bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effects of obstetric emergency team training on patient outcome: A systematic review and meta‐analysis
Authors: Brogaard Lise , Glerup Lauridsen Kasper , Løfgren Bo , Krogh Kristian , Paltved Charlotte , Boie Sidsel , Hvidman Lone 
Published: October 2021

AbstractIntroductionLittle is known about the optimal simulation‐based team training in obstetric emergencies. We aimed to review how simulation‐based team training affects patient outcomes in obstetric emergencies.Material and methodsSearch Strategy: MEDLINE, Embase, Cochrane Library, and Cochrane Central Register of Controlled Trials were searched up to and including May 15, 2021. Selection criteria: randomized controlled trials (RCTs) and cohort studies on obstetric teams in high‐resource settings comparing the effect of simulation‐based obstetric emergency team training with no training on the risk of Apgar scores less than 7 at 5 min, neonatal hypoxic ischemic encephalopathy, severe postpartum hemorrhage, blood transfusion of four or more units, and delay of emergency cesarean section by more than 30 min. Data collection and analysis: The included studies were assessed using PRISMA, EPCO, and GRADE.ResultsWe found 21 studies, four RCTs and 17 cohort studies, evaluating patient outcomes after obstetric team training compared with no training. Annual obstetric emergency team training may reduce brachial plexus injury (six cohort studies: odds ratio [OR] 0.47, 95% CI 0.33–0.68; one RCT: OR 1.30, 95 CI% 0.39–4.33, low certainty evidence) and suggest a positive effect; but it was not significant on Apgar score below 7 at 5 min (three cohort studies: OR 0.77, 95% CI 0.51–1.19; two RCT: OR 0.87, 95% CI 0.72–1.05, moderate certainty evidence). The effect was unclear for hypoxic ischemic encephalopathy, umbilical prolapse, decision to birth interval in emergency cesarean section, and for severe postpartum hemorrhage. Studies with in situ multi‐professional simulation‐based training demonstrated the best effect.ConclusionsEmerging evidence suggests an effect of obstetric team training on obstetric outcomes, but conflicting results call for controlled trials targeted to identify the optimal methodology for effective team training.
Comparison of subconjunctival microinvasive glaucoma surgery and trabeculectomy
Authors: Wagner Felix M. , Schuster Alexander K. , Munder Annika , Muehl Marius , Chronopoulos Panagiotis , Pfeiffer Norbert , Hoffmann Esther M. 
Published: October 2021

AbstractPurposeTo assess surgical success and the post‐operative development of intraocular pressure between XEN45®gelstent, Preserflo®MicroShunt and trabeculectomy with mitomycin C.MethodsData from 105 eyes from 105 patients of matched cases with refractory open‐angle glaucoma, who underwent surgery between January 2019, and August 2020, were evaluated. Patients underwent either stand‐alone XEN gelstent insertion with Mitomycin C, stand‐alone Preserflo with Mitomycin C or trabeculectomy with Mitomycin C. The primary outcome was the proportion of complete surgical success at 6 months post‐operatively (i.e. intraocular pressure between 5mmHg and 18mmHg, no revision surgery, no loss of light perception and no post‐operative pharmaceutical antiglaucomatous treatment). The reduction of intraocular pressure after 6 months, the classes of antiglaucomatous medication used post‐operatively, best‐corrected visual acuity, spherical refractive errors and astigmatism were assessed as secondary outcomes.ResultsWe included 35 eyes in each group. After 6‐month follow‐up, complete success was 73.5% [95%‐CI: 57.9%–89.2%] in the trabeculectomy group, 51.4% [95%‐CI: 34.0%–68.8%] in the XEN group and 74.2% [95%‐CI: 57.9%–90.5%] in the Preserflo group (p = 0.08). Regarding secondary outcomes, the reduction of intraocular pressure was 12.1 ± 7.9 mmHg in the trabeculectomy group and was thereby 5.8 [95%‐CI: 2.2–9.6] mmHg greater compared with the XEN group (p < 0.001) and 4.8 [95%‐CI: 0.9–8.7] mmHg higher than the Preserflo group (p = 0.01).ConclusionsNo statistically significant differences were found between trabeculectomy, XEN45®gelstent implantation and Preserflo®MicroShunt implantation regarding surgical success after 6 months. Yet reduction in intraocular pressure was significantly higher in the trabeculectomy group. However, all three interventions resulted in sufficiently low post‐operative intraocular pressure and may therefore be considered individually for glaucoma treatment.
Real‐world use of first‐generation antiandrogens: impact on patient outcomes and subsequent therapies in metastatic castration‐resistant prostate cancer
Authors: Kelly Richard , Anton Angelyn , Wong Shirley , Shapiro Julia , Weickhardt Andrew , Azad Arun , Kwan Edmond Michael , Spain Lavinia , Muthusamy Arun , Torres Javier , Parente Phillip , Parnis Francis , Goh Jeffrey , Joshua Anthony , Pook David , Baenziger Olivia , Gibbs Peter , Tran Ben 
Published: October 2021

