bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of gastrointestinal failure in the adult critical care setting
Authors: Berger Mette M. , Hurni Claire-Anne 
Published: February 2022

Purpose of review
Gastrointestinal failure is a polymorphic syndrome with multiple causes. Managing the different situations from a practical, metabolic, and nutritional point of view is challenging, which the present review will try to address.

Recent findings
Acute gastrointestinal injury (AGI) has been defined and has evolved into a concept of gastrointestinal dysfunction score (GIDS) built on the model of Sequential Organ Failure Assessment (SOFA) score, and ranging from 0 (no risk) to 4 (life threatening). But there is yet no specific, reliable and reproducible, biomarker linked to it. Evaluating the risk with the Nutrition Risk Screening (NRS) score is the first step whenever addressing nutrition therapy. Depending on the severity of the gastrointestinal failure and its clinical manifestations, nutritional management needs to be individualized but always including prevention of undernutrition and dehydration, and administration of target essential micronutrients. The use of fibers in enteral feeding solutions has gained acceptance and is even recommended based on microbiome findings. Parenteral nutrition whether alone or combined to enteral feeding is indicated whenever the intestine is unable to process the needs.

Summary
The heterogeneity of gastrointestinal insufficiency precludes a uniform nutritional management of all critically ill patients but justifies its early detection and the implementation of individualized care.
SMART - is it practical in the United States?
Authors: Norris Matthew R. , Modi Sunjay , Al-Shaikhly Taha 
Published: February 2022

Purpose of review
The 2020 focused updates to the asthma management guidelines by the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group advocate for inhaled corticosteroid (ICS)-formoterol combinations as single maintenance and reliever therapy (SMART) for patients with persistent asthma. We review the rationale, the evidence supporting SMART use in asthma, and barriers limiting its wide adoption in the United States.

Recent findings
A growing body of evidence supports the use of SMART over the conventional use of controller medicaments with an as-needed short-acting β2 agonist for rescue therapy for the purpose of reducing the risk of asthma exacerbation and maintaining asthma control in adolescents and adults with persistent disease. Lack of US Food and Drug Administration approval, inconsistent insurance coverage, and limited options of ICS-formoterol combination available for use as SMART represent obstacles to wider integration of SMART in clinical practice.

Summary
SMART represents a paradigm shift in asthma management. By identifying and addressing the current and anticipated barriers to implementing SMART, its adoption by providers is likely to increase in the United States.
Routine Catheter Lock Solutions in Pediatric Cancer Care
Authors: Ullman Amanda J. , Edwards Rachel , Walker Rick , Roy John , Paton Andrew , Rickard Claire M. , Cooke Marie , Bradford Natalie , Gibson Victoria , Cattanach Paula , Paterson Rebecca S. , Takashima Mari , Byrnes Joshua , Keogh Samantha , Kleidon Tricia 
Published: February 2022

Background
Central venous access devices (CVADs) are integral to cancer care provision. Despite the high prevalence of CVAD complications in children with cancer, preventative strategies are understudied.

Objective
The aim of this study was to assess study feasibility, occlusive events, thrombolytic use, adverse events, and direct costs of catheter lock solutions.

Methods
A single-center, parallel-group, pilot randomized controlled trial was undertaken at a tertiary-referral pediatric hospital in Australia. Children 18 years or younger with an oncological or malignant hematological condition and a CVAD were eligible. Participants were 1:1 randomized to (1) normal or (2) heparinized (10–100 U/mL; CVAD-type dependent) saline lock solutions.

Results
Of 217 children assessed for eligibility, 61 were recruited and randomized to normal (n = 30; 3850 CVAD days) or heparinized (n = 31; 4036 CVAD days) saline. Eligibility (52%) and recruitment (54%) feasibility targets were not met. Protocol adherence was high (95% assessments), with no attrition. Parent/clinician satisfaction of interventions was high (median, 10/10 clinicians/parents). Complete CVAD occlusion occurred in heparin only (n = 2, 6.7% CVADs; incidence rate [IR], 0.49/1000 CVAD days [0.06–1.78]). Central venous access device partial occlusion was detected in 23.3% of CVADs in heparin (n = 7; IR, 2.73/1000 CVAD days [1.36–4.87]) and 13.8% of CVADs in normal saline (n = 4; IR, 2.59/1000 CVAD days [1.24–4.77]). Thrombolytic agents were used in 16.7% heparin (5 CVADs) and 3.5% normal saline (1 CVAD). Adverse events did not differ between groups.

