bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combining transplant professional’s psychosocial donor evaluation and donor self-report measures to optimise the prediction of HRQoL after kidney donation: an observational prospective multicentre study
Authors: Wirken Lieke , van Middendorp Henriët , Hooghof Christina W , Sanders Jan-Stephan , Dam Ruth , van der Pant Karlijn A M I , Wierdsma Judith , Wellink Hiske , Ulrichts Philip , Hoitsma Andries J , Hilbrands Luuk B , Evers Andrea W 
Published: March 2022

ObjectivesLiving donor kidney transplantation is currently the preferred treatment for patients with end-stage renal disease. The psychosocial evaluation of kidney donor candidates relies mostly on the clinical viewpoint of transplant professionals because evidence-based guidelines for psychosocial donor eligibility are currently lacking. However, the accuracy of these clinical risk judgements and the potential added value of a systematic self-reported screening procedure are as yet unknown. The current study examined the effectiveness of the psychosocial evaluation by transplant professionals and the potential value of donor self-report measures in optimising the donor evaluation. Based on the stress-vulnerability model, the predictive value of predonation, intradonation and postdonation factors to impaired longer term health-related quality of life (HRQoL) of kidney donors was studied.DesignAn observational prospective multicentre study.SettingSeven Dutch transplantation centres.Participants588 potential donors participated, of whom 361 donated. Complete prospective data of 230 donors were available. Also, 1048 risk estimation questionnaires were completed by healthcare professionals.MethodsTransplant professionals (nephrologists, coordinating nurses, social workers and psychologists) filled in risk estimation questionnaires on kidney donor candidates. Furthermore, 230 kidney donors completed questionnaires (eg, on HRQoL) before and 6 and 12 months after donation.Primary and secondary outcome measuresHRQoL, demographic and preoperative, intraoperative and postoperative health characteristics, perceived support, donor cognitions, recipient functioning and professionals risk estimation questionnaires.ResultsOn top of other predictors, such as the transplant professionals’ risk assessments, donor self-report measures significantly predicted impaired longer term HRQoL after donation, particularly by poorer predonation physical (17%–28% explained variance) and psychological functioning (23%).ConclusionsThe current study endorses the effectiveness of the psychosocial donor evaluation by professionals and the additional value of donor self-report measures in optimising the psychosocial evaluation. Consequently, systematic screening of donors based on the most prominent risk factors provide ground for tailored interventions for donors at risk.
Adverse effects of remdesivir, hydroxychloroquine and lopinavir/ritonavir when used for COVID-19: systematic review and meta-analysis of randomised trials
Authors: Izcovich Ariel , Siemieniuk Reed Alexander , Bartoszko Jessica Julia , Ge Long , Zeraatkar Dena , Kum Elena , Qasim Anila , Khamis Assem M , Rochwerg Bram , Agoritsas Thomas , Chu Derek K , McLeod Shelley L , Mustafa Reem A , Vandvik Per , Brignardello-Petersen Romina 
Published: March 2022

BackgroundTo summarise specific adverse effects of remdesivir, hydroxychloroquine and lopinavir/ritonavir in patients with COVID-19.MethodsWe searched 32 databases through 27 October 2020. We included randomised trials comparing any of the drugs of interest to placebo or standard care, or against each other. We conducted fixed-effects pairwise meta-analysis and assessed the certainty of evidence using the grading of recommendations assessment, development and evaluation approach.ResultsWe included 16 randomised trials which enrolled 8152 patients. For most interventions and outcomes the certainty of the evidence was very low to low except for gastrointestinal adverse effects from hydroxychloroquine, which was moderate certainty. Compared with standard care or placebo, low certainty evidence suggests that remdesivir may not have an important effect on acute kidney injury (risk difference (RD) 8 fewer per 1000, 95% CI 27 fewer to 21 more) or cognitive dysfunction/delirium (RD 3 more per 1000, 95% CI 12 fewer to 19 more). Low certainty evidence suggests that hydroxychloroquine may increase the risk of cardiac toxicity (RD 10 more per 1000, 95% CI 0 more to 30 more) and cognitive dysfunction/delirium (RD 33 more per 1000, 95% CI 18 fewer to 84 more), whereas moderate certainty evidence suggests hydroxychloroquine probably increases the risk of diarrhoea (RD 106 more per 1000, 95% CI 48 more to 175 more) and nausea and/or vomiting (RD 62 more per 1000, 95% CI 23 more to 110 more) compared with standard care or placebo. Low certainty evidence suggests lopinavir/ritonavir may increase the risk of diarrhoea (RD 168 more per 1000, 95% CI 58 more to 330 more) and nausea and/or vomiting (RD 160 more per 1000, 95% CI 100 more to 210 more) compared with standard care or placebo.DiscussionHydroxychloroquine probably increases the risk of diarrhoea and nausea and/or vomiting and may increase the risk of cardiac toxicity and cognitive dysfunction/delirium. Lopinavir/ritonavir may increase the risk of diarrhoea and nausea and/or vomiting. Remdesivir may have no important effect on risk of acute kidney injury or cognitive dysfunction/delirium. These findings provide important information to support the development of evidence-based management strategies for patients with COVID-19.
Major cardiovascular events in patients presenting with acute stroke: a 5-year follow-up study in patients who had ischaemic stroke and stroke mimics
Authors: Al Jerdi Salman , Akhtar Naveed , Mahfoud Ziyad , Kamran Saadat , Shuaib Ashfaq 
Published: March 2022