ObjectivesTo investigate the recent real‐world use of first‐generation antiandrogens (FGAs) in metastatic castration‐resistant prostate cancer (mCRPC) using a retrospective multicentre cohort study.Patients and MethodsThe electronic CRPC Australian Database (ePAD) was interrogated to identify patients with mCRPC. Clinicopathological features, treatment and outcome data, stratified by FGA use, were retrieved and reported through descriptive statistics. Survival analyses were calculated using the Kaplan–Meier method and groups compared using log‐rank tests. Factors influencing overall survival (OS) were analysed using Cox proportional hazards regression model.ResultsWe identified 634 patients with mCRPC, enrolled in ePAD between January 2016 and March 2019, including 322 (51%) who received FGAs. The median follow‐up was 21.9 months. Patients treated with FGAs were more likely to have lower International Society of Urological Pathologists (ISUP) grade group (P = 0.04), longer median time to CRPC (25.6 vs 16.0 months, P < 0.001), and were less likely to have visceral metastases (5.0% vs 11.2%, P = 0.005) or to have received upfront docetaxel (P < 0.001). A ≥50% reduction from pre‐treatment prostate‐specific antigen (PSA) level (PSA50 response) during FGA treatment occurred in 119 (37%) patients and was independently associated with improved OS (hazard ratio 0.233, P < 0.001). Prior FGA treatment did not significantly influence the selection of subsequent life‐prolonging treatments for mCRPC or their PSA50 response rates.ConclusionIn our present cohort, FGAs were commonly used in lower‐risk mCRPC and their use did not significantly influence the choice or duration of subsequent systemic therapy. A PSA50 response to FGA therapy was an independent favourable prognostic marker associated with improved OS.
Seawater intrusion: an appraisal of taxa at most risk and safe salinity levels
Authors: Venâncio Cátia , Ribeiro Rui , Lopes Isabel 
Published: October 2021

ABSTRACTSeawater intrusion into low‐lying coastal ecosystems carries environmental risks. Salinity levels at these coastal ecosystems may vary substantially, causing ecological effects from mortality to several sublethal endpoints, such as depression of rates of feeding, somatic growth, or reproduction. This review attempts to establish safe salinity levels for both terrestrial and freshwater temperate ecosystems by integrating data available in the literature. We have four specific objectives: (i) to identify the most sensitive ecological taxa to seawater intrusion; (ii) to establish maximum acceptable concentrations–environmental quality standards (MAC‐EQSs) for sea water (SW) from species sensitivity distributions (SSDs); (iii) to compile from the literature examples of saline intrusion [to be used as predicted environmental concentrations (PECs)] and to compute risk quotients for the temperate zone; and (iv) to assess whether sodium chloride (NaCl) is an appropriate surrogate for SW in ecological risk assessments by comparing SSD‐derived values for NaCl and SW and by comparing these with field data. Zooplankton, early life stages of amphibians and freshwater mussels were the most sensitive ecological receptors for the freshwater compartment, while soil invertebrates were the most sensitive ecological receptors for the terrestrial compartment. Hazard concentration 5% (HC5) values, defined as the concentration (herein measured as conductivity) that affects (causes lethal or sublethal effects) 5% of the species in a distribution, computed for SW were over 22 and 40 times lower than the conductivity of natural SW (≈ 52 mS/cm) for the freshwater and soil compartment, respectively. This sensitivity of both compartments means that small increments in salinity levels or small SW intrusions might represent severe risks for low‐lying coastal ecosystems. Furthermore, the proximity between HC5values for the soil and freshwater compartments suggests that salinized soils might represent an additional risk for nearby freshwater systems. This sensitivity was corroborated by the derivation of risk quotients using real saline intrusion examples (PECs) collected from the literature: risk was >1 in 34 out of 37 examples. By contrast, comparisons of HC5values obtained from SSDs in field surveys or mesocosm studies suggest that natural communities are more resilient to salinization than expected. Finally, NaCl was found to be slightly more toxic than SW, at both lethal and sublethal levels, and, thus, is suggested to be an acceptable surrogate for use in risk assessment.
Multi‐miRNA panel of tumor‐derived extracellular vesicles as promising diagnostic biomarkers of early‐stage breast cancer
Authors: Kim Min Woo , Park Sunyoung , Lee Hyojung , Gwak Hogyeong , Hyun Kyung‐A , Kim Jee Ye , Jung Hyo‐Il , Il Kim Seung 
Published: October 2021

