bluuebunny/crossref_metadata_2025_split huggingface dataset:
Last Resort or Best Interest? Exploring the Risk and Safety Factors That Inform the Rates of Relocation for Young People Abused in Extra-Familial Settings
Authors: Firmin Carlene , Wroe Lauren , Bernard D 
Published: May 2021

Abstract
When young people are harmed in extra-familial settings children’s services may place them into care at a distance from their home authority to remove them from contexts in which they are considered ‘at risk’. Guidance and regulation suggest such intervention be used as a last resort and only in a child’s best interests. Using survey and interview data, this article examines how relocations are used in response to extra-familial harm (EFH) in thirteen children’s services departments inEngland and Wales—exploring the extent to which they are intended to mitigate risk, or build safety, for young people. Findings demonstrate that rates at which relocations were used varied across participating services. Interview data suggest that variation may be informed by the strategic position a service takes on the use of relocation, the goal(s) of interventions used in cases of EFH, and the target of these interventions. In considering each of these factors, the authors recommend further study into the national (varying) rates of relocation and the role of those who review care plans for relocated young people; both intending to create conditions in which young people can safely return to their communities should they choose to do so.
Automatic Diagnosis of Diabetic Retinopathy from Retinal Abnormalities: Improved Jaya-Based Feature Selection and Recurrent Neural Network
Authors: Ravala Lavanya , G K Rajini 
Published: May 2021

Abstract
Accurate diagnosis of lesions bears the highest significance in the early detection of diabetic retinopathy (DR). In this paper, the combination of intelligent methods is developed for segmenting the abnormalities like ‘hard exudates, hemorrhages, microaneurysm and soft exudates’ to detect the DR. The proposed model involves seven main steps: (a) image pre-processing, (b) optic disk removal (c) blood vessel removal, (d) segmentation of abnormalities, (e) feature extraction, (f) optimal feature selection and (f) classification. The pre-processing of the input retinal fundus image is performed by two operations like contrast enhancement by histogram equalization and filtering by average filtering. For the segmentation of abnormalities, the same Circular Hough Transform followed by Top-hat filtering and Gabor filtering is used. Next, the entropy-scale-invariant feature transform (SIFT), grey level co-occurrence matrices and color morphological features are extracted in feature extraction. The optimally selected features are subjected to the classification part, which uses a modified deep learning algorithm called optimized recurrent neural network (RNN). As the main novelty, the optimal feature selection and optimized RNN depends on an improved meta-heuristic algorithm called fitness oriented improved Jaya algorithm. Hence, the beneficial part of the optimization algorithm improves the feature selection and classification.
Senescence mechanisms and targets in the heart
Authors: Chen Maggie S , Lee Richard T , Garbern Jessica C 
Published: May 2021

Abstract
Cellular senescence is a state of irreversible cell cycle arrest associated with ageing. Senescence of different cardiac cell types can direct the pathophysiology of cardiovascular diseases (CVDs) such as atherosclerosis, myocardial infarction, and cardiac fibrosis. While age-related telomere shortening represents a major cause of replicative senescence, the senescent state can also be induced by oxidative stress, metabolic dysfunction, and epigenetic regulation, among other stressors. It is critical that we understand the molecular pathways that lead to cellular senescence and the consequences of cellular senescence in order to develop new therapeutic approaches to treat CVD. In this review, we discuss molecular mechanisms of cellular senescence, explore how cellular senescence of different cardiac cell types (including cardiomyocytes, cardiac endothelial cells, cardiac fibroblasts, vascular smooth muscle cells, and valve interstitial cells) can lead to CVD, and highlight potential therapeutic approaches that target molecular mechanisms of cellular senescence to prevent or treat CVD.
Update on management of hypokalaemia and goals for the lower potassium level in patients with cardiovascular disease: a review in collaboration with the European Society of Cardiology Working Group on Cardiovascular Pharmacotherapy
Authors: Krogager Maria Lukács , Kragholm Kristian , Thomassen Jesper Qvist , Søgaard Peter , Lewis Basil S , Wassmann Sven , Baumgartner Iris , Ceconi Claudio , Schmidt Thomas Andersen , Kaski Juan Carlos , Drexel Heinz , Semb Anne Grete , Agewall Stefan , Niessner Alexander , Savarese Gianluigi , Kjeldsen Keld Per , Borghi Claudio , Tamargo Juan , Torp-Pedersen Christian 
Published: May 2021

