bluuebunny/crossref_metadata_2025_split huggingface dataset:
Broad Ligament Pregnancy: Facing the Battle Unarmed
Authors: Singh Meenakshi , Pandey Nihita , Biswas Ratna 
Published: September 2021

Abstract
Broad ligament pregnancy is defined as gestation that grows in the space formed by anterior and posterior peritoneal folds of the broad ligament. We report a case of 30 years old lady admitted to our hospital with the diagnosis of gravida 2, para 1, live birth 1, with 24 weeks of gestation with low lying placenta with anhydramnios. She was taken up for lower segment cesarian section at 28 weeks gestation in view of low lying placenta with chorioamnionitis. The broad ligament pregnancy was diagnosed peroperatively after identifying the anatomical relationship of the pregnancy. Sac was excised and margins secured after extraction of the baby and placenta. Patient had an uneventful postoperative period. Broad ligament pregnancy may be missed in antenatal period but in cases of displaced cervix, early onset unexplained anhydramnios, and failed induction of labor, it may raise high suspicion. Laparotomy/ laparoscopic management is the mainstay of management of broad ligament pregnancy.
Development of a Novel Analytical Method for Determining Trazodone in Human Plasma by Liquid Chromatography Coupled With Mass Spectrometry Coupled With Automatic 2-Dimensional Liquid Chromatograph-Mass Spectrometer Coupler 9500 and Its Application to Therapeutic Drug Monitoring
Authors: Ding Jing , Zhang Yan , Cui Xiaohua , Zhao Caiping , Zhang Suo 
Published: September 2021

Background:
Trazodone (TZD) is a tetracyclic serotonin antagonist and reuptake inhibitor that is used as a second-generation phenylpiperazine antidepressant. However, the plasma concentrations of TZD have shown individual variations in clinical practice. Quantification of TZD plasma concentrations may be an effective and valuable method to balance the clinical efficacy and adverse reactions. This study aimed to establish a novel liquid chromatography coupled with mass spectrometry (LC-MS) assay for measuring TZD concentrations in human plasma for therapeutic drug monitoring (TDM).

Methods:
After protein precipitation with acetonitrile, LC-MS quantification of TZD was performed in the multiple reaction monitoring mode with chromatographic separation using a mobile phase of MeOH and 0.1% formic acid in water. This method validation intends to investigate specificity, sensitivity, linearity, precision, accuracy, recovery, matrix effect, and stability according to United states food and drug administration guidelines.

Results:
This method showed good selectivity because no interfering peaks were observed in the plasma samples during the 2-minute run time. The range of the calibration curve was 1–3000 ng/mL. The detection and quantification limits were 0.3 and 1 ng/mL, respectively. The intraday and interday accuracies were 96.5%–103.4%, with precision relative SD% values of <5%, except for the limit of quality. The mean TZD recovery from human plasma was 95.4%–104.5%. Finally, this method was successfully applied to TDM in 20 patients. The TZD plasma concentrations of the patients ranged between 21.5 and 2267.3 ng/mL.

Conclusions:
A novel analytical method was established to measure TZD by LC-MS coupled with an automatic 2-dimensional liquid chromatograph mass spectrometer coupler 9500 (LC-MS/MS-Mate 9500), which is superior to the ordinary LC-MS system in separation, transport, anti-interference, sensitivity, and quantitative analysis stability.
“It just makes me feel a little less alone”: a qualitative exploration of the podcast Menopause: Unmuted on women's perceptions of menopause
Authors: Edwards Amy L. , Shaw Philippa A. , Halton Candida C. , Bailey Stacy C. , Wolf Michael S. , Andrews Emma N. , Cartwright Tina 
Published: September 2021

Abstract

Objective:
Menopause can negatively impact women's quality of life, with many women reporting inadequate information and support. Podcasts have grown in popularity in recent years and have been found to be accessible methods for increasing knowledge and challenging perceptions of stigmatized topics. The current research aimed to understand the impact of the podcast “menopause: unmuted” on women's menopause-related knowledge, understanding, and communication practices.

Methods:
A diverse sample of 30 women aged 40 to 60 years listened to the podcast series, which focused on menopause stories, before taking part in semistructured interviews to discuss the impact of the podcast on how they understood and communicated about menopause. The interviews were analyzed thematically.

