bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost‐minimisation analysis of polysomnography and pulse oximetry in a risk stratification protocol for paediatric adenotonsillectomy
Authors: Key Seraphina , Chia Clemente , Nixon Gillian , Paddle Paul 
Published: June 2022

AbstractBackgroundSevere obstructive sleep apnoea (OSA) is associated with increased risk of respiratory compromise in the post‐operative period following adenotonsillectomy (AT). This study analyses the economic cost of polysomnography or overnight oximetry as part of pre‐operative risk stratification in paediatric AT, supplementing previously published research demonstrating the efficacy of this protocol in predicting respiratory complications.MethodsThis cost‐minimisation analysis examines costs associated with pre‐operative overnight oximetry and polysomnography in triaging paediatric patients older than 2 years old, with no major comorbidities except for OSA, undergoing AT for OSA (n = 1801) to either a secondary or quaternary Australian hospital. Decision analysis modelling via probability trees were utilized to estimate pre‐ and peri‐operative costs. A third hypothetical ‘no investigation’ model based upon conducting all AT at a secondary hospital was performed. Costs are derived from the financial year 2020–2021, censored at discharge.ResultsThe total cost per patient of AT including pre‐operative investigations of oximetry and polysomnography, and associated inpatient costs, were AUD4181.34 and 5013.99 respectively. This is more expensive compared to a hypothetical no‐investigation model (AUD3958.98).ConclusionWithin the scope of this partial economic evaluation, this study finds a small additional cost for a model of care involving overnight oximetry as a pre‐operative triage tool, balanced by the reduced cost of care in a lower acuity centre for low‐risk patients and potential high cost of complications if all children are treated in a low acuity centre. This supports oximetry in peri‐operative risk stratification for paediatric AT from a financial perspective.
Machine learning and artificial intelligence in cardiac transplantation: A systematic review
Authors: Naruka Vinci , Arjomandi Rad Arian , Subbiah Ponniah Hariharan , Francis Jeevan , Vardanyan Robert , Tasoudis Panagiotis , Magouliotis Dimitrios E. , Lazopoulos George L. , Salmasi Mohammad Yousuf , Athanasiou Thanos 
Published: June 2022

AbstractBackgroundThis review aims to systematically evaluate the currently available evidence investigating the use of artificial intelligence (AI) and machine learning (ML) in the field of cardiac transplantation. Furthermore, based on the challenges identified we aim to provide a series of recommendations and a knowledge base for future research in the field of ML and heart transplantation.MethodsA systematic database search was conducted of original articles that explored the use of ML and/or AI in heart transplantation in EMBASE, MEDLINE, Cochrane database, and Google Scholar, from inception to November 2021.ResultsOur search yielded 237 articles, of which 13 studies were included in this review, featuring 463 850 patients. Three main areas of application were identified: (1) ML for predictive modeling of heart transplantation mortality outcomes; (2) ML in graft failure outcomes; (3) ML to aid imaging in heart transplantation. The results of the included studies suggest that AI and ML are more accurate in predicting graft failure and mortality than traditional scoring systems and conventional regression analysis. Major predictors of graft failure and mortality identified in ML models were: length of hospital stay, immunosuppressive regimen, recipient's age, congenital heart disease, and organ ischemia time. Other potential benefits include analyzing initial lab investigations and imaging, assisting a patient with medication adherence, and creating positive behavioral changes to minimize further cardiovascular risk.ConclusionML demonstrated promising applications for improving heart transplantation outcomes and patient‐centered care, nevertheless, there remain important limitations relating to implementing AI into everyday surgical practices.
A retrospective cohort study: pre‐operative oral enteral nutritional optimisation for Crohnʼs disease in a UK tertiary IBD centre
Authors: Meade Susanna , Patel Kamal V. , Luber Raphael P. , O'Hanlon Dearbhaile , Caracostea Andra , Pavlidis Polychronis , Honap Sailish , Anandarajah Cheran , Griffin Nyree , Zeki Sebastian , Ray Shuvra , Mawdsley Joel , Samaan Mark A. , Anderson Simon H. , Darakhshan Amir , Adams Katie , Williams Andrew , Sanderson Jeremy D. , Lomer Miranda , Irving Peter M. 
Published: June 2022

