bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of regional anaesthesia and multimodal analgesia in the prevention of chronic postoperative pain: a narrative review
Authors: Chen Y.‐Y. K. , Boden K. A. , Schreiber K. L. 
Published: January 2021

SummaryEffective prevention of chronic postoperative pain is an important clinical goal, informed by a growing body of studies. Peri‐operative regional anaesthesia remains one of the most important tools in the multimodal analgesic toolbox, blocking injury‐induced activation and sensitisation of both the peripheral and central nervous system. We review the definition and taxonomy of chronic postoperative pain, its mechanistic basis and the most recent evidence for the preventative potential of multimodal analgesia, with a special focus on regional anaesthesia. While regional anaesthesia targets several important aspects of the mechanistic pathway leading to chronic postoperative pain, evidence for its efficacy is still mixed, possibly owing to the heterogeneity of risk profiles within the surgical patient, but also to variation in techniques and medications reported in the literature.
Pros and cons of hemi‐thyroidectomy for low‐risk differentiated thyroid cancer
Authors: Papachristos Alexander J. , Glover Anthony , Sywak Mark S. , Sidhu Stan B. 
Published: January 2021

AbstractThe debate regarding the surgical management of low‐risk differentiated thyroid cancer (DTC) is ongoing. The recommended extent of surgery in DTC is based on an assessment of the predicted risk of recurrence and recent guidelines reflect an evolving philosophy of de‐escalation of surgical management, informed by a growing understanding of the determinants of tumour biology and important prognostic factors. However, our current clinical and pathological risk stratification processes are imperfect and hence there is significant variation in clinical practice. Surgeons face the challenge of finding the balance between avoiding overtreatment, minimizing complications and providing adequate oncological management. This article discusses the nuances of the current management guidelines as well as the important considerations in preoperative decision making.
One‐year follow up on post‐placental IUD insertion: A randomized clinical trial
Authors: Marangoni Marcos , Laporte Montas , Surita Fernanda , Kraft Maria B. , Bahamondes Luis , Juliato Cássia R. T. 
Published: January 2021

AbstractIntroductionOur objectives were to compare the 1‐year follow‐up clinical performance of the TCu380A intrauterine device (TCu380A‐IUD) and levonorgestrel (LNG) 52‐mg intrauterine system (IUS) inserted at post‐placental period.Material and methodsWe conducted an open‐label, parallel‐group, randomized clinical trial, 1:1 with pregnant women admitted for childbirth independently of the mode of birth. Our primary outcome was expulsion up to 1 year after device placement by type of IUD and mode of delivery. During the follow up (42, 90 and 365 days (±7 days) after device placement), an ultrasound was performed to evaluate the device position. Kaplan–Meier with log‐rank test was used to compare the survival curves of the TCu380A IUD and the LNG IUS. Couple‐Years of Protection after insertion of both devices was calculated.ResultsOne hundred and forty women were randomized to the TCu380A IUD (n = 70) or the LNG IUS (n = 70). By the end of the first year after device placement, 38 women experienced device expulsion (27.1%), most of them (33/38; 86.8%) within the first 42 days after delivery. The expulsions were significantly higher among users of TCu380A IUD (39.4%) than among users of the LNG IUS (22.2%; P = .039), and among those with vaginal delivery (43.8%) than among women with cesarean delivery (15%; P = .003). The 1‐year cumulative continuation rate was 64.2%, significantly higher for LNG IUS (73.1%) than for TCu380A IUD (54.4%; P = .03), and among women with cesarean delivery (77.6%) than for vaginal delivery (52%; P = .00). The post‐placental IUD insertion provided 356.4 Couple‐Years of Protection.ConclusionsTwo‐thirds of women who accepted a post‐placental IUD placement still used the device 1 year after childbirth. However, expulsion was the most prevalent reason for discontinuation, mainly within 42 days after device placement. The expulsion rate was significantly higher among TCu380A IUD users and among women with vaginal delivery.
Induction of labor in breech presentations ‐ a retrospective cohort study
Authors: Welle‐Strand Johanne Augusta Horn , Tappert Christian , Eggebø Torbjørn Moe 
Published: January 2021

