bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary desmoplastic fibroblastoma of diaphragm
Authors: Guo Chao , Wang Guige , Ma Dongjie , Li Ji , Liu Hongsheng , Li Shanqing 
Published: September 2021

AbstractDesmoplastic fibroblastoma is an extremely rare benign soft tissue tumor and desmoplastic fibroblastoma originating from the diaphragm has not been documented previously. In our case, we report the first primary diaphragm desmoplastic fibroblastoma.
Reasons behind failed prehospital intubation attempts while combining C‐MAC videolaryngoscope and Frova introducer
Authors: Ljungqvist Harry E. , Nurmi Jouni O. 
Published: September 2021

AbstractBackgroundHigh first‐pass success rate is achieved with the routine use of C‐MAC videolaryngoscope and Frova introducer. We aim to identify potential reasons and subgroups associated with failed intubation attempts, analyse actions taken after them and study possible complications.MethodsWe conducted a retrospective observational study of adult intubated patients at a single helicopter emergency medical service unit in southern Finland between 2016 and 2018. We collected data on patient characteristics, reasons for failed attempts, complications and follow‐up measures from a national helicopter emergency medical service database and from prehospital patient records.Results1011 tracheal intubations were attempted. First attempt was successful in 994 cases (FPS 994/1011, 98.3%), 15 needed a second or third attempt and two a surgical airway (non‐FPS 17/1011, 1.7%, 95% CI 1.0–2.7). The failed first attempt group had heterogenous characteristics. The most common cause for a failed first attempt was obstruction of the airway by vomit, food, mucus or blood (10/13, 76%). After the failed first attempt, there were six cases (6/14, 43%) of deviation from the protocol and the most frequent complications were five cases (5/17, 29%) of hypoxia and four cases (4/17, 24%) of hypotension.ConclusionsWhen a protocol combining the C‐MAC videolaryngoscope and Frova introducer is used, the most common reason for a failed first attempt is an airway blocked by gastric content, blood or mucus. These findings highlight the importance of effective airway decontamination methods and questions the appropriateness of anatomically focused pre‐intubation assessment tools when such protocol is used.
Genetics of ataxia telangiectasia in a highly consanguineous population
Authors: Al‐Muhaizea Mohammed A. , Aldeeb Hanouf , Almass Rawan , Jaber Hadeel , Binhumaid Felwa , Alquait Laila , Abukhalid Musaad , Aldhalaan Hesham , Alsagob Maysoon , Al‐Bakheet Albandary , Aldosary Mazhor , Alkofide Hadeel , Alrasheed Maha M. , Colak Dilek , Kaya Namik 
Published: September 2021

AbstractAtaxia telangiectasia (AT) is a rare autosomal recessive multisystemic disorder. It usually presents in toddler years with progressive ataxia and oculomotor apraxia, or less commonly, in the late‐first or early‐second decade of life with mixed movement disorders. Biallelic mutations in ataxia telangiectasia mutated gene (ATM) cause AT phenotype, a disease not well documented in Saudi Arabia, a highly consanguineous society. We studied several Saudi AT patients, identified ATM variants, and investigated associated clinical features. We included 17 patients from 12 consanguineous families. All patients had comprehensive clinical and radiological assessment, and most were examined through whole‐exome sequencing (WES). Selected individuals were analyzed using various genetic approaches. We identified five different ATM variants in our patients: three previously reported mutations, and two novel variants. Nearly all patients had classical AT presentation except for two patients with a milder phenotype. Among the three known variants, a deletion causing truncation (c.381delA resulting in p.(Val128Ter)) was identified in 13 patients. Two patients harboured the other two truncating variants, (c.9001_9002delAG resulting in p.Ser3001Phefs*6) and (c.9066delA resulting in p.Glu3023Alafs*10) and two patients had novel compound heterozygous variants (NM_000051.3:Paternal Allele:c.8762C > G;p.Thr2921Arg and Maternal Allele:c.1057T > C;p.Cys353Arg). We speculate that c.381delA is a founder mutation in our population. This study provides a genotype–phenotype relationship in a previously unstudied consanguineous population. Our findings contribute to improve local clinical care, therapy, and genetic counseling.
Experiences of non‐invasive prenatal screening: A survey study
Authors: Cornell Paige , Armstrong Taylah , Fyfe Rina , Mallise Carly A. , Dudding‐Byth Tracy , Campbell Linda E. 
Published: September 2021

