bluuebunny/crossref_metadata_2025_split huggingface dataset:
The benefits of non-invasive ventilation for community-acquired pneumonia: a meta-analysis
Authors: Klefti G. , Hill A.T. 
Published: March 2020

Summary
There is an observed international increase in non-invasive ventilation (NIV) application as an alternative to endotracheal intubation (ETI) in non-chronic obsructive pulmonary disease (COPD) patients admitted with community-acquired pneumonia (CAP) despite the lack of strong evidence for its use. The aim of this study is the meta-analysis of data from randomized controlled trials (RCTs) on the effectiveness of NIV vs. standard medical care in adults admitted with severe CAP. Monthly electronic searches on CENTRAL and MEDLINE were performed between September 2017 and October 2019. Only RCTs comparing NIV to standard medical care for the treatment of CAP in adults were eligible for inclusion. The primary outcomes were the rate of ETI and the proportion of patients meeting the criteria of ETI as defined by the investigators. Secondary outcomes were the intensive care unit (ICU) and hospital mortality rate. Study eligibility was independently assessed by two investigators. The risk of bias of included studies was assessed using Cochrane’s Risk of bias Tool. Four RCTs involving a total of 218 participants were eligible for inclusion. Results from the meta-analysis showed that NIV significantly reduced rate of ETI (risk ratio (RR) = 0.46, 95% CI [0.26, 0.79]), the proportion of patients that met the criteria for ETI (RR = 0.28, 95% CI [0.16, 0.49]) and ICU mortality rate (RR = 0.3, 95% CI [0.09, 0.93]). No significant effect on hospital mortality rate was found (RR = 0.44, 95% CI [0.05, 3.67]). The authors rated quality of evidence based on GRADE criteria as ‘Moderate’ for the rate of intubation and proportion of patients meeting ETI criteria outcomes, but quality of evidence for ICU and hospital mortality rate as ‘Low’. This study provides evidence supporting the use of NIV as potential means of avoiding ETI and ICU mortality, in patients with acute respiratory failure due to CAP in the critical care setting. However, there is need for further larger international studies.
Computational modelling of social cognition and behaviour—a reinforcement learning primer
Authors: Lockwood Patricia L , Klein-Flügge Miriam C 
Published: March 2020

Abstract
Social neuroscience aims to describe the neural systems that underpin social cognition and behaviour. Over the past decade, researchers have begun to combine computational models with neuroimaging to link social computations to the brain. Inspired by approaches from reinforcement learning theory, which describes how decisions are driven by the unexpectedness of outcomes, accounts of the neural basis of prosocial learning, observational learning, mentalizing and impression formation have been developed. Here we provide an introduction for researchers who wish to use these models in their studies. We consider both theoretical and practical issues related to their implementation, with a focus on specific examples from the field.
Cannabidiol attenuates methamphetamine-induced conditioned place preference via the Sigma1R/AKT/GSK-3β/CREB signaling pathway in rats
Authors: Yang Genmeng , Liu Liu , Zhang Ruilin , Li Juan , Leung Chi-Kwan , Huang Jian , Li Yuanyuan , Shen Baoyu , Zeng Xiaofeng , Zhang Dongxian 
Published: March 2020

Abstract
Methamphetamine (METH) is a highly addictive psychostimulant. Cannabidiol (CBD) is an exogenous cannabinoid without psychostimulating activity, which has potential therapeutic effects on opioid addiction. However, it is unclear whether CBD has therapeutic effects on METH-induced motivational effects. The present study examines whether CBD has a protective effect on METH-induced conditioned place preference (CPP) in rats by regulating the Sigma1R and AKT-GSK3β-CREB signaling pathway. Seventy rats were equally and randomly divided into seven groups. The rat CPP model was established via the intraperitoneal injection (IP) of 2 mg/kg of METH. Next, the intraperitoneal injection of 10, 20, 40, and 80 mg/kg CBD was performed 1 h prior to the injection of saline or METH. The protein expression levels of Sigma1R, AKT, p-AKT, GSK-3β, p-GSK-3β, CREB, and p-CREB in the rats’ prefrontal cortex, nucleus accumbens, and hippocampus and ventral tegmental were detected using western blot analysis. CBD was found to inhibit METH-induced CPP in a dose-dependent fashion. The expression levels of Sigma1R, p-AKT, p-GSK3β, and p-CREB increased significantly in the METH-induced CPP model. Treatment involving different doses of CBD caused differential inhibitory responses in the cellular protein abundance of Sigma1R, p-AKT, p-GSK3β, and p-CREB across various brain regions. The present study found that METH can induce CPP in rats. When a pretreatment of CBD is applied, the CBD can weaken CPP in METH-induced rats by regulating the SigmaR1/AKT/GSK-3β/CREB signaling pathway. The results of this study indicate that CBD has a potential therapeutic effect on METH-induced rewarding effects.
Oxidative stress response associates with the teratogenic effects of benzyl butyl phthalate (BBP)
Authors: Song Ge , Wang Rui , Cui Yi , Hao Chan Juan , Xia Hong-Fei , Ma Xu 
Published: March 2020