Conclusion
Multisite randomized controlled trials examining CVAD locks are safe, but strategies and resources to increase recruitment and eligibility are required.

Implications for Practice
Both routine CVAD lock solutions seem safe but may not prevent all forms of CVAD-associated harm.
Motivational trade-offs in bumblebees
Authors: Gibbons Matilda , Versace Elisabetta , Crump Andrew , Baran Bartosz , Chittka Lars 
Published: February 2022

AbstractMammals can supress their nociceptive responses to prioritise other important responses via endogenous modulation from the brain. It is well established that insects display nociception, but not whether the insect brain can modulate nociceptive processing. To address this question, we investigated whether bumblebees’ (Bombus terrestris) attraction to higher sucrose solution concentrations reduces their avoidance of noxious heat. Bees were given the choice between either unheated or noxiously-heated (55°C) feeders with different sucrose concentrations. The feeders were associated with colour stimuli to act as conditioned cues. Bees fed more from higher sucrose concentration heated feeders than lower sucrose concentration unheated feeders. Further, bees’ “testing out” of feeders (landing but not feeding) reduced as the experiment progressed, demonstrating that conditioned colour cues informed the bees’ behaviour. Therefore, bees trade off competing conditioned motivational stimuli to modulate nocifensive behaviour, suggesting a form of pain perception.
Limitations of molecular and antigen test performance for SARS-CoV-2 in symptomatic and asymptomatic COVID-19 contacts
Authors: Robinson Matthew L. , Mirza Agha , Gallagher Nicholas , Boudreau Alec , Garcia Lydia , Yu Tong , Norton Julie , Luo Chun Huai , Conte Abigail , Zhou Ruifeng , Kafka Kim , Hardick Justin , McManus David D. , Gibson Laura L. , Pekosz Andrew , Mostafa Heba , Manabe Yukari C. 
Published: February 2022

ABSTRACTObjectivesCOVID-19 has brought unprecedented attention to the crucial role of diagnostics in pandemic control. We compared SARS-CoV-2 test performance by sample type and modality in close contacts of SARS-CoV-2 cases.MethodsClose contacts of SARS-CoV-2 positive individuals were enrolled after informed consent. Clinician-collected nasopharyngeal (NP) swabs in viral transport media (VTM) were tested with a nucleic acid test (NAT). NP VTM and self-collected passive drool were tested using the PerkinElmer real-time reverse transcription PCR (RT-PCR) assay. For the first 4 months of study, mid-turbinate swabs were tested using the BD Veritor rapid antigen test. NAT positive NP samples were tested for infectivity using a VeroE6TMPRSS2 cell culture model.ResultsBetween November 17, 2020, and October 1, 2021, 235 close contacts of SARS-CoV-2 cases were recruited, including 95 with symptoms (82% symptomatic for <5 days) and 140 asymptomatic individuals. NP swab reference tests were positive for 53 (22.6%) participants; 24/50 (48%) were culture positive. PerkinElmer testing of NP and saliva samples identified an additional 28 (11.9%) SARS-CoV-2 cases who tested negative by clinical NAT. Antigen tests performed for 99 close contacts showed 83% positive percent agreement (PPA) with reference NAT among early symptomatic persons, but 18% PPA in others; antigen tests in 8 of 11 (72.7%) culture-positive participants were positive.ConclusionsContacts of SARS-CoV-2 cases may be falsely negative early after contact, which more sensitive platforms may identify. Repeat or serial SARS-CoV-2 testing with both antigen and molecular assays may be warranted for individuals with high pretest probability for infection.
AI-aided dynamic prediction of bleeding and ischemic risk after coronary stenting and subsequent DAPT
Authors: Li Fang , Rasmy Laila , Xiang Yang , Feng Jingna , Du Jingcheng , Aguilar David , Dhoble Abhijeet , Wang Qing , Niu Shuteng , Hu Xinyue , Dang Yifang , Zhang Xinyuan , Xie Ziqian , Nian Yi , He JianPing , Zhou Yujia , Abdelhameed Ahmed , Bian Jiang , Zhi Degui , Tao Cui 
Published: February 2022

