bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adjuvant use of melatonin for pain management in dysmenorrhea — a randomized double-blinded, placebo-controlled trial
Authors: Söderman Lisa , Edlund Måns , Böttiger Ylva , Marions Lena 
Published: October 2021

Abstract
Purpose
Dysmenorrhea is a common, recurring, painful condition with a global prevalence of 71%. The treatment regime for dysmenorrhea includes hormonal therapies and NSAID, both of which are associated with side effects.
A dose of 10 mg melatonin daily has previously been shown to reduce the level of pelvic pain in women with endometriosis. We chose to investigate how this regime, administered during the week of menstruation, would affect women with dysmenorrhea but without any signs of endometriosis, as adjuvant analgesic treatment.

Methods
Forty participants with severe dysmenorrhea were randomized to either melatonin or placebo, 20 in each group. Our primary outcome was pain measured with numeric rating scale (NRS); a difference of at least 1.3 units between the groups was considered clinically significant. Secondary outcomes were use of analgesics, as well as absenteeism and amount of bleeding. Mixed model was used for statistical analysis.

Results
Eighteen participants completed the study in the placebo group and 19 in the melatonin group. Mean NRS in the placebo group was 2.45 and 3.18 in the melatonin group, which proved to be statistically, although not clinically significant.

Conclusion
This randomized, double-blinded, placebo-controlled trial could not show that 10 mg of melatonin given orally at bedtime during the menstrual week had better analgesic effect on dysmenorrhea as compared with placebo. However, no adverse effects were observed.

Clinical trials
NCT03782740 registered on 17 December 2018.
Phytotoxic Effects of Antibiotics on Terrestrial Crop Plants and Wild Plants: A Systematic Review
Authors: Carballo Matilde , Rodríguez Antonio , de la Torre Ana 
Published: October 2021

AbstractThis review examines the state of knowledge on the phytotoxic effects of antibiotics on terrestrial crop plants and wild (non-crop) plants with the goal of evaluating differences in their sensitivity. This is important because environmental risk assessments of antibiotics currently consider their potential effects only on crop species but not wild species. Overall, we analysed 275 datasets consisting of antibiotic-plant species-endpoint combinations for germination (mg/L) and 169 datasets for plant growth (elongation and biomass) (mg/kg). EC10 and EC50 of each parameter were compared using a quotient approach, in which the geometric mean and the 5th percentile of the crop data were divided by wild data. Quotients were > 1 for elongation growth, suggesting that wild species were more sensitive than crops, while they were < 1 for biomass growth, suggesting quite the contrary. However, < 1% of the data in each dataset came from wild species, preventing definitive conclusions. Merging crop and wild data to evaluate differences in sensitivity among classes of antibiotics and plant families, we found using a linear mixed effect model and post hoc test that plants were most sensitive to phenicol and least sensitive to macrolides and tetracyclines. Further work must be conducted to gain a better understanding of the phytotoxic effects of antibiotics on terrestrial wild plants and subsequently assess whether the current approach to environmental risk assessment of antibiotics is sufficient to protect plant biodiversity.
Urbanisation weakens selection on the timing of breeding and clutch size in blue tits but not in great tits
Authors: Branston Claire J. , Capilla-Lasheras Pablo , Pollock Christopher J. , Griffiths Kate , White Stewart , Dominoni Davide M. 
Published: October 2021

Abstract
Urbanisation is a globally occurring phenomenon and is predicted to continue increasing rapidly. Urban ecosystems present novel environments and challenges which species must acclimate or adapt to. These novel challenges alter existing or create new selection pressures on behaviours which provide an opportunity to investigate eco-evolutionary responses to contemporary environmental change. We used 7 years of breeding data from urban and forest populations of blue and great tits to understand whether selection for timing of breeding or clutch size differed between the two habitats and species. We found that urban great tits laid eggs earlier than their forest counterparts, but there was no evidence of a difference in selection for earlier breeding. Blue tits, however, did not differ in timing of egg laying between the two habitats, but selection for earlier laying was weaker in the urban environment. Both species laid smaller clutches in the urban site and had positive selection for larger clutch sizes which did not differ in strength for the great tits but did for blue tits, with weaker selection in the urban population. Our results suggest that food availability for nestlings may be constraining urban birds, and that the temporal cues females use to time breeding correctly, such as tree budburst and food availability, may be absent or reduced in urban areas due to lower caterpillar availability. These results have implications for our understanding of the adaptation of wild animals to city life.