Results:
Two overarching themes were identified in the data. A “journey of knowledge gain” explores participants’ understanding of menopause before listening to the podcast and describes how this is deepened by hearing and connecting with women's stories. “Reframing menopause” describes the impact of the podcast, where women reflect on the value of communication amongst women, challenge and re-evaluate the stigmatization of menopause, and discuss ways to make positive behavioral changes in their lives.

Conclusions:
The podcast “menopause: unmuted” helped women to learn about the menopause experience, have a greater sense of belonging to a community of women, and feel empowered to make changes in their own lives. Sharing stories via podcasts has potential as an accessible and impactful medium to educate women and reduce the widespread stigma associated with menopause.
Bilateral Increase of Matrix Metalloproteinase-9 Expression in Tears After the Unilateral Decrease of Corneal Sensitivity
Authors: Lee Seung Hyeun , Chun Yeoun Sook , Moon Nam Ju , Kim Kyoung Woo 
Published: September 2021

Purpose:
The purpose of this study is to analyze bilateral changes of matrix metalloproteinase-9 (MMP-9) expression in the tear film in patients with unilateral neurotrophic keratitis.

Methods:
We included 24 eyes from 24 subjects with normal corneal sensitivity according to Cochet–Bonnet corneal esthesiometry in the control group and 25 subjects with the unilateral neurotrophic keratitis in the unilateral decrease of corneal sensitivity (UDCS) group. The expression of MMP-9 in tears was assessed using point-of-care immunoassay. The clinical parameters including meibomian gland plugging, quality of the secreted meibum, tear secretion using Schirmer I without anesthesia, and corneal erosions were evaluated among the control, affected, and contralateral unaffected eyes in the UDCS group.

Results:
Tear MMP-9 grades in affected (2.5 ± 1.0) and contralateral eyes (2.6 ± 0.9) in the UDCS group were higher than those in control eyes (1.5 ± 0.7, P = 0.0003 and P = 0.0006, respectively). The lacrimal secretion decreased in the affected eyes but preserved in the contralateral eyes. There was no difference in corneal erosion scores between control eyes and contralateral eyes in the UDCS group. Tear MMP-9 grades in the contralateral eyes were significantly correlated with the meibum quality grades in the contralateral eyes (r = 0.525 and P = 0.025).

Conclusions:
Patients with the unilateral neurotrophic keratitis demonstrated a significant bilateral increase of the MMP-9 expression in the tear film as compared with controls. Despite the tearing reflex and corneal surface barrier being preserved in the unaffected contralateral eyes, it is necessary to pay attention to the possible attenuation of meibomian gland function in the opposite eyes as well.
c.-61G>A in OVOL2 is a Pathogenic 5′ Untranslated Region Variant Causing Posterior Polymorphous Corneal Dystrophy 1
Authors: Janeschitz-Kriegl Lucas , Kamdar Dhryata , Quinodoz Mathieu , Kaminska Karolina , Folcher Marc , György Bence , Meyer Peter , Wild Andreas , Escher Pascal , Scholl Hendrik P. N. , Rivolta Carlo , Goldblum David 
Published: September 2021

Purpose:
The purpose of this study was to investigate the clinical and genetic features of a man and his daughter with posterior polymorphous corneal dystrophy (PPCD), referred to our clinic for Descemet membrane endothelial keratoplasty. No other known relatives were affected.

Methods:
Ophthalmic examination and histology, including electron microscopy, were performed. Genetic testing was conducted by means of whole exome sequencing, and variant analysis was achieved by using an internal in silico pipeline. Molecular tests included a dual-luciferase assay.

Results:
Slowly progressive blurred vision was reported from childhood by the daughter. The father's symptoms started at age 55. Best-corrected visual acuity was reduced in both patients (0.2–0.4). Slit-lamp examination in both patients revealed bilateral corneal clouding with gray endothelial lesions; other family members had no ophthalmological signs. Descemet membrane endothelial keratoplasty was performed uneventfully in both patients. Histology showed thickened Descemet membrane and abnormal endothelium resembling epithelial-like cells. Both patients carried the OVOL2 5′ untranslated region NM_021220.4.c.-61G>A variant in the heterozygous state. This change was associated with increased promoter activity and was not present in the unaffected members of the family.