AbstractBackgroundContemporary risk scores for ischemic or bleeding event prediction after drug-eluting stent (DES) implantation are limited to the determination of a single time duration for dual antiplatelet therapy (DAPT) and lack flexibility in providing dynamic risk stratification.ObjectivesThis study sought to develop artificial intelligence (AI) models to dynamically predict the ischemic and bleeding risks at different time intervals for patients with DES implantation for personalized decision support for antiplatelet therapy.MethodsWe identified 81,594 adult patients who received DES implantation in the United States from the Cerner HealthFacts® dataset. The total prediction window covered 12-30 months after DES implantation. We designed eight prediction scenarios with four prediction intervals (3, 6, 12, and 18 months). Five AI models were developed for the ischemic and bleeding risk stratification. Model performance was assessed using the area under the receiver operating characteristic curve (AUROC).ResultsOur proposed AI model outperformed the clinical guideline-recommended tool–the DAPT score– for 12m-30m prediction (with AUROC 0.82 vs. 0.79 for ischemia, 0.77 vs 0.72 for bleeding). In the scenarios that are not covered by the DAPT score, our models demonstrated robust performance (AUROC ranges were 0.79–0.80 for ischemia and 0.75–0.76 for bleeding).ConclusionsAs the first effort dedicated to dynamically forecasting adverse endpoints after DES implantation given DAPT continuation or discontinuation, our AI-empowered approach demonstrates superior capabilities for risk stratification, holding value as a novel clinical tool that can refine the prognostic judgments of clinicians and achieve optimal DAPT management.Condensed abstractWe proposed an innovative AI-based dynamic prediction system that forecasts the ischemic and bleeding events after coronary stenting in varying time intervals given DAPT continuation or discontinuation. Our AI model not only demonstrated superiority compared with the clinical guideline-recommended tool–the DAPT score in the 12-30 months prediction, but also achieved robust performance in other scenarios that were not covered by the DAPT score. Our AI-driven approach holds value as a novel clinical tool that can refine the prognostic judgments of clinicians, enable better informed clinical decisions, and facilitate optimal DAPT management in the context of precision cardiovascular medicine.
Cross-Sectional Study of University students’ attitudes to ‘on campus’ delivery of COVID-19 vaccines and future-proofing MenACWY and MMR vaccination rates by adopting COVID-19 vaccine roll-out strategies
Authors: Webb Adam , Gogoi Mayuri , Weidman Sarah , Woolf Katherine , Zavala Maria , Ladhani Shamez N , Pareek Manish , Gies Lieve , Bayliss Christopher D 
Published: February 2022