Significance statement
Urbanisation is expanding rapidly and changing the environment many species live in. A key challenge is to understand how species adapt to the urban environment, why some species can adapt, why others cannot and what we can do to ensure that cities are ecologically sustainable and biodiversity rich. Here we show that the strength of natural selection for early breeding and larger clutch size is weaker in urban than non-urban blue tits, likely due to reduced and irregular availability of natural insect food in urban areas. This effect was not found in great tits. Thus, urbanisation can alter the selection pressures wild animals are exposed to, but this effect may differ between species, even when closely related. This has implications for our understanding of how species adapt to urban life.
Long‐Term Impact of a Low‐Cost Paediatric Intussusception Air Enema Reduction Simulation‐Based Education Programme in a Low‐Middle Income Country
Authors: Nataraja R. M. , Yin Mar Oo  , Ljuhar D. , Pacilli M. , Nyo Nyo Win  , Stevens S. , Aye Aye  , Nestel D. 
Published: October 2021

AbstractIntroductionIntussusception is one of the commonest causes of bowel obstruction in infants. Most infants in Low‐ and Middle‐Income Countries (LMICs) undergo an invasive operative intervention. Supported by simulation‐based education (SBE), the Air Enema (AE) non‐operative technique was introduced in 2016 in Myanmar. This study assesses the long‐term outcomes.MethodsMixed methods study design over 4 years including clinical outcomes and surgeon's attitudes towards the AE technique and SBE. Prospectively collected clinical outcomes and semi‐structured interview with reflexive thematic analysis (RTA). Primary outcome measure was a long‐term shift to non‐operative intervention. Secondary outcomes: Length of Stay (LoS), recurrence rates, intestinal resection rates, compared to the operative group. The data was analysed according to intention to treat. Quantitative data analysis with Mann–Whitney U test, Fisher's exact test, Student's T‐Test or Wilcoxon Signed‐Rank Test utilised. A p‐value of <.05 was considered significant.ResultsA total of 311 infants with intussusception were included. A sustained shift to AE was revealed with high success rates (86.1–91.2%). AE had a reduced LoS (4 vs. 7 days p ≤ 0.0001), Duration of Symptoms (DoS) was lower with AE (1.9/7 vs. 2.5/7, p = 0.002). Low recurrence rates (0–5.8%) and intestinal resection rates stabilised at 30.5–31.8% vs.15.3% pre‐intervention. Four RTA themes were identified: Expanding conceptions of healthcare professional education and training; realising far reaching advantages; promoting critical analysis and reflective practice of clinicians; and adapting clinical practice to local context. RTA revealed an overall positive paradigm shift in attitudes and application of SBE.ConclusionsA sustained change in clinical outcomes and appreciation of the value of SBE was demonstrated following the intervention.
Half-dose glucarpidase as efficient rescue for toxic methotrexate levels in patients with acute kidney injury
Authors: Heuschkel Sandra , Kretschmann Theresa , Teipel Raphael , von Bonin Simone , Richter Stephan , Quick Susanne , Alakel Nael , Röllig Christoph , Balaian Ekaterina , Kroschinsky Frank , Knoth Holger , Bornhäuser Martin , von Bonin Malte 
Published: October 2021

Abstract
Purpose
High-dose methotrexate (HDMTX)-associated acute kidney injury with delayed MTX clearance has been linked to an excess in MTX-induced toxicities. Glucarpidase is a recombinant enzyme that rapidly hydrolyzes MTX into non-toxic metabolites. The recommended dose of glucarpidase is 50 U/kg, which has never been formally established in a dose finding study in humans. Few case reports, mostly in children, suggest that lower doses of glucarpidase might be equally effective in lowering MTX levels.

Methods
Seven patients with toxic MTX plasma concentrations following HDMTX therapy were treated with half-dose glucarpidase (mean 25 U/kg, range 17–32 U/kg). MTX levels were measured immunologically as well as by liquid chromatography–mass spectrometry (LC–MS). Toxicities were assessed according to National Cancer Institute—Common Terminology Criteria for Adverse Events (CTCAE) v5.0.