Conclusions:
The 5′ untranslated region mutation c.-61G>A in OVOL2 has been previously found in 1 individual with PPCD1 and reported as a variant of unknown significance because of insufficient evidence supporting its pathogenicity. Identification of the second family with 2 individuals affected by PPCD1 carrying this change, together with functional data, provides further proofs that it is disease-causing.
Smoking Cessation Programs for Pregnant Women
Authors: Balmumcu Ayça , Ünsal Atan Şenay 
Published: September 2021

Abstract

Objective
This study aimed to develop a Transtheoretical-Model-based and WhatsApp-text-message-supported smoking cessation program for pregnant women and to evaluate its effectiveness.

Methods
This study is a pretest–posttest designed, randomized controlled and quasi-experimental intervention research. The study was conducted on 50 pregnant women, 25 of them in the intervention group and 25 of them in the control group. A theory-based motivational individual counseling initiative has been applied to the intervention group, and WhatsApp text messages have been sent 3 days a week, in accordance with the stages of change to support the interviews.

Results
In the final follow-up, 60% of pregnant women in the intervention group and 36% of pregnant women in the control group quit smoking. All participants indicated they would recommend the WhatsApp-text-message-supported smoking cessation program. Transtheoretical-Model-based and WhatsApp-text-message-supported smoking cessation programs were found to be effective in reducing nicotine dependency scores and carbon monoxide levels of pregnant women and quitting smoking.

Practice Implications
The smoking cessation program used in the research may be applied by midwives or nurses trained on the subject to help pregnant women quit smoking.
Experiences of Opioid Use Disorder Patients Receiving Buprenorphine Through a Telehealth Program
Authors: Moore Dorothy James , Goyal Deepika , Rodriguez Lori 
Published: September 2021

Abstract

Background
Opioid use disorder (OUD) continues to be a growing and major public health issue in the United States. In an effort to increase OUD treatment access, medication-assisted treatment with buprenorphine via telehealth is emerging as the leading treatment option.

Objective
This study sought to describe the experiences of adults with OUD receiving medication-assisted treatment buprenorphine in a nurse-practitioner-facilitated telehealth program.

Methods
Using a descriptive qualitative design, convenience sampling was used to recruit participants who were currently receiving OUD treatment in one telehealth program with locations in California and Michigan. Participants were invited to participate in the study via an email flyer sent to all clients of the telehealth program. Participants completed demographic data and took part in individual, semistructured interviews that were conducted online.

Results
The study sample included 15 largely White, married, college-educated men (n = 8, 53%) and women (n = 7, 47%). Qualitative content analysis of interview data revealed three overall themes and associated subthemes: (a) improved access to care, (b) isolation, and (c) feeling normal on buprenorphine.

Conclusion
Our findings support a nurse-practitioner-facilitated telehealth treatment program for OUD. However, in a program that offers patient-centered care that does not have a one-size-fits-all approach to service, goals of care must be reevaluated throughout treatment. Moreover, given the increased risk of patients feeling isolated with telehealth appointments and the lack of physical face-to-face interactions, healthcare providers should explore ways to engage patients in meaningful support resources and reduce stigma.
Linking Cellular Metabolism to Epigenetics in Melanoma
Authors: Guo Wei-Nan , Li Chun-Ying 
Published: September 2021

Abstract
Melanoma originates from epidermal melanocytes and is the most malignant form of skin cancer, with an increasing incidence worldwide. In addition to the known pathological mutations in melanoma, the remodeling of epigenetic modification has recently been documented to orchestrate the malignant behaviors of tumor cells and anti-tumor immunity, emerging as an irreversible tumorigenic event that is more preventable and treatable with medications. As a hallmark characteristic of cancer, the disorder of cellular metabolism is also greatly implicated in tumor carcinogenesis and development. Accumulating evidence has revealed the close linkage between metabolism and epigenetics in multiple biological activities. In the pathogenesis of melanoma, the findings of other groups and our laboratory highlight the pivotal role of autophagy, mitochondrial function, and the oncometabolite acetyl-CoA, as well as their epigenetic modification. Targeted metabolism-associated epigenetic modulation might be a novel approach for melanoma therapy in the future.
Autonomic regulation device therapy in patients with heart failure with preserved ejection fraction
Authors: Fukuta Hidekatsu , Goto Toshihiko , Kamiya Takeshi 
Published: September 2021