Background:In Australia, using non‐invasive prenatal testing (NIPT) to screen for fetal abnormalities is becoming more commonplace. However, there is a lack of standardised procedures surrounding pre‐test counselling. This holds the potential for variability in pregnant people’s experiences when undergoing NIPT, which subsequently may impact their ability to make informed decisions surrounding NIPT results.Aim:This study sought to characterise the experiences of Australian women undergoing NIPT, including perceptions of informed choice, counselling experiences and decision to undergo NIPT.Materials and Methods:Australian women who had been recently pregnant (n = 94) completed an online survey which assessed: their knowledge of and attitude toward NIPT; satisfaction with counselling; satisfaction with their decision; and decisional conflict to undergo NIPT. The survey also allowed participants to provide qualitative information about their counselling experience and reasons for undergoing NIPT.Results:Overall, participants had good knowledge of and positive attitudes toward NIPT, experienced low decisional conflict and were overall satisfied with their counselling experience and decision to undergo NIPT. However, some participants expressed dissatisfaction with the lack of information provided, and biased language, by counselling providers. The desire to be informed was the most frequent reason for undergoing NIPT.Conclusion:The provision of accurate and objective information in pre‐test counselling is important to reduce decisional conflict and improve satisfaction with the decision to undergo NIPT. It is recommended counselling providers present pregnant people with neutral, objective, and accurate information at the time of pre‐test counselling.
What we know and still ignore on COVID‐19 immune pathogenesis and a proposal based on the experience of allergic disorders
Authors: Maggi Enrico , Azzarone Bruno Giuseppe , Canonica Giorgio Walter , Moretta Lorenzo 
Published: September 2021

AbstractThe coronavirus disease 2019 (COVID‐19) pandemic started in March 2020 and caused over 5 million confirmed deaths worldwide as far August 2021. We have been recently overwhelmed by a wide literature on how the immune system recognizes severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) and contributes to COVID‐19 pathogenesis. Although originally considered a respiratory viral disease, COVID‐19 is now recognized as a far more complex, multi‐organ‐, immuno‐mediated‐, and mostly heterogeneous disorder. Though efficient innate and adaptive immunity may control infection, when the patient fails to mount an adequate immune response at the start, or in advanced disease, a high innate‐induced inflammation can lead to different clinical outcomes through heterogeneous compensatory mechanisms. The variability of viral load and persistence, the genetic alterations of virus‐driven receptors/signaling pathways and the plasticity of innate and adaptive responses may all account for the extreme heterogeneity of pathogenesis and clinical patterns. As recently applied to some inflammatory disorders as asthma, rhinosinusitis with polyposis, and atopic dermatitis, herein we suggest defining different endo‐types and the related phenotypes along COVID‐19. Patients should be stratified for evolving symptoms and tightly monitored for surrogate biomarkers of innate and adaptive immunity. This would allow to preventively identify each endo‐type (and its related phenotype) and to treat patients precisely with agents targeting pathogenic mechanisms.
Pulmonary haemorrhage in neonates: Systematic review of management
Authors: Barnes Melissa E. , Feeney Emily , Duncan Andrew , Jassim Samher , MacNamara Honora , O’Hara Joseph , Refila Beshoy , Allen John , McCollum Danielle , Meehan Judith , Mullaly Rachel , O’Cathain Niamh , Roche Edna , Molloy Eleanor J. 
Published: September 2021