AbstractHypokalaemia is common in patients with cardiovascular disease. In this review, we emphasize the importance of tight potassium regulation in patients with cardiovascular disease based on findings from observational studies. To enhance the understanding, we also describe the mechanisms of potassium homeostasis maintenance, the most common causes of hypokalaemia and present strategies for monitoring and management of low potassium levels. We propose elevation of potassium in asymptomatic patients with lower normal concentrations and concurrent cardiovascular disease. These proposals are intended to assist clinicians until more evidence is available.
The long-term development of temperate woodland creation sites: from tree saplings to mature woodlands
Authors: Fuentes-Montemayor Elisa , Park Kirsty J , Cordts Kypfer , Watts Kevin 
Published: May 2021

Abstract
Tree planting is at the forefront of the current environmental agenda to mitigate climate change and tackle the biodiversity crisis. In the United Kingdom (UK), tree planting has been a priority for more than a century and has helped increase woodland cover from a historic low of 5 per cent at the beginning of the 20th century to a current figure of 13 per cent. However, we still know relatively little about the long-term development of woodland creation sites (particularly of native woodlands) over ecologically realistic timescales. We surveyed a chronosequence of 133 temperate woodland patches encompassing 106 woodland creation sites (10–160 years old) and 27 mature ‘ancient’ woodlands (&gt;250 years old), using a combination of field surveys and remote sensing techniques to quantify vegetation structural changes associated with woodland development. Woodland creation sites displayed similar vegetation development patterns to those described for other woodland systems, i.e. a gradual transition as woodlands undergo ‘stand initiation’, ‘stem exclusion’ and ‘understorey re-initiation’ stages, and became more similar to ‘ancient’ woodlands over time. Structural heterogeneity, average tree size and tree density were the attributes that varied the most among woodland developmental stages. In general, structural heterogeneity and average tree size increased with woodland age, whilst tree density decreased as would be expected. Younger sites in stand initiation were strongly dominated by short vegetation, stem exclusion sites by taller trees and older sites had a more even vegetation height distribution. There was a large degree of overlap between the vegetation characteristics of woodlands in understorey re-initiation stages and older ancient woodlands (partly driven by a lack of regeneration in the understorey); these results suggest that it takes between 80 and 160 years for woodland creation sites to develop certain vegetation attributes similar to those of mature ancient woodlands included in this study. Woodland management practices to create canopy gaps and reducing grazing/browsing pressure to promote natural regeneration are likely to accelerate this transition, increase the structural heterogeneity and biodiversity value of woodland creation sites and enable adaptation and resilience to climate change.
Perimortem Distribution of U-47700, Tramadol and Their Main Metabolites in Pigs Following Intravenous Administration
Authors: Nordmeier Frederike , Doerr Adrian A , Potente Stefan , Walle Nadja , Laschke Matthias W , Menger Michael D , Schmidt Peter H , Meyer Markus R , Schaefer Nadine 
Published: May 2021

Abstract
In spite of a decreasing number of new releases, new synthetic opioids (NSOs) are gaining increasing importance in postmortem (PM) forensic toxicology. For the interpretation of analytical results, toxicokinetic (TK) data, e.g., on tissue distribution, are helpful. Concerning NSOs, such data are usually not available due to the lack of controlled human studies. Hence, a controlled TK study using pigs was carried out, and the tissue distribution of U-47700 and tramadol as reference was examined. Twelve pigs received an intravenous dose of 100 µg/kg body weight (BW) U-47700 or 1,000 µg/kg BW tramadol. Eight hours after administration, the animals were put to death with T61. Relevant organs, body fluids and tissues were sampled. After homogenization and solid-phase extraction, quantification was performed applying standard addition and liquid chromatography--tandem mass spectrometry. At the time of death, the two parent compounds were determined in all analyzed specimens. Regarding U-47700, concentrations were highest in duodenum content, bile fluid and adipose tissue (AT). Concerning tramadol, next to bile fluid and duodenum content, highest concentrations were determined in the lung. Regarding the metabolites, N-desmethyl-U-47700 and O-desmethyltramadol (ODT) were detected in all analyzed specimens except for AT (ODT). Higher metabolite concentrations were found in specimens involved in metabolism. N-desmethyl-U-47700 showed much higher concentrations in routinely analyzed organs (lung, liver and kidney) than U-47700. To conclude, besides the routinely analyzed specimens in PM toxicology such as blood, urine or standard specimens like kidney or liver, AT, bile fluid and duodenum content could serve as alternative matrices. In case of U-47700, quantification of the main metabolite N-desmethyl-U-47700 is highly recommendable.
Association ofCYP4G19Expression With Gel Bait Performance in Pyrethroid-Resistant German Cockroaches (Blattodea: Ectobiidae) From Taiwan
Authors: Hu I-Hsuan , Tzeng Hau-You , Chen Mei-Er , Lee Chow-Yang , Neoh Kok-Boon 
Published: May 2021