Abstract
Benzyl butyl phthalate (BBP) is a persistent environmental pollutant. BBP exposure and the possible effects on human neural tube defects (NTDs) remain elusive. In this study, we found that the detection ratio of positive BBP and its metabolites in maternal urine was obviously higher in NTDs’ population than that in normal controls by GC-MS (P &lt; 0.01, P &lt; 0.05, respectively). Animal experiments showed that BBP treatment induced developmental toxicity in chick embryo by enhancing the levels of oxidative stress and cell apoptosis (P &lt; 0.01). More interestingly, the supplement of high-dose choline (CHO, 10 5 μg/mL) could partially restore the teratogenic effects of BBP by inhibiting the occurrence of oxidative stress. Our data collectively suggest that BBP exposure may disturb neural tube development by strengthening oxidative stress. CHO can partially restore the toxicity effects of BBP. This study may provide new insight for NTD prevention.
Emerging treatments in advanced urothelial cancer
Authors: Alhalabi Omar , Campbell Matthew , Shah Amishi , Siefker-Radtke Arlene , Gao Jianjun 
Published: March 2020

Purpose of review
Urothelial carcinoma is one of the 10 most common forms of cancer in the world with more than half a million cases diagnosed yearly. The past few years have witnessed a revolution in understanding the biology of urothelial carcinoma and the development of promising therapies. In this review, we summarize the emerging therapeutic approaches in the management of advanced urothelial carcinoma.

Recent findings
Since 2016, the Food and Drug Administration (FDA) has approved five checkpoint inhibitors (CPIs), a fibroblast growth factor receptor (FGFR) inhibitor, and an antibody drug conjugate (ADC) for the treatment of advanced urothelial carcinoma. Additionally, the FDA has granted several breakthrough designations for other therapeutic strategies including other ADCs.

Summary
CPIs, anti-FGFR agents and ADCs are significant advancements that offer new treatment options to patients with advanced urothelial carcinoma. However, there remains a need to understand mechanisms of resistance, identify biomarkers to choose potential responders, and learn the best strategy to sequence these agents in regards to lines of therapy.
Influence of selected polymorphisms in disposition genes on lumefantrine pharmacokinetics when coadministered with efavirenz
Authors: Adegbola Adebanjo Jonathan , Rana Abutaima , Adeagbo Babatunde Ayodeji , Bolarinwa Rahman A. , Olagunju Adeniyi Ebenezer , Siccardi Marco , Owen Andrew , Bolaji Oluseye Oladotun 
Published: March 2020

Background
Coadministration of artemether–lumefantrine and efavirenz has been shown to result in significant interactions. The influence of functional genetic polymorphisms in selected CYPs on the magnitude of this interaction was investigated in pregnant and nonpregnant adults.

Method
A standard 3-day regimen of artemether–lumefantrine was administered to each patient on steady-state efavirenz-based antiretroviral therapy (ART). Pharmacokinetic parameters were obtained from intensive plasma concentration–time data. Genotyping data were tested for compliance with Hardy–Weinberg equilibrium by Chi-square test. Linear regressions, Mann–Whitney U-test or Kruskal–Wallis tests were conducted to examine the association of lumefantrine plasma level with CYP2B6 c.516G>T, NR1I3 152c-1089T>C, CYP2B6 c.983T>C, CYP3A5*3 and CYP3A4*22.