AbstractExtracellular vesicles (EV) have been emerging as potential biomarkers for disease monitoring. In particular, tumor‐derived EV (TDE) are known to carry oncogenic miRNA, so they can be used for diagnosis of early cancer by analyzing the expression levels of EV‐miRNA circulating in the blood. Here, using our novel microfluidic device, we rapidly and selectively isolate cancerous EV expressing breast cancer‐derived surface markers CD49f and EpCAM within 2 minutes. Based on seven candidates of miRNA nominated from The Cancer Genome Atlas (TCGA) database, the expression levels of miRNA in TDE were validated in a total of 82 individuals, including 62 breast cancer patients and 20 healthy controls. Among seven candidates, four miRNAs (miR‐9, miR‐16, miR‐21, and miR‐429) from the EV were highly elevated in early‐stage breast cancer patients compared with healthy donors. The combination of significant miRNAs from specific EV has high sensitivities of 0.90, 0.86, 0.88, and 0.84 of the area under the receiver operating characteristic curve (AUC) in each subtype (luminal A, luminal B, HER‐2, and triple‐negative) of early‐stage breast cancer. Our results suggest that the combination of four miRNA signatures of specific EV could serve as a sensitive and specific biomarker and enable early diagnosis of breast cancer using liquid biopsy.
SNAIL2 contributes to tumorigenicity and chemotherapy resistance in pancreatic cancer by regulating IGFBP2
Authors: Masuo Kenji , Chen Ru , Yogo Akitada , Sugiyama Aiko , Fukuda Akihisa , Masui Toshihiko , Uemoto Shinji , Seno Hiroshi , Takaishi Shigeo 
Published: October 2021

AbstractPancreatic cancer has an extremely poor prognosis because of its resistance to conventional therapies. Cancer stem cell (CSC)‐targeted therapy is considered a promising approach for this disease. Epithelial‐mesenchymal transition‐inducing transcription factors (EMT‐TFs) contribute to CSC properties in some solid tumors; however, this mechanism has not been fully elucidated in pancreatic cancer. Zinc finger protein, SNAIL2 (also known as SLUG), is a member of the SNAIL superfamily of EMT‐TFs and is commonly overexpressed in pancreatic cancer. Patients exhibiting high SNAIL2 expression have a poor prognosis. In this study, we showed that the suppression of SNAIL2 expression using RNA interference decreased tumorigenicity in vitro (sphere formation assay) and in vivo (xenograft assay) in 2 pancreatic cancer cell lines, KLM1 and KMP5. In addition, SNAIL2 suppression resulted in increased sensitivity to gemcitabine and reduced the expression of CD44, a pancreatic CSC marker. Moreover, experiments on tumor spheroids established from surgically resected pancreatic cancer tissues yielded similar results. A microarray analysis revealed that the mechanism was mediated by insulin‐like growth factor (IGF) binding protein 2. These results indicate that IGFBP2 regulated by SNAIL2 may represent an effective therapeutic target for pancreatic cancer.
Teens and Brexit in Northern Ireland: Merging rights with responsibilities
Authors: Leonard Madeleine 
Published: October 2021

AbstractThe purpose of this paper is to ascertain the attitudes of teenagers (aged 13–16) from Belfast to the Brexit referendum through exploring their attitudes to the implications of Brexit for their future lives and how they explain why adults decided to vote leave. The paper illuminates how young people discussed the right to vote alongside responsibilities to non‐voters. In this way, teenagers demonstrated the often messy relationship that exists between citizenship rights and responsibilities and how this has differing generational implications.
Emerging roles of circular RNAs in neuropathic pain
Authors: Xu Derong , Ma Xuexiao , Sun Chong , Han Jialuo , Zhou Chuanli , Chan Matthew T. V. , Wu William K. K. 
Published: October 2021

