bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decision-making approaches in transgender healthcare: conceptual analysis and ethical implications
Authors: Gerritse Karl , Hartman Laura A. , Bremmer Marijke A. , Kreukels Baudewijntje P. C. , Molewijk Bert C. 
Published: May 2021

AbstractOver the past decades, great strides have been made to professionalize and increase access to transgender medicine. As the (biomedical) evidence base grows and conceptualizations regarding gender dysphoria/gender incongruence evolve, so too do ideas regarding what constitutes good treatment and decision-making in transgender healthcare. Against this background, differing care models arose, including the ‘Standards of Care’ and the so-called ‘Informed Consent Model’. In these care models, ethical notions and principles such as ‘decision-making’ and ‘autonomy’ are often referred to, but left unsubstantiated. This not only transpires into the consultation room where stakeholders are confronted with many different ethical challenges in decision-making, but also hampers a more explicit discussion of what good decision-making in transgender medicine should be comprised of. The aim of this paper is to make explicit the conceptual and normative assumptions regarding decision-making and client autonomy underpinning the ‘Standards of Care’ and ‘Informed Consent Model’ currently used in transgender care. Furthermore, we illustrate how this elucidation aids in better understanding stakeholders’ ethical challenges related to decision-making. Our ethical analysis lays bare how distinct normative ambiguities in both care models influence decision-making in practice and how foregrounding one normative model for decision-making is no moral panacea. We suggest that the first steps towards good decision-making in gender-affirming medical care are the acknowledgement of its inherent normative and moral dimensions and a shared, dialogical approach towards the decision-making process.
Generalized Stoichiometry and Biogeochemistry for Astrobiological Applications
Authors: Kempes Christopher P. , Follows Michael J. , Smith Hillary , Graham Heather , House Christopher H. , Levin Simon A. 
Published: May 2021

AbstractA central need in the field of astrobiology is generalized perspectives on life that make it possible to differentiate abiotic and biotic chemical systems McKay (2008). A key component of many past and future astrobiological measurements is the elemental ratio of various samples. Classic work on Earth’s oceans has shown that life displays a striking regularity in the ratio of elements as originally characterized by Redfield (Redfield 1958; Geider and La Roche 2002; Eighty years of Redfield 2014). The body of work since the original observations has connected this ratio with basic ecological dynamics and cell physiology, while also documenting the range of elemental ratios found in a variety of environments. Several key questions remain in considering how to best apply this knowledge to astrobiological contexts: How can the observed variation of the elemental ratios be more formally systematized using basic biological physiology and ecological or environmental dynamics? How can these elemental ratios be generalized beyond the life that we have observed on our own planet? Here, we expand recently developed generalized physiological models (Kempes et al. 2012, 2016, 2017, 2019) to create a simple framework for predicting the variation of elemental ratios found in various environments. We then discuss further generalizing the physiology for astrobiological applications. Much of our theoretical treatment is designed for in situ measurements applicable to future planetary missions. We imagine scenarios where three measurements can be made—particle/cell sizes, particle/cell stoichiometry, and fluid or environmental stoichiometry—and develop our theory in connection with these often deployed measurements.
Mitigating Disparity in Health-care Resources Between Countries for Management of Hereditary Angioedema
Authors: Jindal Ankur Kumar , Reshef Avner , Longhurst Hilary ,   GEHM workgroup (Global Equity in HAE Management), Aberer Werner , Betchel Stephen , Bork Konrad , Aygören-Pürsün Emel , Maurer Marcus , Magerl Markus , Bouillet Laurence , Bygum Anette , Caballero Teresa , Cancian Mauro , Farkas Henriette , Grivcheva-Panovska Vesna , Grumach Anete , Gulbahar Okan , Hide Michihiro , Jindal Ankur , Singh Surjit , Kang Hye-Ryun , Reshef Avner , Kessel Aharon , Longhurst Hilary , Lindsay Karen , Jordan Anthony , Ameratunga Rohan , Lumry William , Bernstein Jonathan , Craig Timothy , Riedl Marc , Levy Don , Malbran Alejandro , Germenis Anastasios , Psarros Fotis , Stobiecki Marcin , Porebski Grzegorz , Valerieva Anna , Wardman Fiona , Zhong Youjia , Weber Christina 
Published: May 2021