Results
All patients experienced HDMTX-associated kidney injury (median increase in creatinine levels within 48 h after HDMTX initiation compared to baseline of 251%, range 80–455%) and showed toxic MTX plasma concentrations (range 3.1–182.4 µmol/L) before glucarpidase injection. The drug was administered 42–70 h after HDMTX initiation. Within one day after glucarpidase injection, MTX plasma concentrations decreased by ≥ 97.7% translating into levels of 0.02–2.03 µmol/L. MTX rebound was detected in plasma 42–73 h after glucarpidase initiation, but concentrations remained consistent at < 10 µmol/L.

Conclusion
Half-dose glucarpidase seems to be effective in lowering MTX levels to concentrations manageable with continued intensified folinic acid rescue.
A score appraising Paleolithic diet and the risk of cardiovascular disease in a Mediterranean prospective cohort
Authors: de la O Víctor , Zazpe Itziar , Goni Leticia , Santiago Susana , Martín-Calvo Nerea , Bes-Rastrollo Maira , Martínez J. Alfredo , Martínez-González Miguel Á. , Ruiz-Canela Miguel 
Published: October 2021

Abstract
Purpose
To assess the association between a score appraising adherence to the PaleoDiet and the risk of cardiovascular disease (CVD) in a Mediterranean cohort.

Methods
We included 18,210 participants from the Seguimiento Universidad de Navarra (SUN) cohort study. The PaleoDiet score comprised six food groups promoted within this diet (fruit, nuts, vegetables, eggs, meat and fish) and five food groups whose consumption is discouraged (cereals and grains, dairy products, legumes, culinary ingredients, and processed/ultra-processed foods). CVD was defined as acute myocardial infarction with or without ST elevation, non-fatal stroke and cardiovascular death. Cox proportional hazards models adjusted for potential confounders were fitted to assess the association between the PaleoDiet score and CVD risk, and the PaleoDiet and MedDiet indices to explore differences between both diets.

Results
During 12.2 years of follow-up, 165 incident CVD cases were confirmed. A significant inverse association was found between the PaleoDiet score and CVD (HR Q5 vs. Q1: 0.45, 95% CI 0.27–0.76, P for trend = 0.007). A weaker association that became non-significant was observed when the item for low consumption of ultra-processed foods was removed from the score. Joint analysis of PaleoDiet and MedDiet Trichopoulou scores suggested that the inverse association between PaleoDiet and CVD was mainly present when adherence to the MedDiet was also high (HR for high adherence vs low adherence to both diet scores: 0.22, 95% CI 0.08–0.64).

Conclusions
Our findings suggest that the PaleoDiet may have cardiovascular benefits in participants from a Mediterranean country. Avoidance of ultra-processed foods seems to play a key role in this inverse association.
Diagnostic accuracy and usability of the EMBalance decision support system for vestibular disorders in primary care: proof of concept randomised controlled study results
Authors: Bamiou Doris-Eva , Kikidis Dimitris , Bibas Thanos , Koohi Nehzat , Macdonald Nora , Maurer Christoph , Wuyts Floris L. , Ihtijarevic Berina , Celis Laura , Mucci Viviana , Maes Leen , Van Rompaey Vincent , Van de Heyning Paul , Nazareth Irwin , Exarchos Themis P. , Fotiadis Dimitrios , Koutsouris Dimitrios , Luxon Linda M. 
Published: October 2021

Abstract
Background
Dizziness and imbalance are common symptoms that are often inadequately diagnosed or managed, due to a lack of dedicated specialists. Decision Support Systems (DSS) may support first-line physicians to diagnose and manage these patients based on personalised data.

Aim
To examine the diagnostic accuracy and application of the EMBalance DSS for diagnosis and management of common vestibular disorders in primary care.

Methods
Patients with persistent dizziness were recruited from primary care in Germany, Greece, Belgium and the UK and randomised to primary care clinicians assessing the patients with (+ DSS) versus assessment without (− DSS) the EMBalance DSS. Subsequently, specialists in neuro-otology/audiovestibular medicine performed clinical evaluation of each patient in a blinded way to provide the “gold standard” against which the + DSS, − DSS and the DSS as a standalone tool (i.e. without the final decision made by the clinician) were validated.

