bluuebunny/crossref_metadata_2025_split huggingface dataset:
Per‐ and polyfluoroalkyl substances and their alternatives in paper food packaging
Authors: Glenn Gregory , Shogren Randal , Jin Xing , Orts William , Hart‐Cooper William , Olson Lauren 
Published: March 2021

AbstractPer‐ and polyfluoroalkyl substances (PFAS) have been used in food contact paper and paperboard for decades due to their unique ability to provide both moisture and oil/grease resistance. Once thought to be innocuous, it is now clear that long chain PFAS bioaccumulate and are linked to reproductive and developmental abnormalities, suppressed immune response, and tumor formation. Second‐generation PFAS have shorter biological half‐lives but concerns about health risks from chronic exposure underscore the need for safe substitutes. Waxes and polymer film laminates of polyethylene, poly(ethylene‐co‐vinyl alcohol), and polyethylene terephthalate are commonly used alternatives. However, such laminates are neither compostable nor recyclable. Lamination with biodegradable polymers, including polyesters, such as polylactic acid (PLA), polybutylene adipate terephthalate, polybutylene succinate, and polyhydroxyalkanoates, are of growing research and commercial interest. PLA films are perhaps the most viable alternative, but performance and compostability are suboptimal. Surface sizings and coatings of starches, chitosan, alginates, micro‐ and nanofibrilated cellulose, and gelatins provide adequate oil barrier properties but have poor moisture resistance without chemical modification. Plant proteins, including soy, wheat gluten, and corn zein, have been tested as paper coatings with soy being the most commercially important. Internal sizing agents, such as alkyl ketene dimers, alkenyl succinic anhydride, and rosin, improve moisture resistance but are poor oil/grease barriers. The difficulty in finding a viable replacement for PFAS chemicals that is cost‐effective, fully biodegradable, and environmentally sound underscores the need for more research to improve barrier properties and process economics in food packaging products.
Thermophilic microbial deconstruction and conversion of natural and transgenic lignocellulose
Authors: Bing Ryan G. , Sulis Daniel B. , Wang Jack P. , Adams Michael W. W. , Kelly Robert M. 
Published: March 2021

SummaryThe potential to convert renewable plant biomasses into fuels and chemicals by microbial processes presents an attractive, less environmentally intense alternative to conventional routes based on fossil fuels. This would best be done with microbes that natively deconstruct lignocellulose and concomitantly form industrially relevant products, but these two physiological and metabolic features are rarely and simultaneously observed in nature. Genetic modification of both plant feedstocks and microbes can be used to increase lignocellulose deconstruction capability and generate industrially relevant products. Separate efforts on plants and microbes are ongoing, but these studies lack a focus on optimal, complementary combinations of these disparate biological systems to obtain a convergent technology. Improving genetic tools for plants have given rise to the generation of low‐lignin lines that are more readily solubilized by microorganisms. Most focus on the microbiological front has involved thermophilic bacteria from the genera Caldicellulosiruptor and Clostridium, given their capacity to degrade lignocellulose and to form bio‐products through metabolic engineering strategies enabled by ever‐improving molecular genetics tools. Bioengineering plant properties to better fit the deconstruction capabilities of candidate consolidated bioprocessing microorganisms has potential to achieve the efficient lignocellulose deconstruction needed for industrial relevance.
The female medical workforce
Authors: Critchley J. , Schwarz M. , Baruah R. 
Published: March 2021

SummaryIn the UK, the proportion of female medical students has remained static over the last decade, at around 55%; however, at consultant level, only 36.6% of doctors are women. The reasons for this drop in numbers are not clear. Given the increase in number of female doctors in training, the proportion of female doctors at consultant level is lower than might be expected. This article discusses issues affecting the female medical workforce in anaesthesia, intensive care and pain medicine. It explores how gender stereotypes and implicit gender bias can affect the way women are perceived in the workplace, especially in leadership positions, and discusses health issues particular to the female medical workforce. While the issues in this article may not affect all women, the cumulative effect of being subject to gender stereotypes within a workplace not designed to accommodate the health needs of women may contribute to a work environment that may promote the attrition of women from our specialties.
Anaesthetic considerations for fertility‐sparing surgery and uterine transplantation
Authors: Kasaven L. S. , Jones B. P. , Keays R. , Saso S. 
Published: March 2021