AbstractOverexpression of a cytochrome P450 gene, CYP4G19, is known to associate with pyrethroid resistance in the German cockroach, Blattella germanica (L.) (Blattodea: Ectobiidae). In this study, we investigated the CYP4G19 expression level in 20 field-collected strains of B. germanica in Taiwan. We also examined the level of adult male susceptibility to imidacloprid, fipronil, indoxacarb, and hydramethylnon using single-diagnostic dose bioassays and their susceptibility to corresponding gel baits to determine how the CYP4G19 expression level influences the cockroach gel bait performance. Results showed that the CYP4G19 gene expression level among the field-collected German cockroach was 1.8- to 9.7-fold higher than that of the susceptible strain. It was negatively correlated (P &lt; 0.05) with the % mortality after treatments with imidacloprid and fipronil diagnostic doses. However, no correlation was found between CYP4G19 gene expression with the % mortality after treatment with indoxacarb and hydramethylnon diagnostic doses. Indoxacarb and hydramethylnon baits showed high efficacy against the field strains with a mean mortality of 97.58 ± 1.35% and 90.95 ±1.65%, respectively. This study provided the first evidence of cross-resistance to imidacloprid and fipronil in pyrethroid-resistant German cockroaches due to overexpression of CYP4G19.
Host-Seeking Behavior ofAphidius gifuensis(Hymenoptera: Braconidae) Modulated by Chemical Cues Within a Tritrophic Context
Authors: Song Yunzhe , Liu Changming , Cai Pumo , Chen Weibin , Guo Yaqing , Lin Jia , Zhang Shufang 
Published: May 2021

AbstractAphidius gifuensis Ashmaed is a generalist endoparasitoid that parasitizes a variety of aphid species. In China, it is widely used as a biological control agent to protect vegetables and tobaccos in open fields; control efficiency is largely dependent on its host-seeking ability. In this study, a six-choice olfactometer was used to investigate the olfactory responses of A. gifuensis to tobacco plants that had suffered damage (either varying degrees of mechanical damage or from aphid-feeding at different time intervals) and tobacco volatiles with different dosages. Furthermore, the regularity of A. gifuensis females’ response toward an aphid/tobacco complex was monitored using a Y-tube olfactometer. Our findings suggest that tobacco plants are significantly attractive to A. gifuensis after they have been punctured with 50 holes, or housed with Myzus persicae (Sulzer) at a density of 400 aphids, except at an infestation time of 12 h. Moreover, aphid density had a more significant effect on the response than the time interval since aphid application. Aphidius gifuensis was found to be active during the daytime and preferred to search for their aphid hosts at 14:00 h. Five EAG-active tobacco volatiles (trans-2-hexenal, methyl salicylate, benzaldehyde, cis-3-hexen-1-ol, and 1-hexanal) were found to significantly attract A. gifuensis females at different concentration ranges. The practical implications of these results are discussed in the framework of the sustainable biological control of pest aphids in agricultural production systems.
Bronchogenic cyst of the floor of mouth combined with ankyloglossia: an extremely rare presentation of rare anomaly
Authors: Wongprakob Nuttadon , Sae-Guay Suthida , Burusapat Chairat , Wongchansom Kittisak , Wanichjaroen Nutthapong 
Published: May 2021