ObjectivesThe long-term acute stroke outcome has not been well studied in the Middle-Eastern population. The primary objective of our study is to compare the long-term outcome of acute ischaemic stroke (IS) with/without previous cerebrovascular/cardiovascular disease (CVD) to stroke mimics (SM) with CVD.Settings and participantsThe Qatar stroke database was reviewed for IS and SM admissions in Qatari Nationals between 2013 and 2019.OutcomesPatients were prospectively assessed for development of recurrent stroke, myocardial infarction or death. Frequency of major cardiovascular events (MACEs) were compared between patients with or without a previous CVD.ResultsThere were 1114 stroke admissions (633 IS (prior CVD 211/18.9%), 481 SM (prior CVD 159/14.3%)). Patients with IS/CVD were significantly older versus others (IS/CVD: 68.3±12.2; IS/no CVD: 63.3±14.4; SM/CVD: 67.6±13.1; SM/no CVD: 52.4±17.9. p<0.0001). Vascular risk factors were significantly higher in patients with IS and SM with previous CVD. Functional recovery (90-day mRS 0–2) was significantly better in SM/no CVD (IS/CVD: 55.0%; IS/no CVD: 64.2%; SM/CVD 59.7%; SM/no CVD: 88.8%. p<0.001). MACE occurred in 36% (76/211) IS/CVD, 24.9% (105/422) IS/no CVD, 22.0% (35/179) SM/CVD and only 6.8% (22/322) SM/no CVD. MACE occurred mostly during the first year of follow-up. Mortality 90 days was significantly higher in IS/CVD (IS/CVD 36%; IS/no CVD 24.9%; SM/CVD: 22%; SM/no CVD: 6.8%. p<0.0001).ConclusionsPrior CVD significantly increases the risk of MACE and early mortality in IS or SM patients. Age, male gender, obesity, atrial fibrillation and admission National Institute of Health Stroke Scale also increases risk of MACE during follow-up. Hence, aggressive vascular risk factor modification is needed even in patients with SM.
Implementation and evaluation of a physical activity counselling programme in primary care among cancer survivors: SoDA study protocol
Authors: Huizinga Famke , Westerink Nico-Derk Lodewijk , Berendsen Annette J , Walenkamp Annemiek M E , de Greef Mathieu H G , de Bock Geertruida H , Berger Marjolein Y , Brandenbarg Daan 
Published: March 2022