SummaryA number of benign and malignant gynaecological conditions can cause infertility. Advancements in assisted reproductive technologies have facilitated the rapidly evolving subspecialty of fertility preservation. Regardless of clinical indication, women now have the reproductive autonomy to make fully informed decisions regarding their future fertility. In particular, there has been an increasing interest and demand among patients and healthcare professionals for fertility‐sparing surgery. Gynaecologists find themselves continually adapting surgical techniques and introducing novel procedures to facilitate this rapidly emerging field and anaesthetists need to manage the consequent physiological demands intra‐operatively. Not only is it important to understand the surgical procedures now undertaken, but also the intra‐operative management in an ever evolving field. This article reviews the methods of fertility‐sparing surgery and also describes important anaesthetic challenges including peri‐operative care for women undergoing complex fertility‐sparing surgeries such as uterus transplantation.
Adolescent gynaecology: anaesthetic and peri‐operative care implications
Authors: Crouch N. S. , Molyneux M. K. 
Published: March 2021

SummaryAdolescents represent a quarter of the world’s population, yet their specific healthcare needs have often not been acknowledged. Whilst many operations in this population will be performed in specialist tertiary centres and children’s hospitals, it is likely that care will be sought in a variety of healthcare settings, and so it is important to have an understanding of the particular approach to this age group. Paediatric and adolescent gynaecology emerged as a speciality in 2000 with the inauguration of the British Society for Paediatric and Adolescent Gynaecology, a specialist society of the Royal College of Obstetricians and Gynaecologists. This is a multidisciplinary group, comprising paediatricians, paediatric surgeons, psychologists and nurses, although the majority of the members are gynaecologists. In this review, we will describe the peri‐operative implications of adolescent gynaecological surgery and the considerations that need to be applied to this specific age group, such as consent, the operative setting and key personnel. We will also discuss specialist situations which are likely to fall to an adolescent gynaecology setting, such as management of those with Mullerian abnormalities, which often present with pelvic pain in adolescence. We discuss those with a history of ritual female genital cutting (female genital mutilation), trans men and those with significant learning difficulties. In all circumstances, teamwork, reflection and pragmatism are key.
Beyond Obstruction: Blockades as Productive Reorientations
Authors: Davis Sasha 
Published: March 2021

AbstractThis paper examines blockades not as disruptions in logistical circulations, but as entities which aim to reorient and produce different political and social processes. Inspired by Deleuzean conceptualisations of assemblage, this paper emphasises the ways blockades and occupations arise from globe‐spanning networks of social relations which then attempt to produce alternative regimes of governance through reorienting places and their topologies of interconnection. To make these points, this paper engages with three case studies which highlight different kinds of blockades. One example focuses on the regional scale where US military interests have expressed concern over potential blockades of Sea Lines of Communication due to the rising geopolitical and economic influence of China in the island Pacific. The second example focuses on blockades at the construction site of a US military base on the coast of Henoko, Okinawa. The third example examines blockade protests by Kanaka Maoli kia‘i (protectors) on Maunakea in Hawai‘i.
Prediction of spontaneous preterm birth by cervical length in the first trimester of pregnancy: Comparison of two measurement methods
Authors: Feng Qiaoli , Duan Honglei , Ju Xiaoqing , Appiah Kubi , Yip Ka Man , Tai Yi‐yun , Sun Qian , Chaemsaithong Piya , Poon Liona C. 
Published: March 2021

