bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementing advance care plans in the peri‐operative period, including plans for cardiopulmonary resuscitation: Association of Anaesthetists clinical practice guideline
Authors: Meek T. , Clyburn R. , Fritz Z. , Pitcher D. , Ruck Keene A. , Young P. J. 
Published: February 2022

SummaryContemporary guidance takes a patient‐centred approach and recommends discussing and planning treatments that should be considered, not just those that should be withheld. Although some organisations and communities still use specific DNACPR (do not attempt cardiopulmonary resuscitation) forms to recommend that cardiopulmonary resuscitation is not attempted, this approach has been shown to have disadvantages and is no longer regarded as best practice. The following guidelines have been produced in response to this change. They are designed to help anaesthetists, as part of the wider healthcare team, to implement and respond to advance care planning documents before and during procedures. The guidelines apply to all procedures, however minor and low risk they are considered to be, and the same ethical and legal principles apply to procedures carried out under local or regional anaesthesia and/or conscious sedation, as well as to those under general anaesthesia.
Enhanced peri‐operative care to improve outcomes for high‐risk surgical patients in Brazil: a single‐centre before‐and‐after cohort study
Authors: Stahlschmidt A. , Passos S. C. , Cardoso G. R. , Schuh G. J. , Gutierrez C. S. , Castro S. M. J. , Caumo W. , Pearse R. M. ,   the Ex‐Care collaborative, Stefani L. C. 
Published: February 2022

SummaryMortality and morbidity for high‐risk surgical patients are often high, especially in low‐resource settings. Enhanced peri‐operative care has the potential to reduce preventable deaths but must be designed to meet local needs. This before‐and‐after cohort study aimed to assess the effectiveness of a postoperative 48‐hour enhanced care pathway for high‐risk surgical patients (‘high‐risk surgical bundle’) who did not meet the criteria for elective admission to intensive care. The pathway comprised of six elements: risk identification and communication; adoption of a high‐risk post‐anaesthesia care unit discharge checklist; prompt nursing admission to ward; intensification of vital signs monitoring; troponin measurement; and prompt access to medical support if required. The primary outcome was in‐hospital mortality. Data describing 1189 patients from two groups, before and after implementation of the pathway, were compared. The usual care group comprised a retrospective cohort of high‐risk surgical patients between September 2015 and December 2016. The intervention group prospectively included high‐risk surgical patients from February 2019 to March 2020. Unadjusted mortality rate was 10.5% (78/746) for the usual care and 6.3% (28/443) for the intervention group. After adjustment, the intervention effect remained significant (RR 0.46 (95%CI 0.30–0.72). The high‐risk surgical bundle group received more rapid response team calls (24% vs. 12.6%; RR 0.63 [95%CI 0.49–0.80]) and surgical re‐interventions (18.9 vs. 7.5%; RR 0.41 [95%CI 0.30–0.59]). These data suggest that a clinical pathway based on enhanced surveillance for high‐risk surgical patients in a resource‐constrained setting could reduce in‐hospital mortality.
The effect of SARS‐Co‐V2 infection on prothrombotic and anticoagulant factors in dialysis patients
Authors: Riddell Anne , Chowdary Pratima , Davenport Andrew 
Published: February 2022

AbstractBackgroundPatients with COVID‐19 infection are at increased risk of thrombosis. We wished to determine whether this was is due to an increase in prothrombotic or reduction in anticoagulant factors and whether heparin would be an appropriate anticoagulant.MethodsWe measured routine coagulation and prothrombotic factors in dialysis patients after a positive COVID‐19 test between March 2020 –April 2021.ResultsRoutine coagulation tests were measured in 227 dialysis patients, 148 males (65.2%), median age 67.5 (53.8–77.0) years. The international normalized ratio was prolonged in 11.5%, activated partial thromboplastin time in 48.5%, thrombin time in 57%. Factor VIII was increased in 59.1%, fibrinogen 73.8%, and D‐dimer 95.5%. Protein C was reduced in 15.3%, protein S 28%, and antithrombin (AT) in 12.1%. Two patients were Lupus anticoagulant positive, and two Factor VLeiden positive. Factor VIII levels increased with clinical disease; outpatients 159 (136–179) IU/dl, hospitalized but not ventilated 228 (167–311) IU, ventilated 432 (368–488) IU/dl (p < 0.01). Overall 75% had an AT level ≥ 88 IU/dl (reference range 79–106), but only 11.7% of non‐hospitalized patients compared to 45% of those who died, p < 0.01, fibrinogen, D‐dimers, and protein S or C did not differ with clinical disease severity, whether patients required hospital admission or not and between survivors and those who died.ConclusionCOVID‐19 dialysis patients have increased levels of fibrinogen and D‐Dimers, but only factor VIII levels in the clotting profile increased with clinical disease severity increasing systemic hypercoagulability. AT concentrations are maintained and as such should not compromise anticoagulation with heparins.
Factors influencing the functional status of aortic valve in ovine models supported by continuous‐flow left ventricular assist device
Authors: Yu Xin‐Yi , Shi Jian‐Wei , Zang Yi‐Rui , Zhang Jie‐Min , Liu Zhi‐Gang 
Published: February 2022