Results
One hundred ninety-four participants (age range 25–85, mean = 57.7, SD = 16.7 years) were assigned to the + DSS (N = 100) and to the − DSS group (N = 94). The diagnosis suggested by the + DSS primary care physician agreed with the expert diagnosis in 54%, compared to 41.5% of cases in the − DSS group (odds ratio 1.35). Similar positive trends were observed for management and further referral in the + DSS vs. the − DSS group. The standalone DSS had better diagnostic and management accuracy than the + DSS group.

Conclusion
There were trends for improved vestibular diagnosis and management when using the EMBalance DSS. The tool requires further development to improve its diagnostic accuracy, but holds promise for timely and effective diagnosis and management of dizzy patients in primary care.

Trial registration number
NCT02704819 (clinicaltrials.gov).
Anti-VEGF therapies for age-related macular degeneration: a powerful tactical gear or a blunt weapon? The choice is ours
Authors: Lanzetta Paolo 
Published: October 2021

Abstract
Purpose
Blindness and vision loss are still frequent disabilities associated with a relevant impact on health care and quality of life, and a high economic burden. Supranational programs established by the World Health Organization (WHO), International Agency for the Prevention of Blindness (IAPB), and World Health Assembly (WHA) aim at reducing avoidable visual impairment. Age-related macular degeneration (AMD), diabetic retinopathy (DR), and other retinal diseases are well known causes of visual disability. Since more than a decade, intravitreal agents are available for the treatment of these diseases. The aim of this study is to review whether pharmacotherapy with anti-vascular endothelial growth factor (VEGF) drugs has led to a decrease in the prevalence of blindness with emphasis on AMD and different countries. A brief analysis of other factors correlated to changes in the rate of blindness is also presented.

Methods
PubMed and Scopus web platforms were used to identify relevant studies on epidemiology of blindness and vision impairment, the influence of intravitreal therapies, and the existence of different vision care models. Additional data and material was searched in web internet accessed by the web browser Firefox.

Results
Age-standardized prevalence of blindness secondary to AMD has started to decline as testified by a number of studies in different countries. This is due to the adoption of anti-VEGF therapy and its adequate management. The frequency of treatment and regimens applied are indirect signs of successful treatment. Local rules and regulations may represent an obstacle.

Conclusions
This review shows that by implementing existing health care systems and dispensing adequate therapies in the field of retinal diseases, the prevalence of blindness due to these conditions can decline.
BINGO: brain-inspired learning memory
Authors: Chakraborty Prabuddha , Bhunia Swarup 
Published: October 2021

AbstractStorage and retrieval of data in a computer memory play a major role in system performance. Traditionally, computer memory organization is ‘static’—i.e. it does not change based on the application-specific characteristics in memory access behaviour during system operation. Specifically, in the case of a content-operated memory (COM), the association of a data block with a search pattern (or cues) and the granularity (details) of a stored data do not evolve. Such a static nature of computer memory, we observe, not only limits the amount of data we can store in a given physical storage, but it also misses the opportunity for performance improvement in various applications. On the contrary, human memory is characterized by seemingly infinite plasticity in storing and retrieving data—as well as dynamically creating/updating the associations between data and corresponding cues. In this paper, we introduce BINGO, a brain-inspired learning memory paradigm that organizes the memory as a flexible neural memory network. In BINGO, the network structure, strength of associations, and granularity of the data adjust continuously during system operation, providing unprecedented plasticity and performance benefits. We present the associated storage/retrieval/retention algorithms in BINGO, which integrate a formalized learning process. Using an operational model, we demonstrate that BINGO achieves an order of magnitude improvement in memory access times and effective storage capacity using the CIFAR-10 dataset and the wildlife surveillance dataset when compared to traditional content-operated memory.
Endogenous growth factors and their empirical verification in the Colombian business context by applying fuzzy measurement techniques
Authors: Gómez-Caicedo Melva Inés , Gaitán-Angulo Mercedes , Quintero Anderson , Danna-Buitrago Jenny Paola 
Published: October 2021

