bluuebunny/crossref_metadata_2025_split huggingface dataset:
Induction of labor or expectant management? Birth outcomes for nulliparous individuals choosing midwifery care
Authors: Erickson Elise N. , Bailey Joanne M. , Colo Shanti D. , Carlson Nicole S. , Tilden Ellen L. 
Published: May 2021

AbstractBackgroundInduction of labor (IOL) has been studied as a strategy to reduce rates of cesarean birth (CB). Midwifery care models are also associated with lower CB rates, even considering that midwives perform fewer IOLs. In this study, we examined childbirth outcomes among individuals undergoing IOL in certified nurse‐midwifery (CNM) care as compared to two categories of expectant management (EM).MethodsData were from two CNM practices in the United States (2007‐2018). The sample was limited to term nulliparous, nondiabetic, singleton, vertex pregnancies. Individuals having an IOL in each week of gestation (37th, 38th, etc) were compared with those having EM. Two methods for defining EM were considered as each method when used alone limits interpretation. Inclusive EM included all births starting in the same week as IOL. The exclusive EM group was comprised of all births occurring in the next gestational age week relative to the IOL cases (ie, 39th week IOL versus all births occurring at 40 weeks or later). Adjusted regression models were used to examine differences in CB by IOL versus EM (inclusive or exclusive) at each week of gestation.ResultsAmong 4057 CNM‐attended pregnancies, the overall rate of IOL was 28.9% (95% CI 27.5%‐30.3%) and CB was 19.4% (95% CI 18.1%‐20.6%). Most IOLs involved obstetric indications. CB rates did not differ by IOL versus inclusive EM when performed between 37 and 40 weeks, though post hoc power calculations indicate these comparisons were low‐powered. In multivarable models, IOL in the 40th week was associated with lower odds for CB versus exclusive EM definition (ie, births occurring at 41 0/7 weeks or later, OR (95% CI) = 0.57 (0.36‐0.90)). This finding is explained by the large increase in CB rates after IOL during the 41st week (34.3%, up from 21.9% in the 40th week). Furthermore, the adjusted odds for CB in the 41st week were 55% higher relative to inclusive EM (all labors 41st week and later), OR (95% CI) = 1.55(1.11‐2.15). Neonatal outcomes (aside from macrosomia) did not differ by IOL/EM at any gestational age.DiscussionOutcomes for nulliparous individuals having IOL or EM in the context of a midwifery model of care include low overall use of CB and low frequency of IOL before 41 weeks. In this model, IOL in the 40th week may lower CB odds, especially in comparison to those who do not have spontaneous labor and later undergo an IOL in the 41st week.
What tactical repertoire to use in strikes and when to use it? Strategies of workers and their mobilization power in Chile (2010–2018)
Authors: Velásquez Orellana Diego , Pérez Domingo , Link Sebastián 
Published: May 2021

AbstractThis research analyses workers’ mobilization power in Chile through the joint‐cost model, suggesting that wider tactical repertoires, and especially transgressive ones, tend to result in shorter strikes, as a proxy of relative success against the employers. Using the Labor Strike Observatory's original dataset, we study this relation in the Chilean case, where neoliberalism has weakened unions and constrained the occurrence of strikes at the workplace level. We advanced two quantitative methods of analysis. First, using latent class analysis, we identify the tactical repertoires used by strikers. Second, following an event history methodology, we estimate the contribution of each repertoire to the risk of ending the strike. This paper analyses the strategies and milestones of strikers’ actions, shows the greater power of violent tactics compared to peaceful ones at the beginning of the conflict and finally discusses some limitations of the joint‐cost model in the capital–labour relation.
Surgical outcomes and proposal for a treatment algorithm for urethral strictures in transgender men
Authors: de Rooij Freek P. W. , Peters Femke R. M. , Ronkes Brechje L. , van der Sluis Wouter B. , Al‐Tamimi Muhammed , van Moorselaar R. Jeroen A. , Bouman Mark‐Bram , Pigot Garry L. S. 
Published: May 2021

