bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prophylactic phenylephrine and fluid co‐administration to reduce spinal hypotension during elective caesarean section in a resource‐limited setting: a prospective alternating intervention study
Authors: Buthelezi A. S. , Bishop D. G. , Rodseth R. N. , Dyer R. A. 
Published: December 2019

SummarySpinal hypotension is a common and clinically important problem during caesarean section. Current consensus recommendations for resource‐rich settings suggest the use of a titrated phenylephrine infusion, in combination with fluid coloading, for prevention of maternal hypotension. In resource‐limited settings, where syringe drivers are unavailable, these recommendations advise the addition of 500 μg phenylephrine to the first 1 l of intravenous fluid given after initiation of spinal anaesthesia, with additional vasopressor boluses as required. This prospective, alternating intervention study compared the use of a conventional phenylephrine rescue bolus strategy for prevention of hypotension, defined as systolic arterial pressure < 90 mmHg, with a phenylephrine infusion given according to the consensus recommendation. We studied 300 women having elective caesarean section. There were 77 (51%) women who developed hypotension in the bolus group vs. 55 (37%) in the phenylephrine infusion group (p = 0.011). This represented a 29% reduction in hypotension, with a number needed to treat of 6.8. The six highest systolic arterial pressure readings occurred in the phenylephrine infusion group (range 166–188 mmHg), and there were four instances of bradycardia (heart rate < 50 beats.min−1) with preserved systolic arterial pressure in each group. There were no adverse clinical sequelae, and no differences in neonatal Apgar scores in either group. The consensus recommendation for phenylephrine and fluid co‐administration in resource‐limited settings appears effective in preventing maternal hypotension, but at the cost of sporadic systolic hypertension.
Predictive role of ventricular repolarization parameters for the occurrence of complete heart block in patients undergoing transcatheter aortic valve implantation
Authors: Karacop Erdem , Enhos Asim 
Published: December 2019

AbstractBackgroundWe investigated the role of ventricular repolarization parameters to predict complete atrioventricular block in patients undergoing transcatheter aortic valve implantation (TAVI).MethodsA total of 150 patients undergoing TAVI due to severe aortic stenosis were included in this retrospective cohort study. Patients were assigned in two groups based on the presence (n: 49) or absence (n: 101) of complete atrioventricular block after TAVI. Ventricular repolarization intervals (QT, QTc, JT, JTc, TP‐E), indices (QT dispersion), and ratios (TP‐E/QT, TP‐E/QTc, TP‐E/JTc) were measured.ResultsElectrocardiographic repolarization parameters such as Tp‐e interval: 74.2 ± 5.1 versus 59.2 ± 6.1 ms, p < .001; QTc interval: 397.6 ± 3.4 versus 368.1 ± 7.8 ms, p < .001; JTc interval: 317.4 ± 11.3 versus 291.1 ± 6.7 ms, p < .001; Tp‐e/QT ratio: 0.28 ± 0.04 versus 0.20 ± 0.04, p < .001; Tp‐e/QTc ratio: 0.29 ± 0.04 versus 0.19 ± 0.03, p < .001; Tp‐e/JT ratio: 0.32 ± 0.03 versus 0.23 ± 0.03, p < .001; Tp‐e/JTc ratio: 0.30 ± 0.02 versus 0.2 ± 0.03, p < .001; and QT dispersion: 34.4 ± 3.0 versus 17.8 ± 3.6 ms, p < .01 were significantly higher in post‐TAVI permanent pacemaker group. In a univariate regression analysis, pulmonary artery pressure, heart rate, coronary artery disease, Tp‐e/QTc, Tp‐e/JTc, and PR interval were significantly associated with complete heart block. Tp‐e/JTc (OR 0.373, p = .067) and PR interval (OR 0.898, p = .079) were found to be independent predictors of these type of arrhythmias in a multivariate analysis. But it is not statistically significant.ConclusionOur results suggest that repolarization parameters may play a role in predicting complete atrioventricular block. Tp‐e/JTc was found to be potential independent risk marker for this setting.
Utility of digitally supported surgical competency assessments in a work‐based setting: a systematic review of the literature
Authors: Oh Daniel D. , Bains Harinder , Agostinho Nelson , Young Christopher J. , Storey David , Hong Jonathan S. 
Published: December 2019