SummaryBackgroundLow‐quality evidence suggests that pre‐operative exclusive enteral nutrition (E/EN) can improve postoperative outcomes in patients with Crohn's disease (CD). It is not standard practice in most centres.AimsTo test the hypothesis that pre‐operative EN in patients undergoing ileal/ileocolonic surgery for CD is associated with improved postoperative outcome.MethodsWe performed a single centre retrospective observational study comparing surgical outcomes in patients receiving pre‐operative EN (≥600 kcal/day for ≥2 weeks) with those who received no nutritional optimisation. Consecutive adult patients undergoing ileal/ileocolonic resection from 2008 to 2020 were included. The primary outcome was postoperative complications <30 days. Secondary outcomes included EN tolerance, specific surgical complications, unplanned stoma formation, length of stay, length of bowel resected, readmission and biochemical/anthropometric changes.Results300 surgeries were included comprising 96 without nutritional optimisation and 204 optimised cases: oral EN n = 173, additional PN n = 31 (4 of whom had received nasogastric/nasojejunal EN). 142/204 (69.6%) tolerated EN. 125/204 (61.3%) initiated EN in clinic. Patients in the optimised cohort were younger at operation and diagnosis, with an increased frequency of penetrating disease and exposure to antibiotics or biologics, and were more likely to undergo laparoscopic surgery. The optimised cohort had favourable outcomes on multivariate analysis: all complications [OR 0.29; 0.15–0.57, p < 0.001], surgical complications [OR 0.41; 95% CI 0.20–0.87, p = 0.02], non‐surgical complications [OR 0.24 95% CI 0.11–0.52, p < 0.001], infective complications [OR 0.32; 95% CI 0.16–0.66, p = 0.001].ConclusionsOral EN was reasonably well tolerated and associated with a reduction in 30‐day postoperative complications. Randomised controlled trials are required to confirm these findings.
“A canary is supposed to sit in a cage and look at someone else's happiness”: Domestic rewilding in fin‐de‐siècle St Petersburg
Authors: Petri Olga 
Published: June 2022

AbstractIn this paper, I suggest a new way of looking at the aesthetically motivated invitation of the putative wild into the inner sanctum of human artifice, the domestic sphere. I use the urban historical geography of Russia as my example. Rather than interpreting such interventions as simply the transplantation of the wild in time and space, the biological recovery of an often imaginary rural past, I argue that the paradoxes of what I call “domestic rewilding” deserve particular attention, as they reveal the aesthetic and political preoccupations motivating such projects. I put a special stress on the gendered cultural politics of canary‐keeping in fin‐de‐siècle St Petersburg, which saw a craze for canaries in the homes of all classes. In many cases, it was women who bought, trained, and traded these birds in order to beautify – via an ecological imaginary– the cultural spaces that had been created with the objective of keeping the non‐urban wild at bay. By installing these acoustic artefacts in the heart of the home, these women obtained a covert licence to go out on a figurative limb. The human/non‐human symbiosis of canary domestication provided a cover for women's incursions into traditionally male public formats of organised societies and scientific publications. The paradoxes of domestic rewilding thus subversively re‐constituted the gendered spaces of St Petersburg's urban modernity.
Reduction in seroprevalence of viral transfusion‐transmitted infections in southwest Nigeria in children with sickle cell disease using an enhanced screening strategy
Authors: Ogbenna Ann A. , Akinsete Adeseye M. , Kalejaiye Olufunto O. , Matthew Oyewole Kunmi , Sharma Deva , Andrews Jennifer , Kassim Adetola A. 
Published: June 2022

SummaryBlood transfusion is an integral component in the management of children and adults with sickle cell disease (SCD). Concerns about blood safety due to the high risk of bloodborne infections in sub‐Saharan Africa limits the application of this cost‐effective strategy in the management of individuals with SCD. In a single‐centre, retrospective, longitudinal study in southwest Nigeria, we hypothesised that the use of stringent blood donor selection, along with very sensitive enzyme‐linked immunosorbent assay (ELISA) screening methods would reduce transfusion‐transmitted infections (TTIs). Among 45 002 eligible blood donors at the Lagos University Teaching Hospital in Nigeria, over a 5‐year review period (2015–2019), the seroprevalence rate of viral TTIs was 9.83%. The seroprevalence rates for human immunodeficiency, hepatitis B, and hepatitis C viruses were 1.37%, 6.2%, and 2.25% respectively. Among 172 children with SCD, 71% (122/172) on regular blood transfusion and 29% (50/172) who had never been transfused or had less than two transfusions per lifetime, none acquired any TTIs using our enhanced screening approach during the study period. Thus, safe blood transfusion practices can be provided for children with SCD in sub‐Saharan Africa with the use of stringent donor selection protocols and fourth‐generation ELISA kits for TTI screening.
Bicultural competence and academic adjustment across Latino youth adaptation from high school to college
Authors: Safa M. Dalal , Gusman Michaela S. , Doane Leah D. 
Published: June 2022