Abstract

Background:
Nearly half of patients with heart failure (HF) have preserved ejection fraction (EF) and the mortality and morbidity of patients with HF with preserved EF (HFpEF) are high. However, there is no established therapy to improve survival in these patients. HFpEF patients are often elderly and their primary chronic symptom is severe exercise intolerance. Thus, improvement of exercise capacity presents another important clinical outcome in HFpEF patients. HF is characterized by increased sympathetic activity and the raised sympathetic drive is involved in the maintenance of the pathological state. Studies have examined the effect of autonomic regulation device therapy (ART) in patients with HF with reduced EF. Recent meta-analysis on the effect of ART in heart failure with reduced EF patients have reported the potential benefits. However, there is insufficient evidence as to the effect of ART in HFpEF patients.

Methods:
This meta-analysis will include randomized controlled trials on the effects of ART on HF symptoms, exercise capacity, and health-related quality of life in HFpEF patients. Information of studies will be collected from PubMed, Web of Science, Cochrane Library, and ClinicalTrials.gov. The primary outcome will be exercise capacity (6-minute walking distance). The secondary outcomes will be HF symptoms, health-related quality of life, and mortality and hospitalization rates.

Discussion:
This meta-analysis will evaluate the effect of ART in HFpEF patients, providing evidence to the clinical use of ART in these patients.

Systematic review registration:
PROSPERO CRD42020212668.
Safety and efficacy of high dose pulse calcitriol and docetaxel for androgen-independent prostate cancer
Authors: Guan Xiaoyong , Ding Yanling , Qi Tao 
Published: September 2021

Abstract

Background:
Previous therapy usually included prostatectomy or radiation to remove or destroy the cancerous cells within the prostate capsule. But, many patients eventually fail therapy and die of recurrent androgen-independent prostate cancer (AIPC). To date, there is no effective cure for prostate cancer. This study aims to evaluate the clinical safety and efficacy of high-dose pulse calcitriol and docetaxel for androgen-independent prostate cancer to guide the clinician's drug use.

Methods:
Seven Eight databases included PubMed, PubMed Central, EMbase, Medline, China National Knowledge Infrastructure, WAN FANG Database, and Web of Science will be systematically retrieved from January 1st, 2010 to May 30th, 2021. We will screen eligible studies to meet the inclusion criteria. Two independent reviewers will extract data, evaluate the risk of bias and analyze data independently. The quality of the included studies will be evaluated by the RevMan 5.4 software. The Cochrane risk of bias tool will be used to assess the quality of the studies.

Results:
This systematic review will provide high-quality evidence for the safety and efficacy of high-dose pulse calcitriol and docetaxel for AIPC.

Conclusions:
The findings of the study will provide scientific evidence of the safety and efficacy of high dose pulse calcitriol, and docetaxel for AIPC to guide the clinician's drug use.

Ethics and dissemination:
Not applicable

INPLASY registration number:
INPLASY202170028.
Evolving Factors in Hospital Safety: A Systematic Review and Meta-Analysis of Hospital Adverse Events
Authors: Sauro Khara M. , Machan Matthew , Whalen-Browne Liam , Owen Victoria , Wu Guosong , Stelfox Henry T. 
Published: September 2021

Objective
This study aimed to estimate the frequency of hospital adverse events (AEs) and explore the rate of AEs over time, and across and within hospital populations.

Methods
Validated search terms were run in MEDLINE and EMBASE; gray literature and references of included studies were also searched. Studies of any design or language providing an estimate of AEs within the hospital were eligible. Studies were excluded if they only provided an estimate for a specific AE, a subgroup of hospital patients or children. Data were abstracted in duplicate using a standardized data abstraction form. Study quality was assessed using the Newcastle-Ottawa Scale. A random-effects meta-analysis estimated the occurrence of hospital AEs, and meta-regression explored the association between hospital AEs, and patient and hospital characteristics.

Results
A total of 45,426 unique references were identified; 1,265 full-texts were reviewed and 94 studies representing 590 million admissions from 25 countries from 1961 to 2014 were included. The incidence of hospital AEs was 8.6 per 100 patient admissions (95% confidence interval [CI], 8.3 to 8.9; I
2 = 100%, P < 0.001). Half of the AEs were preventable (52.6%), and a third resulted in moderate/significant harm (39.7%). The most evaluated AEs were surgical AEs, drug-related AEs, and nosocomial infections. The occurrence of AEs increased by year (95% CI, −0.05 to −0.04; P < 0.001) and patient age (95% CI = −0.15 to −0.14; P < 0.001), and varied by country income level and study characteristics. Patient sex, hospital type, hospital service, and geographical location were not associated with AEs.