AbstractBackgroundAdequate training and assessment of competency in surgical trainees are important in minimizing adverse events and achieving good patient outcomes. The purpose was to investigate the current literature on digitally supported methods of facilitating work‐based competency assessment of surgical trainees.MethodsTwo concurrent literature searches were performed by two independent researchers using three databases: MEDLINE, Embase and Education Resources Information Center. Eligible studies reported on digitally supported tools for assessing surgical competency in a work‐based setting for interns, residents or trainees of a post‐graduate surgical programme. Studies focusing primarily on training courses, simulations or other tools for assessing surgical skills in a setting outside of work were excluded. Articles published as abstracts only, articles not published in English and review articles that did not contain original data were excluded.ResultsA total of 11 eligible studies were included, with six of these implementing smartphone application‐based programmes, and five utilizing web‐based programmes. Five studies implemented the ‘System for Improving and Measuring Procedural Learning’ smartphone application. Studies were based predominantly on general surgery residents, and were limited to the North American context. There was significant variability between studies regarding methodology, including the scoring system used to assess competency.ConclusionThis review confirms that digitally supported competency assessment of surgical trainees in a work‐based setting is both feasible and effective. Digital platforms allow evaluations to be performed in a timely fashion without significant disturbance to workflow.
Prevalence, risk factors and management strategies for otological problems in girls with Turner syndrome
Authors: Lim David , Hassani Sarah , Lupton Kenneth , Gault Emma Jane , Wynne David , Clement William , Kubba Haytham , Mason Avril , Donaldson Malcolm 
Published: December 2019

AbstractAimTo determine the prevalence and risk factors of ear disease in Turner syndrome (TS), propose an algorithm for future surveillance and recommend preventative strategies.MethodsReview of TS patients seen in the West of Scotland between 1989 and 2015, with questionnaire follow‐up in 2015.ResultsOf 168 girls, median age 27.3 (3.8‐47.2) years, ear problems occurred more frequently with 45,X and 45,X/46,XiXq than other karyotypes: 71/103 (69%) versus 23/65 (35%). Recurrent acute otitis media (AOM) first developed at 0‐5 years in 23 (40%) girls, persisting in 16 (10%) at 5‐10 years; and first developing at 5‐10 years in 11 (7%). Persistent otitis media with effusion (OME) first developed at 0‐5 and 5‐10 years in 23 (40%) and 14 (8%) girls. Recurrent AOM was significantly linked with cholesteatoma in 8 (4.9%) girls (7 aged >10 years). Permanent hearing loss was documented in 28 girls (16.7%), with 16 (9.5%) receiving hearing aids (bone‐anchored in 3).ConclusionAcute otitis media and OME occur commonly in preschool TS girls and may persist or newly develop in later childhood. Recurrent AOM predisposes to cholesteatoma. Strategies to reduce otological morbidity include: intensive patient education, annual audiology, vaccinations and a randomised trial of antibiotic prophylaxis in high‐risk groups.
A new Swedish reference for total and prepubertal height
Authors: Albertsson‐Wikland Kerstin , Niklasson Aimon , Holmgren Anton , Gelander Lars , Nierop Andreas F. M. 
Published: December 2019

AbstractAimWe aimed to develop up‐to‐date references with standard deviation scores (SDS) for prepubertal and total height.MethodsLongitudinal length/height measures from 1572 healthy children (51.5% boys) born at term in 1989‐1991 to non‐smoking mothers and Nordic parents were obtained from the GrowUp 1990 Gothenburg cohort. A total height SDS reference from birth to adult height was constructed from Quadratic‐Exponential‐Pubertal‐Stop (QEPS) function estimated heights based on individual growth curves. A prepubertal height SDS reference, showing growth trajectory in the absence of puberty, was constructed using the QE functions.ResultsThe total height reference showed taller prepubertal mean heights (for boys 1‐2 cm; for girls 0.5‐1.0 cm) with a narrower normal within ± 2SDS range vs the GrowUp 1974 Gothenburg reference. Adult height was increased by + 0.9 cm for women (168.6 cm) and by + 1.6 cm for men (182.0 cm). Height in children growing at −2SDS (the cut‐off used for referrals) differed up to 2 cm vs the GrowUp 1974 Gothenburg reference, 3 cm vs Swedish 1981 references and World Health Organisation (WHO) 0‐5 years standard, and 6‐8 cm vs the WHO 5‐19 years reference.ConclusionUp‐to‐date total and prepubertal height references offer promise of improved growth monitoring compared with the references used in Sweden today.
The first wide‐scale drug repurposing screen using the Prestwick Chemical Library (1200 bioactive molecules) against Neisseria gonorrhoeae identifies high in vitro activity of auranofin and many additional drugs
Authors: Foerster Sunniva , Gustafsson Tomas N. , Brochado Anna Rita , Desilvestro Valentino , Typas Athanasios , Unemo Magnus 
Published: December 2019

