bluuebunny/crossref_metadata_2025_split huggingface dataset:
Healthcare professionals‐related factors affecting parents' participation in decision making for neonates with life‐threatening conditions: A qualitative study
Authors: Banazadeh Marjan , Khanjari Sedigheh , Naddaf Amir , Oskouie Fatemeh 
Published: October 2020

AbstractRationale, aims, and objectivesNeonates with life‐threatening conditions face complex clinical circumstances that confront parents and professionals with ethical decisions. Parents' participation in decision making has not gained sufficient attention in practice. Understanding factors affecting parents' participation is required. This study is part of a comprehensive project that explored the process of parents' participation in decision making for neonates with life‐threatening conditions. The current study aimed to explore healthcare professionals‐related factors affecting parents' participation in decision‐making for neonates with life‐threatening conditions.MethodsA grounded theory methodology was used in the comprehensive project. Twenty‐two interviews/68 hours of observation were conducted. Data were concurrently analysed throughout data generation and constant comparative analysis. Data collected until theoretical saturation was reached, the extracted categories were coherent and the emerging theory made sense. After coding stages, the core category and the relationships with other main categories involved in the process of parents' participation in decision‐making were developed. For this study, the category reflecting healthcare professionals‐related factors affecting parents' participation in decision‐making was reported.ResultsFour themes were found: risk aversion including fear of litigation, fear of being accountable to the parents, and fear of bearing emotional distress; unprofessionalism including poor adherence to professional ethics, inadequate skill/knowledge, poor communication, and nurses' negligence in playing their professional role; information deficiencies including insufficient information, conflicting information, and complex and technical information, and clashes of attitudes including conflict about parents' participation in decision‐making and conflict about the best interest of neonates.ConclusionProfessionals should be aware of their role in involving parents in decision making. Training professionals on family centred care principle and communication skills contribute to support parents emotionally and respond empathically to their negative expressions. Training on ethics, development, and dissemination of guidelines and rules of conduct can make professionals more sensitive to ethical aspects of their work and may reduce their fear of litigation.
A serum containing vitamins C & E and a matrix‐repair tripeptide reduces facial signs of aging as evidenced by Primos® analysis and frequently repeated auto‐perception
Authors: Lintner Karl , Gerstein Francine , Solish Nowell 
Published: October 2020

AbstractBackgroundAllegations on the benefits of incorporating vitamin C, vitamin E, and combinations thereof in topical skincare formulations are mostly based on in vitro and ex vivo experiments and/or limited protocols of specific stress conditions (pollution, UV exposure, laser irradiation,…).ObjectiveTo evaluate the instrumentally measurable effects and quantitative consumer perceptions of a protective and reparative serum on a panel of volunteers under normal nonstressed conditions of use, employing FOITS technology and innovative self‐assessment methods.MethodIn an open‐label study women of ≥40 years with visible signs of photoaging applied a serum comprising l‐ascorbic acid USP (15% w/v), tocopheryl acetate USP, and 5 ppm palmitoyl tripeptide‐38 to the face once daily for 56 days. Skin roughness and isotropy changes were evaluated on days 0, 28, and 56, visual instrumental evaluation of skin‐tone parameters was assessed on days 0 and 56. Subjects completed self‐assessment questionnaires every third day of the trial period for radiance, homogeneity, and wrinkle appearance.ResultsSkin‐roughness parameters decreased significantly by 8%‐9% (P < .05) and subjects experienced a significant increase in skin isotropy (P < .05). Photographic analysis revealed significant improvements in skin tone, with a 9% decrease in redness and 8% increase in homogeneity (P < .0001 for both), in excellent agreement with subjects' perception of significant improvements of radiance, complexion, and wrinkles.ConclusionThe study confirms statistically significant correlation between objectively measured and quantitative subjectively perceived benefits of the bespoke serum containing antioxidants and a matrix‐restoring peptide.
Safety profile of high molecular weight polymerized hemoglobins
Authors: Muller Cynthia R. , Williams Alexander T. , Munoz Carlos J. , Eaker Allyn M. , Breton Amanda N. , Palmer Andre F. , Cabrales Pedro 
Published: October 2020

