bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment following hysteroscopy and endometrial diagnostic biopsy increases the chance for live birth in women with chronic endometritis
Authors: Mitter Vera R. , Meier Sheila , Rau Tilman T. , Gillon Tessa , Mueller Michael D. , Zwahlen Marcel , von Wolff Michael , Kohl Schwartz Alexandra S. 
Published: July 2021

AbstractProblemRepeated implantation failure and recurrent pregnancy loss are associated with chronic endometritis, a persistent endometrial inflammation. Its diagnosis and treatment may increase pregnancy and live birth rates. The aim of this study was to assess the effectiveness of endometrial diagnostic biopsy and subsequent antibiotic treatment in cases of chronic endometritis on reproductive outcomes over a long observation period.Method of StudyWe conducted a historical cohort study (2014–2018) at our University‐based infertility center that included women (n = 108) with repeated implantation failure or recurrent pregnancy loss without known pathologies associated with either condition. Forty‐one women underwent a hysteroscopy only (reference group); the remaining 67 women underwent, in addition to the hysteroscopy, an endometrial diagnostic biopsy with immunohistochemically staining for CD138 to detect plasma cells (biopsy group). If one or more plasma cells were detected, the women were treated with doxycycline 100 mg twice a day orally for 2 weeks. We performed stratified survival analysis (Kaplan‐Meier) and Cox regression.ResultsThe biopsy group had higher chances of pregnancy (hazard ratio 2.28; 95% confidence interval 1.23–4.24; p = .009) and of live birth (hazard ratio 2.76; 95% confidence interval 1.30–5.87; p = .008) compared with the reference group. In the sensitivity analysis, repeated implantation failure or recurrent pregnancy loss did not affect the outcome.ConclusionEndometrial diagnostic biopsy followed by antibiotic treatment in case of chronic endometritis in women with repeated implantation failure or recurrent pregnancy loss may increase the chances for live birth.
X‐ray micro‐computed tomography in the assessment of penile cavernous fibrosis in a rabbit castration model
Authors: Kogan Mikhail I. , Popov Igor V. , Kirichenko Evgeniya Y. , Mitrin Boris I. , Sadyrin Evgeniy V. , Kulaeva Elizaveta D. , Popov Ilya V. , Kulba Sergey N. , Logvinov Alexander K. , Akimenko Marina A. , Pasechnik Dmitry G. , Tkachev Sergey Yu. , Karnaukhov Nikolay S. , Lapteva Tatyana O. , Sukhar Irina A. , Maksimov Alexey Yu. , Ermakov Alexey M. 
Published: July 2021

AbstractBackgroundCurrent assessment methods of penile cavernous fibrosis in animal models have limitations due to the inability to provide complex and volume analysis of fibrotic alterations.ObjectiveThe aim was to evaluate micro‐computed tomography for assessment of cavernous fibrosis and compare it with histological, histochemical, immunohistochemical, and RT‐PCR analysis.Materials and methodsA controlled trial was performed involving 25 New Zealand male rabbits with induced testosterone deficiency by orchidectomy. Penile samples were obtained before and after 7, 14, 21, and 84 days from orchidectomy. We consistently performed (a) gray value analysis of corpora cavernosa 3D models reconstructed after micro‐computed tomography, (b) morphometry of smooth muscles/connective tissue ratio, collagen type I/III ratio, and area of TGF‐beta‐1 expression in corpora cavernosa, and (c) RT‐PCR of TGF‐beta‐1 expression.ResultsMicro‐computed tomography allowed visualization of penile structures at a resolution comparable to light microscopy. Gray values of corpora cavernosa decreased from 1673 (1512–1773) on the initial day to 1184 (1089–1232) on the 21st day (p < 0.005). However, on the 84th day, it increased to 1610 (1551–1768). On 21st and 84th days, there was observed a significant decrease in smooth muscle/connective tissue ratio and a significant increase in collagen type I/III ratio (p < 0.05). TGF‐beta1 expression increased on the 84th day according to immunohistochemistry (p < 0.005). RT‐PCR was impossible to conduct due to the absence of RNA in obtained samples after micro‐CT.Discussion and conclusionsMicro‐computed tomography provided 3D visualization of entire corpora cavernosa and assessment of radiodensity alterations by gray value analysis in fibrosis progression. We speculate that gray value changes at early and late fibrosis stages could be related to tissue reorganization. RT‐PCR is impossible to conduct on tissue samples studied by micro‐CT due to RNA destruction. We also suggest that micro‐computed tomography could negatively affect the immunohistochemical outcome, as a significant increase of TGF‐beta‐1 expression occurs later than histological fibrotic signs.
Fontan circulation has improved life expectancy for infants born with complex heart disease over the last 50 years but has also resulted in significant morbidity
Authors: Hedlund Eva , Lundell Bo 
Published: July 2021