Treatment options for gonorrhoea are scarce. Drug repurposing of bioactive molecules approved for other conditions might therefore be of value. We developed a method for wide‐scale, systematic drug repurposing screen to identify molecules with activity against Neisseria gonorrhoeae and screened the Prestwick Chemical Library (1200 FDA‐approved drugs). As a proof‐of‐concept, we further examined one promising and interesting screening hit (auranofin; antirheumatic agent). Three WHO gonococcal reference strains (WHO F, O, P) were used for the Library screening. The strains were grown in presence of a fixed concentration of the library drugs in 384‐well plates for 12 h, and the remaining bacterial respiration, to reflect growth, was then quantitatively measured using optical density (OD) 450 nm and a resazurin assay. The activity of auranofin was further examined using in vitro susceptibility testing (minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC)) against genetically diverse antimicrobial‐resistant N. gonorrhoeae strains and time‐kill assays. Sixty‐eight molecules significantly inhibited bacterial growth of WHO F, O and P. Auranofin showed potent in vitro bactericidal activity (in MIC‐, MBC‐ and time‐kill assays) against four WHO reference strains. No cross‐resistance between auranofin and any antimicrobial currently or previously used for gonorrhoea treatment was found when examining 51 selected antimicrobial‐resistant gonococcal strains. In conclusion, this is the first wide‐scale systematic screening effort for repurposing drugs for future treatment of gonorrhoea. Additional studies examining mechanism(s) of action, resistance development, in vivo anti‐gonococcal activity and pharmacokinetics/pharmacodynamics for gonococcal infections of auranofin and several other significant screening hits would be valuable.
Impact of imaging modality on clinical outcome in Hodgkin lymphoma in a resource constraint setting
Authors: Korula Anu , Devasia Anup Joseph , Kulkarni Uday , Abubacker Fouzia N. , Lakshmi Kavitha M. , Abraham Aby , Srivastava Alok , George Biju , Mathews Vikram 
Published: December 2019

SummaryTreatment of Hodgkin lymphoma (HL) has evolved with risk‐stratified therapy based on PET‐CT scan at multiple timepoints. In a resource constraint setting even a single PET‐CT scan ($400) is inaccessible to many patients, who are re‐assessed with only clinical examination, abdominal ultrasonogram and/or x‐ray (C/U/X) ($10). To compare clinical outcomes in patients with HL who have had suboptimal imaging after completion of chemotherapy for HL, with those who had a CT or PET‐CT, 283 patients were treated for HL from 2011 to 2015, and 268 patients completed six cycles of ABVD therapy with response assessment modality by CT/PET in 185 patients and by C/U/X in 83. There was no difference in the number of patients with advanced (64·1% vs. 61·1%; P = 0·650) or bulk disease (8·1% vs. 7·2%). A significantly higher number of patients in the CT/PET group received IFRT (25·4% vs. 7·7%; P = 0·0005). The three‐year overall survival and progression‐free survival of all treated patients (n = 283) was 83·5 ± 2·3% and 76·7 ± 2·6% respectively [median follow‐up 36 months (range 2–93)]. At three years, the overall relapse‐free survival (RFS) was 80·1 ± 2·5%, with RFS of 77 ± 3·2% vs. 85 ± 4·0% in the CT/PET group and C/U/X groups respectively (P = 0·349). There was no difference in RFS between the two groups either in early‐stage disease (88·1 ± 4·6% vs. 91·8 ± 5·6%; P = 0·671) or late‐stage disease (73·9 ± 4·8% vs. 81·3 ± 6·0%; P = 0·747). The only significant factor adversely affecting RFS was advanced disease (P = 0·004). Factors not affecting RFS were age (P = 0·763), sex (P = 0·925), bulk disease (P = 0·889) and imaging modality (P = 0·352). There was no difference in relapse rates between patients who had suboptimal imaging compared to those who had a PET/CT. It is possible to use these basic imaging modalities when resources are a constraint, with acceptable outcomes.
Poor outcomes for double‐hit lymphoma patients treated with curative‐intent second‐line immunochemotherapy following failure of intensive front‐line immunochemotherapy
Authors: Landsburg Daniel J. , Ayers Emily C. , Bond David A. , Maddocks Kami J. , Karmali Reem , Behdad Amir , Curry Madeira , Wagner‐Johnston Nina D. , Modi Dipenkumar , Ramchandren Radhakrishnan , Assouline Sarit E. , Faramand Rawan , Chavez Julio C. , Torka Pallawi , Mier Hicks Angel , Medeiros L. Jeffrey , Li Shaoying 
Published: December 2019