IntroductionPhysical activity (PA) favourably affects various health outcomes in cancer survivors, but little is known about how to implement a PA programme in primary care. We therefore aim to implement and evaluate such a programme for cancer survivors in general practice.Methods and analysesThe Stimulation of Daily Activity study is an implementation study with a single-arm longitudinal design in 15 Dutch general practices. Patients aged ≥18 years who finished cancer treatment more than 6 months ago will be eligible for inclusion. The intervention will comprise six coaching sessions with the practice nurse in 9 months, seeking to increase PA in daily activities and using an activity tracker for goal setting and feedback. TheReach, Effectiveness, Adoption, Implementation and Maintenanceframework will be used to evaluate implementation in terms of the health outcomes, extent of implementation and barriers and facilitators to implementation, using a mixed methods approach. Descriptive analyses and linear mixed model analyses will be performed on the quantitative data, while qualitative data from focus groups and interviews will be analysed by thematic analyses.Ethics and disseminationThe Medical Research Ethics Committee of the University Medical Centre Groningen, the Netherlands, concluded that this study was not subject to the Dutch Medical Research Involving Human Subjects Act (registration number: 201900586). The study results will be made available to patients and general practitioners via (inter)national publications and conferences, newsletters, public summaries and via (social) media.
Optimizing therapeutic outcomes of immune checkpoint blockade by a microbial tryptophan metabolite
Authors: Renga Giorgia , Nunzi Emilia , Pariano Marilena , Puccetti Matteo , Bellet Marina Maria , Pieraccini Giuseppe , D’Onofrio Fiorella , Santarelli Ilaria , Stincardini Claudia , Aversa Franco , Riuzzi Francesca , Antognelli Cinzia , Gargaro Marco , Bereshchenko Oxana , Ricci Maurizio , Giovagnoli Stefano , Romani Luigina , Costantini Claudio 
Published: March 2022

BackgroundDespite the great success, the therapeutic benefits of immune checkpoint inhibitors (ICIs) in cancer immunotherapy are limited by either various resistance mechanisms or ICI-associated toxic effects including gastrointestinal toxicity. Thus, novel therapeutic strategies that provide manageable side effects to existing ICIs would enhance and expand their therapeutic efficacy and application. Due to its proven role in cancer development and immune regulation, gut microbiome has gained increasing expectation as a potential armamentarium to optimize immunotherapy with ICI. However, much has to be learned to fully harness gut microbiome for clinical applicability. Here we have assessed whether microbial metabolites working at the interface between microbes and the host immune system may optimize ICI therapy.MethodsTo this purpose, we have tested indole-3-carboxaldehyde (3-IAld), a microbial tryptophan catabolite known to contribute to epithelial barrier function and immune homeostasis in the gut via the aryl hydrocarbon receptor (AhR), in different murine models of ICI-induced colitis. Epithelial barrier integrity, inflammation and changes in gut microbiome composition and function were analyzed. AhR, indoleamine 2,3-dioxygenase 1, interleukin (IL)-10 and IL-22 knockout mice were used to investigate the mechanism of 3-IAld activity. The function of the microbiome changes induced by 3-IAld was evaluated on fecal microbiome transplantation (FMT). Finally, murine tumor models were used to assess the effect of 3-IAld treatment on the antitumor activity of ICI.ResultsOn administration to mice with ICI-induced colitis, 3-IAld protected mice from intestinal damage via a dual action on both the host and the microbes. Indeed, paralleling the activation of the host AhR/IL-22-dependent pathway, 3-IAld also affected the composition and function of the microbiota such that FMT from 3-IAld-treated mice protected against ICI-induced colitis with the contribution of butyrate-producing bacteria. Importantly, while preventing intestinal damage, 3-IAld did not impair the antitumor activity of ICI.ConclusionsThis study provides a proof-of-concept demonstration that moving past bacterial phylogeny and focusing on bacterial metabolome may lead to a new class of discrete molecules, and that working at the interface between microbes and the host immune system may optimize ICI therapy.
Is music the food of the anesthesia in children?
Authors: Hekimoglu Sahin Sevtap , Duran Ridvan , Basaran Umit Nusret , Sut Necdet , Colak Alkin , Duran Sedef 
Published: March 2022