AbstractThis study investigated the association between bicultural competence and academic adjustment (i.e., engagement, efficacy, achievement) among 193 Latino youth (65.3% female; 89.1% U.S.‐born) followed from their senior high school year (Mage = 17.58 years, SD = 0.53) to their fifth college semester (2016–2019). Latent growth analyses revealed that youth's overall bicultural competence trajectory was moderately high and stable across this period. Youth who maintained or increased bicultural competence levels over time (slopes) demonstrated greater self‐efficacy. Youth with greater high school bicultural competence (intercepts) demonstrated higher engagement but lower achievement. No other associations emerged. This study highlights that the promoting influence of bicultural competence may not extend to all indicators of academic adjustment but may depend upon the contexts and demands they navigate.
Functional status of heart transplant recipients predicts survival
Authors: Shaw Taylor B. , Blitzer David , Carter Kristen T. , Lirette Seth , Mohammed Asim , Copeland Jack , Baran David A. , Copeland Hannah 
Published: June 2022

AbstractIntroductionRecipient functional status prior to transplantation can significantly impact post‐transplant survival.MethodsThe United Network for Organ Sharing database was queried for adult heart transplants including data on functional capacity and from February 1, 2005 to March 1, 2021; there were 32 875 cases included. The four functional categories studied were based on adult daily activities of living and were separated into total assistance required, some assistance required, no assistance required, and near death. Survival outcomes were compared for recipient's pretransplant level of functional status versus those with near death status. These were compared using adjusted logistic regression (odds of death at 30 days and 1 year) and conditional Cox models (overall survival and time until post‐transplant rejection). All models were adjusted for donor age, sex, ethnicity, ischemic time, as well as recipient age, sex, ethnicity, length of stay, UNOS region, ventricular assist device, creatinine, days on the waiting list, and status at transplant.ResultsThere were 12 953 recipients classified as “near death” or “severely disabled”; 7711 “required total assistance in daily living”, 7,328 “needed some”, and 4883 “needed none”. In adjusted models, the probabilities of death for the lowest functioning groups within 30 days and 1 year were 5% and 10%, respectively. Those “requiring total assistance” had analogous probabilities of 3% (OR = 0.58; p < 0.001) and 9% (OR = 0.81; p < 0.001). Those “requiring some assistance” had probabilities of 3% (OR = 0.56; p < 0.001) and 9% (OR = 0.74; p < 0.001). Lastly, those “requiring no assistance” had probabilities of death of 2% (OR = 0.35; p < 0.001) and 7% (OR = 0.63; p < 0.001).ConclusionRecipient functional status assessed pre‐transplant and recorded in the UNOS database is a strong predictor of post‐transplant survival.
Parenting roles for young people with attention‐deficit/hyperactivity disorder transitioning to adult services
Authors: Janssens Astrid , Blake Sharon , Eke Helen , Price Anna , Ford Tamsin 
Published: June 2022

AbstractAimTo inform transitions from child to adult health services, we explored the work and roles parents take in the care of young people with attention‐deficit/hyperactivity disorder (ADHD) aged 14 to 25 years old.MethodUsing framework thematic analysis, we analysed data collected from 28 semi‐structured interviews with parents of young people with ADHD to generate a typology and triangulated it against findings from 64 interviews with young people with ADHD. The interviews were carried out as part of a three‐strand, interactive mixed‐method study.ResultsAn entourage typology of three parent roles was identified. Parents moved between ‘manager’ and ‘roadie’ roles as their child gradually matured. A ‘superfan’ role was identified which supported young people's positive self‐image but may impede withdrawal from the ‘manager’ role. Continued parental involvement into adulthood reflected a need to maintain the balance of resources required to maintain quality of life for the whole family.InterpretationThis is the first study to explore parental roles in the health care of young people with ADHD. Parents will vary in their capacity to fulfil the identified roles and step back their care as their children reach adulthood. The findings can inform intervention development to support families and transition between services.What this paper adds