SummaryWhile patients with double‐hit lymphoma (DHL) are now frequently treated with intensive front‐line immunochemotherapy, outcomes for those who fail these regimens and subsequently receive curative‐intent second‐line immunochemotherapy are unknown. We identified 55 such patients who achieved an overall/complete response rate of 29%/11%, median progression‐free/overall survival (PFS/OS) of 2/5·1 months and one‐year PFS/OS of 10/19% following the start of second‐line therapy. These outcomes may serve as a standard against which future second‐line treatment strategies for relapsed/refractory DHL can be measured and justify investigation of non‐cytotoxic therapies in the second‐line setting for these patients.
Longitudinal associations between parental incarceration and children's emotional and behavioural development: Results from a population cohort study
Authors: Bradshaw Daragh , Hannigan Ailish , Creaven Ann‐Marie , Muldoon Orla T. 
Published: December 2019

AbstractBackgroundParental incarceration (PI) is associated with adverse developmental outcomes for children affected. However, research in this area often reports conflicting results with few studies following children across time in non‐U.S. populations. Additionally, more research is called for using multi‐informant perspectives rather than relying on adult reports of child outcomes alone.MethodsThis study used data from the first two waves of a nationally representative cohort study of 8,568 children aged 9 years and followed up at age 13 living in the Republic of Ireland (2007–2012). Propensity score matching was used to match children who had experienced PI by the age of nine to children who had not experienced PI by sociodemographics and experience of other stressful events. Mental health, as measured by self‐concept (Piers‐Harris II) and externalizing and internalizing difficulties (strength and difficulties questionnaire), was compared across both groups.ResultsFifty of the 8,568 children (weighted percentage 0.9%) reported experiencing PI by the age of nine. These children came from more socially disadvantaged homes and were more likely to have experienced other potentially stressful life events. In comparison to a matched sample of children not affected by PI, children affected by PI reported higher levels of anxiety at age nine. Longitudinal analysis indicated these children affected by PI also reported lower levels of happiness at age 13 with higher levels of emotional difficulties reported by their primary caregiver.ConclusionsChildren of incarcerated parents face a greater array of life challenges. PI had an association with child‐reported levels of anxiety at age nine. PI also had a medium‐term association on caregiver assessments of emotional difficulties of children affected as well child‐reported levels of happiness over time.
Validity and reliability of three‐dimensional costal cartilage imaging for donor‐site assessment and clinical application in microtia reconstruction patients: A prospective study of 22 cases
Authors: Mao Xiaoyan , Li Xiaojian , Jia James , Kang Deni , Miao Yong , Lu Zijing , Hu Zhiqi 
Published: December 2019

AbstractObjectivesThis study assesses the ability to reconstruct costal cartilage images by using three‐dimensional visualisation software (Mimics) based on semi‐automated segmentation algorithm and to investigate its reliability and validity with an anthropometric analysis.DesignObservational prospective study.SettingPlastic surgery department of a tertiary hospital.ParticipantsTwenty‐two microtia patients who underwent autologous ear reconstruction.Main outcome measuresPreoperative thoracic computed tomography data were processed to Mimics software for three‐dimensional costal cartilage imaging. The length, width, thickness and volume of the 9th costal cartilages were calculated from these images and compared with the direct measurements (DM) obtained intraoperatively.ResultsThe intra‐examiner reliability and inter‐examiner reliability were high in terms of all four measurements (intraclass correlation coefficients, ICC: 0.876‐0.984). There were no significant differences between image‐based anthropometry and DM in the linear measurements except for the volume (P < .05). The mean volume calculation error of Mimics was −0.08 ± 0.13 mL. No correlation was found between the anthropometric variables and the absolute errors (P > .05). Furthermore, Bland‐Altman plots were used to evaluate the agreement between the two methods.ConclusionsDespite a very small error was found in volume calculation, Mimics software was accurate and reliable in linear calculation. Three‐dimensional costal cartilage imaging was found to be an efficient tool for morphological evaluation of costal cartilages. We believe that with the application of individualised cartilage models based on three‐dimensional printing, the use of customised ear framework carving will be practicable in surgical training.
Shared and unique individual risk factors and clinical biomarkers in children with allergic rhinitis and obstructive sleep apnea syndrome
Authors: Ha Eun Kyo , Park Jun Hyeong , Lee Seung Jin , Yon Dong Keon , Kim Ju Hee , Jee Hye Mi , Lee Kyung Suk , Sung Myongsoon , Kim Mi Ae , Shin Youn Ho , Han Man Yong 
Published: December 2019