AbstractHereditary angioedema (HAE) is a rare genetic disorder characterized by recurrent episodes of skin and mucosal edema. The main treatment goal is to enable a “normal life” for all patients. However, due to high costs, there are limited options for the management of HAE in most developing and low-income countries. As a result, most of the recommended first-line treatments are not available. In this review, we attempt to highlight the disparities in health-care resources for the management of patients with HAE amongst different countries. Data was collected from HAE experts in countries who provide tabulated information regarding management and availability of HAE treatments in their countries. We reviewed the two most recent international HAE guidelines. Using India, the world’s second most populous country, as a paradigm for HAE management in lower-income countries, we reviewed the evidence for second-line and non-recommended practices reported by HAE experts. Results suggest significant inequities in provision of HAE services and treatments. HAE patients in low-income countries do not have access to life-saving acute drugs or recently developed highly effective prophylactic medications. Most low-income countries do not have specialized HAE services or diagnostic facilities, resulting in consequent long delays in diagnosis. Suggestions for optimizing the use of limited resources as a basis for future discussion and reaching a global consensus are provided. There is an urgent need to improve HAE services, diagnostics and treatments currently available to lower-income countries. We recommend that all HAE stakeholders support the need for global equity and access to these essential measures.
The role of BAFF and G-CSF for rituximab-induced late-onset neutropenia (LON) in lymphomas
Authors: Tesfa Daniel , Sander Birgitta , Lindkvist Henric , Nilsson Christer , Kimby Eva , Hägglund Hans , Wahlin Björn E. , Klimkowska Monika , Palmblad Jan 
Published: May 2021

AbstractMechanisms for late-onset neutropenia (LON) after rituximab treatment are poorly defined both for non-Hodgkin lymphoma (NHL) and for autoimmune disorders. We performed a case–control analysis of a prospective cohort of 169 evaluable consecutive rituximab-treated NHL patients to assess cytokines involved in neutro- and lymphopoiesis (G-CSF, SDF1, BAFF, APRIL) and inflammation (CRP) as possible LON mechanisms. Fifteen patients (9%) developed LON (peripheral blood /PB/ absolute neutrophil counts /ANC/ < 0.5 G/L, all with marked depletion of CD20+ B-lymphocytes in bone marrows); they were compared with 20 matched NHL controls without LON. At start of LON, significantly higher PB G-CSF and BAFF levels (P = 0.0004 and 0.006, respectively), as well as CRP rises were noted compared to controls; these G-CSF and BAFF and most CRP values returned to levels of the controls in post-LON samples. G-CSF (but not BAFF) changes correlated to CRP rises (but not to ANC levels). BAFF levels correlated significantly to absolute monocyte counts and PB large granular lymphocyte counts (but not to ANC, C-CSF or CRP values). No changes of SDF1 or APRIL levels were noted. Neither LON cases nor controls displayed anti-neutrophil autoantibodies. Collectively, LON in NHL patients was timewise related to transient bursts of blood G-CSF and BAFF concentrations, suggesting that these neutro- and lymphopoiesis growth factors play a role in emergence of rituximab-induced LON, and that inflammation may be a trigger for G-CSF production during LON.
Upfront metastasis-directed therapy in oligorecurrent prostate cancer does not decrease the time from initiation of androgen deprivation therapy to castration resistance
Authors: Triggiani Luca , Mazzola Rosario , Tomasini Davide , Bruni Alessio , Alicino Giulia , Matrone Fabio , Bortolus Roberto , Francolini Giulio , Detti Beatrice , Magli Alessandro , Bonù Marco Lorenzo , Ingrosso Gianluca , Lancia Andrea , Trippa Fabio , Maranzano Ernesto , Franzese Ciro , Ghirardelli Paolo , Vavassori Vittorio , Scorsetti Marta , Alongi Filippo , Magrini Stefano Maria 
Published: May 2021