AbstractObjectivesAn acute animal experiment was performed to observe factors influencing the functional status of the aortic valve functional status after continuous‐flow left ventricular assist device (CF‐LVAD) implantation in an ovine model, and a physiologic predictive model was established.MethodsA CF‐LVAD model was established in Small Tail Han sheep. The initial heart rate (HR) was set to 60 beats/min, and grouping was performed at an interval of 20 beats/min. In all groups, the pump speed was started from 2000 rpm and was gradually increased by 50–100 rpm. A multi‐channel physiological recorder recorded the HR, aortic pressure, central venous pressure, and left ventricular systolic pressure (LVSP). A double‐channel ultrasonic flowmeter was used to obtain real‐time artificial vascular blood flow (ABF). A color Doppler ultrasound device was applied to assess the aortic valve functional status. Multivariate dichotomous logistic regression was used to screen significant variables for predicting the functional status of the aortic valve.ResultsObservational studies showed that ABF and the risk of aortic valve closure (AVC) were positively correlated with pump speed at the same HR. Meanwhile, the mean arterial pressure (MAP) was unaltered or slightly increased with increased pump speed. When the pump speed was constant, an increase in HR was associated with a decrease in the size of the aortic valve opening. This phenomenon was accompanied by an initial transient increase in the ABF and MAP, which subsequently decreased. Statistical analysis showed that the AVC was associated with increased pump speed (OR = 1.02, 95% CI = 1.01–1.04, p = 0.001), decreased LVSP (OR = 0.95, 95% CI = 0.91–0.98, p = 0.003), and decreased pulse pressure (OR = 0.82, 95% CI = 0.68–0.96, p = 0.026). ABF or MAP was negatively associated with the risk of AVC (OR < 1). The prediction model of AVC after CF‐LVAD implantation exhibited good differentiation (AUC = 0.973, 95% CI = 0.978–0.995) and calibration performance (Hosmer–Lemeshow χ2 = 9.834, p = 0.277 > 0.05).ConclusionsThe pump speed, LVSP, ABF, MAP, and pulse pressure are significant predictors of the risk of AVC. Predictive models built from these predictors yielded good performance in differentiating aortic valve opening and closure after CF‐LVAD implantation.
Review article: emerging drug therapies in inflammatory bowel disease
Authors: Grossberg Laurie B. , Papamichael Konstantinos , Cheifetz Adam S. 
Published: February 2022

SummaryBackgroundThe landscape of inflammatory bowel disease (IBD) treatment is rapidly expanding with the development of new therapeutic options.AimTo review the mechanisms of action and the available clinical trial data on emerging drug therapies for IBD.MethodsPubmed, Medline and Cochrane databases were queried up to July 2021 using keywords “inflammatory bowel disease,” “IBD,” “Crohn’s disease,” “ulcerative colitis” and “trial,” “phase” and “study.” In addition, we manually reviewed the grey literature including clinical trial registries and abstracts from major gastroenterology conferences in 2020 and 2021 to include pertinent information.ResultsIn ulcerative colitis (UC), phase 2b and/or phase 3 studies met primary endpoints for S1P receptor agonists (estrasimod, ozanimod), anti‐IL‐23 agent (mirikizumab), anti‐lymphocyte trafficking agents (ontamalimab, subcutaneous vedolizumab), JAK inhibitors (upadacitinib, filgotinib) and TLR9 agonist (cobitolimod). In Crohn’s disease (CD), anti‐IL‐23 agents (risankizumab, mirikizumab, guselkumab), JAK inhibitors (upadacitinib, filgotinib) and anti‐lymphocyte trafficking agents (ontamalimab, etrolizumab) met primary endpoints in randomised controlled clinical trials.ConclusionSeveral new IBD drug therapies have positive efficacy and safety data in early clinical trials, and there are several drugs in the therapeutic pipeline. As more treatments for CD and UC are approved for clinical use, research to assess predictors of response to therapy and head‐to‐head trials is needed to inform providers on how to best position therapeutic options for patients with IBD.
Systematic review with meta‐analysis: incidence and factors for progression to advanced neoplasia in inflammatory bowel disease patients with indefinite and low‐grade dysplasia
Authors: Wan Jian , Wang Xuan , Zhang Yujie , Chen Min , Wang Min , Wu Kaichun , Liang Jie 
Published: February 2022