ObjectivesTo assess our results of surgical treatment for urethral strictures in transgender men, and to provide a surgical treatment algorithm.Patients and methodsA single centre, retrospective cohort study was conducted of transgender men who underwent surgical correction of their urethral stricture(s) between January 2013 and March 2020. The medical charts of 72 transgender men with 147 urethral strictures were reviewed. The primary outcomes were the success and recurrence rates after surgical treatment for urethral strictures.ResultsThe median (interquartile range [IQR]) follow‐up was 61 (25–202) months. At last follow‐up, 50/72 (69%) were able to void while standing (after one [60%], two [20%], three [6%], four [8%], five [4%], or seven [2%] procedures), 10/72 (14%) await further treatment, two of the 72 (3%) sat to void despite good urodynamic function, and 10/72 (14%) had a definitive urethrostomy. Of 104 surgical treatments included in separate success rate analysis, 65 (63%) were successful (43/75 [57%] after phalloplasty, 22/29 [76%] after metoidioplasty). The highest success rates in short urethral strictures were seen after a Heineke‐Mikulicz procedure (six of seven cases), and in longer or more complicated urethral strictures after two‐stage with graft (four of six), two‐stage without graft (10/12), pedicled flap (11/15, 73%), and single‐stage graft (seven of seven) urethroplasties. Grafts used were buccal mucosa or full‐thickness skin grafts. Success rates improved over time, with success rates of 38% and 36% in 2013 and 2014, to 71% and 73% in 2018 and 2019, respectively. We concluded with a surgical treatment algorithm based on previous literature, stricture characteristics, and our surgical outcomes.ConclusionThe highest success rates were seen after a Heineke‐Mikulicz procedure in short urethral strictures; and after graft, pedicled flap, or two‐stage urethroplasties in longer or more complicated urethral strictures. Finally, most of the transgender men were able to void while standing, although in some multiple surgical procedures were necessary to accomplish this.
Alleviating carbohydrate counting with a FiASP‐plus‐pramlintide closed‐loop delivery system (artificial pancreas): Feasibility and pilot studies
Authors: Tsoukas Michael A. , Cohen Elisa , Legault Laurent , von Oettingen Julia E. , Yale Jean‐François , Vallis Michael , Odabassian Madison , El Fathi Anas , Rutkowski Joanna , Jafar Adnan , Ghanbari Milad , Gouchie‐Provencher Nikita , René Jennifer , Palisaitis Emilie , Haidar Ahmad 
Published: May 2021

AbstractAimTo assess whether a FiASP‐and‐pramlintide closed‐loop system has the potential to replace carbohydrate counting with a simple meal announcement (SMA) strategy (meal priming bolus without carbohydrate counting) without degrading glycaemic control compared with a FiASP closed‐loop system.Materials and MethodsWe conducted a 24‐hour feasibility study comparing a FiASP system with full carbohydrate counting (FCC) with a FiASP‐and‐pramlintide system with SMA. We conducted a subsequent 12‐day outpatient pilot study comparing a FiASP‐and‐placebo system with FCC, a FiASP‐and‐pramlintide system with SMA, and a FiASP‐and‐placebo system with SMA. Basal‐bolus FiASP‐and‐pramlintide were delivered at a fixed ratio (1 U:10 μg). Glycaemic outcomes were measured, surveys evaluated gastrointestinal symptoms and diabetes distress, and participant interviews helped establish a preliminary coding framework to assess user experience.ResultsSeven participants were included in the feasibility analysis. Time spent in 3.9‐10 mmol/L was similar between both interventions (81%‐84%). Four participants were included in the pilot analysis. Time spent in 3.9‐10 mmol/L was similar between the FiASP‐and‐placebo with FCC and FiASP‐and‐pramlintide with SMA interventions (70%), but was lower in the FiASP‐and‐placebo with SMA intervention (60%). Time less than 3.9 mmol/L and gastrointestinal symptoms were similar across all interventions. Emotional distress was moderate at baseline, after the FiASP‐and‐placebo with FCC and SMA interventions, and fell after the FiASP‐and‐pramlintide with SMA intervention. SMA reportedly afforded participants flexibility and reduced mealtime concerns.ConclusionsThe FiASP‐and‐pramlintide system has the potential to substitute carbohydrate counting with SMA without degrading glucose control.
Comparative efficacy of glucose‐lowering medications on body weight and blood pressure in patients with type 2 diabetes: A systematic review and network meta‐analysis
Authors: Tsapas Apostolos , Karagiannis Thomas , Kakotrichi Panagiota , Avgerinos Ioannis , Mantsiou Chrysanthi , Tousinas Georgios , Manolopoulos Apostolos , Liakos Aris , Malandris Konstantinos , Matthews David R. , Bekiari Eleni 
Published: May 2021