Results
Among a total of 69 malaria–HIV coinfected patients (34 nonpregnant and 35 pregnant), median (interquartile range) age was 33 (27–36.5) years and body weight was 59.5 (50–67.5) kg. In nonpregnant group, CYP2B6 c.516G>T was significantly associated with lower log C
day 7 of lumefantrine using multivariate linear regressions (β = −0.239; P = 0.013). In 59% of women with CYP2B6 c.516T, C
day 7 of lumefantrine was below the target of 280 ng/mL compared to 47% in the noncarriers. CYP2B6 c.983T>C significantly associated with higher log C
day 7 of desbutyl lumefantrine in both pregnant (β = 0.383; P = 0.033) and nonpregnant (β = 0.395; P = 0.023) groups. Composite genotypes for both CYP2B6 Single-nucleotide polymorphisms strongly associated with lumefantrine plasma concentration. An associative trend between lumefantrine pharmacokinetics and NR1I3 152c-1089T>C genotypes indicated that 70% of the C
day 7 of lumefantrine in those with NR1I3 152c-1089TT genotype was below 280 ng/mL compared to 53% in those with NR1I3 152c-1089CC or CT genotype.

Conclusion
The findings revealed that the efavirenz–lumefantrine interaction was accentuated in the group with CYP2B6 c.516T, c.983C and NR1I3 152c-1089T alleles. This warrants further investigations of other drug–drug interactions for optimising dosing in genetically defined subgroups, particularly during drug development.
Use of Social Media to Teach Global Reconstructive Surgery: Initiation of a Secret Facebook Group
Authors: Deptula Peter L. , Auten Brieanne , Chang James 
Published: March 2020

Background:
The ReSurge Global Training Program (RGTP) is a model for building reconstructive surgery capacity in low- and middle-income countries.
1
The aim of this study is to assess attitudes toward social media, to develop an initial RGTP Facebook Education Group, and to assess the early results of the group’s implementation.

Methods:
A survey of the RGTP community assessed group demographic, interests, concerns, and familiarity with Facebook from July to August of 2018. A “secret” Facebook group was launched on October 30, 2018. Narrated lectures were posted weekly to the group. Educational cases were shared on the group’s discussion page. Facebook “Group Insights” and individual post review were used to obtain group statistics.

Results:
Senior faculty were less likely to have an existing Facebook account (58% vs 93%, P < 0.05). Trainees were more confident using Facebook (97% vs 54%, P < 0.05) and favored viewing the training curriculum through Facebook (93.0%, P < 0.05). At 6 months, the group enrolled 103 members from 14 countries. Twenty-two lectures were posted, obtaining an average of 59.4 views (range, 36–78). Fourteen cases were presented for group discussion with an average of 61.1 views (range, 43–87).

Conclusions:
The RGTP Facebook group has continued to expand in its early months. This group allows our community to view RGTP’s training curriculum, while providing global access to expert opinion and collaboration. The secret Facebook group can be used as an effective and easy-to-use platform for educational outreach in global reconstructive surgery.
Acral Lentiginous Melanoma: Do Surgical Approach and Sentinel Lymph Node Biopsy Matter?
Authors: Walker Marc E. , Han Gang , Gabrick Kyle , Kanouzi Jack , Lo Ying-Chun , Galan Anjela , Clune James , Narayan Deepak , Ariyan Stephan , Han Dale 
Published: March 2020

Background:
Management of acral lentiginous melanoma (ALM) remains controversial. Traditionally, ALM was managed with digit amputation (DA), resulting in significant morbidity, but recent evidence has advocated for digit sparing management. Furthermore, the significance of nodal metastasis for ALM is not well reported. The aims of this study were to determine if surgical approach for primary ALM impacts outcomes and to evaluate the predictive value of nodal status for ALM.

Methods:
Patients with localized ALM diagnosed from 1982 to 2017 were retrospectively identified. Clinicopathologic characteristics were correlated with surgical approach, nodal metastasis, overall survival, and recurrence-free survival.

Results:
There were 47 patients with ALM. Median age was 59 years, and median thickness was 3 mm. 51% of patients underwent wide local excision (WLE), 27.9% underwent DA, and 20.9% underwent partial digit amputation (PDA). ALM on the hand versus foot (OR: 12.7, 95%, confidence interval (CI), 2.0–80.1; P = 0.007) and subungual versus nonsubungual location (OR: 28.0, 95% confidence interval, 2.7–295.7; P = 0.006) were significantly associated with surgical approach (DA and PDA versus WLE). There were no significant differences in overall survival or recurrence-free survival between DA, PDA, or WLE cases (P = 0.481 and P = 0.778, respectively). There were no significant differences in overall survival or recurrence-free survival based on nodal status (P = 0.562 and P = 0.136, respectively).