SummaryBackgroundDue to limited research on the natural history of indefinite for dysplasia (IND) and low‐grade dysplasia (LGD) in inflammatory bowel disease (IBD), the management of these patients is controversial.AimsThis systematic review and meta‐analysis aimed to estimate the incidence and identify the risk factors for advanced neoplasia in IBD patients with IND and LGD.MethodsPubMed, Embase and Cochrane Central Register of Controlled Trials were searched until 24 December, 2021, to identify studies that reported pathological results of follow‐up colonoscopy or surgery in IBD patients with IND and LGD. The main outcomes were the incidence and risk factors for advanced neoplasia in IBD patients with IND and LGD.ResultsBased on the analysis of 38 studies, the pooled incidences of advanced neoplasia in IBD patients with IND and LGD were 9.9% (95% CI 4.4%‐15.4%) and 10.7% (95% CI 7.0%‐14.4%) respectively. The risk factors for advanced neoplasia in IND patients were primary sclerosing cholangitis (PSC) and aneuploidy. The risk factors for advanced neoplasia in LGD patients included male, PSC, previous IND, colonic stricture, index lesion ≥1 cm, distal location, multifocal lesions, distal and flat lesions, nonpolypoid/flat lesions and invisible lesions.ConclusionsThe incidence of advanced neoplasia was similar between IND and LGD in IBD patients, as high as one in ten, so more rigorous surveillance is also suggested in IND patients. Since the effects of most factors were derived from the pooled results of only two to three studies, further research was needed to confirm our results.
Gut‐brain axis dysfunction underlies FODMAP‐induced symptom generation in irritable bowel syndrome
Authors: Wu Jie , Masuy Imke , Biesiekierski Jessica R , Fitzke Heather E , Parikh Chinar , Schofield Laurel , Shaikh Hafsa , Bhagwanani Anisha , Aziz Qasim , Taylor Stuart A , Tack Jan , Van Oudenhove Lukas 
Published: February 2022

SummaryBackgroundFODMAPs produce similar small bowel water and colonic gas in patients with irritable bowel syndrome (IBS) and healthy controls (HCs), despite IBS patients reporting increased gastrointestinal (GI) symptoms.AimTo unravel the mechanisms underlying FODMAP‐induced symptom reporting, we investigated gut and brain responses to fructan administration in IBS patients and HC.MethodsThis randomised, double‐blind, cross‐over study consisted of three visits where fructans (40 g/500 mL saline), glucose (40 g/500 mL saline) or saline (500 mL) were infused intragastrically during 1 h MR brain scanning; abdominal MRI was performed before, 1 h, and 2 h post‐infusion. Symptoms were rated using validated scales.ResultsIn IBS (n = 13), fructans induced more cramps, pain, flatulence and nausea compared to glucose (P = 0.03, 0.001, 0.009 and <0.001 respectively), contrary to HC (n = 13) (all P > 0.14), with between‐group differences for cramps and nausea (P = 0.004 and 0.023). Fructans increased small bowel motility and ascending colonic gas and volume equally in IBS and HC (between‐group P > 0.25). The difference in colonic gas between fructans and saline covaried with differences in bloating and cramps in IBS (P = 0.008 and 0.035 respectively). Pain‐related brain regions responded differentially to fructans in IBS compared to HC, including the cerebellum, supramarginal gyrus, anterior and midcingulate cortex, insula and thalamus (pFWE‐corrected < 0.05); these brain responses covaried with symptom responses in IBS.ConclusionsFructans increase small bowel motility and colon gas and volume similarly in IBS patients and HC. Increased symptom responses to fructans in IBS covary with altered brain responses in pain‐related regions, indicating that gut‐brain axis dysregulation may drive FODMAP‐induced symptom generation in IBS.
Inference for Set-Based Effects in Genetic Association Studies with Interval-Censored Outcomes
Authors: Sun Ryan , Zhu Liang , Li Yimei , Yasui Yutaka , Robison Leslie 
Published: February 2022