AbstractThe aim of the present study was to explore the potential impact of upfront metastases-directed therapy (MDT) in terms of prolongation of castration-sensitive phase in a series of oligorecurrent castration-sensitive prostate cancer (PC) patients. The present article is a multicenter retrospective study. The population of interest was castrate-sensitive oligorecurrent PC, defined as the presence of 1–3 uptakes in non-visceral sites such as bones or nodes detected by means of 18F-Choline PET/CT or 68-Gallium PSMA PET/CT. Primary endpoint was the time to castration resistance. Secondary endpoints were ADT-free survival, local progression-free survival, and overall survival. Eighty-two patients and 118 lesions were analyzed. The median time to castration resistance for the entire population of the study was 49 months (95% CI 43.6–54.4 months). The 1- and 2-year TTCR-free survival rates were 94% and 82%, respectively. At the time of analysis, 52 patients were still in the castration-sensitive phase of the disease. In this cohort of patients, the median ADT-free survival was 20 months (range 3–69 months). On the other hand, during follow-up 30 patients switched to the castration-resistant phase of disease. In this last group of patients, the median ADT-free survival was 20 months (range 4–50 months). After the ADT administration, the median castration-sensitive phase was 29 months (range 5–71 months). Castration resistance generally occurs at a median follow-up of 24–36 months following ADT. In the current study, upfront MDT does not decrease the time from initiation of ADT to castration resistance.
Novel Monoclonal Antibodies Against Mouse C1q: Characterisation and Development of a Quantitative ELISA for Mouse C1q
Authors: Byrne Robert A. J. , Torvell Megan , Daskoulidou Nikoleta , Fathalla Dina , Kokkali Eirini , Carpanini Sarah M. , Morgan B. Paul 
Published: May 2021

AbstractRecent studies have identified roles for complement in synaptic pruning, both physiological during development and pathological in Alzheimer’s disease (AD). These reports suggest that C1q initiates complement activation on synapses and C3 fragments then tag them for removal by microglia. There is an urgent need to characterise these processes in rodent AD models; this requires the development of reagents and methods for detection and quantification of rodent C1q in fluids and pathological tissues. These will enable better evaluation of the role of C1q in disease and its value as disease biomarker. We describe the generation in C1q-deficient mice of novel monoclonal antibodies against mouse and rat C1q that enabled development of a sensitive, specific, and quantitative ELISA for mouse and rat C1q capable of measuring C1q in biological fluids and tissue extracts. Serum C1q levels were measured in wild-type (WT), C1q knockout (KO), C3 KO, C7 KO, Crry KO, and 3xTg and APPNL-G-F AD model mice through ageing. C1q levels significantly decreased in WT, APPNL-G-F, and C7 KO mice with ageing. C1q levels were reduced in APPNL-G-F compared to WT at all ages and in 3xTg at 12 months; C3 KO and C7 KO, but not Crry KO mice, also demonstrated significantly lower C1q levels compared to matched WT. In brain homogenates, C1q levels increased with age in both WT and APPNL-G-F mice. This robust and adaptable assay for quantification of mouse and rat C1q provides a vital tool for investigating the expression of C1q in rodent models of AD and other complement-driven pathologies.
Performance of a finite mixture model in CPUE standardization for a longline fishery with target change
Authors: Shibano Ayumi , Kanaiwa Minoru , Kai Mikihiko 
Published: May 2021

AbstractStandardized catch per unit effort (CPUE) is frequently used to represent annual fish-stock abundance trends. In multispecies fisheries, the catchability coefficient differs depending on the target strategy. Consideration of the target strategy in CPUE standardization is therefore crucial in improving the accuracy and precision of annual CPUE estimates. This study focuses on the potential of a finite mixture model (FMM), where target species and their annual trends are estimated simultaneously in a single model. The eight candidates of CPUE standardization methods—including the FMM—were used to evaluate the methodological performance as to whether they could identify the target strategy. A numerical simulation was undertaken using simplified data that mimic a Japanese longline fishery considering the target change over years, area effect, and multispecies abundance trends. Our simulation study indicated that the FMM outperformed other methods in the various scenarios, and therefore it is concluded that the FMM is an effective and robust methodology for clarifying the target strategy in the modeling of CPUE standardization.
eG Coated Stents Exhibit Enhanced Endothelial Wound Healing Characteristics
Authors: Rodriguez-Garcia Belen , Bureau Christophe , Barakat Abdul I. 
Published: May 2021

Abstract
Purpose
Despite their widespread use, a significant fraction of coronary stents suffer from in-stent restenosis and stent thrombosis. Stent deployment induces extensive injury to the vascular endothelium. Rapid endothelial wound closure is essential for the success of a stenting procedure. A recent study has demonstrated that the BuMA Supreme® sirolimus-eluting stent exhibits particularly attractive strut coverage characteristics. A unique feature of this stent is the presence of a thin brush layer of poly-butyl methacrylate (PBMA), covalently bonded to the stent’s cobalt-chromium frame via electro-grafting (eG™). The present study aimed to determine whether the PBMA coating has an effect on endothelial cell wound healing and stent strut coverage.

