bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of norepinephrine infusion during cardiopulmonary bypass on perioperative changes in lactic acid level (Norcal)
Authors: Khalil Mohamed A , El Tahan Mohamed R , Khidr Alaa M , Fallatah Summayah , Abohamar Ahmad D , Amer Mahmoud M , Makhdom Fahd , El Ghoneimy Yasser , Al Bassam Bassam , Alghamdi Talal , Abdulfattah Dalia 
Published: August 2022

Introduction Hyperlactatemia, a problem reported in up to 30% of cardiac surgery patients, results from excessive production of or decreased clearance of lactate. It is typically a symptom of tissue hypoperfusion and may be associated with the prevalence of postoperative acute mesenteric ischemia and renal failure, or prolonged intensive care unit (ICU) and hospital stay, and increased 30-day mortality. Methods and measurements Eighty cardiac surgery patients using cardiopulmonary bypass (CPB) were randomly assigned into either a placebo (n = 39) or norepinephrine 0.05–0.2 µg/kg/min (n = 41) as well as norepinephrine boluses during CPB to maintain mean arterial blood pressure (MAP) at 65 to 80 mm Hg. Patient assignments were done after receiving ethical approval to proceed. The primary result was the perioperative changes in lactic acid level. Secondary findings were also recorded, including hemodynamic variables, the incidence of vasoplegia, intraoperative hypotension, myocardial ischemia, the need for vasopressor support, postoperative complications, and mortality. Results The peak levels and perioperative changes in blood lactate during the first 24 postoperative hours, the number of patients who experienced early hyperlactatemia on admission to the ICU (Placebo: 46.2%, Norepinephrine: 51.2%, p = .650), vasoplegia, hemodynamic changes, incidences of intraoperative hypotension, myocardial ischemia, postoperative complications, and mortality rates were similar in the two groups. Patients in the norepinephrine group received lower intraoperative rescue norepinephrine boluses to maintain the target MAP (p = .039) and had higher MAP values during the CPB and intraoperative blood loss [mean difference [95% confidence interval]; 177 [20.9–334.3] ml, p = .027]. Conclusion norepinephrine and placebo infusions during the CPB with the maintenance of MAP from 65 to 80 mmHg had comparative effects on the changes in blood lactate and incidence of vasoplegia after cardiac surgery. Norepinephrine infusion maintained higher MAP values during the CPB.
Integrating model explanations and hybrid priors into deep stacked networks for the “safe zone” prediction of acetabular cup
Authors: Han Fuchang , Liao Shenghui , Bai Sifan , Wu Renzhong , Zhang Yingqi , Hao Yongqiang 
Published: August 2022

Background Existing state-of-the-art “safe zone” prediction methods are statistics-based methods, image-matching techniques, and machine learning methods. Yet, those methods bring a tension between accuracy and interpretability. Purpose To explore the model explanations and estimator consensus for “safe zone” prediction. Material and Methods We collected the pelvic datasets from Orthopaedic Hospital, and a novel acetabular cup detection method is proposed for automatic ROI segmentation. Hybrid priors comprising both specific priors from data and general priors from experts are constructed. Specifically, specific priors are constructed based on the fine-tuned ResNet-101 convolutional neural networks (CNN) model, and general priors are constructed based on expert knowledge. Our method considers the model explanations and dynamic consensus through appending a SHapley Additive exPlanations (SHAP) module and a dynamic estimator stacking. Results The proposed method achieves an accuracy of 99.40% and an area under the curve of 0.9998. Experimental results show that our model achieves superior results to the state-of-the-art conventional ensemble classifiers and deep CNN models. Conclusion This new screening model provides a new option for the “safe zone” prediction of acetabular cup.
The application of metagenomic next-generation sequencing for detection of pathogens from dialysis effluent in peritoneal dialysis–associated peritonitis
Authors: Ye Peiyi , Xie Chao , Wu Cuixia , Yu Cuiyan , Chen Yuhe , Liang Zijie , Chen Youyuan , Chen Qiyan , Kong Yaozhong 
Published: August 2022