AbstractBackgroundHemoglobin (Hb)‐based oxygen (O2) carriers (HBOCs) are being developed as alternatives to red blood cells and blood when these products are unavailable. Clinical trials of previous HBOC generations revealed side effects, including hypertension and vasoconstriction, that were not observed in preclinical studies. Large molecular weight (MW) polymerized bovine Hb (PolybHb) represents a new class of HBOC with promising results. We evaluated the safety profile of PolybHb after an exchange transfusion (ET) in guinea pigs (GPs). This study compares changes in indices of cardiac, inflammatory, and organ function after ET with high (R‐state) and low (T‐state) O2affinity PolybHb with high MW.Study Design and MethodsGuinea pigs underwent a 20% ET with PolybHb. To assess the implication of PolybHb ET on the microcirculation, hamsters instrumented with a dorsal window chamber were subjected to a similar volume ET.ResultsT and R‐state PolybHb did not induce significant alterations in cardiac function. T‐state PolybHb induced mild vasoconstriction shortly after transfusion, while R‐state did not have acute effects on microvascular tone.ConclusionLarge MW PolybHbs were found to be safe and efficacious in increasing O2carrying capacity and the O2affinity of the PolybHb did not affect O2delivery or extraction by tissues in relevant preclinical models. In conclusion, these results suggest that both T‐state and R‐state PolybHb are safe and do not impair O2delivery. The results are encouraging and support further evaluation of high MW PolybHbs and their future feasibility compared to allogenic blood in a trauma model.
Combination of radiotherapy and suppression of Tregs enhances abscopal antitumor effect and inhibits metastasis in rectal cancer
Authors: Ji Dengbo , Song Can , Li Yongheng , Xia Jinhong , Wu Yanjing , Jia Jinying , Cui Xinxin , Yu Songmao , Gu Jin 
Published: October 2020

BackgroundDistant metastasis is the major cause of mortality in patients with locally advanced rectal cancer (LARC) following neoadjuvant chemoradiotherapy. Local radiotherapy can trigger an abscopal response to metastatic tumor cells. However, the abscopal effect is a rare event. CD4+ regulatory T (Treg) cell is a highly immune-suppressive subset which impedes immune surveillance against cancer, prevents the development of effective antitumor immunity and promotes tumor progression. We assume that the exploitation of the proimmunogenic effects of radiotherapy with anti-CD25 or anti-Cytotoxic T-Lymphocyte Associated Protein 4 (anti-CTLA4) monoclonal antibodies (mAbs) may enhance the local and abscopal effects in rectal cancer and improve the therapeutic outcome.MethodsmRNA expression profiling of 81 pretreatment biopsy samples from LARC patients who received neoadjuvant radiotherapy (nRT) was performed to analyze the correlation between gene expression and prognosis. A retrospective analysis of patients with rectal cancer with distant metastasis or synchronous extracolonic cancers was performed to evaluate the abscopal effect of radiotherapy on rectal cancer. Two different dual-tumor mouse models were established to investigate the efficacy of single dose and dose-fractionated radiotherapy combined with anti-CD25 or anti-CTLA4 and anti-Programmed cell death 1 ligand 1 (anti-PD1) mAbs on the local tumor growth and liver metastasis. The univariate Cox regression analysis, one-way analysis of variance, Dunnett’s test, a mixed-effect linear model and Kaplan-Meier survival analysis were used to calculate p values.ResultsThe proportion of Tregs in pre-nRT biopsies was negatively correlated with prognosis (p=0.007). The retrospective analysis showed that regressing liver metastases were infiltrated by CD8+ T cells. In contrast, stable/progressing metastases and synchronous extracolonic cancers were characterized by PD1+ T cells and Tregs infiltration. Animal experiment results demonstrated that the combination of radiotherapy and anti-CD25/CTLA4 mAb resulted in a significant increase in CD8+ T cells and CD8+/CD4+ ratio in primary and secondary tumors compared with the irradiation alone group (all p<0.05 or p<0.01). The combined treatment was able to decrease Tregs, PD1+CD8+ and PD1+CD4+ T cells (p<0.05), suppress locally irradiated and distal unirradiated tumor growth, and improve overall survival rate. Radiotherapy in conjunction with anti-CTLA4 reduced liver metastasis (p<0.05).ConclusionsThese data indicated that radiotherapy plus depletion of Tregs was able to improve the antitumor response and generate an abscopal effect.
Propensity-adjusted cost analysis of radial versus femoral access for neuroendovascular procedures
Authors: Catapano Joshua S , Ducruet Andrew F , Koester Stefan W , Cole Tyler S , Baranoski Jacob F , Rutledge Caleb , Majmundar Neil , Srinivasan Visish M , Wilkinson D Andrew , Lawton Michael T , Albuquerque Felipe C 
Published: October 2020

