride (Si3N4) ceramics have been carried out using the ball‐on‐disk method in dry and lubrication (deionized [DI] water and ethanol) environment. Scanning electron microscopy (SEM) was used to understand the morphology and chemical composition of the tribo‐surfaces. Sintered SiC (Hexoloy‐SA) had the highest friction coefficient during dry sliding with an average of ∼0.34. Deionized water showed a minor improvement in friction (∼0.27) while ethanol reduced the friction greatly to ∼0.18 compared to dry sliding. During dry sliding, the presence of an abrasive third body was responsible for the high wear rates (WRs) in these compositions. Hexoloy‐SA showed a lower WR during ethanol and DI water lubrication due to the formation of stable tribofilms as well as higher hardness which resisted the formation of third bodies. In comparison, Si3N4 samples showed a lower WR in DI water and ethanol. The samples also showed composition‐dependent behavior which indicates that grain structure and grain boundary chemistry are playing a vital role in the tribological process.
Large‐scale precipitation synthesis of α‐alumina with poly aluminum chloride: Optimization of synthesis parameters
Authors: Shahroudi Ali , Vahidi Omid 
Published: December 2022

Abstractα‐Alumina production has been industrialized since many years ago. Nevertheless, there are still challenges in the efficient synthesis of α‐alumina with subtle specifications for high‐tech applications, specifically on large scales. So, here, we investigated the large‐scale synthesis of α‐alumina by the precipitation method and with industrial grade poly aluminum chloride (PAC) as the aluminum precursor, for the first time. The synthesis procedure was optimized in terms of synthesis yield and facilitation of α‐alumina formation by adjusting the concentration of the precursor (PAC) and precipitant (NaOH) solutions. The samples were characterized by conducting several analyses, including X‐ray diffraction, X‐ray fluorescence, field emission scanning electron microscopy, transmission electron microscopy, energy‐dispersive X‐ray spectroscopy, dynamic light scattering, and gas adsorption. The results indicated the significant effects of PAC and NaOH concentrations on the synthesis yield and facilitation of the α‐alumina formation. According to the results and process considerations, working at higher levels of PAC (.75 g/ml) and NaOH (1.0 M) concentrations was found to be the optimum synthesis conditions. Moreover, the potential of the optimized sample as the abrasive material and the catalyst support was evaluated. The results confirmed the high potential of the optimized sample in these applications. This study therefore introduces a promising and cost‐effective method for the large‐scale synthesis of versatile α‐alumina.
Structural, spectroscopic, and radiation shielding properties of Pb2+‐doped borate and phosphate glasses
Authors: Othman Hosam , Topper Brian , Elkholy Hagar , Möncke Doris 
Published: December 2022

AbstractLead‐containing alkali/alkaline‐earth borate and barium lead phosphate glasses were prepared by melt‐quenching for a detailed investigation of the Pb2+ ions’ optical properties. UV–Vis absorption and photoluminescence spectroscopy reveal variations in the s–p transition of Pb2+, which are shown to correlate with the optical basicity of the host glass in both borates and phosphates. Pb2+ emission differs significantly for borate and phosphate glasses, as the nature of the charged sites available to accommodate Pb2+ cations vary. Optical basicity values were determined from the composition (Λth) and the measured refractive index (Λn). The UV‐cutoff shifts toward higher wavelengths with increasing optical basicity and lead content. In borate glasses, the frequency of the stretching modes due to nonbridging oxygen atoms of trigonal metaborate species is identified to be inversely proportional to the excitation wavelength (directly proportional to the excitation energy) of Pb2+. Lead‐containing alkali and alkaline‐earth borate glasses show additional correlations between the Pb2+ emission wavelength and the weighted average of the field strength of the modifier(s). Complementary to the investigation of optical properties, radiation and neutron shielding parameters were calculated, suggesting the potential utility of some of the studied compositions for radiation shielding applications.
A comparison of international treatment guidelines for Stevens‐Johnson Syndrome and Toxic Epidermal Necrolysis
Authors: Pisano Catherine , Brown Margaret , Jambusaria Anokhi 
Published: December 2022

AbstractStevens‐Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are rare and life‐threatening mucocutaneous diseases that occur almost exclusively as a result of adverse drug reactions, although there are rare cases attributed to infection, immunization, or malignancy.1,2 Given the low incidence of these diseases as well as the high level of morbidity and mortality, randomized controlled clinical trials are difficult to perform, making it difficult to establish a “gold‐standard” treatment. To date, there are only five published articles in the literature detailing evidence‐based guidelines for the treatment of SJS and TEN, one of which is specifically tailored to pediatric and young adult patients.3–7 These guidelines have significant overlap in regards to the importance of prompt discontinuation of the offending drug and the need for supportive care, but there are differences in regards to the ideal supportive care measures. Additionally, there is still no clear consensus agreement on the pharmacological treatment of SJS and TEN.4–7 Herein, we aim to compare the international treatment guidelines for management of SJS and TEN as well as promote continued discussion and a multidisciplinary approach to establish consensus recommendations for these mucocutaneous emergencies.