AbstractThe prognosis for infants born with complex heart disease improved dramatically with the introduction of the Fontan circulation 50 years ago. With today's carefully designed and staged operations to a Fontan circulation, life expectancy has increased and most children will survive into adult life. The Fontan circulation entails an unphysiological circulation with high risk for multiple organ system dysfunction. Neurodevelopmental disabilities with adverse psychosocial effects are prevalent. The Fontan circulation may eventually fail and necessitate heart transplantation.ConclusionFifty years development of the Fontan circulation to today's staged surgical procedures has improved survival but also revealed the burden of a high morbidity for a growing number of patients.
Letter: real‐world use of terlipressin in patients with hepatorenal syndrome
Authors: Weng Fangbin 
Published: July 2021

LINKED CONTENTThis article is linked to Moore et al and Allegretti et al papers. To view these articles, visit https://doi.org/10.1111/apt.15836 and https://doi.org/10.1111/apt.16486
Decreased secondary faecal bile acids in children with ulcerative colitis and Clostridioides difficile infection
Authors: Rotondo‐Trivette Sarah , Wang Beibei , Gayer Christopher , Parsana Riddhi , Luan Yihui , Sun Fengzhu , Michail Sonia 
Published: July 2021

SummaryBackgroundPatients with ulcerative colitis (UC) have an increased risk of Clostridioides difficile infection (CDI). There is a well‐documented relationship between bile acids and CDI.AimsTo evaluate faecal bile acid profiles and gut microbial changes associated with CDI in children with UC.MethodsThis study was conducted at Children's Hospital Los Angeles. Faecal bile acids and gut microbial genes related to bile acid metabolism were measured in 29 healthy children, 23 children with mild to moderate UC without prior CDI (UC group), 16 children with mild to moderate UC with prior CDI (UC+CDI group) and 10 children without UC with prior CDI (CDI group).ResultsSecondary faecal bile acids, especially lithocholic acid (3.296 vs 10.793, P ≤ 0.001) and ursodeoxycholic acid (7.414 vs 10.617, P ≤ 0.0001), were significantly lower in children with UC+CDI when compared to UC alone. Secondary faecal bile acids can predict disease status between these groups with 84.6% accuracy. Additionally, gut microbial genes coding for bile salt hydrolase, 7α‐hydroxysteroid dehydrogenase and 7α/β‐dehydroxylation were all diminished in children with UC+CDI compared to children with UC alone.ConclusionsBile acids can distinguish between children with UC based on their prior CDI status. Bile acid profile changes can be explained by gut microbial genes encoding for bile salt hydrolase, 7α‐hydroxysteroid dehydrogenase and 7α/β‐dehydroxylation. Bile acid profiles may be helpful as biomarkers to identify UC children who have had CDI and may serve as future therapeutic targets.
External validation of the Medication Risk Score in polypharmacy patients in general practice: A tool for prioritizing patients at greatest risk of potential drug‐related problems
Authors: Høj Kirsten , Pedersen Henrik Schou , Lundberg Anne Sofie Baymler , Bro Flemming , Nielsen Lars Peter , Sædder Eva Aggerholm 
Published: July 2021