BackgroundTransradial artery (TRA) access for neuroendovascular procedures is associated with fewer complications than transfemoral artery (TFA) access. This study compares hospital costs associated with TRA access to those associated with TFA access for neurointerventions.MethodsElective neuroendovascular procedures at a single center were retrospectively analyzed from October 1, 2018 to May 31, 2019. Hospital costs for each procedure were obtained from the hospital financial department. The primary outcome was the difference in the mean hospital costs after propensity adjustment between patients who underwent TRA compared with TFA access.ResultsOf the 338 elective procedures included, 63 (19%) were performed through TRA versus 275 (81%) through TFA access. Diagnostic procedures were more common in the TRA cohort (51 of 63, 81%) compared with the TFA cohort (197 of 275, 72%), but the difference was not significant (p=0.48). The TRA cohort had a shorter length of hospital stay (mean (SD) 0.3 (0.5) days) compared with the TFA cohort (mean 0.7 (1.3) days; p=0.02) and lower hospital costs (mean $12 968 ($6518) compared with the TFA cohort (mean $17 150 ($10 946); p=0.004). After propensity adjustment for age, sex, symptoms, angiographic findings, procedure type, sheath size, and catheter size, TRA access was associated with a mean hospital cost of $2514 less than that for TFA access (95% CI −$4931 to −$97; p=0.04).ConclusionNeuroendovascular procedures performed through TRA access are associated with lower hospital costs than TFA procedures. The lower cost is likely due to a decreased length of hospital stay for TRA.
Dual-roadmap guidance for endovascular recanalization of medically refractory non-acute intracranial arterial occlusions: consecutive multicenter series and technical review
Authors: Gao Feng , Guo Xu , Sun Xuan , Liu Yan , Wu Yingchun , Miao Zhongrong 
Published: October 2020

BackgroundThe optimal treatment for medically refractory non-acute intracranial artery occlusion is uncertain, and endovascular recanalization remains a technical challenge. Here, a multicenter clinical experience of dual-roadmap guidance for endovascular recanalization of non-acute intracranial artery occlusion is reported, focusing on the technical feasibility and safety.MethodsFrom January 2014 to December 2019, 52 consecutive patients with medically refractory atherosclerotic non-acute intracranial artery occlusion who underwent endovascular recanalization under dual-roadmap guidance in three large regional referral stroke centers were analyzed retrospectively. Four types of dual-roadmap technical schemes were applied during endovascular recanalization. The rates of technical success, periprocedural complications, any stroke or death within 30 days, and follow-up results were evaluated.ResultsThe technical success rate was 92.3% (48/52). The perioperative complication rate was 7.7% (4/52), and the rate of any stroke or death within 30 days was 3.8% (2/52). Asymptomatic dissection occurred in two patients, acute in-stent thrombosis followed by postoperative mild stroke (National Institutes of Health Stroke Scale (NIHSS) 3) in one patient, and death due to reperfusion hemorrhage after successful recanalization in one patient. The rate of stroke or death beyond 30 days was 6.5% (3/46). The median clinical follow-up period was 19 months, and the median imaging follow-up period was 12 months. The restenosis rate was 13.2% (5/38).ConclusionsEndovascular recanalization of non-acute intracranial occlusions can be performed with a high rate of technical success and few complications with assistance of the dual-roadmap technique for navigation. Four types of dual-roadmap schemes provide technical references.
Effectiveness of onabotulinumtoxinA (BOTOX) in pediatric patients experiencing migraines: a randomized, double-blinded, placebo-controlled crossover study in the pediatric pain population
Authors: Shah Shalini , Calderon Michael-David , Crain Nikhil , Pham Jason , Rinehart Joseph 
Published: October 2020