AbstractAimPulmonary haemorrhage (PH) is an acute catastrophic event with low incidence yet high mortality among neonates. We aimed to systematically review the management of PH.MethodsA search was carried out of the PubMed, EMBASE and Cochrane databases according to the PRISMA guidelines. Data were extracted on study design and size, patient demographics, primary and adjunctive treatment methods, and treatment outcomes.ResultsSixteen studies with 385 newborn infants were included and were significantly heterogeneous regarding treatment methods. Primary treatments included surfactant, high‐frequency oscillatory ventilation (HFOV), epinephrine, coagulopathy management, intermittent positive pressure ventilation, cocaine and tolazoline. Adjunctive treatment methods included blood products, HFOV, increased positive end‐expiratory pressure, vitamin K, surfactant, adrenaline, vasopressors and inotropes. All five studies using surfactant as primary treatment were effective in improving oxygenation index measures and preventing recurrence of PH, and three studies found no association between surfactant and death or long‐term disability. Ventilatory support, epinephrine, management of coagulopathy and tolazoline were all found to be effective primary treatments for PH.ConclusionThere are several effective methods of managing PH in neonates. Further understanding of the aetiology of PH and ongoing research will allow future prevention and improvements in management of PH.
Diagnostics with clinical microbiome‐based identification of microorganisms in patients with brain abscesses—a prospective cohort study
Authors: Hansen Katrine Hartung , Justesen Ulrik Stenz , Kelsen Jesper , Møller Kirsten , Helweg‐Larsen Jannik , Fuursted Kurt 
Published: September 2021

Brain abscesses are often polymicrobial and of unclear primary origin. Here, we compare the use of next‐generation sequencing (NGS) technology with classical microbiological diagnostics for identification of clinically relevant microorganisms and describe the microbiome profiling with respect to the primary source of brain abscess. Thirty‐six samples from 36 patients, with primary brain abscesses, were subjected to both culture‐ and 16S/18S rRNA Sanger sequencing‐based diagnostics (“standard methods”) and compared to a 16S/18S amplicon‐based NGS, which were also subjected to a microbiome diversity analyses. Forty‐seven species were identified with “standard methods” compared to 96 species with NGS, both confirming and adding to the number of species identified (p < 0.05). The variation of the brain abscess microbiome diversity was not continuous but could be stratified comparing the presumable origin of infection (“dental,” “sinus,” “disseminated,” or “unknown”). Alpha diversity did not differ (p > 0.05) between groups while beta diversity differed significantly (p = 0.003) comparing disseminated vs the other presumable origin of infection. Interesting, clustering was also detected between “dental” and “sinusitis,” although not significantly (p = 0.07). Microbiome‐based diagnostics can increase sensitivity without losing specificity. The bacterial beta diversity differed between the presumably origin of the brain abscess and might help to clarify the primary source of infection.
Randomised clinical trial: semaglutide versus placebo reduced liver steatosis but not liver stiffness in subjects with non‐alcoholic fatty liver disease assessed by magnetic resonance imaging
Authors: Flint Anne , Andersen Grit , Hockings Paul , Johansson Lars , Morsing Anni , Sundby Palle Mads , Vogl Thomas , Loomba Rohit , Plum‐Mörschel Leona 
Published: September 2021