AbstractBackgroundUniversity students are a critical group for vaccination programmes against COVID-19, meningococcal disease (MenACWY), and measles, mumps and rubella (MMR). We aimed to evaluate risk factors for vaccine hesitancy (refusal or intention to refuse a vaccine) and views of university students about on-campus vaccine delivery.MethodsCross-sectional anonymous online questionnaire study of undergraduate students at a British university in June 2021. Chi-squared, Fisher’s exact, univariate and multivariate tests were applied to detect associations.ResultsComplete data were obtained from 827 participants (7.6% response-rate). Two-thirds (64%; 527/827) reported having been vaccinated against COVID-19 and a further 23% (194/827) agreed to be vaccinated. Other responses were either unclear (66) or indicated an intention to refuse vaccination (40). Hesitancy for COVID-19 vaccines was 5% (40/761). COVID-19 vaccine hesitancy was associated with black ethnicity (aOR, 7.01, 95% CI, 1.8-27.3) and concerns about vaccine side-effects (aOR, 1.72; 95% CI, 1.23-2.39). Lower levels of vaccine hesitancy were detected amongst students living in private accommodation (aOR, 0.13; 95% CI, 0.04-0.38) compared to those living at home. Uncertainty about their personal vaccine status was frequently observed for MMR (11%) and MenACWY (26%) vaccines. Campus-associated COVID-19 vaccine campaigns were definitely (45%) or somewhat (16%) favoured by UK-based students and more so among UK-based international students (62% and 12%, respectively).ConclusionsVaccine hesitancy among students of black ethnicity and those living at home requires further exploration because attitudes in these groups may affect COVID-19 vaccine uptake. High levels of uncertainty among students about their MMR and MenACWY vaccine status are also a concern for the effectiveness of these vaccine programmes. This issue could be tackled by extending the capabilities of digital platforms for accessing vaccine information, such as the NHSapp in the UK. Sector-wide implementation of on-campus vaccine delivery may also improve vaccine uptake, especially for international students.
Effectiveness of Financial Incentives for a Pedometer-Based Walking Promotion Program
Authors: Komiya Eriko , Taniuchi Satsuki , Shiba Masatsugu , Shintani Ayumi , Nakamura Hiroaki 
Published: February 2022

AbstractPhysical inactivity contributes significantly to poor health and the onset of disease. Physical inactivity is also associated with severe economic burdens. Japan’s Ministry of Health, Labor and Welfare (MHLW) cites the provision of various health promotion incentives aimed at health-indifferent groups, which are made up of individuals less interested in health promotion. This study investigated the relationship between medical costs and a pedometer-based walking program providing monetary incentives based on daily step counts. The study sample included 16,816 citizens aged 40–75 years who lived in Takaishi City and were enrolled in the NIH from October 2016 to March 2018. The results of the ordinal logistic regression analysis showed that participation in a walking promotion program with an HPFI was correlated with a reduction in healthcare costs over 1 year in a sample of Takaishi City residents. In fact, there was a difference of 67,077 yen in the average medical cost per person per year between the walking and control groups. With 1,923 walking group participants, the total medical cost reduction was predicted to be at least 12,898,904 yen. In this study, we evaluated the effectiveness of a walking promotion program with incentives. With program context differing widely from region to region and country to country, future investigations are needed to inform the selection of appropriate incentive schemes for programs offered in other regions and countries.
Environmental monitoring and health assessment in an industrial town in central India: A cross-sectional study protocol
Authors: Trushna Tanwi , Dhiman Vikas , Aher Satish Bhagwatrao , Raj Dharma , Ahirwar Rajesh , Shubham Swasti , Nandi Subroto Shambhu , Tiwari Rajnarayan R 
Published: February 2022

AbstractBackgroundTextile industry has been widely implicated in environmental pollution. The health effects of residing near manufacturing industries are not well documented in India, especially in central India. Hence, a cross-sectional environmental monitoring and health assessment study was initiated as per directions of the local authorities.MethodsComprehensive exposure data about the concentrations of relevant pollutants in the ambient air and ground water samples in the study area will be collected over 1 year. Using stratified random sampling, 3003 apparently healthy adults will be selected from the study area. Sociodemographic and anthropometric information, relevant medical and family history, and investigations including spirometry, electrocardiogram, neurobehavioral tests, and laboratory investigations (complete blood count, lipid profile and random blood glucose) will be conducted. Finally Iodine azide test and heavy metal level detection in urine and blood samples respectively will be conducted in a subset of selected participants to assess individual pollution exposure. Ethics approval has been obtained from the Institutional Ethics Committee of the National Institute for Research in Environmental Health (No: NIREH/IEC-7-II/1027, dated 07/01/2021).DiscussionThis manuscript describes the protocol for a multi-disciplinary study that aims to conduct environmental monitoring and health assessment in residential areas near viscose rayon and associated chemical manufacturing industries. Although India is the second largest manufacturer of rayon, next only to China, and viscose rayon manufacturing has been documented to be a source of multiple toxic pollutants, there is a lack of comprehensive information about the health effects of residing near such manufacturing units in India. Therefore implementing this study protocol will aid in filling in this knowledge gap.
Antibody response after a single dose of BBV152 vaccine negatively correlates with pre-existing antibodies and induces a significant but low levels of neutralizing antibodies to Omicron variant
Authors: Das Suman , Singh Janmejay , Shaman Heena , Singh Balwant , Anantharaj Anbalagan , Sharanabasava Patil , Pandey Rajesh , Lodha Rakesh , Pandey Anil Kumar , Medigeshi Guruprasad R. 
Published: February 2022