IntroductionOnabotulinumtoxinA (OBTA) is approved for treating chronic headaches and migraines in adults, but there is limited scientific literature on the outcomes in pediatric patients. The aim of this study was to determine if subjects treated with OBTA reported a statistically significant improvement in the primary features (frequency, intensity, duration and disability scoring) associated with migraines compared with placebo at follow-up visits.MethodsAfter obtaining approval by the appropriate local (HS# 2016–3108) and federal institutions, the principal investigator enrolled candidates aged 8 to 17 years old diagnosed with chronic migraines (at least 6 months), and 15 or more headache days in a 4-week baseline period. This randomized control trial consisted of two phases: double-blind and open-label for the first two and last two sets of treatments, respectively. Subjects were randomly assigned to receive a treatment protocol—155 units at 31 injection sites—in 3-month intervals and follow-up visits every 6 weeks. Non-parametric testing (Wilcoxon signed-rank test) was performed using widely available open-source statistical software (‘R’).ResultsFrom February 2017 to November 2018, 17 subjects presented for a screening visit; 15 met eligibility criteria. Subjects that received OBTA reported a statistically significant decrease from the following baseline values compared with placebo 6-week post-treatment compared with placebo: frequency (20 (7 to 17) vs 28 (23 to 28); p=0.038), intensity (5 (3 to 7) vs 7 (5 to 9); p=0.047), and PedMIDAS (Pediatric Migraine Disability Score) (3 (2 to 4) vs 4 (4 to 4); p=0.047). There was no statistically significant difference in the duration (10 (2 to 24) vs 24 (4 to 24); p=0.148) of migraines between the two groups.DiscussionOnabotulinumtoxinA showed a statistically significant decrease in frequency and intensity of migraines compared with placebo. No adverse effects or serious adverse events related to the use of OBTA were reported. In the future, we aim to evaluate the specific nature of migraines, for example, quality/location of pain presented during an initial consult to predict the likelihood of OBTA being a truly effective modality of pain management for pediatric migraineurs.Trial registration numberNCT03055767.
Hypecoum pendulum L. (Papaveraceae: Ranunculales): a new record for the flora of Haryana, India
Authors: Naina Palria  , Singh Nidhan , Bhoo Dev Vashistha  
Published: October 2020

Hypecoum pendulum L., a rare, herbaceous angiosperm plant is being reported here as a new record for the flora of Haryana State. In the present communication, a detailed account of the plant along with coloured photographic plates has been provided to facilitate its easy identification.

Keywords: New record, wild herb
Implementation of a National 5‐Year Plan for Prehospital Emergency Care in Singapore and Impact on Out‐of‐Hospital Cardiac Arrest Outcomes From 2011 to 2016
Authors: Ho Andrew Fu Wah , De Souza Nurun Nisa Amatullah , Blewer Audrey L. , Wah Win , Shahidah Nur , White Alexander Elgin , Ng Yih Yng , Mao Desmond Renhao , Doctor Nausheen , Gan Han Nee , Chia Michael Yih Chong , Leong Benjamin Sieu‐Hon , Cheah Si Oon , Tham Lai Peng , Ong Marcus Eng Hock , Tiah Ling , Ng Wei Ming , Tay Wei Ling , Lim Shir Lynn 
Published: October 2020

Background
Outcomes of patients from out‐of‐hospital cardiac arrest (OHCA) vary widely globally because of differences in prehospital systems of emergency care. National efforts had gone into improving OHCA outcomes in Singapore in recent years including community and prehospital initiatives. We aimed to document the impact of implementation of a national 5‐year Plan for prehospital emergency care in Singapore on OHCA outcomes from 2011 to 2016.

Methods and Results

Prospective, population‐based data of OHCA brought to Emergency Departments were obtained from the Pan‐Asian Resuscitation Outcomes Study cohort. The primary outcome was Utstein (bystander witnessed, shockable rhythm) survival‐to‐discharge or 30‐day postarrest. Mid‐year population estimates were used to calculate age‐standardized incidence. Multivariable logistic regression was performed to identify prehospital characteristics associated with survival‐to‐discharge across time. A total of 11 465 cases qualified for analysis. Age‐standardized incidence increased from 26.1 per 100 000 in 2011 to 39.2 per 100 000 in 2016. From 2011 to 2016, Utstein survival rates nearly doubled from 11.6% to 23.1% (
P
=0.006). Overall survival rates improved from 3.6% to 6.5% (
P
<0.001). Bystander cardiopulmonary resuscitation rates more than doubled from 21.9% to 56.3% and bystander automated external defibrillation rates also increased from 1.8% to 4.6%. Age ≤65 years, nonresidential location, witnessed arrest, shockable rhythm, bystander automated external defibrillation, and year 2016 were independently associated with improved survival.