Background: Metagenomic next-generation sequencing (mNGS) can improve pathogen identification in infectious diseases. Methods: A prospective parallel control study was undertaken to evaluate the clinical significance of mNGS in identifying pathogens in dialysis effluent of patients with peritoneal dialysis–associated peritonitis (peritonitis). Dialysis effluent specimens were detected both by peritoneal dialysis effluent culture and mNGS. The positive rates and coincidence rates of the two methods were compared. Results: From April 2020 to March 2021, 30 patients presenting with peritonitis were enrolled in this study. The positive pathogen detection rate of mNGS was significantly higher than that of the traditional culture method (86.67% vs. 60.00%; p = 0.039). Fifteen specimens were positive for both of the methods, while 11 specimens were negative for culture but positive for mNGS. Three specimens were positive for culture but negative for mNGS; all of them were streptococcus mitis. One specimen was negative for both methods. The culture method detected one type of pathogen in all specimens; however, two or more types of pathogens were detected in eight specimens by mNGS. In addition to common pathogens, additional pathogens detected by mNGS included Coxiella burnetii, human herpesvirus type 5, human herpesvirus type 6B and Mortierella. Conclusion: The pathogen detection rate of mNGS in dialysis effluent of peritonitis patients was significantly higher than that of traditional culture. The mNGS is advantageous in diagnosing the pathogens that are difficult to be cultured. However, mNGS did not demonstrate sensitivity to streptococcus mitis. Results from this study show that mNGS, combined with traditional culture, has potential application for detecting pathogens in peritoneal dialysis patients with peritonitis.
Rate of Inpatient Hypoglycemia Following a 1:1 Dose Interchange Between Concentrated Insulin Glargine to Insulin Detemir
Authors: Wulfe S. D. , Janzen K. M. , Addison J. , Kelley D. 
Published: August 2022

Background Insulin remains a mainstay of treating hyperglycemia in an acute setting. Insulin glargine 300 units/mL (Toujeo, iGlar300) has a different pharmacokinetic profile than 100 units/mL basal insulins, such as insulin detemir (iDet100) and iGlar100. While conversion from iGlar300 to iGlar100 requires a 20% dose decrease, there is currently no recommended interchange from iGlar300 to iDet100. Objective Compare the incidence of hypoglycemia in patients who received a 1:1 unit interchange from home iGlar300 or iGlar100 to iDet100 while admitted. Methods A retrospective study was conducted to evaluate adults within a multi-site network admitted between May and December 2019. Patients were included if they received at least one dose of iDet100 following interchange from home iGlar300 or iGlar100. The primary endpoint was the incidence of hypoglycemic events following a 1:1 interchange of iGlar300 vs. iGlar100 to inpatient iDet100. Secondary outcomes include overall hypoglycemic events, time to hypoglycemia, and doses given before hypoglycemia. Results Of 615 patients, 394 received a 1:1 unit interchange to iDet100 (52 from iGlar300 and 342 from iGlar100). Incidence of hypoglycemic events was significantly higher in those with a 1:1 interchange from iGlar300 versus iGlar100 (36.5% vs. 18.7%, p = 0.007). Significant differences were observed in overall hypoglycemic events, time to hypoglycemia, and number of doses given before hypoglycemic event. Conclusion and Relevance A 1:1 unit interchange from iGlar300 to iDet100 led to a higher incidence of hypoglycemic events compared to those interchanged from iGlar100. Dose reduction should be considered when transitioning from home iGlar300 to iDet100 in the inpatient setting.
Draping in Dermatology: A Patient’s Perspective
Authors: Cyr Janelle , Choi Bohmyi , Melkis Justina , Gresham Louise , Huang Christina M. , Beecker Jennifer 
Published: August 2022

Background/Objectives Patient dignity is a core component of the Canadian health care system; however, there may be challenges to maintaining patient dignity in clinical settings requiring total body skin examination (TBSE) for adequate assessment and diagnosis. As standardized TBSE draping practices have not been investigated in a dermatology setting, we sought out to investigate subjective patient experiences of draping practices. Methods A cross-sectional study was performed using a paper survey in dermatology hospital clinics over a 6-month period to 150 patients. Results Draping was considered important by over 50% of patients surveyed (54.7%). Respondents who indicated that draping impacted their comfort level “a lot” or “very much” had a mean age of 52 and were more likely to be females ( P < .05). Females were also more likely to answer that their body weight/shape ( P < .05), physician of same ( P < .01) or opposite sex ( P < .001), and the degree of privacy offered by drapes ( P < .001) impacted their comfort level when undressing for a TBSE. Respondents who reported that any assessed factor impacted their comfort during a TBSE were also younger ( P < .05), suggesting that younger and female patients were more likely to have comfort concerns than males. Conclusions Our study confirmed that most patients surveyed considered draping to be important. Our findings highlight the importance of adequate draping practices to maintain patient privacy and dignity for all patients, with special attention to younger female patients to ensure they feel as comfortable as possible. Future research should focus on how these identified patient comfort factors can be implemented into medical education.
Clinical frailty score: A useful tool in predicting outcomes in patients with fragility fractures
Authors: Brown Robyn , Gatfield Sophie , Rogers Michaela , Peter Noel , Torrie Alex 
Published: August 2022