Abstract
Bronchogenic cyst (BC), cyst lined by respiratory epithelium, is uncommon congenital anomaly of bronchial tree. Intraoral BC is extremely rare lesions. Here, we report the unusual presentation of 2-year-old boy with symptomatic cystic lesion at floor of month combined with ankyloglossia. The operation was performed under general anesthesia. Frenotomy was performed. Complete cystic removal was successful with minimal leakage of cyst wall. Sclerosing agent was injected at surgical site to prevent the residual undetected cystic malformation. Pathological examination was demonstrated a unicystic lesion lined by ciliated pseudostratified columnar and cuboidal cells. The final diagnosis was bronchogenic cyst. No postoperative complication was found. The long-term course was uneventful with no signs of recurrence at 1 year. To our best knowledge, a rare example of BC at the floor of mouth combined with ankyloglossia has never been reported.
Sandpaper Sensation in the Shoulder
Authors: Cuevas-Trisan Ramon 
Published: May 2021

Abstract
The evaluation of patients with shoulder pain should follow a systematic approach, initially separating extrinsic (referred pain) and intrinsic (pain from the shoulder girdle structures) causes, followed by evaluation of glenohumeral versus extraglenohumeral causes of pain. Shoulder (glenohumeral) osteoarthritis is not an uncommon cause of intrinsic shoulder pain, with a prevalence that is higher in Caucasians, predominantly affecting males older than age 45 years and females older than age 55 years, as well as overweight and inactive individuals. Evaluation of shoulder pain in the setting of an acute traumatic shoulder injury usually requires imaging studies, whereas imaging requirements in nontraumatic cases should be carefully guided by the patient’s history and examination findings. Management of shoulder osteoarthritis should follow a stepwise approach, from conservative to minimally invasive and, last, surgical.
A Softball Weekend Warrior’s Nightmare
Authors: Martinez-Silvestrini Julio A. 
Published: May 2021

Abstract
Shoulder impingement syndrome is the most common condition causing shoulder pain, occurring in 44–65% of patients who complain of shoulder pain. Subacromial bursitis, rotator cuff tendinopathy, biceps tendinopathy, calcific tendinosis, and rotator cuff tears are specific problems that may be seen in patients with this syndrome. Other painful shoulder conditions, such as adhesive capsulitis and osteoarthritis, are commonly confused with impingement. Adequate history and examination help distinguish these entities, yet in some cases imaging studies are required. Simple analgesics and physical therapy are very effective for managing this condition. Injections or surgical care should be considered when patients have tried and failed conservative management.
Very Bothersome Ballooning Arm
Authors: Motta-Valencia Keryl , Correa-Mendoza Ady M. 
Published: May 2021

Abstract
Primary and secondary lymphedema are plausible, albeit rare, etiologies of upper limb pain and dysfunction. This chapter summarizes the clinical comprehensive assessment, which supported by laboratory and imaging tests can validate significant clinical parameters to define the lymphedema stages and facilitate therapeutic decisions. Clinical criteria for considering nonsurgical and surgical care are presented, as are considerations for preventive and lifestyle management to be implemented throughout all lymphedema stages. Identifying and managing the risk factors can impact patient outcomes of pain, quality of life, psychological health, disability, and socioeconomic sequelae. The comprehensive assessment of lymphedema is complex. It entails careful clinical examination, testing with labs/imaging, and surveying for psychological health and quality of life.
Fetal Physiology and Antepartum Fetal Surveillance
Authors: Streiff Agathe , Spitzer Yelena 
Published: May 2021

Abstract
Fetal surveillance is an integral part of prenatal care, especially in the last trimester. In order to understand antepartum fetal surveillance modalities, clinicians must be familiar with fetal physiology. This chapter will describe fetal cardiac physiology, which is primarily monitored. The authors will also describe fetal respiratory physiology and neurologic function to understand the impact of fetal distress, which may result in lifelong sequelae. In the subsequent sections, antepartum fetal surveillance technology is described, including nonstress tests, the biophysical profile, and umbilical artery Doppler velocimetry. The indications and limitations of these studies will be described. The purpose of this chapter is to educate clinicians on the roles of these modalities and the assessment they offer.
Pharmacology and Non-anesthetic Drugs During Pregnancy and Lactation
Authors: Wendling Adam L. 
Published: May 2021