AbstractAimTo compare the effects of glucose‐lowering drugs on body weight and blood pressure in adults with type 2 diabetes.MethodsWe searched Medline, Embase, the Cochrane Library, and grey literature sources until 29 September 2020 for randomized controlled trials of at least 24 weeks' duration assessing the effects of glucose‐lowering drugs on body weight and blood pressure in adults with type 2 diabetes. We performed frequentist network meta‐analyses and calculated weighted mean differences and 95% confidence intervals combining trial arms of different approved doses of a given intervention into a single group. We evaluated the confidence in pooled estimates using the CINeMA (Confidence In Network Meta‐Analysis) framework.ResultsIn total, 424 trials (276 336 patients) assessing 21 antidiabetic medications from nine drug classes were included. Subcutaneous semaglutide was the most efficacious in reducing body weight followed by oral semaglutide, exenatide twice‐daily, liraglutide, and the sodium‐glucose co‐transporter‐2 (SGLT‐2) inhibitors empagliflozin, canagliflozin, dapagliflozin and ertugliflozin. The same agents also conferred the greatest reductions in systolic blood pressure. Metformin had a modest effect in reducing body weight and systolic blood pressure. Diastolic blood pressure was reduced with the SGLT‐2 inhibitors pioglitazone, exenatide twice‐daily and semaglutide. In subgroup analyses of trials with over 52 weeks' duration, semaglutide and SGLT‐2 inhibitors reduced both body weight and systolic blood pressure.ConclusionsSemaglutide and SGLT‐2 inhibitors conferred reductions both in body weight and blood pressure that were sustainable for over 1 year of treatment. These agents may be preferable treatment options for patients with type 2 diabetes who are overweight/obese and/or hypertensive.
Deep learning‐based scheme to diagnose Parkinson's disease
Authors: Vyas Tarjni , Yadav Raj , Solanki Chitra , Darji Rutvi , Desai Shivani , Tanwar Sudeep 
Published: May 2021

AbstractParkinson's disease (PD) is a neurological disorder of the central nervous system that causes difficulty in movement, often including tremors and rigidity. Early detection of PD can prevent symptoms up to a certain age and increase life expectancy. For this purpose, we have used brain images from magnetic resonance imaging (MRI) technique. A deeper level of feature detection in MRI can identify biomarkers that can be used to know how the disease spreads, leading to a cure in the future. With these motives, we have presented two novel approaches using deep learning (DL) techniques. 2D and 3D convolution neural networks (CNN) are used, which are trained on MRI scans in the axial plane. The dataset was constructed using images from Parkinson's progression markers initiative (PPMI). The four pre‐processing techniques used in this article are bias field correction, histogram matching, Z‐score normalization, and image resizing. Pre‐processing techniques were essential inaccurate training models. Every class prediction done by the model would have taken multiple features into account across multiple layers of the brain and not relied on a single or few important features, making DL a powerful concept. A total of 318 MRI scans were used to train and test a 2D CNN and a 3D CNN model. We have compared the models' results using different evaluation parameters such as accuracy, loss, confusion matrix, receiver operating characteristic (ROC) curve, and precision‐recall (PR) curve. The 3D model learned key features from the data and was able to classify the test data with 88.9% accuracy with 0.86 area under curve (AUC). In contrast, the 2D model achieved a mediocre accuracy of 72.22% with 0.50 AUC. This shows that the 3D model is more accurate and reliable than the 2D model.
The effect of a toothpaste containing oleanolic acid in reducing plaque and gingivitis: a proof‐of‐concept randomized trial
Authors: Ramírez Gloria M. , Villar Cristina Cunha , Saraiva Luciana , Benítez Carlos G. , Rubio Carlos M. , Malheiros Zilson Magalhães , Stewart Bernal , Kilpatrick LaTonya , Romito Giuseppe A. 
Published: May 2021

