bluuebunny/crossref_metadata_2025_split huggingface dataset:
Organizational aspects of pediatric anesthesia and surgery between two waves of Covid‐19
Authors: Camporesi Anna , Melloni Giorgio E. M. , Diotto Veronica , Bertani Patrizia , La Pergola Enrico , Pelizzo Gloria 
Published: February 2021

BackgroundThe initial wave of the Covid‐19 pandemic has hit Italy, and Lombardy in particular, with violence, forcing to reshape all hospitals' activities; this happened even in pediatric hospitals, although the young population seemed initially spared from the disease. “Vittore Buzzi” Children's Hospital, which is a pediatric/maternal hospital located in Milan (Lombardy Region), had to stop elective procedures—with the exception of urgent/emergent ones—between February and May 2020 to leave space and resources to adults' care. We describe the challenges of reshaping the hospital's identity and structure, and restarting pediatric surgery and anesthesia, from May on, in the most hit area of the world, with the purpose to avoid and contain infections. Both patients and caregivers admitted to hospital have been tested for Sars‐CoV‐2 in every case.MethodsObservational cohort study via review of clinical charts of patients undergoing surgery between 16th May and 30th September 2020, together with SARS‐CoV ‐2 RT‐PCR testing outcomes, and comparison to same period surgeries in 2019.ResultsAn increase of approximately 70% in pediatric surgeries (OR 1.68 [1.33‐2.13], P < .001) and a higher increase in the number of surgeries were reported (OR 1.75 (1.43‐2.15), P < .001). Considering only urgent procedures, a significant difference in the distribution of the type of surgery was observed (Chi‐squared P‐value < .001). Sars‐CoV‐2‐positive patients have been 0.8% of total number; 14% of these was discovered through caregiver's positivity.ConclusionWe describe our pathway for safe pediatric surgery and anesthesia and the importance of testing both patient and caregiver.
Genetic architecture of four smoking behaviors using partitioned SNP heritability
Authors: Evans Luke M. , Jang Seonkyeong , Hancock Dana B. , Ehringer Marissa A. , Otto Jacqueline M. , Vrieze Scott I. , Keller Matthew C. 
Published: February 2021

AbstractBackground and AimsAlthough genome‐wide association studies have identified many loci that influence smoking behaviors, much of the genetic variance remains unexplained. We characterized the genetic architecture of four smoking behaviors using single nucleotide polymorphism (SNP) heritability (h2SNP). This is an estimate of narrow‐sense heritability specifically estimating the proportion of phenotypic variation due to causal variants (CVs) tagged by SNPs.DesignPartitioned h2SNP analysis of smoking behavior traits.SettingUK Biobank.ParticipantsUK Biobank participants of European ancestry. The number of participants varied depending on the trait, from 54 792 to 323 068.MeasurementsSmoking initiation, age of initiation, cigarettes per day (CPD; count, log‐transformed, binned and dichotomized into heavy versus light) and smoking cessation with imputed genome‐wide SNPs.FindingsWe estimated that, in aggregate, approximately 18% of the phenotypic variance in smoking initiation was captured by imputed SNPs [h2SNP = 0.18, standard error (SE) = 0.01] and 12% [SE = 0.02] for smoking cessation, both of which were more than twice the previously reported estimates. Estimated age of initiation (h2SNP = 0.05, SE = 0.01) and binned CPD (h2SNP = 0.1, SE = 0.01) were substantially below published twin‐based h2 of 50%. CPD encoding influenced estimates, with dichotomized CPD h2SNP = 0.28. There was no evidence of dominance genetic variance for any trait.ConclusionA biobank study of smoking behavior traits suggested that the phenotypic variance explained by SNPs of smoking initiation, age of initiation, cigarettes per day and smoking cessation is modest overall.
Evaluating the effects of the Licensing Act 2003 on the characteristics of drinking occasions in England and Wales: a theory of change‐guided evaluation of a natural experiment
Authors: Stevely Abigail Kate , de Vocht Frank , Neves Rita Borges , Holmes John , Meier Petra Sylvia 
Published: February 2021