AbstractIntroductionThere is limited evidence on the safety and outcome of induction of breech labor. In this study, we aimed to compare the outcomes of spontaneous and induced breech deliveries and to describe variations in induction rates.Material and methodsThis was a retrospective cohort study comprising 1054 singleton live fetuses in breech presentation at Trondheim University Hospital from 2012 to 2019. The main outcome was intrapartum cesarean section, and secondary outcomes were postpartum hemorrhage, anal sphincter ruptures, Apgar scores, pH in the umbilical artery, and metabolic acidosis. All data were obtained from the hospital birth journal.ResultsInduction of labor was performed in 127/606 (21.0%) women with planned vaginal birth. The frequency of intrapartum cesarean section was 48.0% for induced labor vs 45.7% for spontaneous labor (P = .64). We found no differences in the frequency of postpartum hemorrhage or anal sphincter ruptures between induced and spontaneous births. The median pH in the umbilical artery was significantly lower in neonates with induced labor compared with neonates with spontaneous labor (7.22 vs 7.25; P = .02). The frequency of pH <7.05 was 7.0% for induced labor vs 2.9% (P = .05) for spontaneous labor, but the frequency of pH <7.0 was not significantly different: 2.6% vs 0.8% (P = .14), respectively. Three neonates with planned vaginal birth had metabolic acidosis: two with spontaneous labors and one with induced labor. Three fetuses with planned vaginal birth died during labor: two with spontaneous onset of labor and one with induced labor. All three were extremely preterm: two were delivered in week 23 and one in week 25. We did not observe any significant trend in induction rates in either parous or nulliparous women.ConclusionsThe induction rates were stable during the study period. We did not observe any significant difference in intrapartum cesarean section rates, in the frequency of pH <7.0 in the umbilical artery, or in the frequency of metabolic acidosis when comparing induced and spontaneous breech deliveries.
Efficacy and safety of different agents, dosages and strategies of anti‐vascular endothelial growth factor treatment for neovascular age‐related macular degeneration: a network meta‐analysis of randomized controlled trials
Authors: Zhao Xin‐Yu , Meng Li‐Hui , Liu Sheng‐zhi , Chen You‐Xin 
Published: January 2021

AbstractPurposeTo evaluate the efficacy and safety of different agents, dosages and strategies of anti‐vascular endothelial growth factor (VEGF) treatment for neovascular age‐related macular degeneration (nAMD) by network meta‐analysis.MethodsElectronic database searches were conducted on PubMed, Embase and Cochrane Central Register of Controlled Trials up to 1 December 2019 to `identify relevant randomized controlled trials (RCTs). The standardized mean difference (SMD), odds ratios (OR), 95% confidence intervals (CI), the surface under the cumulative ranking curves and the mean ranks of each outcome were estimated by Stata 14.0.ResultsForty‐seven RCTs encompassing 17 872 nAMD patients randomly assigned to 36 regimens of anti‐VEGF agents or sham treatment were included. T&E strategy shows top‐level effect both in BCVA changes and the percentage of patients with a gain of 3 lines or more of BCVA. When taking the same strategy, there is no significant difference of efficacy among ranibizumab, bevacizumab and aflibercept (p > 0.05); The combination of radiation, topical NSAIDs and photodynamic therapy (PDT) might provide additional benefit in central retinal thickness (CRT) reduction; all these therapeutic regimens of different anti‐VEGF agents do not significantly increase the risk of severe ocular or cardiocerebral vascular adverse events (ADEs) compared with sham treatment (p > 0.05).ConclusionsT&E strategy showed a satisfactory effect in visual improvement and there is no significant difference in efficacy or safety among ranibizumab, bevacizumab and aflibercept. All the included regimens have an acceptable risk of ADEs.
MicroRNA‐122 and cytokeratin‐18 have potential as a biomarkers of drug‐induced liver injury in European and African patients on treatment for mycobacterial infection
Authors: Rupprechter Sarah A.E. , Sloan Derek J. , Oosthuyzen Wilna , Bachmann Till T. , Hill Adam T. , Dhaliwal Kevin , Templeton Kate , Matovu Joshua , Sekaggya‐Wiltshire Christine , Dear James W. 
Published: January 2021