Abstract
The rapid acceleration of genetic data collection in biomedical settings has recently resulted in the rise of genetic compendiums filled with rich longitudinal disease data. One common feature of these data sets is their plethora of interval-censored outcomes. However, very few tools are available for the analysis of genetic data sets with interval-censored outcomes, and in particular, there is a lack of methodology available for set-based inference. Set-based inference is used to associate a gene, biological pathway, or other genetic construct with outcomes and is one of the most popular strategies in genetics research. This work develops three such tests for interval-censored settings beginning with a variance components test for interval-censored outcomes, the interval-censored sequence kernel association test (ICSKAT). We also provide the interval-censored version of the Burden test, and then we integrate ICSKAT and Burden to construct the interval censored sequence kernel association test—optimal (ICSKATO) combination. These tests unlock set-based analysis of interval-censored data sets with analogs of three highly popular set-based tools commonly applied to continuous and binary outcomes. Simulation studies illustrate the advantages of the developed methods over ad hoc alternatives, including protection of the type I error rate at very low levels and increased power. The proposed approaches are applied to the investigation that motivated this study, an examination of the genes associated with bone mineral density deficiency and fracture risk.
Linking cognitive processes and learning outcomes: The influence of cognitive presence on learning performance in MOOCs
Authors: Liu Bowen , Xing Wanli , Zeng Yifang , Wu Yonghe 
Published: February 2022

AbstractMassively open online courses (MOOCs) offer learners opportunities for self‐improvement and knowledge development. Linking cognitive processes and learning outcomes is helpful in supporting students learning with the help of MOOCs. Based on the cognitive presence of the Community of Inquiry framework, this study quantified the effect of cognitive presence on students’ learning performance by analysing more than 400,000 posts of 13 MOOCs. First, the study built a highly predictive classification model using a machine learning algorithm to automatically identify the phases of cognitive presence in MOOC forum posts. Subsequently, multilevel modelling was used to analyse the influence of learners’ cognitive presence on their learning performance. The results showed that different phases of cognitive presence influenced students’ learning differently. The findings help us understand the phases and depth of students’ cognitive presence and can be used as the basis for MOOCs to automatically provide appropriate cognitive feedback and support to students.
Practitioner notesWhat is already known about this topic

Massively open online courses (MOOCs) offer learners opportunities for self‐improvement and knowledge development.
Linking cognitive processes and learning outcomes is helpful in supporting student learning in MOOCs.
Little is known so far about the role of cognitive presence in influencing students’ learning performance.
What this paper adds

This study built a highly predictive classification model using a machine learning algorithm to automatically identify the phases of cognitive presence in MOOC forum posts.
Multilevel modelling was used to quantify the influence of learners’ cognitive presence on their learning performance.
The results showed that different phases of cognitive presence influenced students’ learning differently.
Implications for practice and/or policy

This study built an effective, high‐performance machine learning model with easy feature extraction, which could be used to automatically identify students’ cognitive processes in MOOC forums and beyond.
The combination of cognitive presence and learning performance helps us understand the phases and depth of students’ cognitive presence.
The findings can be used as the basis for MOOCs to automatically provide appropriate cognitive feedback and support to students.
The impact of smoking on sexual function
Authors: Mima Mahmoud , Huang Jason B. , Andriole Gerald L. , Freedland Stephen J. , Ohlander Samuel J. , Moreira Daniel M. 
Published: February 2022

ObjectivesTo evaluate the hypothesis that there is an improvement in sexual function following smoking cessation (as smoking is a well‐established risk factor for sexual dysfunction), we analysed the association between cigarette smoking and smoking cessation with sexual function among participants of the REduction by DUtasteride of prostate Cancer Events (REDUCE) study.Subjects and MethodsWe analysed baseline data of 6754 men, aged 50–75 years divided into: lifelong non‐smokers, former smokers, and current smokers. We examined total testosterone (TT, normal range ≥10 nmol/L) and sexual function variables: self‐reported sexual activity, low libido, and erectile dysfunction (ED). Differences between current vs non‐smokers and former vs current smokers were analysed using the chi‐square test, linear and logistic regressions.ResultsA total of 3069 (45.4%) men were non‐smokers, 2673 (39.6%) former smokers, and 1012 (15%) current smokers. Current smokers were significantly younger than former and non‐smokers (mean age 61.6, 63.2, and 62.7 years, respectively), leaner (mean body mass index 27.0, 27.7, and 27.2 kg/m2, respectively), and had less hypertension (32.4%, 41.6%, and 36.8%, respectively; all P < 0.01). In uni‐ and multivariable analysis, current smokers had higher mean TT than non‐smokers (485.4 vs 451.2 nmol/L, P < 0.001), higher prevalence of low libido (25.6% vs 21.0%, P = 0.002) and ED (31.6% vs 26.0%, P < 0.001) with comparable sexual activity (81.7% vs 82.8%, P = 0.420). In multivariable analysis, former smokers had statistically significantly less prevalence of low libido (odds ratio [OR] 0.8, P = 0.013) and ED (OR 0.8, P = 0.006) compared to current smokers.ConclusionCigarette smoking was associated with worse sexual health compared to non‐smokers, while former smokers had better erectile function and libido than current smokers. Smoking cessation may improve male sexual health and counselling on smoking cessation may be considered at the time of sexual health evaluations.
Prevalence of traumatic dental injuries in emergency dental services: A systematic review and meta‐analysis
Authors: Lima Thiago César da Silva , Coste Sylvia Cury , Fernandes Marina Izabelle Avelar Pires , Barbato‐Ferreira Daniela Augusta , Colosimo Enrico Antônio , Del Fabbro Massimo , Ribeiro Sobrinho Antônio Paulino , Côrtes Maria Ilma de Souza , Bastos Juliana Vilela 
Published: February 2022