ABSTRACTMost adults in India have received at least one dose of COVID-19 vaccine and also been infected naturally during the pandemic. As immunization of individuals continues under this situation where the virus has attained endemicity, we assessed whether this hybrid immunity is further boosted by a single dose of BBV152, an inactivated SARS-CoV-2 vaccine, and, if these antibodies can neutralize SARS-CoV-2 delta and omicron variants. We found that natural infection during the second wave in 2021 led to generation of neutralizing antibodies against other lineages of SARS-CoV-2 including the omicron variant, albeit at a significantly lower level for the latter. A single dose of BBV152 boosted antibody titers against the delta and the omicron variants but the antibody levels remained low for the omicron variant. Boosting of antibodies showed negative correlation with baseline neutralizing antibody titers suggesting anergy of the immune system in individuals with high levels of antibodies.
Preclinical Pharmacokinetics andIn VitroProperties of GS-441524, A Potential Oral Drug Candidate for COVID-19 Treatment
Authors: Wang Amy Q. , Hagen Natalie R. , Padilha Elias C. , Yang Mengbi , Shah Pranav , Chen Catherine Z. , Huang Wenwei , Terse Pramod , Sanderson Philip , Zheng Wei , Xu Xin 
Published: February 2022

ABSTRACTPreclinical pharmacokinetics (PK) andin vitroADME properties of GS-441524, a potential oral agent for the treatment of Covid-19, were studied. GS-441524 was stablein vitroin liver microsomes, cytosols, and hepatocytes of mice, rats, monkeys, dogs, and humans. The plasma free fractions of GS-441524 were 62-78% across all studied species. Thein vitrotransporter study results showed that GS-441524 was a substrate of MDR1, BCRP, CNT3, ENT1, and ENT2; but not a substrate of CNT1, CNT2, and ENT4. GS-441524 had a low to moderate plasma clearance (CLp), ranging from 4.1 mL/min/kg in dogs to 26 mL/min/kg in mice; the steady state volume distribution (Vdss) ranged from 0.9 L/kg in dogs to 2.2 L/kg in mice after IV administration. Urinary excretion appeared to be the major elimination process for GS-441524. Following oral administration, the oral bioavailability was 8.3% in monkeys, 33% in rats, 39% in mice, and 85% in dogs. The PK and ADME properties of GS-441524 support its further development as an oral drug candidate.
Evaluation of the fire performance of unprotected composite beams with fin-plate joints
Authors: Yotsumoto Naoya , Hirashima Takeo , Toyoda Koji 
Published: February 2022

PurposeThis paper aims to investigate the fire performance of composite beams when considering the hogging moment resistance of the fin-plate beam-to-girder joints including the effect of continuity of reinforcements.Design/methodology/approachExperiments on composite beams with fin-plate joints protected only at the beam ends are conducted. The test parameter is the specification of reinforcement, which affects the rotational restraint of the beam ends. In addition, a simple method for predicting the failure time of the beam using an evaluation model based on the bending moment resistance of the beam considering the hogging moment resistance of the fin-plate joint and the reinforcement is also presented.FindingsThe test results indicate that the failure time of the beam is extended by the hogging moment resistance of the joints. This is particularly noticeable when using a reinforcing bar with a large plastic deformation capability. The predicted failure times based on the evaluation method corresponded well with the test results.Originality/valueRecent studies have proposed large deformation analysis methods using FEM that can be used for fire-resistant design of beams including joints, but these cannot always be applicable in practice due to the cost and its complexity. Our method can consider the hogging moment resistance of the joint and the temperature distribution in the axial direction using a simple method without requirement of FEM.