Methods
We used an in vitro coronary artery model whose wall consisted of an annular collagen hydrogel and whose luminal surface was lined with a monolayer of endothelial cells. Mechanical wounding of the endothelial lining was preformed prior to deployment of a bare cobalt-chromium stent either with or without the PBMA layer. The migration of fluorescently labeled endothelial cells was monitored automatically over a period of 48 h to determine endothelial wound healing rates.

Results
Quantitative assessment of endothelial wound healing rates within the simulated arterial model is achievable using automated image analysis. Wound healing is significantly faster (44% faster at 48 h) for stents with the PBMA eG Coating™ compared to bare metal stents.

Conclusion
The PBMA eG Coating™ has the effect of promoting endothelial wound healing. Future studies will focus on elucidating the mechanistic basis of this observation.
Segmental Volatility in Ethnically Divided Societies: (Re)assessing Party System Stability in Southeast Europe
Authors: Kapidžić Damir , Komar Olivera 
Published: May 2021

AbstractThis article examines the role of ethnicity and ethnic parties as stabilizing factors in Southeast European party systems. It compares two ethnically divided countries in Southeast Europe: Bosnia and Herzegovina, where ethnic identities that form the political cleavage are firm, and Montenegro, where they are malleable. Theoretically, it addresses the debate between scholars who either find stability or instability in East European post-communist party systems. The article traces the role of ethnicity in the formation and development of electoral contests and compares the two cases by utilizing measures of block volatility, based on analysis of official electoral data. We argue that party systems in ethnically diverse countries are stable at the subsystems level, but unstable within them. In BiH, firm ethnic identity stabilizes the party system by limiting competition between blocks, leading to closure. Malleable ethnic identity in Montenegro opens competition to non-ethnic parties seeking to bridge ethnic divisions, leading to more instability. We find that party system dynamics in ethnically divided new democracies depend on identity rigidity and cleavage salience, in addition to levels of heterogeneity.
Quantitative plant biology—Old and new
Authors: Morris Richard J. , ten Tusscher Kirsten H. 
Published: May 2021

AbstractQuantitative approaches in plant biology have a long history that have led to several ground-breaking discoveries and given rise to new principles, new paradigms and new methodologies. We take a short historical trip into the past to explore some of the many great scientists and influences that have led to the development of quantitative plant biology. We have not been constrained by historical fact, although we have tried not to deviate too much. We end with a forward look, expressing our hopes and ambitions for this exciting interdisciplinary field.
Morphological and molecular identification of four isolates of the entomopathogenic fungal genus Akanthomyces and their effects against Bemisia tabaci on cucumber
Authors: Broumandnia Fereshteh , Rajabpour Ali , Hamed Ghodoum Parizipour Mohamad , Yarahmadi Fatemeh 
Published: May 2021

AbstractThe cotton whitefly, Bemisia tabaci Gen. (Hem., Aleyrodidae), is a key pest of many vegetables. Entomopathogenic fungi are promising microbial control agents against B. tabaci, but limited information is available concerning indigenous Iranian isolates. In this study, three isolates of Akanthomyces lecanii (PAL6, PAL7, and PAL8) and one isolate of A. muscarius (AGM5) were obtained from citrus hemipteran pests, Pulvinaria aurantii Cock. and Aphis gossypii Glover, in Mazandaran province, northern Iran. The isolates were then morphologically and molecularly identified. The efficacies of five different agar media for vegetative growth and conidiation of each isolate were determined. Potato dextrose agar was the medium on which the fungal mycelia developed at a relatively high rate. However, the highest rate of conidiation was found on Sabouraud dextrose agar. To determine the effects of the isolates on B. tabaci, a dose–response bioassay was carried out to estimate lethal concentration (LC50) and lethal time (LT50) values of each fungal isolate to second instar nymphs. The mean LC50 values of A. lecanii isolates ranged from 4.22 × 106 to 7.35 × 1013 conidia ml−1 at 5 to 7 days after the treatment. For A. muscarius, the values varied from 9.2 × 104 to 8.7 × 1010 conidia ml−1 at 5 to 7 days after the treatment. The lowest and the highest mean LC50 values were observed for A. mucarius (AGM5) and A. lecanii (isolate PAL6), respectively. The mean LT50 values of A. lecanii and A. muscarius isolates were 7.1–9.0 and 4.9–7.2 days, respectively. The LT50 values of A. muscarius were significantly lower than the other isolates. Overall, all isolates, especially A. muscarius (AGM5), exhibited appropriate potential as a biological control agent against B. tabaci.
Coronavirus disease 2019: changing the future of emergency epistaxis management
Authors: Devabalan Y , Cereceda-Monteoliva N , Lorenz H , Magill J C , Unadkat S , Ferguson M , Rennie C 
Published: May 2021