AbstractObjectivesThis study aimed to perform a systematic review and meta‐analysis regarding the prevalence of traumatic dental injuries (TDI) in emergency dental services.MethodsSeven electronic and two grey literature databases were searched, up to December 2021, for studies that reported the TDI prevalence among dental emergencies. The Joanna Briggs Institute critical appraisal checklist for prevalence studies, and The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach were used to assess the risk of bias and quality of evidence respectively. The R software was used to perform a proportion meta‐analysis on a random‐effects model to estimate the pooled prevalence and respective 95% CI.ResultsFrom a total of 1476 studies identified after excluding duplicates, 38 met the inclusion criteria, and another five were identified through hand searching, summing 43 included observational studies with a total sample of 209099 individuals searching for emergency dental care. The overall pooled prevalence of TDI was 15.4% (95% CI: 11%‐21%, I² = 100%). Paediatric dental emergency services and age group from 0 to 21 years presented the highest prevalence, 29% (95% CI: 22%‐38%, I² = 99.5%) and 24% (95% CI: 15%‐35%, I² = 98%) respectively.ConclusionsThe overall pooled prevalence of TDI in emergency dental services was 15.4%, and 24% in the age group under 21 years. Considering the impact of prompt and correct emergency care in the long‐term prognosis of TDI, such knowledge is relevant to organize emergency healthcare and support public policies in this area.
Radiographic assessment of deproteinized bovine bone mineral (DBBM) and collagen‐stabilized DBBM for transalveolar sinus floor elevation: A 2‐year retrospective cohort study
Authors: Wu Yefeng , Xiao Pei , Xu Antian , He Fuming 
Published: February 2022

AbstractBackgroundTheoretically, collagen‐stabilized deproteinized bovine bone mineral (DBBM‐C) has better operability compared with DBBM. DBBM‐C avoids dispersing during the transalveolar sinus floor elevation (TSFE) because of its block shape.PurposeTo evaluate radiological changes of using DBBM‐C in TSFE.Materials and MethodsPatients who received TSFE using DBBM (Bio‐Oss®) or DBBM‐C (Bio‐Oss® collagen) with simultaneous implantation were recruited. Graft bone height apically (aGH), endo‐sinus bone gain (ESBG), and crest bone level (CBL) were assessed through panoramic radiograph and cone beam computed tomography (CBCT).ResultsA total of 138 patients (138 implants) were retrospectively enrolled. After 2 years of implantation, the incidence of postoperative complications was 4.2% (95% CI: 0.9%–11.7%) and 4.5% (95% CI: 0.9%–12.7%) for DBBM and DBBM‐C groups, respectively. Measured in panoramic radiograph, ΔaGH of DBBM‐C (1.8 mm, SD: 1.4, 95% CI: 1.2–2.4, P = 0.044) group was significantly higher than that of DBBM (1.2 mm, SD: 1.4, 95% CI: 0.7–1.7) after 24 months. No significant differences for ΔCBL were noted during the entire observation period. Measured through CBCT, ESBG was 5.0 (SD: 1.8, 95% CI: 4.1–5.8) mm in DBBM group and 4.6 (SD: 1.6, 95% CI: 3.9–5.3) mm in DBBM‐C group 24 months after implantation. The aGH value of DBBM‐C group was significantly higher compared with DBBM in CBCT (OR = 1.4, 95% CI: 1.1–1.9, P = 0.020).ConclusionsDBBM‐C could achieve similar bone generation as DBBM in TSFE. Both materials could maintain aGH, ESBG, and CBL relatively stable 2 years after implantation.