Parents move from a ‘manager’ to ‘roadie’ role as young people mature.
A ‘superfan’ role supports positive self‐image and directed health care work.
Continued involvement reflects parental responsibility to juggle wider family needs and resources.
Parents differ in capacity to fulfil and move between these roles.
What is a clinical practice guideline? A roadmap to their development. Special report from the Guidelines Task Force of the International League Against Epilepsy
Authors: Jetté Nathalie , Kirkpatrick Martin , Lin Katia , Fernando Sanjaya M. S. , French Jacqueline A. , Jehi Lara , Kumlien Eva , Triki Chahnez C. , Wiebe Samuel , Wilmshurst Jo , Brigo Francesco 
Published: June 2022

AbstractClinical practice guidelines (CPGs) are statements that provide evidence‐based recommendations aimed at optimizing patient care. However, many other documents are often published as “guidelines” when they are not; these documents, although also important in clinical practice, are usually not systematically produced following rigorous processes linking the evidence to the recommendations. Specifically, the International League Against Epilepsy (ILAE) guideline development toolkit aims to ensure that high‐quality CPGs are developed to fill knowledge gaps and optimize the management of epilepsy. In addition to adhering to key methodological processes, guideline developers need to consider that effective CPGs should lead to improvements in clinical processes of care and health care outcomes. This requires monitoring the effectiveness of epilepsy‐related CPGs and interventions to remove the barriers to epilepsy CPG implementation. This article provides an overview of what distinguishes quality CPGs from other documents and discusses their benefits and limitations. We summarize the recently revised ILAE CPG development process and elaborate on the barriers and facilitators to guideline dissemination, implementation, and adaptation.
How large and diverse are field populations of fungal plant pathogens? The case of Zymoseptoria tritici
Authors: McDonald Bruce A. , Suffert Frederic , Bernasconi Alessio , Mikaberidze Alexey 
Published: June 2022

AbstractPathogen populations differ in the amount of genetic diversity they contain. Populations carrying higher genetic diversity are thought to have a greater evolutionary potential than populations carrying less diversity. We used published studies to estimate the range of values associated with two critical components of genetic diversity, the number of unique pathogen genotypes and the number of spores produced during an epidemic, for the septoria tritici blotch pathogen Zymoseptoria tritici. We found that wheat fields experiencing typical levels of infection are likely to carry between 3.1 and 14.0 million pathogen genotypes per hectare and produce at least 2.1–9.9 trillion pycnidiospores per hectare. Given the experimentally derived mutation rate of 3 × 10−10 substitutions per site per cell division, we estimate that between 27 and 126 million pathogen spores carrying adaptive mutations to counteract fungicides and resistant cultivars will be produced per hectare during a growing season. This suggests that most of the adaptive mutations that have been observed in Z. tritici populations can emerge through local selection from standing genetic variation that already exists within each field. The consequences of these findings for disease management strategies are discussed.
Characteristics and management of skin cancers in very elderly patients: A real‐world challenge for clinicians
Authors: Lai Michela , Pampena Riccardo , Mirra Marica , Raucci Margherita , Benati Elisa , Borsari Stefania , Lombardi Mara , Banzi Maria , Castagnetti Fabio , Palmieri Tamara , Piana Simonetta , Ramundo Dafne , Pellacani Giovanni , Longo Caterina 
Published: June 2022