Introduction Frailty is a known risk factor for falls and subsequent fractures and is linked to greater hospitalisation, morbidity, and mortality in various areas of medicine. A 2017 Trauma Audit and Research Network (TARN) report identified that further research was needed to determine the effect of frailty on outcomes in trauma patients. The UK Best Practice Tariff currently awards a financial incentive for frailty scoring for all patients sustaining major trauma who are managed at Major Trauma Centres (MTCs). However, this currently does not extend to Trauma Units (TUs) or to patients without major trauma. This retrospective cohort study sought to investigate whether frailty also has a significant effect on outcomes in patients presenting with fragility fractures presenting to trauma units without major trauma. Methods Notes from all patients aged ≥65 admitted to Gloucestershire Royal Hospital in 2019 with any fragility fracture were reviewed retrospectively. Age, injury, length of stay, and mortality were recorded. A Clinical Frailty Score (CFS) was assigned retrospectively using the Rockwood Clinical Frailty Scale. Results Eight hundred sixty patients were reviewed (male:female 258:602, mean age 83 ± 8.2). Each consecutive stepwise increase in CFS was independently associated with an average cumulative increase in mortality rate at 30-day and 1 year (OR 1.55 and 1.58 respectively, p < 0.001), as well as average cumulative percentage increase in length of stay (OR 1.094, p < 0.001). Conclusion Clinical frailty score independently predicts adverse outcome in patients with fragility fractures managed at trauma units. Clinical frailty score could be used to easily identify patients at risk of poorer outcomes and may assist in allocation of limited orthogeriatric resources and future BPT guidelines. Further work should promote recognition of frailty within trauma settings, investigate how additional resources affect outcomes for patients of varying degrees of frailty, and consider multicentre studies relating to frailty-associated outcomes in trauma.
Changes in Small Noncoding RNA Expression during Chondrocyte Senescence
Authors: Xiao Fei , Wang Chenglong , Peng Jianping , Zhou Xing , Ma Ding , Wang Yu , Li Yanpeng , Chen Xiaodong , Wang Chuandong 
Published: August 2022

Objective Osteoarthritis (OA) is characterized by the chronic and progressive deterioration of articular cartilage. Chondrocyte senescence could lead to a shift in the balance between extracellular matrix (ECM) component synthesis and degradation. Small noncoding RNAs (sncRNAs), including microRNAs (miRNAs), P-element-induced wimpy testis-(PIWI-) interacting RNAs (piRNAs), small nucleolar RNAs (snoRNAs), small nuclear RNAs (snRNAs), and repeat-associated siRNAs (rasiRNAs), are a class of important epigenetic molecules. We aimed to gain insights into the changes and roles of sncRNA in chondrocyte senescence. Design Healthy mouse postnatal chondrocytes were isolated, and a replicative aging model was constructed. We used small RNA sequencing (small RNA-seq) to generate extensive small RNA data. We identified differentially expressed sncRNAs and performed tissue-specific analysis using real-time quantitative polymerase chain reaction (qRT-PCR). β-galactosidase staining was used to detect chondrocyte senescence. The results showed that the expression profiles of sncRNA in passage 5 chondrocytes were significantly different from those in passage 0 chondrocytes. The expression of sncRNA was tissue specific. We found that 40 miRNAs were upregulated and 70 miRNAs were downregulated during chondrocyte senescence, and that miR-132-5p expression inhibition prevented chondrocyte senescence. We found that 8 piRNAs were upregulated and 17 piRNAs were downregulated during chondrocyte senescence, and that piRNA piR_025576 overexpression delayed chondrocyte senescence. We found that 24 snoRNAs were upregulated and 28 snoRNAs were downregulated during chondrocyte senescence, and that snoRNA ENSMUSG00000087935 overexpression delayed chondrocyte senescence. We found that 5 snRNAs were upregulated and 6 snRNAs were downregulated during chondrocyte senescence, and that snRNA ENSMUSG00000064682 overexpression delayed chondrocyte senescence. We found that 1 rasiRNA was upregulated and 4 rasiRNAs were downregulated during chondrocyte senescence. Conclusions These findings might provide novel insights into OA pathogenesis and contribute to the development of candidates for targeted therapeutics in OA.
Record of a dense succession of drowning phases in the Alpstein mountains, north-eastern Switzerland: part I—the Lower Cretaceous Tierwis Formation (latest Hauterivian to latest Barremian)
Authors: Pictet Antoine , Kürsteiner Peter , Tschanz Karl , Tajika Amane 
Published: August 2022