Conclusions
Hospital AEs are common, and reported rates are increasing in the literature. Given the increase in AEs over time, hospitals should reinvest in improving hospital safety with a focus on interventions targeted toward the more than half of AEs that are preventable.
Healthcare Provider Characteristics and Cardiopulmonary Resuscitation Quality During Infant Resuscitation
Authors: Khattab Mona , Frisell Karin , MacKinnon Ralph , Chang Todd , Raymond Tia , Lofton Lydia , Tofil Nancy , Forrester Katherine , Gohel Charmin , Aitken Deborah , Scalzo Anthony , Moore-Clingenpeel Melissa , Auerbach Marc 
Published: September 2021

Introduction
Healthcare providers' anthropometric characteristics can adversely affect adult cardiopulmonary resuscitation (CPR) performance quality. However, their effects on infant CPR are unknown. We aimed to determine any relationships between healthcare provider characteristics (anthropomorphic, demographics, training, occupational data) and simulated infant CPR performance at multiple international sites. Our secondary aim was to examine provider's CPR performance degradation.

Methods
Providers from 4 international hospitals performed 2 minutes of single-rescuer simulated infant CPR using 2015 American Heart Association Basic Life Support criteria with guidance from a real-time visual performance feedback device. Providers' characteristics were collected, and the simulator collected compression and ventilation data. Multivariate analyses examined the entire 2 minutes and performance degradation.

Results
Data from 127 participants were analyzed. Although median values for all compression variables (depth, rate, lean) and ventilation volume were within guideline target ranges, when looking at individuals, only 52% chest compressions and 20% ventilations adhered to the American Heart Association guidelines. Age was found to be independently associated with ventilation volume (direct-relationship), and height was associated with chest compression lean (shorter participant-deeper lean). No significant differences were noted based on sex or body mass index. Neonatal intensive care unit participants were noted to perform shallower chest compressions (P < 0.001). Overall, there was minimal evidence of performance degradation over 2 minutes.

Conclusions
Isolated provider characteristics were noted among a diverse cohort of healthcare providers that may affect the CPR quality on a simulated infant. Understanding the relationships between provider characteristics and CPR quality could inform future infant CPR guidelines customized for the provider and not just the patient.
Direct Impact of Human Platelets on the Development of Transplant Arteriosclerosis
Authors: Görner Susann , Heim Christian , Weigmann Benno , von Silva-Tarouca Benjamin , Kuckhahn Annika , Ramsperger-Gleixner Martina , Zimmermann Robert , Weyand Michael , Ensminger Stephan M. 
Published: September 2021

Background.
Platelets play an important role in the pathogenesis of inflammatory and proliferative vascular changes. The aim of this study was to investigate whether human platelets are able to induce transplant arteriosclerosis in a humanized C57/Bl6-Rag2−/−γc−/− mouse xenograft model.

Methods.
Nonactivated and in vitro–activated human platelets were analyzed and phenotyped for surface markers by flow cytometry. Side branches of human mammary arteries were implanted into the infrarenal aorta of recipients, followed by daily application of human platelets and histological analyzed on day 30 after transplantation.

Results.
Human platelets collected by apheresis had low levels of platelet activation markers. However, after in vitro activation, expression was markedly increased. Sixty minutes after injection in recipient mice, nonactivated human platelets become significantly activated. Increased adhesion of platelets to the vascular endothelium was detected by in vivo fluorescence microscopy. After intravenous injection of nonactivated or activated platelets, human xenografts showed pronounced intimal proliferation. Immunohistological analysis showed that the group treated with activated human platelets exhibited significantly increased intragraft protein expression of intracellular adhesion molecule-1 and platelet-derived growth factor receptor beta and smooth muscle cell migration into the neointima.

Conclusions.
These data demonstrate that an isolated daily application of both in vivo– and in vitro–activated human platelets results in the development of transplant arteriosclerosis in a humanized mouse transplantation model.