Abstract

Background
Acute epistaxis can be a life-threatening airway emergency, requiring in-patient admission. The coronavirus disease 2019 pandemic placed significant strain on hospital resources, and management has shifted towards an out-patient-centred approach.

Methods
A five-month single-centre retrospective study was undertaken of all epistaxis patients managed by the ENT department. A pre-coronavirus disease 2019 pandemic group was managed with pre-existing guidelines, compared to new guidelines for the coronavirus disease 2019 pandemic group. A telephone survey was performed on out-patients with non-dissolvable packs to assess patient comfort and satisfaction.

Results
A total of 142 patients were seen. The coronavirus disease 2019 pandemic group had significantly more patients aged over 65 years (p = 0.004), an increased use of absorbable dressings and local haemostatic agents (Nasopore and Surgiflo), and fewer admissions (all p < 0.0005). Rates of re-presentation and morbidity, and length of hospital stay were similar. The telephone survey revealed out-patient management to be efficacious and feasible.

Conclusion
The coronavirus disease 2019 pandemic has shifted epistaxis management towards local haemostatic agents and out-patient management; this approach is as safe and effective as previously well-established regimens.
Effectiveness and comparative effectiveness of evidence-based psychotherapies for posttraumatic stress disorder in clinical practice
Authors: Maguen Shira , Madden Erin , Holder Nicholas , Li Yongmei , Seal Karen H. , Neylan Thomas C. , Lujan Callan , Patterson Olga V. , DuVall Scott L. , Shiner Brian 
Published: May 2021

Abstract

Background
While evidence-based psychotherapy (EBP) for posttraumatic stress disorder (PTSD) is a first-line treatment, its real-world effectiveness is unknown. We compared cognitive processing therapy (CPT) and prolonged exposure (PE) each to an individual psychotherapy comparator group, and CPT to PE in a large national healthcare system.

Methods
We utilized effectiveness and comparative effectiveness emulated trials using retrospective cohort data from electronic medical records. Participants were veterans with PTSD initiating mental healthcare (N = 265 566). The primary outcome was PTSD symptoms measured by the PTSD Checklist (PCL) at baseline and 24-week follow-up. Emulated trials were comprised of ‘person-trials,’ representing 112 discrete 24-week periods of care (10/07–6/17) for each patient. Treatment group comparisons were made with generalized linear models, utilizing propensity score matching and inverse probability weights to account for confounding, selection, and non-adherence bias.

Results
There were 636 CPT person-trials matched to 636 non-EBP person-trials. Completing ⩾8 CPT sessions was associated with a 6.4-point greater improvement on the PCL (95% CI 3.1–10.0). There were 272 PE person-trials matched to 272 non-EBP person-trials. Completing ⩾8 PE sessions was associated with a 9.7-point greater improvement on the PCL (95% CI 5.4–13.8). There were 232 PE person-trials matched to 232 CPT person-trials. Those completing ⩾8 PE sessions had slightly greater, but not statistically significant, improvement on the PCL (8.3-points; 95% CI 5.9–10.6) than those completing ⩾8 CPT sessions (7.0-points; 95% CI 5.5–8.5).

Conclusions
PTSD symptom improvement was similar and modest for both EBPs. Although EBPs are helpful, research to further improve PTSD care is critical.