AbstractIntroductionOur objectives were to compare the single‐line and two‐line methods of cervical length measurement in the first trimester of pregnancy and to evaluate the potential value of the first trimester cervical length measured by the two methods in predicting spontaneous preterm birth.Material and methodsThis was a prospective study in singleton pregnancies at 11+0 to 13+6 weeks of gestation. Cervical length was measured by two methods: (i) a linear distance between the two ends of the glandular area around the endocervical canal (single‐line method) and (ii) a sum of a linear distance from the internal os to the greatest cervical curvature and a linear distance from this point of the cervix to the external os (two‐line method). The screening performance of the first trimester cervical length measured by the two different methods for the prediction of spontaneous preterm delivery was assessed by receiver‐operating characteristics (ROC) curve analysis. The areas under the ROC (AUROC) were compared by De Long test.ResultsA total of 1484 consecutive singleton pregnancies were included in this study. Spontaneous preterm delivery at <37 and <32 weeks occurred in 75 cases (5.1%) and 12 cases (0.8%), respectively. The median cervical length measured by the single‐line method was significantly shorter than that by the two‐line method (33.5 vs 36.5 mm, p < .001). Compared with the term delivery group, the median cervical length measured by the two‐line method was shorter in women with spontaneous delivery at <32 weeks of gestation (36.5 vs 33.6 mm, p < .01). No significant difference in the median cervical length measured by the single‐line method was detected between the spontaneous preterm delivery and term delivery groups. Receiver‐operating‐characteristic curves demonstrated that cervical length measured by the two‐line method achieved better performance in predicting spontaneous delivery at <32 weeks compared with the single‐line method (AUROC: 0.72 vs 0.61, p < .01).ConclusionsWe have demonstrated that the first trimester cervical length, measured by the two‐line approach, holds promise as a potential screening tool for early spontaneous preterm delivery.
Multi‐constituent simulation of thrombus formation at LVAD inlet cannula connection: Importance of Virchow’s triad
Authors: Méndez Rojano Rodrigo , Zhussupbekov Mansur , Antaki James F. 
Published: March 2021

AbstractAs pump thrombosis is reduced in current‐generation ventricular assist devices (VAD), adverse events such as bleeding or stroke remain at unacceptable rates. Thrombosis around the VAD inlet cannula (IC) has been highlighted as a possible source of stroke events. Recent computational fluid dynamics (CFD) studies have attempted to characterize the thrombosis risk of different IC‐ventricle configurations. However, purely CFD simulations relate thrombosis risk to ad hoc criteria based on flow characteristics, with little consideration of biochemical factors. This study investigates the genesis of IC thrombosis including two elements of the Virchow's triad: endothelial injury and hypercoagulability. To this end a multi‐scale thrombosis simulation that includes platelet activity and coagulation reactions was performed. Our results show significant thrombin formation in stagnation regions (|u| < 0.005 m/s) close to the IC wall. In addition, high shear‐mediated platelet activation was observed over the leading‐edge tip of the cannula. The current study reveals the importance of biochemical factors to the genesis of thrombosis at the ventricular‐cannula junction in a perioperative state. This study is a first step toward the long‐term objective of including clinically relevant pharmacological kinetics such as heparin or aspirin in simulations of inflow cannula thrombosis.
UpFrontPSMA: a randomized phase 2 study of sequential 177Lu‐PSMA‐617 and docetaxel vs docetaxel in metastatic hormone‐naïve prostate cancer (clinical trial protocol)
Authors: Dhiantravan Nattakorn , Emmett Louise , Joshua Anthony M. , Pattison David A. , Francis Roslyn J. , Williams Scott , Sandhu Shahneen , Davis Ian D. , Vela Ian , Neha Nitika , Bressel Mathias , Murphy Declan G. , Hofman Michael S. , Azad Arun A. 
Published: March 2021

ObjectiveTo assess the activity and safety of sequential lutetium‐177 (177Lu)‐PSMA‐617 and docetaxel vs docetaxel on a background of androgen deprivation therapy (ADT) in men with de novo metastatic hormone‐naïve prostate cancer (mHNPC).Patients and MethodsUpFrontPSMA (NCT04343885) is an open‐label, randomized, multicentre, phase 2 trial, recruiting 140 patients at 12 Australian centres. Key eligibility criteria include: prostate cancer with a histological diagnosis within 12 weeks of screening commencement; prostate‐specific antigen (PSA) >10 ng/mL at diagnosis; ≤4 weeks on ADT; evidence of metastatic disease on computed tomography (CT) and/or bone scan; high‐volume prostate‐specific membrane antigen (PSMA)‐avid disease with a maximum standardized uptake value >15; and absence of extensive discordant fluorodeoxyglcuose (FDG)‐positive, PSMA‐negative disease. 68Ga‐PSMA‐11 and 18F‐FDG positron‐emission tomography (PET)/CT undergo central review to determine eligibility. Patients are randomized 1:1 to experimental treatment, Arm A (177Lu‐PSMA‐617 7.5GBq q6w × 2 cycles followed by docetaxel 75 mg/m2 q3w × 6 cycles), or standard‐of‐care treatment, Arm B (docetaxel 75 mg/m2 q3w × 6 cycles). All patients receive continuous ADT. Patients are stratified based on disease volume on conventional imaging and duration of ADT at time of registration. The primary endpoint is the proportion of patients with undetectable PSA (≤0.2 ng/L) at 12 months after study treatment commencement. Secondary endpoints include safety, time to castration resistance, overall survival, PSA and radiographic progression‐free survival, objective tumour response rate, early PSMA PET response, health‐related quality of life, and frequency and severity of adverse events. Enrolment commenced in April 2020.Results and ConclusionsThe results of this trial will generate data on the activity and safety of 177Lu‐PSMA‐617 in men with de novo mHNPC in a randomized phase 2 design.
Shade alters the growth and architecture of tropical grasses by reducing root biomass
Authors: Solofondranohatra Cédrique L. , Vorontsova Maria S. , Dewhirst Rebecca A. , Belcher Claire M. , Cable Stuart , Jeannoda Vololoniaina , Lehmann Caroline E.R. 
Published: March 2021