AbstractIn the Alpstein massif of north-eastern Switzerland, a complete succession of uppermost Hauterivian to uppermost Barremian condensed hemipelagic sediments crops out. This succession is known as Tierwis Formation, comprising in ascending order, the Altmann and Drusberg members. The sedimentary succession bears a number of fossiliferous glauconite- or phosphate-rich beds. A large number of newly discovered ammonites from these key beds and from several poorly explored levels of the Tierwis Formation allows for a new age calibration. The new dating as well as revised sequence stratigraphic interpretations and geochemistry contribute to a better understanding of the lithostratigraphic complexity of the Tierwis Formation and its spatio-temporal relationship with the Schrattenkalk Formation. The new lithostratigraphic observations, backed by ammonites, shows that the Altmann type-section and the Tierwis paratype-section do not cover the same stratigraphic interval because of dynamic sedimentation processes as erosion and sedimentation in submarine channels. We suggest that a phosphatic conglomerate in the Dursberg Member of middle late Barremian age corresponds to the Chopf Bed, which we recognised for the first time in the Alsptein massif. The Drusberg Member strongly thickens toward the southeast and progressively covers an upward extended stratigraphic range. Furthermore, the new dating of the key-surfaces and beds highlight a dense succession of drowning phases which occurred through the latest Hauterivian to late Barremian time interval. The latest Hauterivian onset of the glauconite-rich sedimentation of the Altmann Member is associated with a first major drowning phase, followed by the Faraoni oceanic anoxic event. The change of sedimentation to a rhythmic marl-limestone alternation of the Drusberg Member takes place over a polyzonal phosphatic conglomerate. This conglomerate coincides with a second major drowning phase and the onset of the Mid-Barremian Event, which is calibrated on the Tethyan ammonite biozonation.
Relationship between time from symptom’s onset to diagnosis and prognosis in patients with symptomatic colorectal cancer
Authors: Esteva Magdalena , Leiva Alfonso , Ramos-Monserrat María , Espí Alejandro , González-Luján Luis , Macià Francesc , Murta-Nascimento Cristiane , Sánchez-Calavera María A. , Magallón Rosa , Balboa-Barreiro Vanesa , Seoane-Pillado Teresa , Pertega-Díaz Sonia 
Published: August 2022

Abstract
Background
Controversy exists regarding the relationship of the outcome of patients with colorectal cancer (CRC) with the time from symptom onset to diagnosis. The aim of this study is to investigate this association, with the assumption that this relationship was nonlinear and with adjustment for multiple confounders, such as tumor grade, symptoms, or admission to an emergency department.

Methods
This multicenter study with prospective follow-up was performed in five regions of Spain from 2010 to 2012. Symptomatic cases of incident CRC from a previous study were examined. At the time of diagnosis, each patient was interviewed, and the associated hospital and clinical records were reviewed. During follow-up, the clinical records were reviewed again to assess survival. Cox survival analysis with a restricted cubic spline was used to model overall and CRC-specific survival, with adjustment for variables related to the patient, health service, and tumor.

Results
A total of 795 patients had symptomatic CRC and 769 of them had complete data on diagnostic delay and survival. Univariate analysis indicated a lower HR for death in patients who had diagnostic intervals less than 4.2 months. However, after adjustment for variables related to the patient, tumor, and utilized health service, there was no relationship of the diagnostic delay with survival of patients with colon and rectal cancer, colon cancer alone, or rectal cancer alone. Cubic spline analysis indicated an inverse association of the diagnostic delay with 5-year survival. However, this association was not statistically significant.