AbstractObjectivesTo assess the safety and efficacy of an oleanolic acid (OA)‐containing toothpaste in reducing gingival inflammation and plaque in patients with gingivitis.MethodsThis proof‐of‐concept parallel, double‐blind, randomized controlled clinical trial included 99 patients. Following a 1‐week washout, patients were randomized into three groups: OA group (fluoride toothpaste containing 0.1% OA and placebo mouthwash); negative control (fluoride toothpaste and placebo mouthwash); and CHX group (fluoride toothpaste and 0.12% chlorhexidine mouthwash). Patients were clinically assessed at inclusion, pre‐washout visit, baseline and after 4 days, 1 week and 2 weeks of twice‐daily use of the products. Patients received a diary for documentation of bleeding on brushing and provided unstimulated saliva samples.ResultsAfter two weeks, all groups showed significant reductions in all clinical parameters. The CHX group exhibited significantly greater reductions in gingival index and interproximal gingival index scores at week 2, as compared to patients in the negative control (p = 0.04). In contrast, reductions in gingival index scores did not differ between CHX and OA groups and between OA and negative control groups at week 2. The CHX group had significantly greater reductions in plaque index scores at day‐4, 1‐week and 2‐week evaluations, as compared to the negative control and OA groups. The frequency of adverse events was similar among the groups. None of the groups reduced salivary transferrin levels. Finally, the OA group had the lowest percentage of self‐reported bleeding events.ConclusionOA toothpaste failed to provide antiplaque and antigingivitis effects superior to those of a fluoride toothpaste after 2 weeks of use.
Dosimetry of pulsed magnetic field towards attaining bacteriostatic effect on Enterococcus faecalis: Implications for endodontic therapy
Authors: Naskar Sharmistha , Chandan  , Baskaran Divya , Roy Choudhury Aditya N. , Chatterjee Subhomoy , Karunakaran Subbaraj , Murthy B.V. Sreenivasa , Basu Bikramjit 
Published: May 2021

AbstractAimTo examine in a laboratory setting the efficacy of moderate to high strength magnetic fields, as a potential bacteriostatic stimulus, against Enterococcus faecalis, one of the causative agents for infection during root canal treatments.MethodologyFour different strengths (1, 2, 3 and 4 T) of the pulsed magnetic field (PMF) were applied in thirty repetitions to bacterial suspension. A pickup coil setup was used to measure the electromotive force induced inside the bacterial suspensions. The optical density (OD) was monitored over time (for 16 h 40 min) during the post‐treatment period to assess bacterial growth. Along with the change in OD values, live/dead assay, membrane depolarization study, atomic force microscopy (AFM), scanning electron microscopy (SEM) and reactive oxygen species (ROS) assay on selected samples were studied to evaluate the effect of PMFs. All results were analysed using one‐way ANOVA followed by post hoc Tukey test and considered significant at p < .05. Regression analysis (at a confidence of 95%, α = 0.05) was performed on the bacterial growth and membrane depolarization studies to determine progressive changes of the outcomes.ResultsThe peak value of the induced electromotive force was recorded as 0.25 V, for the 4 T magnetic field pulse with a pulse width of 16 ms. There was a significant arrest of bacterial cell growth after an exposure to PMFs of 1 T, 3 T and 4 T (ANOVA score: F (4, 495) =395.180 at p = .05). The image‐based qualitative results of the live/dead assay using fluorescence microscopy techniques indicated that an exposure to higher PMFs (3 T/ 4 T) induced a bacteriostatic effect in a longer post‐exposure timescale. Evidence of altered membrane potential within the 2 h of exposure to 4 T PMF was supported by the incidence of elevated ROS. For the ROS assay, a significant difference occurred for 4 T exposed samples (ANOVA score: calculated F (1, 3) =20.2749 at p = .05). SEM and AFM observations corroborated with the outcomes, by portraying significant membrane damage.ConclusionIn a laboratory setting, PMFs with higher magnitudes (3 T and 4 T) were capable of inducing bacteriostatic effects on E. faecalis.
Prevalence and antimicrobial resistance profile of Staphylococcus aureus in inherited epidermolysis bullosa: a cross‐sectional multicenter study in Brazil
Authors: Santin Juliana T. , Mariath Luiza M. , Rossato Adriana M. , Schuler‐Faccini Lavínia , Kiszewski Ana E. 
Published: May 2021