AbstractBackground and AimsThe Licensing Act 2003 deregulated trading hours in England and Wales. Previous evaluations have focused upon consumption and harm outcomes, finding mixed results. Several evaluations speculated on the reasons for their results, noting the role of changes in the characteristics of drinking occasions. This study aimed to test proposed mechanisms of effect for the Licensing Act 2003 by evaluating changes in characteristics of drinking occasions.Design, Setting and ParticipantsInterrupted monthly time–series analysis of effects in England and Wales versus a Scottish control series, using 2001–08 data collected via 7‐day drinking occasions diaries by the market research company Kantar (n = 89 192 adults aged 18+).MeasurementsOutcomes were start‐ and end‐time of each reported occasion; variation in finish time; prevalence of pre‐loading, post‐loading and late‐night drinking; and alcohol consumption (in units).FindingsAfter the introduction of the Act, occasions shifted later at night in England and Wales [finish time +11.4 minutes; 95% confidence interval (CI) = 3.6–19.2]. More occasions involved pre‐loading in England and Wales relative to Scotland (0.02% increase; 95% CI = 0.01–0.03). There was no evidence of changes in variation in finish time, post‐loading, late‐night drinking or alcohol consumption.ConclusionsThe Licensing Act 2003 in England and Wales appears to have had only limited effects on the characteristics of drinking occasions. This may help to explain its lack of substantial impacts on alcohol harms
CKLF and IL1B transcript levels at diagnosis are predictive of relapse in children with pre‐B‐cell acute lymphoblastic leukaemia
Authors: Fitter Stephen , Bradey Alanah L. , Kok Chung Hoow , Noll Jacqueline E. , Wilczek Vicki J. , Venn Nicola C. , Law Tamara , Paisitkriangkrai Sakrapee , Story Colin , Saunders Lynda , Dalla Pozza Luciano , Marshall Glenn M. , White Deborah L. , Sutton Rosemary , Zannettino Andrew C. W. , Revesz Tamas 
Published: February 2021

SummaryDisease relapse is the greatest cause of treatment failure in paediatric B‐cell acute lymphoblastic leukaemia (B‐ALL). Current risk stratifications fail to capture all patients at risk of relapse. Herein, we used a machine‐learning approach to identify B‐ALL blast‐secreted factors that are associated with poor survival outcomes. Using this approach, we identified a two‐gene expression signature (CKLF and IL1B) that allowed identification of high‐risk patients at diagnosis. This two‐gene expression signature enhances the predictive value of current at diagnosis or end‐of‐induction risk stratification suggesting the model can be applied continuously to help guide implementation of risk‐adapted therapies.
Soluble PD‐L1 is a promising disease biomarker but does not reflect tissue expression in classic Hodgkin lymphoma
Authors: Veldman Johanna , Alsada Zainab N. D. , van den Berg Anke , Plattel Wouter J. , Diepstra Arjan , Visser Lydia 
Published: February 2021

SummaryIndividually, tissue and soluble markers involved in the programmed cell death protein 1/programmed death‐ligand (PD‐1/PD‐L) axis have been described as biomarkers with clinical value in classical Hodgkin lymphoma (cHL). In the context of the success of immune checkpoint blockade therapy in cHL, it is interesting to discover whether plasma levels of proteins in the PD‐1/PD‐L axis are a reflection of expression by the corresponding tissue. Paired tissue and plasma samples of cHL patients were collected and analysed for PD‐1, PD‐L1 and PD‐L2 levels. In addition, vascular endothelial growth factor (VEGF) and CD83, molecules regarded to influence the expression of PD‐1, PD‐L1 and/or PD‐L2, were included. PD‐L1 was upregulated in the plasma of cHL patients compared to healthy controls and correlated well with several clinical parameters. Strong PD‐L1 expression in the tumour microenvironment contributed to high soluble (s)PD‐L1 levels, although there was no direct correlation between plasma PD‐L1 levels and total expression of PD‐L1 in corresponding cHL tissue. Interestingly, we observed a positive correlation between VEGF and PD‐1 levels in both tissue and plasma. In conclusion, although PD‐L1 is a promising soluble biomarker in cHL, its levels do not reflect the total tissue expression. Future studies focusing on PD‐L1 as a predictor for immune checkpoint treatment response, should include both biopsy and plasma samples.
Obesity as a multisystem disease: Trends in obesity rates and obesity‐related complications
Authors: Sarma Shohinee , Sockalingam Sanjeev , Dash Satya 
Published: February 2021