BackgroundThe noise in an operating room may have a detrimental effect on human cognitive functions, and it may cause perioperative anxiety with prolonged exposure. The aim of this study was to investigate the effects of music therapy and use of earplugs and normal noise level in the operating room under general anesthesia of pediatric patients on hemodynamic parameters and postoperative emergence delirium.MethodsOne hundred and five pediatric patients were involved in this study. The patients were randomly divided into three groups. Group N was exposed to the ambient operating room noise, group S received earplugs from an independent anesthesiologist, and group M used a CD player. The preoperative anxiety levels of children were evaluated with the Modified Yale Preoperative Anxiety Scale (M-YPAS). Mean arterial pressure (MAP) and heart rate were recorded at 30-minute periods until the completion of surgery, end of surgery and postoperatively. During each measurement, noise level recordings were performed using sonometer. Pediatric Anesthesia Emergency Delirium (PAED) score was evaluated after postoperative extubation.ResultsM-YPAS was similar between groups. The MAP at 30 and 60 min intraoperatively, at end of surgery, and at 5, 10, and 15 min postoperatively was significantly lower in group S than in group N. There were no differences in heart rate among the groups. Postoperative PAED score was not significantly different among the groups.ConclusionsThe music therapy was not more effective than silence and operating noise room in reducing PAED score postoperatively in pediatric patients.Trial registration numberClinicalTrials.gov Registry (NCT03544502).
Capsaicin Attenuates Arterial Calcification Through Promoting SIRT6-Mediated Deacetylation and Degradation of Hif1α (Hypoxic-Inducible Factor-1 Alpha)
Authors: Luo Dongling , Li Wenxin , Xie Changming , Yin Li , Su Xiaoyan , Chen Jie , Huang Hui 
Published: March 2022

Background:
Sustained Hif1α (hypoxic-inducible factor-1 alpha) accumulation plays a central role in osteogenic transdifferentiation and subsequent calcification. Capsaicin, the potent agonist of TRPV1 (transient receptor potential vanilloid type 1), was found to mitigate hypoxic-related injury and reverse phenotypic switch of vascular smooth muscle cells. However, its role in arterial calcification and the underlying mechanisms remain unexplored.

Methods:
We used data from Multi-Ethnic Study of Atherosclerosis to examine the association of coronary artery calcification and chili consumption. Chronic kidney disease mice and high phosphate–induced vascular smooth muscle cells calcification models were established to investigate the anticalcification effect of capsaicin, evaluated by calcium deposition and changes in phenotype markers.

Results:

Chili consumption was negatively correlated with coronary artery calcification and conferred a smaller progression burden during follow-up. Capsaicin reduced calcium deposition and osteogenic transdifferentiation both in vivo and in vitro. Using siTRPV1 (small interfering RNA and the antagonist of TRPV1), the anticalcification effect of capsaicin was abrogated. Hif1α was increased in phosphate-treated vascular smooth muscle cells and its degradation was accelerated by capsaicin. Retaining Hif1α stability using cobalt chloride (CoCl
2
) or MG132 abolished the protective effect of capsaicin. We further identified an increased expression of SIRT6 (Sirtuin 6) in response to capsaicin and confirmed the physical interaction between SIRT6 and Hif1α. Acetylated Hif1α was decreased, whereas hydroxylated Hif1α was increased under capsaicin treatment. Using immunohistochemistry analysis, we observed increased SIRT6 and reduced Hif1α in both SIRT6 transgenic and capsaicin-treated chronic kidney disease mice.

Conclusions:
Capsaicin facilitates deacetylation and degradation of Hif1α by upregulating SIRT6, which inhibits osteogenic transdifferentiation and protects against arterial calcification. These data highlight a promising therapeutic target for the management of arterial calcification.
Prediction and Judgment: Why Artificial Intelligence Increases the Importance of Humans in War
Authors: Goldfarb Avi , Lindsay Jon R. 
Published: March 2022

Abstract
Recent scholarship on artificial intelligence (AI) and international security focuses on the political and ethical consequences of replacing human warriors with machines. Yet AI is not a simple substitute for human decision-making. The advances in commercial machine learning that are reducing the costs of statistical prediction are simultaneously increasing the value of data (which enable prediction) and judgment (which determines why prediction matters). But these key complements—quality data and clear judgment—may not be present, or present to the same degree, in the uncertain and conflictual business of war. This has two important strategic implications. First, military organizations that adopt AI will tend to become more complex to accommodate the challenges of data and judgment across a variety of decision-making tasks. Second, data and judgment will tend to become attractive targets in strategic competition. As a result, conflicts involving AI complements are likely to unfold very differently than visions of AI substitution would suggest. Rather than rapid robotic wars and decisive shifts in military power, AI-enabled conflict will likely involve significant uncertainty, organizational friction, and chronic controversy. Greater military reliance on AI will therefore make the human element in war even more important, not less.
Defending the United States: Revisiting National Missile Defense against North Korea
Authors: Sankaran Jaganath , Fetter Steve 
Published: March 2022