AimsPatients on antituberculosis (anti‐TB) therapy are at risk of drug‐induced liver injury (DILI). MicroRNA‐122 (miR‐122) and cytokeratin‐18 (K18) are DILI biomarkers. To explore their utility in this global context, circulating miR‐122 and K18 were measured in UK and Ugandan populations on anti‐TB therapy for mycobacterial infection.MethodsHealthy subjects and patients receiving anti‐TB therapy were recruited at the Royal Infirmary of Edinburgh, UK (ALISTER—ClinicalTrials.gov Identifier: NCT03211208). African patients with human immunodeficiency virus–TB coinfection were recruited at the Infectious Diseases Institute, Kampala, Uganda (SAEFRIF—NCT03982277). Serial blood samples, demographic and clinical data were collected. In ALISTER samples, MiR‐122 was quantified using polymerase chain reaction. In ALISTER and SAEFRIF samples, K18 was quantified by enzyme‐linked immunosorbent assay.ResultsThe study had 235 participants (healthy volunteers [n = 28]; ALISTER: active TB [n = 30], latent TB [n = 88], nontuberculous mycobacterial infection [n = 25]; SAEFRIF: human immunodeficiency virus‐TB coinfection [n = 64]). In the absence of DILI, there was no difference in miR‐122 and K18 across the groups. Both miR‐122 and K18 correlated with alanine transaminase (ALT) activity (miR‐122: R = .52, 95%CI = 0.42–0.61, P < .0001. K18: R =0.42, 95%CI = 0.34–0.49, P < .0001). miR‐122 distinguished those patients with ALT>50 U/L with higher sensitivity/specificity than K18. There were 2 DILI cases: baseline ALT, 18 and 28 IU/L, peak ALT 431 and 194 IU/L; baseline K18, 58 and 219 U/L, peak K18 1247 and 3490 U/L; baseline miR‐122 4 and 17 fM, peak miR‐122 60 and 336 fM, respectively.ConclusionIn patients treated with anti‐TB therapy, miR‐122 and K18 correlated with ALT and increased with DILI. Further work should determine their diagnostic and prognostic utility in this global context‐of‐use.
Population pharmacokinetics of clofarabine for allogeneic hematopoietic cell transplantation in paediatric patients
Authors: Nijstad A. Laura , Nierkens Stefan , Lindemans Caroline A. , Boelens Jaap Jan , Bierings Marc , Versluys A. Birgitta , van der Elst Kim C.M. , Huitema Alwin D.R. 
Published: January 2021

AimsClofarabine has recently been evaluated as part of the conditioning regimen for allogeneic hematopoietic stem cell transplantation (HCT) in children. Pharmacokinetic (PK) exposure of different agents commonly used in conditioning regimens is strongly related to HCT outcome. Consequently, the PK of clofarabine may be important for outcome. This report describes the population PK of clofarabine in paediatric patients and one adult.MethodsFrom 80 paediatric (0.5–18 years) and 1 adult patient (37 years), 805 plasma concentrations were included in pharmacokinetic analyses using nonlinear mixed effects modelling.ResultsA two‐compartment model adequately described the PK of clofarabine. Body weight and estimated glomerular filtration rate (eGFR) were included as covariates. Clearance was differentiated into nonrenal and renal clearance (approximately 55% of total clearance), resulting in population estimates of 24.0 L/h (95% confidence interval [CI] 13.7–34.4) and 29.8 L/h (95% CI 23.9–36.1) for a patient of 70 kg with normal renal function, respectively. Unexplained interindividual variability in clearance was 17.8% (95% CI 14.6–22.4). A high variability in exposure was observed (range area under the curveT0‐inf 1.8–6.0 mg/L*h) after body surface area (BSA) based dosing. Interestingly, children with low body weight had a lower exposure than children with a higher body weight, which indicates that the currently practised BSA‐based dosing is not adequate for clofarabine.ConclusionA clofarabine dosing algorithm based on this PK model, using body weight and eGFR, results in a more predictable exposure than BSA‐based dosing. However, the exact target exposure needs to be further investigated.
Finding the voice of students engaging in online alternative provision via digital data collection methods
Authors: Smith Sharon 
Published: January 2021