AbstractDrug‐related problems are important causes of patient harm and increased healthcare costs. To assist general practitioners in prioritizing patients in need of a critical medication review, we aimed to assess the ability of the Medication Risk Score (MERIS) to stratify patients with polypharmacy in general practice according to their risk of drug‐related problems. We conducted a cross‐sectional multi‐centre external validation study. Patients receiving more than five concomitant medications (polypharmacy) were eligible. The outcome was potentially serious drug‐related problems as evaluated by expert consensus. Performance was assessed in terms of calibration and discrimination indices. Of 497 patients, 489 were included in the main analysis. The median age (interquartile range) was 70.5 years (60–79). In total, 372 potentially serious drug‐related problems were observed in 253 patients (52%). The MERIS was well calibrated above a score level of 10. The area under the receiver operating characteristic curve was 0.70 (95% confidence interval: 0.65–0.74). The performance of the MERIS was fair in patients with polypharmacy in general practice. Given the scale of drug‐related problems and the lack of efficient prioritization tools in this setting, the MERIS could be a useful risk indicator to complement usual practice.
Newborn screening for severe combined immunodeficiency—Coming to a region near you soon
Authors: Elliman David A C , Gennery Andrew R 
Published: July 2021

Abstract
The most profound of primary immunodeficiencies, severe combined immunodeficiency (SCID), presents in infancy. Infants appear healthy at birth, but they are unable to clear pathogens, particularly viruses, and present with recurrent infection, progressive pnueumonitis and failure to thrive due to enteric viral infection, often associated with persistent vaccine-strain rotavirus. The administration of live vaccines is contraindicated in these infants, but most who are eligible receive bacillus Calmette–Guérin vaccination and the live rotavirus vaccine before the diagnosis of SCID is made, making treatment more complicated. Newborn infants with SCID can be screened using the newborn bloodspot to measure T lymphocyte receptor excision circles (TRECs), episomal DNA formed during T lymphocyte receptor development and very low or absent in SCID. Introduction of this programme in the United Kingdom will require the neonatal BCG vaccination programme to be altered, with vaccination at 28 days, once the SCID screening result is known. Although SCID newborn screening has been successfully introduced in other countries, the change in neonatal BCG vaccination requires the introduction of newborn screening to be carefully introduced. An evaluation of impact of screening on SCID diagnosis, treatment and outcomes, together with an evaluation of the technology used to detect TRECs, and the impact of screening and changes to the BCG programme on families will commence in six screening regions in England in September 2021 for 2 years – should the evaluation prove positive, it is likely that screening for this fatal disease will be introduced across the United Kingdom.
A clinical research priority setting study for issues related to the use of methamphetamine and emerging drugs of concern in Australia
Authors: Siefried Krista J. , Ezard Nadine , Christmass Michael , Haber Paul , Ali Robert ,   The NCCRED Methamphetamine and Emerging Drugs Clinical Research Network Working Group
Published: July 2021

AbstractIntroductionThis study aimed to gather a range of opinions, including those of affected people (consumers, concerned others) to identify clinical research priorities for methamphetamine and emerging drugs of concern in Australia, to guide the work of the National Centre for Clinical Research on Emerging Drugs (NCCRED).MethodsA priority setting study was conducted (February–March 2019) in four phases: online stakeholder survey, thematic analysis of responses, rapid literature review, expert panel ranking of priorities against predetermined criteria.ResultsForty‐seven respondents completed the survey, including people identifying as one or more of: researcher (53%, n = 25), clinician (45%; n = 21), family/friend/caregiver of someone who uses methamphetamine/emerging drugs (15%, n = 7) and consumer of methamphetamine/emerging drugs (13%, n = 6). Expert panel, evidence‐informed top‐ranked clinical research priorities for methamphetamine were: strategies to overcome barriers to intervention uptake, pilot medication trials for adults seeking treatment, and communication strategies regarding evidence‐based treatments. For emerging drugs of concern, top‐ranked priorities were: piloting community‐located drug checking, feasibility of social media/other opportunities to alert consumers of emerging risks, GHB overdose and withdrawal management, and impacts of an early warning information system on reducing harms.Discussion and ConclusionsWe demonstrate feasibility of a structured, collaborative clinical research priority setting process. Results have informed the establishment of NCCRED; using the identified priorities to guide seed funding, fellowships/scholarships and research programs. Broader uptake of this methodology by policymakers/research funders would assist to embed areas of concern identified by affected communities and other stakeholders in research prioritisation.
Damage behavior due to rolling contact fatigue and bending fatigue of a gear using crystal plasticity modeling
Authors: Wang Wei , Wei Peitang , Liu Huaiju , Yu Yong , Zhou Hao 
Published: July 2021