AbstractObesity is a chronic multisystem disease associated with increased morbidity and mortality. The increasing prevalence of obesity makes it a major healthcare challenge across both developed and developing countries. Traditional measures such as body mass index do not always identify individuals at increased risk of comorbidities, yet continue to be used in deciding who qualifies for weight loss treatment. A better understanding of how obesity is associated with comorbidities, in particular non‐metabolic conditions, is needed to identify individuals at risk in order to prioritize treatment. For metabolic disorders such as type 2 diabetes (T2D), weight loss can prevent T2D in individuals with prediabetes. It can improve and reverse T2D if weight loss is achieved early in the course of the disease. However, access to effective weight loss treatments is a significant barrier to improved health for people with obesity. In the present paper, we review the rising prevalence of obesity and why it should be classed as a multisystem disease. We will discuss potential mechanisms underlying its association with various comorbidities and how these respond to treatment, with a particular focus on cardiometabolic disease, malignancy and mental health.
Use of the ADAPTE method to develop a clinical guideline for the improvement of psychoses and schizophrenia care: Example of involvement and participation of patients and family caregivers
Authors: Hurtado María M. , Quemada Casta , García‐Herrera José María , Morales‐Asencio José Miguel 
Published: February 2021

AbstractIntroductionThe aim of this study is to analyse different ways of participation during the development of a clinical guideline to improve the early detection of psychosis and to deploy a comprehensive treatment plan to improve prognosis and social integration.Materials and methodThe clinical guideline was developed using the ADAPTE method with the participation of 40 authors and 80 external reviewers. The process was divided into three major phases: set up, adaptation and finalization. During adaptation and completion, a total of 44 patients and 18 family caregivers were involved.Results and conclusionsThe different roles assumed by the patients and their family caregivers were described, depending on the panel in which they participated, with diverse grades of complexity: a user as author, integration of the results of qualitative research with the participation of local users and family caregivers, 13 users as individual external reviewers and the participation of users and caregiver organizations in the external review. In the guideline, contributions from patients during the qualitative research were included in an innovative way, placing them just behind the recommendations. On the other hand, the results of the family caregivers’ study were included in a specific area of uncertainty. Further, the expressed point of view was considered as the collective demands of users and family caregivers’ organizations in the cost‐benefit analysis made by the organizing committee. There were diverse ways to conduct direct patient participation during the guideline development, ensuring that their individual experiences contributed significantly to the final version.
External validation and comparison of current scoring systems in retrograde intrarenal surgery: Multi‐institutional study with 949 patients
Authors: Bozkurt Ibrahim Halil , Karakoyunlu Ahmet Nihat , Koras Omer , Celik Serdar , Sefik Ertugrul , Cakici Mehmet Caglar , Degirmenci Tansu , Imamoglu Muhammed Abdurrahim 
Published: February 2021

AbstractObjectivesTo externally validate and compare Resorlu‐Unsal stone score (RUSS), modified Seoul National University Renal Stone Complexity Score(S‐ReSC), Ito’s nomogram, and Retrograde Intra‐Renal Surgery (R.I.R.S.) scoring systems for predicting capabilities of both the stone‐free status and complications in a multi‐institutional study.Materials and MethodsWe performed a retrospective analysis of 949 patients who underwent flexible ureterorenoscopy (f‐URS) and laser lithotripsy for renal stones in two institutions between March‐2015 and June‐2020. The RUSS, modified S‐ReSC, Ito’s nomogram, and R.I.R.S. scores were calculated for each patient by the same surgeon on imaging methods. Results were compared for their predictive capability of stone‐free status and complications.ResultsOf 949 patients 603 were male and 346 were female with a mean age of 47.2 ± 14.3 (range 2‐84 years). Mean stone burden was 102.6 ± 42.2 (48‐270 mm2). All nomograms predicted stone‐free status (Area Under Curve (AUC) were 0.689, 0.657, 0.303, and 0.690, respectively). All four scoring systems predicted complications with AUC values of 0.689, 0.646, 0.286, and 0.664 for RUSS, modified S‐ReSC, Ito’s nomogram, and R.I.R.S., respectively. Although all scoring systems were able to predict complications only Ito’s nomogram was able to predict Clavien ≥2 complications.ConclusionAll four scoring systems (RUSS, modified S‐ReSC, Ito’s nomogram, and R.I.R.S.) could predict stone‐free status after f‐URS, however, the AUC values are not satisfactory in our large patient cohort. Although these scoring systems were not developed for predicting post‐operative complications, they were associated with complications in our study. However, these four scoring systems have some significant limitations. The ideal scoring system is yet to be developed.
Isoflurane post‐conditioning contributes to anti‐apoptotic effect after cerebral ischaemia in rats through the ERK5/MEF2D signaling pathway
Authors: Zhang Qingtong , Yin Jiangwen , Xu Feng , Zhai Jingwen , Yin Jieting , Ge Mingyue , Zhou Wenyi , Li Nian , Qin Xinlei , Li Yan , Wang Sheng 
Published: February 2021