Conclusions
Our results indicated that the duration of diagnostic delay had no significant effect on the outcome of patients with CRC. We suggest that the most important determinant of the duration of diagnostic delay is the biological profile of the tumor. However, it remains the responsibility of community health centers and authorities to minimize diagnostic delays in patients with CRC and to implement initiatives that improve early diagnosis and provide better outcomes.
The relationship between primary colorectal cancer histology and the histopathological growth patterns of corresponding liver metastases
Authors: Höppener Diederik J. , Stook Jean-Luc P. L. , Galjart Boris , Nierop Pieter M. H. , Nagtegaal Iris D. , Vermeulen Peter B. , Grünhagen Dirk J. , Verhoef Cornelis , Doukas Michail ,   PALGA Group
Published: August 2022

Abstract
Background
The histopathological growth patterns (HGPs) are a prognostic and predictive biomarker in colorectal cancer liver metastasis (CRLM). This study evaluates the relationship between the HGP and primary colorectal cancer (CRC) histopathology.

Methods
A total of 183 treatment-naive patients with resected CRC and CRLM were included. Thirteen CRC histopathology markers were determined and compared between the desmoplastic and non-desmoplastic HGP; tumour sidedness, pT&pN stage, tumour grade, tumour deposits, perineural- (lympho-)vascular- and extramural venous invasion, peritumoural budding, stroma type, CRC growth pattern, Crohn’s-like lymphoid reaction, and tumour-infiltrating lymphocyte (TIL) density. Logistic regression analysis was performed using both CRC and CRLM characteristics.

Results
Unfavourable CRC histopathology was more frequent in non-desmoplastic CRLM for all markers evaluated, and significantly so for a lower TIL density, absent Crohn’s-like lymphoid reaction, and a “non-mature” stroma (all p < 0.03). The cumulative prevalence of unfavourable CRC histopathology was significantly higher in patients with non-desmoplastic compared to desmoplastic CRLM, with a median (IQR) of 4 (3–6) vs 2 (1–3.5) unfavourable characteristics observed, respectively (p < 0.001). Multivariable regression with 9 CRC histopathology markers and 2 CRLM characteristics achieved good discriminatory performance (AUC = 0.83).

Conclusions
The results of this study associates primary CRC histopathology with the HGP of corresponding liver metastases.
Don’t blame psychosis, blame the lack of services: a message for early intervention from the Greek standard care model
Authors: Dimitrakopoulos Stefanos , Stefanatou Pentagiotissa , Vlachos Ilias , Selakovic Mirjana , Xenaki Lida-Alkisti , Ralli Irene , Soldatos Rigas-Filippos , Nianiakas Nikolaos , Kosteletos Ioannis , Foteli Stefania , Mantonakis Leonidas , Kollias Costas T. , Stefanis Nikos C. 
Published: August 2022

Abstract
Background
Early Intervention Services (EIS) aim to reduce relapse rates and achieve better treatment and functional outcomes for first episode psychosis (FEP) patients. Existing models of services in Greece are still treatment as usual (TAU), however a reform of mental health services is underway and initial steps have been taken to shift standard care towards EIS. The purpose of the study is to address therapeutic gaps by exploring service engagement and relapse rates in the current standard care model for psychosis.

Methods
We examined follow-up and relapse rates one year after initial treatment contact in the first longitudinal FEP study conducted in Greece. 225 patients were enrolled between 2015–2020. Sociodemographic, clinical and functional characteristics were assessed in association with follow-up and relapse rates.

Results
Within a TAU follow-up setting, one year attrition rates were high. Only 87 patients (38,7%) retained contact with services after one year and within this time frame, 19 of them (21,8%) experienced a severe relapse requiring rehospitalization. Demographic, clinical and functional contributors failed to predict service engagement and relapse rates, with the exception of treatment adherence.

Conclusion
Both follow-up and one-year rehospitalization rates in our FEP sample, highlight the need for the implementation of early intervention services, that will aim at engagement maximization and relapse prevention. These indexes also provide a benchmark against which future early intervention services for psychosis in Greece will have to demonstrate superior efficacy.