AbstractGear fatigue issues, including bending and contact fatigue, are attractive problems with significant engineering safety implications. Currently, no fatigue analysis model can combine the effects of bending and contact fatigue to predict gear fatigue life because of their different failure mechanisms. In addition, most gear fatigue studies are still limited to the understanding at the macro level, thus cannot provide theoretical interpretations for practical engineering observations such as scattered experimental data and material deterioration. Here, we proposed a unified microstructure model by considering different failure mechanisms of rolling contact and bending fatigue. The crystal plasticity model combing the multiaxial fatigue criteria was established to capture the stress–strain history at the microlevel. The deterioration of mechanical properties of the material was simulated based on the continuum damage theory. This work provides more insight into the physical understanding of gear fatigue failure mechanism and theoretical support for gear antifatigue design.
Factors influencing distributional shifts and abundance at the range core of a climate‐sensitive mammal
Authors: Billman Peter D. , Beever Erik A. , McWethy David B. , Thurman Lindsey L. , Wilson Kenneth C. 
Published: July 2021

AbstractSpecies are frequently responding to contemporary climate change by shifting to higher elevations and poleward to track suitable climate space. However, depending on local conditions and species’ sensitivity, the nature of these shifts can be highly variable and difficult to predict. Here, we examine how the American pika (Ochotona princeps), a philopatric, montane lagomorph, responds to climatic gradients at three spatial scales. Using mixed‐effects modeling in an information‐theoretic approach, we evaluated a priori model suites regarding predictors of site occupancy, relative abundance, and elevational‐range retraction across 760 talus patches, nested within 64 watersheds across the Northern Rocky Mountains of North America, during 2017–2020. The top environmental predictors differed across these response metrics. Warmer temperatures in summer and winter were associated with lower occupancy, lower relative abundances, and greater elevational retraction across watersheds. Occupancy was also strongly influenced by habitat patch size, but only when combined with climate metrics such as actual evapotranspiration. Using a second analytical approach, acute heat stress and summer precipitation best explained retraction residuals (i.e., the relative extent of retraction given the original elevational range of occupancy). Despite the study domain occurring near the species’ geographic‐range center, where populations might have higher abundances and be at lower risk of climate‐related stress, 33.9% of patches showed evidence of recent extirpations. Pika‐extirpated sites averaged 1.44℃ warmer in summer than did occupied sites. Additionally, the minimum elevation of pika occupancy has retracted upslope in 69% of watersheds (mean: 281 m). Our results emphasize the nuance associated with evaluating species’ range dynamics in response to climate gradients, variability, and temperature exceedances, especially in regions where species occupy gradients of conditions that may constitute multiple range edges. Furthermore, this study highlights the importance of evaluating diverse drivers across response metrics to improve the predictive accuracy of widely used, correlative models.
Advanced analysis of flexural test results of sealant for solid oxide cells
Authors: Fakouri Hasanabadi Masood , Kokabi Amir Hossein , Faghihi‐Sani Mohammad Ali , Abdoli Hamid , Malzbender Jürgen , Gross‐Barsnick Sonja‐Michaela 
Published: July 2021