Abstract
Medication use during pregnancy and lactation is very common yet understudied. There is a long history of medication use in pregnancy and lactation, although the dangers involved, including loss of the pregnancy and birth defects, have not always been well understood. In addition to concerns regarding teratogenicity, the physiologic changes of pregnancy can dramatically alter the pharmacokinetics of various medications. There can be clear indications for the use of medications during pregnancy and lactation, as untreated disease may have serious adverse outcomes for both the mother and baby. Specific medications have their own risks and benefits but, ultimately, the risk of untreated disease must be weighed against the potential risk of medication exposure during pregnancy and/or lactation.
Opioid Analgesia
Authors: Izadpanah Najmeh , Lee Seung , Gattu Kanchana , Watterworth Blake 
Published: May 2021

Abstract
This chapter focuses on the different systemic opioids that can be used during labor, including the side effects of each, advantages and disadvantages of using one agent over another, and routes of administration for each particular agent. Analgesia during labor can be administered via several routes. Neuraxial analgesia remains the most commonly employed technique for pain management during labor primarily due to its lower maternal and fetal systemic effects. There are circumstances, however, that prevent the use of neuraxial analgesia for labor pain including contraindications to neuraxial analgesia, unavailability of neuraxial analgesia, unsuccessful placement of neuraxial analgesia, or simply patient refusal. Nonpharmacologic and nonopioid alternatives exist, yet systemic opioids remain the most widely used non-neuraxial analgesia technique in the world. Advantages to using systemic opioids include ease of administration, lower cost, and lack of specialized equipment or personnel. Disadvantages include the inability to provide adequate or predictable analgesia; nausea, vomiting, pruritus; maternal and fetal respiratory depression; and decreased fetal heart rate variability and movement due to the ability of systemic opioids to cross the placenta. Several different systemic opioids can be used during labor including meperidine, morphine, fentanyl, alfentanil, remifentanil, codeine, and tramadol. Mixed agonist-antagonist agents like nalbuphine and butorphanol can also be used. The chapter also reviews the treatment of labor pain in opioid-tolerant parturients. Choice of labor analgesia is one that is individualized to patient-specific risks, goals, and comorbidities and is a choice that should be made by joint decision making between the parturient, obstetrician, and anesthesiologist.
General Anesthesia for Cesarean Delivery
Authors: Straube Lacey E. 
Published: May 2021

Abstract
“General anesthesia for cesarean delivery” examines the pertinent perioperative anesthetic concerns in the parturient, focusing specifically on techniques to keep both the mother and neonate safe. It touches on the unique physiology and anatomic changes of the parturient that impact anesthetic care. This chapter explores the implications of medications and anesthetic technique on uterine tone, placental transfer, fetal well-being, and breastfeeding. It also reviews prevention and treatment of many of the major risks of general anesthesia for cesarean delivery, including supine hypotension, aspiration, difficult airway, intraoperative awareness, postoperative pain, and uterine atony with subsequent hemorrhage.
Neuroscience for Clinicians
Authors: Benarroch Eduardo E. 
Published: May 2021

Abstract
The aim of this book is to provide the clinician with a comprehensive and clinical relevant survey of emerging concepts on the organization and function of the nervous system and neurologic disease mechanisms, at the molecular, cellular, and system levels. The content of is based on the review of information obtained from recent advances in genetic, molecular, and cell biology techniques; electrophysiological recordings; brain mapping; and mouse models, emphasizing the clinical and possible therapeutic implications. Many chapters of this book contain information that will be relevant not only to clinical neurologists but also to psychiatrists and physical therapists. The scope includes the mechanisms and abnormalities of DNA/RNA metabolism, proteostasis, vesicular biogenesis, and axonal transport and mechanisms of neurodegeneration; the role of the mitochondria in cell function and death mechanisms; ion channels, neurotransmission and mechanisms of channelopathies and synaptopathies; the functions of astrocytes, oligodendrocytes, and microglia and their involvement in disease; the local circuits and synaptic interactions at the level of the cerebral cortex, thalamus, basal ganglia, cerebellum, brainstem, and spinal cord transmission regulating sensory processing, behavioral state, and motor functions; the peripheral and central mechanisms of pain and homeostasis; and networks involved in emotion, memory, language, and executive function.