SummaryBackgroundGlucagon‐like peptide‐1 receptor agonists may be a treatment option in patients with non‐alcoholic fatty liver disease (NAFLD).AimsTo investigate the effects of semaglutide on liver stiffness and liver fat in subjects with NAFLD using non‐invasive magnetic resonance imaging (MRI) methods.MethodsThis randomised, double‐blind, placebo‐controlled trial enrolled subjects with liver stiffness 2.50‐4.63 kPa by magnetic resonance elastography (MRE) and liver steatosis ≥10% by MRI proton density fat fraction (MRI‐PDFF). The primary endpoint was change from baseline to week 48 in liver stiffness assessed by MRE.ResultsSixty‐seven subjects were randomised to once‐daily subcutaneous semaglutide 0.4 mg (n = 34) or placebo (n = 33). Change from baseline in liver stiffness was not significantly different between semaglutide and placebo at week 48 (estimated treatment ratio 0.96 (95% CI 0.89, 1.03; P = 0.2798); significant differences in liver stiffness were not observed at weeks 24 or 72. Reductions in liver steatosis were significantly greater with semaglutide (estimated treatment ratios: 0.70 [0.59, 0.84], P = 0.0002; 0.47 [0.36, 0.60], P < 0.0001; and 0.50 [0.39, 0.66], P < 0.0001) and more subjects achieved a ≥ 30% reduction in liver fat content with semaglutide at weeks 24, 48 and 72, (all P < 0.001). Decreases in liver enzymes, body weight and HbA1c were also observed with semaglutide.ConclusionsThe change in liver stiffness in subjects with NAFLD was not significantly different between semaglutide and placebo. However, semaglutide significantly reduced liver steatosis compared with placebo which, together with improvements in liver enzymes and metabolic parameters, suggests a positive impact on disease activity and metabolic profile.ClinicalTrials.gov identifier: NCT03357380.
Evaluation of atezolizumab immunogenicity: Efficacy and safety (Part 2)
Authors: Peters Solange , Galle Peter R. , Bernaards Coen A. , Ballinger Marcus , Bruno René , Quarmby Valerie , Ruppel Jane , Vilimovskij Alexandr , Wu Benjamin , Sternheim Nitzan , Reck Martin 
Published: September 2021

AbstractAntibody therapeutics can be associated with unwanted immune responses resulting in the development of anti‐drug antibodies (ADA). Optimal methods to evaluate the potential effects of ADA on clinical outcomes in oncology are not well established. In this study, we assessed efficacy and safety, based on ADA status, in patients from over 10 clinical trials that evaluated the immune checkpoint inhibitor atezolizumab as a single agent or as combination therapy for several types of advanced cancers. ADA can only be observed post randomization, and imbalances in baseline prognostic factors can confound the interpretation of ADA impact. We applied methodology to account for the confounding effects of baseline clinical characteristics and survivorship bias on efficacy. Adjusted meta‐analyses revealed that despite numerical differences in overall survival and progression‐free survival between ADA‐positive and ADA‐negative patients from some studies, ADA‐positive patients from studies with an overall treatment effect derived benefit from atezolizumab, compared with their adjusted controls. Based on large, pooled populations from atezolizumab monotherapy or combination studies, unadjusted descriptive analyses did not identify a clear relationship between ADA status and frequency or severity of adverse events. Data also suggested that any ADA impact is not driven by neutralizing activity. Collectively, this exploratory analysis suggests that the potential for ADA development should not impact treatment decisions with atezolizumab.
Offshoring, Wages, and Skill Premiums: Firm‐level Evidence from China
Authors: Zhang Liang , Qiu Bin , Xu Xiaocong , Sun Shaoqin 
Published: September 2021

AbstractUsing detailed Chinese manufacturing firm production and trade data from 2000 to 2006, this study finds that offshoring significantly increases firms’ average wages. First, using the quasi‐natural experiment of China's accession to the World Trade Organization, we investigate how a reduction in offshoring costs affects the manufacturing firm's wages and find that a productivity effect and a job‐relocation effect are two possible channels. Second, the dynamic decomposition of industry‐level wages indicates that the within‐firm effect is 0.547, accounting for 31.5 percent of the total variation. Finally, a Mincer‐type regression shows that offshoring also increases within‐firm skill premiums. Our findings have strong implications for the government related to framing appropriate industrial policies to raise wages and reduce income inequality.
Mapping the nutrient adequacy of farm production and food consumption to target policy in Uganda
Authors: Marivoet Wim , Ulimwengu John M. 
Published: September 2021