AbstractThe number of students accessing Alternative Provision (AP) in the UK is growing and the ways in which such provision is facilitated is evolving with the use of EdTech. However, there is very little evidence of such provisions being evaluated in terms of their educational impact nor regarding the way in which students engage with them. This results in the voices of students participating in AP being further marginalised by being out of mainstream education, as they fail to be heard by their educators, schools or local authorities. Within this exploratory paper digital data collection methods are shown to offer a solution to this problem and reveal student voice insights into how they engage with and experience one specific form of synchronistic online AP. This study provides evidence of how student voice can effectively be collated in order to provide an opportunity for marginalised student voices to be heard.
Practitioner NotesWhat is already known about this topic

Student voice is a critical tool in both engaging students and student engagement.
There is a preference in students to give anonymous feedback and this facilitates more honest, open responses.
AP uptake is increasing.
There has been little evidence of any effort to obtain student voice from students in AP.
What this paper adds

Gathering student voice from students in AP is critical to assess how students view and respond to their provision.
Digital data collection facilitates AP student voice; students both younger and potentially more vulnerable to disengagement can have their voices heard more easily.
A substantial majority of students in AP who have left mainstream education perceive online learning delivery methods to have positive impacts.
Implications for practice/pedagogy

Practitioners should strive to ensure AP students have avenues through which they may have their student voices heard to gain insights into the effectiveness of the provision from a student perspective.
Anonymous feedback, which enables students to be confident in expressing their views, even when verbally expressed, can be facilitated through digital data collection methods.
Use of live, online interactive lessons are a valuable form of AP worthy of further exploration.
Non‐renewable resources and the possibility of sustainable economic development in an economy with positive or negative population growth
Authors: Sasaki Hiroaki 
Published: January 2021

AbstractThe purpose of this study is to investigate how the long‐run growth rate of per capita output is determined when an economy is subject to non‐renewable resource constraints and the population growth is negative by using a theoretical model. From this, we can examine the effect of population decline and the effect of depletion of natural resources on economic growth. Our results show that irrespective of whether the population growth rate is positive or negative, the long‐run growth rate of per capita output can be positive depending on conditions. This result suggests that even an economy with non‐renewable resources and declining population can obtain sustainable economic growth.
Characterization of cytochrome P450 (CYP) 2D6 drugs as substrates of human organic cation transporters and multidrug and toxin extrusion proteins
Authors: Neul Claudia , Hofmann Ute , Schaeffeler Elke , Winter Stefan , Klein Kathrin , Giacomini Kathleen M. , Eichelbaum Michel , Schwab Matthias , Nies Anne T. 
Published: January 2021

Background and PurposeThe metabolic activity of cytochrome P450 (CYP) 2D6 is highly variable and CYP2D6 genotypes insufficiently explain the extensive and intermediate metabolic phenotypes, limiting the prediction of drug response plus adverse drug reactions. Since CYP2D6 prototypic substrates are positively charged, the aim of this study was to evaluate the organic cation transporters (OCTs) and multidrug and toxin extrusion proteins (MATEs) as potential contributors to the variability of CYP2D6 hydroxylation of debrisoquine, dextromethorphan, diphenhydramine, perhexiline and sparteine.Experimental ApproachOCT1/SLC22A1‐, OCT2/SLC22A2‐, OCT3/SLC22A3‐, MATE1/SLC47A1‐, and MATE2K/SLC47A2‐overexpressing cell lines were used to investigate the transport of the selected drugs. Individuals from a study cohort, well defined with respect to CYP2D6 genotype and sparteine pharmacokinetics, were genotyped for the common OCT1 variants rs12208357 (OCT1‐R61C), rs34130495 (OCT1‐G401S), rs202220802 (OCT1‐Met420del), rs34059508 (OCT1‐G465R), OCT2 variant rs316019 (OCT2‐A270S) and MATE1 variant rs2289669. Sparteine pharmacokinetics was stratified according to CYP2D6 and OCT1, OCT2 or MATE1 genotype.Key ResultsOCTs and MATE1 transport sparteine and debrisoquine with high affinity in vitro, but OCT‐ and MATE1‐dependent transport of dextromethorphan, diphenhydramine and perhexiline was not detected. Sparteine and debrisoquine transport depends on OCT1 genotype; however, sparteine pharmacokinetics is independent from OCT1 genotype.Conclusions and ImplicationsSome drugs that are substrates of CYP2D6 are also substrates of OCTs and MATE1, suggesting overlapping specificities. Variability in sparteine hydroxylation in extensive and intermediate metabolizers cannot be explained by OCT1 genetic variants indicating presence of other factors. Dose‐dependent toxicities of dextromethorphan, diphenhydramine and perhexiline appear to be independent from OCTs and MATEs.
Invasion of temperate deciduous broadleaf forests by N‐fixing tree species – consequences for stream ecosystems
Authors: Ferreira Verónica , Figueiredo Albano , Graça Manuel A. S. , Marchante Elizabete , Pereira Ana 
Published: January 2021