Conclusions
Implementation of a national prehospital strategy doubled OHCA survival in Singapore from 2011 to 2016, along with corresponding increases in bystander cardiopulmonary resuscitation and bystander automated external defibrillation. This can be an implementation model for other systems trying to improve OHCA outcomes.
Surface Urban Heat and Cool Islands and Their Drivers: An Observational Study in Nanjing, China
Authors: Wang Liang , Li Dan , Zhang Ning , Sun Jianning , Guo Weidong 
Published: October 2020

AbstractUrban heat islands (UHIs) are caused by a multitude of changes induced by urbanization. However, the relative importance of biophysical and atmospheric factors in controlling the UHI intensity remains elusive. In this study, we quantify the magnitude of surface UHIs (SUHIs), or surface urban cool islands (SUCIs), and elucidate their biophysical and atmospheric drivers on the basis of observational data collected from one urban site and two rural grassland sites in and near the city of Nanjing, China. Results show that during the daytime a strong SUCI effect is observed when the short grassland site is used as the reference site whereas a moderate SUHI effect is observed when the tall grassland is used as the reference site. We find that the former is mostly caused by the lower aerodynamic resistance for convective heat transfer at the urban site and the latter is primarily caused by the higher surface resistance for evapotranspiration at the urban site. At night, SUHIs are observed when either the short or the tall grassland site is used as the reference site and are predominantly caused by the stronger release of heat storage at the urban site. In general, the magnitude of SUHI is much weaker, and even becomes SUCI during daytime, with the short grassland site being the reference site because of its larger aerodynamic resistance. The study highlights that the magnitude of SUHIs and SUCIs is mostly controlled by urban–rural differences of biophysical factors, with urban–rural differences of atmospheric conditions playing a minor role.
Trends in the Extremes of Environments Associated with Severe U.S. Thunderstorms
Authors: Koch Erwan , Koh Jonathan , Davison Anthony C. , Lepore Chiara , Tippett Michael K. 
Published: October 2020

AbstractSevere thunderstorms can have devastating impacts. Concurrently high values of convective available potential energy (CAPE) and storm relative helicity (SRH) are known to be conducive to severe weather, so high values of PROD = (CAPE)1/2 × SRH have been used to indicate high risk of severe thunderstorms. We consider the extreme values of these three variables for a large area of the contiguous United States over the period 1979–2015 and use extreme-value theory and a multiple testing procedure to show that there is a significant time trend in the extremes for PROD maxima in April, May, and August, for CAPE maxima in April, May, and June, and for maxima of SRH in April and May. These observed increases in CAPE are also relevant for rainfall extremes and are expected in a warmer climate but have not previously been reported. Moreover, we show that El Niño–Southern Oscillation explains variation in the extremes of PROD and SRH in February. Our results suggest that the risk from severe thunderstorms in April and May is increasing in parts of the United States where it was already high and that the risk from storms in February is increased over the main part of the region during La Niña years.
Economic Valuation of Coccidioidomycosis (Valley Fever) Projections in the United States in Response to Climate Change
Authors: Gorris Morgan E. , Neumann James E. , Kinney Patrick L. , Sheahan Megan , Sarofim Marcus C. 
Published: October 2020

AbstractCoccidioidomycosis, or valley fever, is an infectious fungal disease currently endemic to the southwestern United States. Symptoms of valley fever range in severity from flu-like illness to severe morbidity and mortality. Warming temperatures and changes in precipitation patterns may cause the area of endemicity to expand northward throughout the western United States, putting more people at risk for contracting valley fever. This may increase the health and economic burdens from this disease. We developed an approach to describe the relationship between climate conditions and valley fever incidence using historical data and generated projections of future incidence in response to both climate change and population trends using the Climate Change Impacts and Risk Analysis (CIRA) framework developed by the U.S. Environmental Protection Agency. We also developed a method to estimate economic impacts of valley fever that is based on case counts. For our 2000–15 baseline time period, we estimated annual medical costs, lost income, and economic welfare losses for valley fever in the United States were $400,000 per case, and the annual average total cost was $3.9 billion per year. For a high greenhouse gas emission scenario and accounting for population growth, we found that total annual costs for valley fever may increase up to 164% by year 2050 and up to 380% by 2090. By the end of the twenty-first century, valley fever may cost $620,000 per case and the annual average total cost may reach $18.5 billion per year. This work contributes to the broader effort to monetize climate change–attributable damages in the United States.