AbstractThe increase life expectancy led to an expected increase in skin cancer incidence in older patients. Their treatment can require a complex decision‐making process. Limited data are available on characteristics, management and outcome of skin tumours in nonagenarian and centenarian patients. The aim of our study was to describe epidemiology, clinical‐pathological features and treatment strategies of skin cancers in a cohort of patients aged ≧95 years. A total of 116 patients ≧95 years of age presented for the evaluation of 225 skin lesions (mean of 1.94 lesions per patient). The mean age was 97.4 years, 57.8% were women. Most patients had an ECOG score of 3 (49.3%) or 4 (32%). Lesions were mainly located on the head and neck area (74.2%), upper (7.1%) and lower (6,2%) limbs. The majority of patients presented with non‐melanoma skin cancers (183/225; 81.3%), 25/225 (11.1%) had actinic keratosis, 5 (2.2%) melanoma and 2 (0.9%) atypical fibroxanthoma. Forty‐eight lesions (21.3%) were treated with surgery, 58 (25.8%) with radiotherapy. The management of 73 lesion (32.4%) was discussed at the multidisciplinary tumour board meeting. One patient died for the progression of a squamous cell carcinoma; 74 patients died for causes unrelated to skin tumours, 36 are still alive after a mean follow‐up of 27.27 months. This cohort study confirms that age is not per se a contraindication for treatment of skin cancers in elderly patients. Our results support the importance of a patient‐centred care approach that should take into consideration patient's preferences, comorbidities, compliance and possible adverse events.
Experimental study on cracking behaviors of coarse and fine sandstone containing two flaws under biaxial compression
Authors: Zhou Xiao‐Ping , Peng Sen‐Lin , Zhang Jian‐Zhi , Zhou Jian‐Nan , Berto Filippo 
Published: June 2022

AbstractIn this paper, the effects of materials and confining pressures on the mechanical properties of flawed coarse and fine sandstone is first analyzed. Then, the evolution processes of spatiotemporal acoustic emission (AE) events of coarse and fine sandstone specimens containing two flaws subjected to biaxial compression are investigated to character the damage characteristics and the fracture mechanism. Third, the ultimate failure modes of coarse sandstone specimens are compared with those of the fine sandstone specimens. Finally, the Electron Probe Microscope Analysis (EPEI) technique is conducted to observe the main macrofracture surfaces of coarse and fine sandstone specimens. Besides, the distribution characteristics of two AE indexes are also employed to qualitatively reveal the failure mechanism of tested specimens. The experimental results can provide new insight into the mechanical responses and the cracking behaviors of flawed rocks in complex stress loading conditions.
Comparative lactic acid fermentation with five Lactobacillus strains of supernatants made of extruded and saccharified chickpea flour
Authors: Mariscal Mireya , Espinosa‐Ramírez Johanan , Pérez‐Carrillo Esther , Santacruz Arlette , Cervantes‐Astorga Enrique , Serna‐Saldívar Sergio O. 
Published: June 2022

SummaryGlucose‐rich supernatants were developed based on the enzymatic hydrolysis of raw and extruded chickpea flours first treated with alcalase® and then with a combination of alpha‐amylase and amyloglucosidase or only amyloglucosidase. The optimum treatments were the extruded hydrolysates further treated with amyloglucosidase ‘EF(AMG)’, or the raw chickpea flour treated with a combination of alpha‐amylase and amyloglucosidase ‘RF (Amyl+AMG)’. The resulting supernatants were further fermented with five different strains of Lactobacillus and monitored for 24 h in terms of pH, titratable acidity, and microbial counts. Also, the glucose content and oligosaccharides, total protein, and viability were determined. Both supernatants presented a successful fermentation as estimated by the pH drop (<4.2), lactic acid produced (>0.7%), and microbial counts 9 log (CFU mL−1) which increased up to 5 log during the 24 h fermentation. However, the EF(AMG) supernatant induced fewer reductions in glucose and protein contents in comparison to the RF (Amyl+AMG) counterpart. Among bacteria, the strain Lp 29 in EF(AMG) showed the fastest growth rate (K) and the highest residual protein. In all cases, the proposed technology enhanced the growth of five Lactobacillus strains by taking advantage of the hydrolyzed chickpea chemical composition.
Diagnostic overshadowing: An evolutionary concept analysis on the misattribution of physical symptoms to pre‐existing psychological illnesses
Authors: Hallyburton Ann 
Published: June 2022

ABSTRACTThis evolutionary concept analysis explores the meaning of diagnostic overshadowing within the context of physical health care for individuals with mental illness. Diagnostic overshadowing, the misattribution of symptoms of one illness to an already diagnosed comorbidity, leads to compromised patient care and likely contributes to increased mortality experienced by individuals with mental illness. A systematic literature search led to identification of a sample of 25 publications on the topic. Following Rodgers' Evolutionary Concept Analysis methodology, this literature sample yielded unifying definitions, shared themes, factors contributing to the action of diagnostic overshadowing, outcomes caused by this type of misdiagnosis, and possible interventions available to nurses and other healthcare providers. Understanding of the concept diagnostic overshadowing may help prevent its occurrence and its adverse results.