ABSTRACTBiological invasions are a major threat to biodiversity and ecosystem functioning. Forest invasion by alien woody species can have cross‐ecosystem effects. This is especially relevant in the case of stream–riparian forest meta‐ecosystems as forest streams depend strongly on riparian vegetation for carbon, nutrients and energy. Forest invasion by woody species with dissimilar characteristics from native species may be particularly troublesome. The invasion of temperate deciduous broadleaf forests with low representation of nitrogen (N)‐fixing species by N‐fixers has the potential to induce ecosystem changes at the stream level. Although effects of tree invasion on stream ecosystems have been under assessed, knowledge of native and invasive tree characteristics allows prediction of invasion effects on streams. Here we present a conceptual model to predict the effects of forest invasion by alien N‐fixing species on streams, using as a background the invasion of temperate deciduous broadleaf forests by leguminousAcaciaspecies, which are among the most aggressive invaders worldwide. Effects are discussed using a trait‐based approach to allow the model to be applied to other pairs of invaded ecosystem–invasive species, taking into account differences in species traits and environmental conditions. Anticipated effects of N‐fixing species invasions include changes in water quality (increase in N concentration) and quantity (decrease in flow) and changes in litter input characteristics (altered diversity, seasonality, typology, quantity and quality). The magnitude of these changes will depend on the magnitude of differences in species traits, the extent and duration of the invasion and stream characteristics (e.g. basal nutrient concentration). The extensive literature on effects of nutrient enrichment of stream water, water scarcity and changes in litter input characteristics on aquatic communities and processes allows prediction of invasion effects on stream structure and function. The magnitude of invasion effects on aquatic communities and processes may, however, depend on interactions among different pathways (e.g. effects mediated by increases in stream nutrient concentration may contrast with those mediated by decreases in water availability or by decreases in litter nutritional quality). A review of the literature addressing effects of increasing cover of N‐fixing species on streams suggests a wide application of the model, while it highlights the need to consider differences in the type of system and species when making generalizations. Changes induced by N‐fixing species invasion on streams can jeopardize multiple ecosystem services (e.g. good quality water, hydroelectricity, leisure activities), with relevant social and economic consequences.
Health professional–educator collaboration in the delivery of school‐based tiered support services: A qualitative case study
Authors: Phoenix Michelle , Dix Leah , DeCola Cindy , Eisen Isabel , Campbell Wenonah 
Published: January 2021

AbstractBackgroundEducators and health professionals support the learning and participation of diverse children in school environments. Tiered approaches to service delivery may assist these efforts through consideration of universal supports that are useful to all children, targeted supports for some children and individualized supports for the smallest number of children. This study explored how an interprofessional team worked with educators to develop and implement tiered services in two school communities where many families experience economic and social disadvantages.MethodsUsing a participatory action research approach and qualitative case study methods, the research and stakeholder teams jointly designed and conducted this study in two schools during the 2017–2018 school year. Data collected included weekly logs written by the interprofessional team members and 16 interviews conducted with team members, parents, educators and administrators.ResultsThe team provided a variety of services to individual students, groups, whole classes and the school community. Collaboration and communication were needed to define roles and expectations and to plan and share student information. Reported benefits included timely service, capacity building and student goal achievement. The main barriers were related to service fragmentation, time and workload.ConclusionsRecommendations included clearer direction about expectations and improved coordination within the systems that offer services. Further research should include exploration of comparative cases with varying contexts, the inclusion of child perspectives and direct observation.