AbstractNeuropathic pain is a major type of chronic pain caused by the disease or injury of the somatosensory nervous system. It afflicts about 10% of the general population with a significant proportion of patients’ refractory to conventional medical treatment. This highlights the importance of a better understanding of the molecular pathogenesis of neuropathic pain so as to drive the development of novel mechanism‐driven therapy. Circular RNAs (circRNAs) are a type of non‐coding, regulatory RNAs that exhibit tissue‐ and disease‐specific expression. An increasing number of studies reported that circRNAs may play pivotal roles in the development of neuropathic pain. In this review, we first summarize circRNA expression profiling studies on neuropathic pain. We also highlight the molecular mechanisms of specific circRNAs (circHIPK3, circAnks1a, ciRS‐7, cZRANB1, circZNF609 and circ_0005075) that play key functional roles in the pathogenesis of neuropathic pain and discuss their potential diagnostic, prognostic, and therapeutic utilization in the clinical management of neuropathic pain.
More than meets the eye: decrypting diversity reveals hidden interaction specificity between frogs and frog‐biting midges
Authors: Virgo Jonas , Ufermann Lasse , Lampert Kathrin P. , Eltz Thomas 
Published: October 2021

1. Female frog‐biting midges (Diptera: Corethrellidae) eavesdrop on the nocturnal mating calls of their blood hosts – male frogs. Available data suggest variable degrees of specialisation among Corethrella‐host associations, with limited information on the mechanisms involved in host selection and partitioning on a community level.2. Our study provides a first comprehensive analysis of host interactions for a neotropical community of frog‐biting midges, based on both morphological and molecular genetic species delimitation. We used quantitative bipartite interaction networks to investigate host specificity among the midge‐frog community of La Gamba, Pacific lowland Costa Rica.3. Midges that were collected directly from frog hosts (16 frog species) showed more pronounced levels of specificity (network‐wide degree of specialisation: H2′ = 0.3) than those caught with acoustic traps broadcasting their calls (12 frog species; H2′ = 0.08). This indicates that, despite a rather generalist acoustic foraging behaviour, frog‐biting midges discriminate between potential hosts by using additional close‐range recognition cues.4. Based on COI and ITS2 sequencing data, we identified considerable levels of cryptic diversity within our five Corethrella morphotypes, with at least 17 distinct MOTUs of Corethrella in La Gamba. Including these MOTUs in bipartite network analyses produced higher resolution in species interactions, and increased estimators of network specificity (H2′ = 0.42).
BOSS: A new QoS aware blockchain assisted framework for secure and smart healthcare as a service
Authors: Singh Prabh Deep , Kaur Rajbir , Dhiman Gaurav , Bojja Giridhar Reddy 
Published: October 2021

AbstractThe latest epidemic of COVID‐19 has significantly impacted both human capital and the global economy, contributing to pandemics and severe global crises. Research into the creation and propagation of the disease is desperately needed. The Internet of Things, cloud computing, and artificial intelligence offer modern technology for real‐time processing for multiple applications such as healthcare applications, transport, traffic control, and so on blockchain is an evolving technology that will dramatically boost transaction protection in finance, supply chain, and other transaction networks. A stable and latency‐sensitive Quality of Service framework for COVID‐19 is the need of an hour. The purpose of this paper is to combine Fog computing and Artificial Intelligence with smart health to establish a reliable platform for early‐stage detection of COVID‐19 infection. A new ensemble‐based classifier is proposed to detect COVID‐19 patients. This research offers a blockchain platform to analyse how the unrelated cases of the COVID‐19 virus can be tracked and identified using peer‐to‐peer, time stamping, and the shared storage advantages of blockchain. In addition to growing patient loyalty, this would effectively enhance the consistency, flexibility, productivity, performance, and effectiveness of healthcare services. The idea of blockchain is used to establish security for the whole framework. Different implementations measure the efficiency of the suggested system. The performance of the proposed framework is evaluated in terms of delay, network usages, RAM usages, and energy consumption. On the other hand, the classifier is evaluated in terms of classifier accuracy, recall, precision, kappa static, and root mean square error. The result shows the performance of the proposed framework and classifier is always better than the traditional frameworks and classifiers.
Constellations of family closeness and adolescent friendship quality
Authors: Xia Mengya , Fosco Gregory M. , Bray Bethany C. , Grych John H. 
Published: October 2021