SummaryMotivationSpatial variation in crop and livestock production, combined with variation in market purchases and food transfers, lead to geographic differences in malnutrition that can inform food system policies.PurposeThis article quantifies nutrient production and consumption by sub‐region in Uganda, to identify the magnitude and location of gaps left by farm households’ own production, market purchases, and food transfers relative to household nutrient requirements.Methods and approachUsing the fourth round of Uganda’s National Panel Survey (2013/2014), we convert households’ food production and consumption to nutrient equivalents, then identify the spatial pattern of nutrient inadequacy relative to requirements in each sub‐region. To inform policy, we identify the main food sources of five key micronutrients as well as their least‐cost alternatives to fill corresponding gaps.FindingsSufficient calories and protein are generally available from farm production, purchases, and transfers, but alarming deficits can be seen in the supply of calcium, iron, and zinc as well as vitamins A and B12. Deficits are especially marked in the North East sub‐region. A variety of foods currently available in small quantities could be scaled up to fill these gaps.We find severe limitations in the available data, however, revealing the need for future work to cover all nutrient sources throughout the year with sufficient spatial and temporal precision to target interventions.Policy implicationsThe data analysed provide a suggestive but incomplete picture of how farm production, food markets, and transfers could be enhanced to meet nutrient requirements. Candidate foods for production and marketing to fill nutrient gaps include diverse vegetal crops, milk, and fish. Perishability, transport, and high production costs currently limit supply while low incomes limit demand, implying that a variety of food system interventions as well as social protection transfers are needed to fight hidden hunger in Uganda.
Measuring child‐rearing goals for parents with young children: A scoping review
Authors: Ho Grace W.K. , Chan Athena C.Y. , Gross Deborah A. 
Published: September 2021

AbstractThis scoping review summarizes and consolidates the parenting goals for young children captured in existing parent‐report measures, and the characteristics of studies that employed them. Five electronic databases were systematically searched to identify original studies that used a self‐report measure for parenting goals during the child's first 5 years. Characteristics of the parenting goals measures and the studies that employed them were extracted and synthesized. A deductive approach was used to reduce the parenting goals items across instruments into representative domains. Fourteen original parenting goals measures and their modifications (i.e., 24 unique measures in total) were identified in 44 research articles from 41 original studies. Items from these measures were synthesized into 33 representative domains. Findings will inform the direction of future research and the development of a comprehensive measure of parenting goals for parents with young children that can be applied across cultures, economic backgrounds, informants, and parenting contexts.
Impact of the COVID‐19 pandemic on the University of British Columbia Geriatric Dentistry Program: Clinical education and service
Authors: Tong Nicholas , To Shunhau , Wyatt Chris C.L. 
Published: September 2021

AbstractBackground and ObjectiveIn Canada, the COVID‐19 pandemic was associated with significant morbidity and mortality in older adults, particularly those in long‐term care (LTC). Access to oral health services was limited during the pandemic due to public health restrictions. The aim of this paper was to describe the impact of the pandemic on the clinical education and service of the University of British Columbia (UBC) Geriatric Dentistry Program (GDP), which provides care to LTC residents.MethodsData were collected from UBC GDP AxiUm dental software records, including number of dental appointments in 2019 and 2020. Data on revenue in 2019 and 2020 based on clinical production were collected through financial summary reports. Data on the number of educational rotations were collected from summary reports from scheduling software.ResultsIn 2020, significant reductions in clinical service, revenue, and productivity were observed in the UBC GDP relative to 2019. The number of GDP appointments for June‐December 2020 was lower by 68%. The clinical productivity reduced by 67% for the same period. Expenses were slightly reduced. The overall number of LTC clinical rotations for students were only slightly lower for undergraduate students in 2020 than in 2019, and it increased for graduate students.ConclusionThe COVID‐19 pandemic and associated public health restrictions had a negative impact on the clinical service and productivity of the UBC GDP in 2020 relative to 2019. However, clinical educational rotations to LTC were slightly increased in 2020 relative to 2019. Dental care for LTC residents can be provided if rigorous administrative controls, engineering controls and personal protective equipment are employed.