Conclusions:
No significant differences in overall survival or recurrence-free survival were seen between ALM patients treated with DA, PDA, and WLE. Given these results, PDA or WLE may be options in select patients with digital ALM; however, careful consideration must be taken when deciding on the surgical approach.
Immediate Targeted Nipple–Areolar Complex Reinnervation: Improving Outcomes in Gender-affirming Mastectomy
Authors: Rochlin Danielle H. , Brazio Phil , Wapnir Irene , Nguyen Dung 
Published: March 2020

Background:
Female-to-male mastectomy often renders the chest skin and nipple–areolar complex (NAC) insensate. We propose a new technique of preserving the intercostal nerves and using them to reinnervate the NAC after mastectomy.

Methods:
We performed a prospective analysis of transmasculine patients who underwent female-to-male mastectomy. The technique involves dissecting out the lateral intercostal nerves to length and performing a neurorrhaphy to nerve stumps at the base of the NAC. Sensory outcomes, as assessed with Semmes–Weinstein monofilaments, were compared to a cohort of patients who underwent mastectomy without neurotization.

Results:
Ten patients with a mean age of 17.5 years (range: 16–19 years) underwent mastectomy. The final follow-up was a mean of 15.4 ± 4.3 months for the treated group and 40.7 ± 12.9 months for the control group. Compared to control patients, treated patients had significant improvement in sensation at the nipple (P ≤ 0.0002), areola (P = 0.0001), and peripheral breast skin (P = 0.0001). For treated patients, there was no statistically significant difference in sensation between preoperative and postoperative sensation in all tested areas at final follow-up.

Conclusion:
This proof of concept study suggests that immediate reinnervation of the NAC after mastectomy enhances recovery of NAC sensation in patients undergoing female-to-male mastectomy and may be further generalized to women undergoing postmastectomy breast reconstruction.
Comparison of clinical and PET-derived prognostic factors in patients with non-Hodgkin lymphoma: a special emphasis on bone marrow involvement
Authors: Kupik Osman , Akin Serkan , Tuncel Murat , Eren Gülnihan , Türker Alev , Kars Ayşe , Erbaş Belkis 
Published: March 2020

Objective
In patients with non-Hodgkin lymphoma (NHL), we investigated 18F FDG PET/computed tomography (CT) parameters, clinical findings, laboratory parameters, and bone marrow involvement (BMI) status for predictive methods in progression-free survival (PFS) and overall survival (OS), and whether 18F FDG PET/CT could take the place of bone marrow biopsy (BMB).

Methods
The performance of 18F FDG PET/CT (BMPET) was evaluated. The prognostic value of maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), stage, international prognostic index (IPI) score, IPI risk, lactate dehydrogenase (LDH), B2 microglobulin, Ki67 proliferation index, and the presence of BMI was evaluated for OS and PFS. Kaplan–Meier curves were drawn for each designated cutoff value, and 5-year PFS and 7-year OS were evaluated using log-rank analysis.

Results
The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of BMPET and BMB to identify BMI were 69, 100, 86.1, 80, 100%, and 81.6, 100, 92.5, 89, 100%, respectively. The sensitivity, specificity, PPV, NPV, and accuracy of BMPET in patients with Ki67- proliferation index >25% were all 100%. BMPET, IPI risk, MTV, and LDH were found to be independent prognostic predictors for PFS, whereas BMPET, SUVmax, and MTV for OS. Five-year PFS analysis estimated as follows: BMPET (+) = 22%, BMPET (−) = 80%, LDH ≤ 437 (U/L) = 86%, LDH > 437 (U/L) = 51%, MTV ≤ 56 (cm3) = 87%, MTV > 56 (cm3) = 49%, low IPI risk = 87%, intermediate IPI risk = 69%, high IPI risk = 25%. Seven-year OS analysis was found as: SUVmax ≤ 17.6 = 80%, SUVmax > 17.6 = 48%, MTV ≤ 56 (cm3) = 84.4%, MTV > 56 (cm3) = 45.8%, BMPET (−) = 72.5%, BMPET (+) = 42%.

Conclusion
In the Ki-67 proliferation index > 25% group, 18F FDG PET/CT was able to differentiate BMI independently from NHL subgroups. We recommend using this method with large patient groups. MTV and BMPET were independent prognostic indicators for OS and PFS and may help to determine high-risk patients.
A Multisite Study Demonstrates Positive Impacts to Systems Thinking Using a Table-top Simulation Experience
Authors: Sanko Jill S. , Gattamorta Karina , Young Judith , Durham Carol F. , Sherwood Gwen , Dolansky Mary 
Published: March 2020

Background
Systems thinking (ST) is the ability to recognize, understand, and synthesize interactions and interdependencies in a set of components designed for a purpose. Systems thinking has been shown to improve systems and decrease error. Despite these benefits, ST has not yet been consistently integrated into all health care education programs.