AbstractIntroductionRhinitis and obstructive sleep apnea syndrome (OSAS) are different diseases, but have some similar risk factors.ObjectiveThe aims of this study were to compare the risk factors and clinical biomarkers for rhinitis and OSAS in children.MethodsWe examined 3917 children (age 4‐13 years) who were enrolled in a cross‐sectional study conducted in Seongnam, Korea. Their parents completed the Pediatric Sleep Questionnaire (PSQ) for evaluation of OSAS and the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire for evaluation of rhinitis. Clinical biomarkers, including total eosinophil count and neutrophil‐lymphocyte ratio (NLR), were measured in a subset of these children.ResultsOSAS and rhinitis had prevalences of 4.0% and 43.5%, respectively. Body mass index (P < 0.001) and prematurity (P = 0.016) were significantly associated with OSAS, but not with rhinitis. Higher parental education and income increased the risk for rhinitis, but decreased the risk for OSAS. Having more siblings and birth by Cesarean delivery decreased the risk for rhinitis, but living in a new household increased the risk for rhinitis. A short distance of the residence to a main road during pregnancy significantly increased the risk of OSAS. Males, increased exposure to mould, and firstborns had increased risk of OSAS and rhinitis. The NLR was higher in OSAS patients than in those with allergic rhinitis (P = 0.001).ConclusionOSAS and rhinitis shared some risk factors, whereas other factors had inverse association with the two disorders. These results imply that different strategies might be used for prevention of rhinitis and OSAS.
Disentangling the far transfer of language comprehension gains using latent mediation models
Authors: Melby‐Lervåg Monica , Hagen Åste Mjelve , Lervåg Arne 
Published: December 2019

AbstractWhile we know that interventions targeting oral language can be effective, little is known about what drives these effects. In this study, we examine whether gains in transfer measures are mediated through the specific words that are trained in a language intervention. Based on a large‐scale randomized controlled trial of language intervention in 4‐ to 5‐year‐old children, latent mediation models were used to disentangle oral language gains in transfer measures. The results first showed that the effects of the language intervention and the transfer effects are generated through expressive rather than receptive measures of language. Second, we found that the effects of the intervention on intermediate transfer measures of language were mediated through the ability to define the trained words. Third, and critically, for far transfer measures that did not contain any of the trained words, the effects were mediated through the trained words. The findings relate to theories of transfer and support the idea that far transfer is possible, at least within the same domain. In addition, it seems that effects on receptive language skills are difficult to obtain and that what is improved is instead the children's ability to express themselves and use procedures to explain words. Thus, to optimize intervention effects, future studies should focus on expressive language.
Mitochondrial DNA diversity and geographical distribution of sexual and asexual strains of the braconid parasitoid Meteorus pulchricornis
Authors: Fujie Shunpei , Wachi Nakatada , Umemoto Hironobu , Maeto Kaoru 
Published: December 2019

AbstractAsexuality is an important tool with regard to the use of parasitoid wasps as biocontrol agents. Asexual (apomictic thelytokous) strains of Meteorus pulchricornis (Wesmael) (Hymenoptera: Braconidae), a polyphagous endoparasitoid of lepidopteran larvae, are sympatric with sexual (arrhenotokous) strains in Japan. The results of phylogenetic analyses of mitochondrial cytochrome c oxidase subunit I (COI) sequences indicated two major haplotype groups on the Japanese islands. The northern group I predominantly contained sexual strains, whereas the southern group II contained both sexual and asexual strains. Most asexual strains were likely derived within group II. An asexual strain recently established in New Zealand has the identical haplotype to a strain in Japan and was proven to have originated from East Asia. Three hypotheses on the evolution of asexuality are discussed for this parasitoid wasp: recessive gene, hybridization, and cytoplasmic element.