Abstract
North Korea has made significant strides in its attempt to acquire a strategic nuclear deterrent. In 2017, it tested intercontinental ballistic missiles (ICBMs) and completed a series of nuclear test explosions. These may provide North Korea with the technical foundation to deploy a nuclear-armed ICBM capable of striking the United States. The Ground-based Midcourse Defense (GMD) missile defense system is intended to deter North Korean nuclear coercion and, if deterrence fails, to defeat a limited North Korean attack. Despite two decades of dedicated and costly efforts, however, the GMD system remains unproven and unreliable. It has not demonstrated an ability to defeat the relatively simple and inexpensive countermeasures that North Korea can field. The GMD system has suffered persistent delays, substantial cost increases, and repeated program failures because of the politically motivated rush to deploy in the 1990s. But GMD and other U.S. missile defense efforts have provoked serious concerns in Russia and China, who fear it may threaten their nuclear deterrents. Diplomacy and deterrence may reassure Russia and China while constraining North Korea's nuclear program. An alternate airborne boost-phase intercept system may offer meaningful defense against North Korean missiles without threatening the Russian or Chinese deterrents.
Comparison of the Representational Power of Random Forests, Binary Decision Diagrams, and Neural Networks
Authors: Kumano So , Akutsu Tatsuya 
Published: March 2022

Abstract
In this letter, we compare the representational power of random forests, binary decision diagrams (BDDs), and neural networks in terms of the number of nodes. We assume that an axis-aligned function on a single variable is assigned to each edge in random forests and BDDs, and the activation functions of neural networks are sigmoid, rectified linear unit, or similar functions. Based on existing studies, we show that for any random forest, there exists an equivalent depth-3 neural network with a linear number of nodes. We also show that for any BDD with balanced width, there exists an equivalent shallow depth neural network with a polynomial number of nodes. These results suggest that even shallow neural networks have the same or higher representation power than deep random forests and deep BDDs. We also show that in some cases, an exponential number of nodes are required to express a given random forest by a random forest with a much fewer number of trees, which suggests that many trees are required for random forests to represent some specific knowledge efficiently.
Modulation of North Atlantic Polar Low Activity and Associated Flow Patterns by Sudden Stratospheric Warmings
Authors: Chang Chuan-Chieh , Wang Zhuo , Walsh John , Stoll Patrick J. 
Published: March 2022

Abstract
Polar lows (PLs) are intense maritime mesoscale cyclones that can pose hazards to coastal communities and marine operation in the Arctic. This study examines the impacts of sudden stratospheric warmings (SSWs) on PL activity in the subarctic North Atlantic. The 20 days following SSWs are characterized by tropospheric circulation anomalies resembling the negative phase of the North Atlantic Oscillation. PL activity decreases significantly over the Labrador Sea, which can be attributed to the infrequent occurrence of low static stability and strong environmental baroclinicity, as well as reduced surface turbulent heat fluxes. These results suggest that a skillful prediction of SSWs can improve the extended-range forecast of PL activity over the Labrador Sea. For the Nordic seas, the results imply that the spatial structure of an SSW event is important for the PL modulation through different tropospheric circulation patterns. Situations with increased PL frequency in the Nordic seas are characterized by SSWs centered close to northern Greenland occurring over a smaller area, and a tropospheric response featuring enhanced cold-air outbreaks over the Norwegian Sea. Conversely, PL activity is suppressed over the Nordic seas when the SSW favors the formation of a tropospheric anticyclone above Greenland and Scandinavia.

Significance Statement
This study investigates the relationships between polar lows (PLs) and sudden stratospheric warmings (SSWs) over the subarctic North Atlantic. A better understanding of the effect of SSWs on PL development has the potential to improve extended-range forecasts of PLs. It is shown that SSWs are responsible for the significantly suppressed regional PL activity over the Labrador Sea, suggesting that SSWs can serve as a predictor for the extended-range forecast of PLs over this region. Following SSW events, the thermodynamic state of atmosphere becomes more stable over the Labrador Sea and hinders the convective development of PLs. For the northern Nordic seas, the impacts of SSWs on PL activity are sensitive to the spatial structure of stratospheric warming.