Purpose
This study examined the impact of Friday Night at the ER (FNER), a table-top simulation designed to teach ST to a variety of prelicensure and postlicensure health care students.

Methods
A multisite study was conducted in 5 academic institutions targeting both graduate and prelicensure students enrolled in nursing, medicine, physical therapy, public health, psychology, and pharmacy programs.

Results
The FNER simulation was followed by statistically significant improvements in ST scores.

Conclusions
The FNER table-top simulation was found to improve ST in a wide variety of health-related majors.
The Moderating Role of Emotion Regulation in the Association Between Stressors With Psychological and Biological Measures in Adolescence
Authors: Klosowska Joanna Cecylia , Verbeken Sandra , Braet Caroline , Wijnant Kathleen , Debeuf Taaike , De Henauw Stefaan , Michels Nathalie 
Published: March 2020

ABSTRACT

Objective
This study explored the role of emotion regulation (ER) as a moderator in the stressor–adjustment outcome relationship while identifying the relevant stressors.

Methods
In 214 adolescents (10–18 years; 51.4% boys), stressors (parent and peer relations, negative events), psychological outcomes (adolescent perceived stress, psychopathology symptoms, negative affect), and biological measures related to the stress response (hair cortisol [HC], heart rate variability [HRV]) as well as ER strategies—maladaptive (MalER), adaptive (AdER), and their ratio (Mal/AdER)—were measured and analyzed via linear regression, adjusted for age, sex, and socioeconomic status.

Results
Parental rejection and bullying were the stressors with the strongest association with psychological outcomes (β range = |0.217–0.352|, p < .05). In addition, parental rejection was associated with HC (β = 0.242, p = .035), whereas none of the stressors were associated with HRV. MalER was linked to all, and AdER to most psychological outcomes (β range = |0.21–0.49|, p < .05). MalER, but not AdER, was associated with HC (β = 0.25, p = .009), whereas none of the ER strategy types were associated with HRV. Moreover, several associations between stressors and psychological outcomes were moderated by MalER and Mal/AdER, whereas AdER’s role as a moderator was not confirmed.

Conclusions
The study confirmed that adolescents’ stressors are associated with both psychological and physiological outcomes and moderated by MalER or Mal/AdER. The lack of moderation by AdER directs toward the maladaptive shift theory. Investigations through a longitudinal, rather than a cross-sectional design, could further elucidate the current observations. Moreover, training in how to use ER effectively has a potential of increasing adolescents’ stress resilience.
Evaluation of Learning Teams Versus Root Cause Analysis for Incident Investigation in a Large United Kingdom National Health Service Hospital
Authors: Robbins Tim , Tipper Stephen , King Justin , Ramachandran Satya Krishna , Pandit Jaideep J. , Pandit Meghana 
Published: March 2020

Introduction
Significant resource is invested into investigation of adverse healthcare events. Outcomes of such investigations have varying degrees of effectiveness. The “hierarchy of effectiveness” model proposes system-focused changes have greater impact than person-focused actions. The traditional approach to investigation is root cause analysis (RCA); however, such an approach does not prioritize system-focused action generation. Learning team-based investigations are thought to generate more effective system-focused actions; however, this has not been evaluated.

Methods
Retrospective mixed methods evaluation of learning teams compared with RCA. Twenty-two learning team investigations compared with 22 RCA investigations, with quantitative assessment of the number of system-focused and person-focused actions generated. Assignment of the two different methods to incidents was not random, with learning teams being selected for cases, which were initially judged to be process-focused problems. Semistructured interviews were conducted with four learning team facilitators with thematic analysis to identify causes for outcome variations.

Results
Learning team investigations yielded a median of 7.5 actions compared with 3.5 actions for RCA: 57% of learning team actions were system focused versus 30% for RCA. We identified variations in personnel involved, culture of the investigation, and differences in the investigative approaches as potential drivers for these differences.

Conclusions
We observed that learning team investigations that targeted process-focused problems generated more actions and a higher number of system-focused actions. There is a difference in culture created during learning team investigations. Although learning teams are not suitable for all investigations, they represent a readily reproducible and valuable addition to the investigative toolkit.