AbstractThis paper centers on the role and economic effect of the factors that affect the endogenous growth of organizations. To this end, it analyzes the case of Colombian companies, whose economy has been characterized in Latin America by maintaining a traditional economic policy and sectors that seek to maximize the opportunities offered by international markets. This study seeks to identify and analyze the factors that influence the endogenous economic growth of organizations and that allow them to be sustainable over time. For this purpose, adaptation algorithms based on fuzzy logics and supervised and unsupervised learning methods were used, generating an adaptation strategy that allows classifying and knowing the endogenous growth of companies in the Colombian context and identifying the most relevant aspects to take into account. Finally, it was found that most Colombian companies focus their business policies on strengthening human capital, followed by innovation, financial resources and, to a lesser extent, strategic alliances.
Social implementation of a remote surgery system in Japan: a field experiment using a newly developed surgical robot via a commercial network
Authors: Morohashi Hajime , Hakamada Kenichi , Kanno Takahiro , Kawashima Kenji , Akasaka Harue , Ebihara Yuma , Oki Eiji , Hirano Satoshi , Mori Masaki 
Published: October 2021

Abstract
Purpose
In recent years, the expectations for telesurgery have grown with the development of robot-assisted surgical technology and advances in communication technology. To verify the feasibility of the social implementation of telesurgery, we evaluated the communication integrity, availability, and communication delay of robotic surgery by remote control under different communication conditions of commercial lines.

Methods
A commercial line was used to connect hospitals 150 km apart. We had prepared guaranteed-type lines (1Gbps, 10Mbps, 5Mbps) and best effort-type lines. Two types of robotic teleoperations were performed, and we evaluated the round-trip time (RTT) of communication, packet loss, and glass-to-glass time.

Results
The communication delay was 4 ms for the guaranteed-type line and 10 ms for the best effort-type line. Packet loss occurred on the 5 Mbps guaranteed-type line. The mean glass-to-glass time was 92 ms for the guaranteed-type line and 95 ms for the best effort-type line. There was no significant difference in the number of errors in the task according to the type of line or the bandwidth speed.

Conclusions
The social implementation of telesurgery using the currently available commercial communication network is feasible.
Soft tissue dimensional changes after alveolar ridge preservation using different sealing materials: a systematic review and network meta-analysis
Authors: Canullo Luigi , Pesce Paolo , Antonacci Donato , Ravidà Andrea , Galli Matthew , Khijmatgar Shahnawaz , Tommasato Grazia , Sculean Anton , Del Fabbro Massimo 
Published: October 2021

AbstractBackgroundAlveolar ridge preservation (ARP) is a proactive treatment option aiming at attenuating post-extraction hard and soft tissue dimensional changes. A high number of different types of biomaterials have been utilized during ARP to seal the socket, but their effectiveness in terms of soft tissue outcomes has rarely been investigated and compared in the literature.ObjectiveTo evaluate the efficacy of different types of membranes and graft materials in terms of soft tissue outcomes (keratinized tissue width changes, vertical buccal height, and horizontal changes) after ARP, and to assign relative rankings based on their performance.Materials and methodsThe manuscript represents the proceedings of a consensus conference of the Italian Society of Osseointegration (IAO).PUBMED (Medline), SCOPUS, Embase, and Cochrane Oral Health’s Information Specialist were utilized to conduct the search up to 06 April 2021. English language restrictions were placed and no limitations were set on publication date. Randomized controlled trials that report ARP procedures using different sealing materials, assessing soft tissue as a primary or secondary outcome, with at least 6-week follow‐up were included.Network meta-analysis (NMA) was performed using mean, standard deviation, sample size, bias, and follow-up duration for all included studies. Network geometry, contribution plots, inconsistency plots, predictive and confidence interval plots, SUCRA (surface under the cumulative ranking curve) rankings, and multidimensional (MDS) ranking plots were constructed.ResultsA total of 11 studies were included for NMA. Overall, the level of bias for included studies was moderate. Crosslinked collagen membranes (SUCRA rank 81.8%) performed best in vertical buccal height (VBH), autogenous soft tissue grafts (SUCRA rank 89.1%) in horizontal width change (HWch), and control (SUCRA rank 85.8%) in keratinized mucosa thickness (KMT).ConclusionsNMA confirmed that the use of crosslinked collagen membranes and autogenous soft tissue grafts represented the best choices for sealing sockets during ARP in terms of minimizing post-extraction soft tissue dimensional shrinkage.Clinical relevanceGrafting materials demonstrated statistically significantly better performances in terms of soft tissue thickness and vertical buccal height changes, when covered with crosslinked collagen membranes. Instead, soft tissue grafts performed better in horizontal width changes. Non-crosslinked membranes and other materials or combinations presented slightly inferior outcomes.