AbstractThe conventional relations for calculating the fracture stresses consider only elastic deformation but ignore viscoelastic and viscoplastic behaviors. Measuring the joining strength of a composite glass sealant‐metallic interconnect specimen at solid oxide cell application relevant at high temperatures is a case where such effects can become significant. In the current study, three‐point and four‐point bending test results were analyzed using the finite element method (FEM) to assess systematic and random errors. It is shown that plastic deformation of the steel interconnect material at high temperature, although having a large effect on the stress distribution in the steel/glass–ceramic/steel specimen, does not cause a significant difference in the FEM‐derived true and the standard equation‐based analytically derived flexural stress values. It is also observed that even if the viscous flow of the glass–ceramic is considered in the simulations, the samples’ behavior in a realistic testing condition is not biased significantly by inelastic behavior due to the short testing time.
Improving hand hygiene in a low‐resource setting: A nurse‐led quality improvement project
Authors: Kamanga Patricia , Ngala Patricia , Hebron Caitlin 
Published: July 2021

AbstractHand hygiene is a simple but often ignored practice in health care systems worldwide, but it is integral for nosocomial infection prevention, with many hospital‐acquired infections being linked to inadequate hand hygiene practice. At the burns unit in Kamuzu Central Hospital, 50% of patients were found to have acquired pseudomonas infections: one of the contributing factors being inadequate hand hygiene. This quality improvement project was part of a course for nurses to introduce change for patient benefit, with the aim of increasing the baseline figures for hand hygiene practices and hand hygiene facilities from 37% and 22%, respectively (baseline collected in November 2019). Using robust, standard quality improvement processes, measures were put in place such as checklists to observe hand hygiene compliance and facilities, appointment of a hand hygiene committee who monitored and sustained activities of the project, procurement and distribution of handrub and placement of hand‐washing buckets and soap at strategic points. The project saw an increase in availability of hand‐washing facilities to 95.6% and hand hygiene practices increase to >80% within 6 months. The project demonstrates that low cost interventions, led by nurses, can make a real difference to practice in resource poor countries.
Improving caring quality for people with dementia in nursing homes using IPOS‐Dem: A stepped‐wedge cluster randomized controlled trial protocol
Authors: Spichiger Frank , Koppitz Andrea L. , De Wolf‐Linder Susanne , Murtagh Fliss E. M. , Volken Thomas , Larkin Philip 
Published: July 2021

AbstractAimsWe aim to evaluate the effectiveness of the Integrated Palliative Care Outcome Scale for people with dementia‐based case studies to improve the caring quality for people with dementia in nursing homes by frontline staff and family members.BackgroundSwiss nursing homes mostly care for people with dementia. This population is at high risk of receiving little to no palliation for their complex needs. The majority of Swiss frontline healthcare staff do not systematically report on the needs of their residents. Additionally, family members do not routinely participate in assessment processes.DesignWe will conduct a stepped‐wedge cluster randomized trial of repeated assessment using the Integrated Palliative Care Outcome Scale for people with dementia (IPOS‐Dem) and subsequent case studies. Clusters will consist of Swiss nursing homes randomly assigned to one of three sequential intervention time points.MethodsThe study population will consist of people with dementia living in nursing homes with and without specialized dementia care facilities. Over 16 months, staff working at the frontline and family members will assess the needs and concerns of people with dementia using IPOS‐Dem. Depending on sequence allocation, facilitated case studies will start after 3, 6 or 9 months. The primary outcome will be caring quality measured by QUALIDEM. The secondary outcome will be symptoms and concerns, as indicated by the IPOS‐Dem sum‐score. The Zürich Ethics Committee approved the study in 2019 (2019‐01847).ImpactThe results of this study will contribute to improving the effectiveness of person‐centred care for people with dementia. Collaboration between healthcare staff and family members will be systematically developed and built upon thorough assessment using the IPOS‐Dem and related case studies. The use of IPOS‐Dem will offer all frontline staff a systematic approach to have an independent voice within the nursing process, regardless of their qualification or grade.