AbstractObjectiveThis study aims to investigate the association between family relationship constellations and adolescent friendship quality in a more holistic way and disentangle gender differences on their associations.BackgroundFamily relationships are important for adolescent friendship, but little is known about how mother–adolescent and father–adolescent relationships work in the context of each other.MethodLatent profile analysis was conducted in a sample of 326 ethnically diverse high schoolers (ages: 14–19 years; 60.4% female) to identify different combinations of mother– and father–adolescent closeness and their associations with friendships for adolescent boys and girls.ResultsFindings revealed five family relationship patterns: Cohesive (22%; high closeness with both parents), Alliance With Mother (9%; high mother–adolescent closeness only), Alliance With Father (10%; high father–adolescent closeness only), Disengaged (22%; low closeness with both parents), and Average (36%; average closeness with both parents) profiles. Adolescents in Cohesive families had high conflict resolution, and adolescents in alliance families had high companionship, whereas adolescents in Disengaged and Average families had the worst friendships. Adolescent boys in Disengaged families had the poorest friendships in all four domains when compared to adolescent girls in Disengaged families and adolescent boys in other family types; mother–adolescent closeness was important for adolescent boys' validation and intimate exchange. Adolescent girls' friendship quality generally was highest in Cohesive families.ConclusionFindings highlight the importance of simultaneously accounting for relationships with both parents from the family systems perspective.ImplicationsBeing close to at least one parent is critical for adolescent social–emotional and friendship development, and this is especially important for adolescent boys' friendship quality.
Clinical and patient reported outcome in total ankle replacement compared to ankle fusion in end‐stage haemophilic arthropathy
Authors: Mussawy Haider , Kehrer Michael , Strahl André , Rolvien Tim , Hubert Jan , Beil Frank Timo , Wirtz Dieter Christian , Oldenburg Johannes , Holstein Katharina , Strauss Andreas Christian 
Published: October 2021

AbstractBackgroundAnkle arthropathy is a frequent complication of haemophilia, reducing the patients’ quality of life. Despite intensive conservative therapy, end‐stage arthropathy requires surgical treatment, either by ankle fusion (AF) or total ankle replacement (TAR).MethodsEleven consecutive AFs were performed in nine patients and 11 TARs were implemented in 10 patients. Outcomes were assessed clinically by AOFAS score and radiologically by the Pettersson and Gilbert scores.ResultsThe mean age of the patients in these groups were 35.7 years and 49.4 years, respectively. Of the 11 ankles that underwent fusion, 10 showed bony consolidation not later than 12 weeks after surgery, whereas one still showed non‐union after 6 months. VAS pain scores decreased significantly in both groups. Mean AOFAS scores also improved significantly, from 28.1 before to 80.3 after AF and from 21.5 before to 68.0 after ankle replacement. No perioperative complications were observed in either group. Late deep infection was observed in two patients that underwent TAR, which required removal of the implant.ConclusionOur data indicate that both AF and TAR result in significantly reduced pain in patients with haemophilia with end‐stage haemophilic arthropathy. While TAR is associated with a higher risk of deep infection and minimal persistent pain, it preserves the pre‐operative range of motion. AF on the other hand is associated with the risk of non‐union and a longer post‐operative recovery period but results in greater pain reduction.
Millipedes step up: species extend their upper elevational limit in the Alps in response to climate warming
Authors: Gilgado José D. , Rusterholz Hans‐Peter , Baur Bruno 
Published: October 2021

AbstractClimate warming is predicted to result in changes to phenology, behaviour and abundance as well as poleward shifts or upslope displacements of the distribution of species. However, climate‐warming induced changes in distribution patterns have rarely been studied in ground‐dwelling arthropods.We investigated changes in the upper elevational limit and relative abundance of 11 millipede species by repeating historical surveys from 1917 to 1919 in five valleys in the Swiss National Park (Eastern Alps) in 2018–2019.We found that the upper elevational limit for 10 out of 11 millipede species has risen, on average, by 161 m in 100 years, accompanying a 1.5 °C rise in mean annual temperature in the investigation area. The 10 millipede species differed in upslope expansion of their distribution with the shift ranging from 50 m to 363 m.The relative abundances of species (percentage of individuals sampled for each of the 11 millipede species) were very similar in 1917–1919 and 2018–2019. Only three species showed a change in frequency >6% over 100 years: two species had reduced abundances by 13.7% and 12.5% in the recent survey, while one species increased in abundance by 12.2%.We provide evidence showing that soil‐dwelling millipede species with low dispersal ability have raised their upper distribution limit to higher elevation between the surveys done in 1917–1919 and 2018–2019. This upslope shift in distribution is most probably due to the significant increase in temperature recorded in the investigation area in past decades.