AbstractBackgroundInfection is an important complication of epidermolysis bullosa (EB), and Staphylococcus aureus has been pointed out as the most common pathogen among this population. The objective of this study was to investigate the prevalence and antimicrobial resistance profile of S. aureus colonizing EB patients in Brazil.MethodsThis cross‐sectional multicenter study was conducted between December 2015 and December 2017. We included a total of 89 individuals with EB from medical centers across Brazil. Data were obtained through clinical and bacteriological investigation. S. aureus were identified by biochemical tests. The nuc and mecA genes were confirmed by PCR assay. Antimicrobial susceptibility was investigated by disk diffusion method.ResultsThe overall prevalence of S. aureus was 51.7% (46/89). Methicillin‐resistant S. aureus (MRSA) was detected in 24.7% (19/77) of all S. aureus isolates, colonizing 15.7% (14/89) of all patients. Community‐associated (CA)‐MRSA strains were resistant against sulfamethoxazole/trimethoprim and levofloxacin (P < 0.05%). S. aureus colonization of the nares and belly button represented a 3.4 times higher risk of simultaneous skin lesion colonization (P < 0.05%).ConclusionsThe high frequency of MRSA colonizing patients with EB is alarming considering its association with life‐threatening complications and poorer outcomes. EB patients are at increased risk of colonization and infection by Staphylococcus aureus and CA‐MRSA. Getting to know S. aureus carriage sites and its antimicrobial susceptibility profile is key when planning new individualized and more effective prophylactic and therapeutic measures.
Demographics, clinical characteristics and outcomes among 197 patients with COVID‐19 in the Gold Coast area
Authors: Je David , O'Brolchain Aongus , Ulett Kimberly B. , Zainudheen Amith , Gerrard John , Alcorn Kylie , Memon Salim 
Published: May 2021

AbstractBackgroundClinical characteristics and outcomes of coronavirus disease 2019 (COVID‐19) patients have been varied internationally but have not been studied in an Australian cohort.AimTo describe characteristics and outcomes of approximately the first 200 documented COVID‐19 cases during the first outbreak in the Gold Coast.MethodsRetrospective observational cohort study of COVID‐19 patients managed by Gold Coast Hospital and Health Service (GCHHS). Demographics, clinical characteristics and outcomes data were collected.ResultsOne hundred and ninety‐seven patients were included (mean age 45 years); 52.3% were female and 9.1% were healthcare workers. Most were overseas travellers (53.8%), contacts of a local confirmed case (25.4%) or cruise ship passengers (17.3%). The commonest comorbidities were hypertension (14.2%) and asthma (11.2%). The commonest symptoms were cough (74.1%), fever (58.9%), sore throat (48.7%), headache (48.7%) and rhinorrhoea (46.2%). Sixty‐three patients were hospitalised and the rest admitted to a ‘virtual ward’. Of 63 hospitalised patients, 5 (7.9%) required intensive care unit (ICU) admission and 3 (4.8%) required intubation. No patients died. Due to low numbers of accurate exposure dates, the incubation period could not be reliably calculated for a significant proportion of the cohort. Average duration of symptoms was 14 days, time from first symptom to hospitalisation was 5.3 days and time from first symptom to ICU admission was 11.6 days. The majority (88%) experienced mild disease and achieved complete symptom resolution (97%). Nasopharyngeal swab polymerase chain reaction was the main diagnostic method (99%). Twenty‐four patients received anti‐viral pharmacotherapy, with 87.5% getting hydroxychloroquine.ConclusionsThe present study provides characteristics and outcomes of the first 197 patients with COVID‐19 in the Gold Coast.
Nurses’ perceptions on and experiences in conflict situations when caring for adolescents with anorexia nervosa: A qualitative study
Authors: Wu Wan‐Ling , Chen Shu‐Ling 
Published: May 2021

AbstractAnorexia nervosa (AN), which primarily affects adolescent girls and young women, is characterized by excessive dieting, leading to severe weight loss and a pathological fear of becoming overweight, or unhealthy behaviours that hinder weight gain. Caring for patients who have AN is particularly challenging for nursing staff, who are on the front line and have the closest contact with patients. However, little is known about how nursing staff care for adolescent patients with AN in Taiwan. This study aimed to explore nurses’ perceptions on and experiences in conflict situations in caring for adolescents with AN. A qualitative study approach was conducted. Through semi‐structured interviews, ten nursing staff from the paediatric ward at a university‐affiliated medical centre in central Taiwan shared their experiences. Recorded interviews were transcribed and analysed by content analysis. This analysis identified three themes with eight subthemes: (i) struggling to develop therapeutic relationships, (ii) selective focusing, and (iii) difficulty changing minds. The findings of this study indicated a need for ongoing support for nursing staff, the development of therapeutic relationships with adolescent patients with AN, extensive nursing staff preparation, and the development of in‐service training programs to enable nursing staff to care for these patients with greater understanding.