AbstractThe mechanisms of brain protection during ischaemic reperfusion injury induced by isoflurane (ISO) post‐conditioning are unclear. Myocyte enhancement factor 2 (MEF2D) has been shown to promote neural survival in a variety of models, in which multiple survival and death signals converge on MEF2D and modulate its activity. Here, we investigated the effect of MEF2D on the neuroprotective effects of ISO post‐conditioning on rats after cerebral ischaemia/reperfusion (I/R) injury. Rats underwent middle cerebral artery occlusion (MCAO) surgery with ischaemia for 90 minutes and reperfusion for 24‐48 hours. After MCAO, neurological status was assessed at 12, 24 and 48 hours by the Modified Neurological Severity Score (mNSS) test. The passive avoidance test (PAT) was used to assess cognition function. Histological and neuropathological evaluations were performed with HE staining and Nissl's staining, respectively. We measured the expression of MEF2D, ERK5, GFAP and caspase‐3 by immunofluorescent staining and Western blotting, and TUNEL staining to assess the severity of apoptosis in hippocampal CA1 area. We found that MEF2D was involved in nerve protection after I/R injury, and post‐treatment of ISO significantly promoted the phosphorylation of ERK5, increased MEF2D transcriptional activity, inhibited the expression of caspase‐3 and played a role of brain protection.
Addressing challenges associated with long‐term topical treatment and benefits of proactive management in patients with psoriasis
Authors: Lebwohl M. , Thaçi D. , Warren R.B. 
Published: February 2021

AbstractThe majority of patients with psoriasis vulgaris (chronic plaque psoriasis) can be treated successfully with short‐term topical therapies. However, long‐term management of psoriasis with topicals is challenging and tends to take a reactive approach to disease relapse, rather than a proactive approach aimed at maintaining disease remission. Patients are often dissatisfied with the delay in treatment response and inconvenience of applying topical treatments, and therefore frequently discontinue treatment leading to poor outcomes. Relapse is common, particularly with reactive management, as underlying residual disease can remain following initial skin clearance; some patients find that their disease at relapse may be worse than their initial symptoms. This can have a detrimental effect on patient quality of life (QoL) and increase the risk of psoriasis‐associated depression. A long‐term proactive management approach, with maintenance treatment following initial treatment success, could help sustain disease remission and improve clinical and QoL outcomes for patients. Treatment with fixed‐dose calcipotriol 50 µg/g betamethasone dipropionate 0.5 mg/g cutaneous foam (Cal/BD foam) is effective in the short term, providing a fast onset of action and improvements in disease at 4 weeks. Results from the Phase III PSO‐LONG study demonstrated that long‐term proactive management was superior to reactive management in prolonging time to first relapse, reducing number of relapses and increasing days in remission in adults with psoriasis vulgaris. Furthermore, Cal/BD foam was well tolerated in PSO‐LONG. No new safety concerns were identified over 52 weeks; the safety profile was consistent with that described previously. Given this, Cal/BD foam should be considered when prescribing topicals for the long‐term proactive management for patients with psoriasis.
Calcipotriol/betamethasone dipropionate foam demonstrates comparable efficacy to clinical trial data in the real world, improves patient satisfaction and is cost‐effective
Authors: Armstrong A. , Gerdes S. 
Published: February 2021

AbstractReal‐world evidence studies are becoming increasingly important in providing insight into clinical effectiveness and safety, economic outcomes, patient‐reported outcomes and health‐related quality of life of treatments in the clinical setting. These studies also help to complement data reported in clinical studies. Fixed‐dose combination calcipotriol 50 µg/g plus betamethasone dipropionate 0.5 mg/g cutaneous foam (Cal/BD foam) is a topical agent used for the treatment of psoriasis vulgaris. In clinical studies, Cal/BD foam has demonstrated a significantly greater efficacy and rapid onset of action compared with both single and combination formulations such as ointments and gels. To date, three observational studies have examined the real‐world efficacy and safety of Cal/BD foam in clinical practice in the United States, Germany and Spain. Data gathered from these studies reinforce the positive findings reported in clinical studies assessing Cal/BD foam for the treatment of psoriasis and demonstrate improved patient satisfaction with Cal/BD foam. Using Cal/BD foam has been shown to be cost‐effective based on results from randomised clinical trials and cost‐effective analysis. As such, Cal/BD foam has the potential to lower treatment costs by reducing the need for some patients to progress to more expensive treatments, such as phototherapy and biologics. Cal/BD foam is therefore a cost‐effective solution for the treatment of psoriasis vulgaris that should be considered when prescribing topicals.
Going the distance: Associations between adverse birth outcomes and obstetric provider distances for adolescent pregnancies in South Carolina
Authors: Purser Jessica , Harrison Sayward , Hung Peiyin 
Published: February 2021

AbstractPurposeDistances to obstetric care providers are a persistent concern, especially for rural pregnant adolescents. Births to adolescents are disproportionately affected by adverse birth outcomes (ABOs), yet little is known regarding how driving distances may impact ABOs. This study examines the association between driving distances to obstetric providers and ABOs among adolescent mothers in South Carolina.MethodsThis retrospective cross‐sectional study derived ZIP Code‐level birth statistics from mothers aged 10–19 in South Carolina using 2013–2017 statewide birth certificate data. ABOs included preterm birth and/or low birthweight. Provider distance was calculated between an obstetric provider's ZIP Code tabulated area (ZCTA) centroid and a maternal resident's ZCTA centroid. Descriptive statistics and weighted generalized linear regression were conducted.ResultsMean provider distances to obstetric providers were similar between urban (11.76 miles) and rural adolescent mothers (12.04 miles). An increase in provider distance, on average, was associated with a decrease in ABO rates (–0.79, p= .0038); however, rural–urban differences were found. Living in a rural ZCTA was associated with a decrease in ABOs (4.94%, p = .0043). Urban ZCTAs showed a U‐shaped association with provider distance, with ABO rates decreasing until approximately 17 miles away from a provider and then increasing.ConclusionRural adolescent mothers with greater distance to providers had lower ABO rates, while, in urban ZCTAs, provider distance over 17 miles was associated with higher ABO rates. Understanding what mitigates the effects of driving distance on ABOs in rural South Carolina would help inform future policy planning in underserved communities.
Nonmetropolitan COVID‐19 Incidence and Mortality Rates Surpassed Metropolitan Rates Within the First 24 Weeks of the Pandemic Declaration: United States, March 1–October 18, 2020
Authors: Matthews Kevin A. , Ullrich Fred , Gaglioti Anne H. , Dugan Susan , Chen May S. , Hall Diane M. 
Published: February 2021

AbstractPurposeThis report compares COVID‐19 incidence and mortality rates in the nonmetropolitan areas of the United States with the metropolitan areas across three 11‐week periods from March 1 to October 18, 2020.MethodsCounty‐level COVID‐19 case, death, and population counts were downloaded from USAFacts.org. The 2013 NCHS Urban‐Rural Classification Scheme was collapsed into two categories called metropolitan (large central, large fringe, medium, and small metropolitans) and nonmetropolitan (micropolitan/noncore). Daily COVID‐19 incidence and mortality rates were computed to show temporal trends for each of these two categories. Maps showing the ratio of nonmetropolitan to metropolitan COVID‐19 incidence and mortality rates by state identify states with higher rates in nonmetropolitan areas than in metropolitan areas in each of the three 11‐week periods.FindingsIn the period between March 1 and October 18, 2020, 13.8% of the 8,085,214 confirmed COVID‐19 cases and 10.7% of the 217,510 deaths occurred among people residing in nonmetropolitan counties. The nonmetropolitan incidence and mortality trends steadily increased and surpassed those in metropolitan areas, beginning in early August.ConclusionsDespite the relatively small size of the US population living in nonmetropolitan areas, these areas have an equal need for testing, health care personnel, and mitigation resources. Having state‐specific rural data allow the development of prevention messages that are tailored to the sociocultural context of rural locations.