AbstractTropical grassy biomes have variable tree cover and are often characterized by a flammable grassy ground layer where the dominating grass species have strategies to persist and proliferate with frequent fire. However, there is limited understanding of how grass growth and flammability traits respond to light availability. We experimentally grew 14 grass species characteristic of the Malagasy Central Highlands for one year with four treatments of light exclusion ranging from 0 – 60%. Eight plant functional traits and four leaf flammability traits were measured: plant height, bulk density, aboveground biomass, belowground biomass, ratio of root to shoot biomass, specific leaf area, leaf length, leaf width, leaf heat release capacity, temperature of maximum decomposition, total heat release and peak heat release rate. Belowground biomass, the ratio of root to shoot biomass, and bulk density were all negatively affected by decreasing light availability. Surprisingly, aboveground biomass showed no significant change with changing light availability, although there was a trend toward shorter plants in low light. At a leaf level, declining light availability increased specific leaf area, leaf length, and leaf width. In terms of leaf flammability, of the four traits measured, unexpectedly, only leaf total heat release was significantly positively related to declining light availability. These results suggest field alterations in grass flammability may be primarily related to plant architecture and microclimates. The shifts in allometry and substantial reduction in belowground biomass suggest that grasses would be rapidly lost from shaded environments with a diminished competitive capacity to resprout.
Procalcitonin‐guided antibiotic therapy in AECOPD patients: Overview of systematic reviews
Authors: Di Jiaqi , Li Xuanlin , Xie Yang , Yang Shuguang , Yu Xueqing 
Published: March 2021

AbstractBackgroundProcalcitonin (PCT)‐guided antibiotic therapy has emerged as mainstream treatment for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and has been studied in many systematic reviews (SRs), but robust conclusion has not been drawn. Thus, this overview aims to summarize and critically evaluate the methodological and evidence quality of SRs on this topic.MethodsPubMed, EMBASE, Cochrane library, and Web of science were searched for SRs regarding on PCT‐guided antibiotic therapy on AECOPD. Two reviewers assessed the quality of SRs in line with AMSTAR‐2 tool and evaluated the strength of evidence quality with the grading of recommendations, assessment, development, and evaluation (GRADE) system for concerned outcomes independently.ResultsSix SRs were published from Jun 2011 to Aug 2019, with from 4 (556 patients) to 15 (2571 patients) randomized controlled trials (RCTs) and retrospective studies. All the included SRs were classified as critical low methodology quality according to A MeaSurement Tool to Assess Systematic Reviews 2 (AMSTAR‐2) tool. Most of SRs were absented a list of excluded studies (item 7), and adequate investigation of publication bias and discuss its likely impact on the results (item 15). The PCT‐guided antibiotic therapy may reduce antibiotic exposure days and antibiotic prescription rate in patients with AECOPD without affecting treatment success rate or causing adverse events (all‐cause mortality, re‐admission, re‐exacerbation), but the results should be study deeper for the low or moderate evidence quality.ConclusionCurrent SRs show that PCT‐guided antibiotic therapy could be employed by clinicians in treatment of AECOPD. However, the high‐quality evidence of outcomes is lacking, further intensive exploration should be carried out on the precise role of PCT‐guided antibiotic therapy on AECOPD.
Peripapillary vascular density and retinal nerve fibre layer changes in patients with chronic obstructive pulmonary disease
Authors: Alkan Abdurrahman Alpaslan , Düzgün Eyüp , Özkarafakılı Müfide Arzu 
Published: March 2021

AbstractIntroductionChronic obstructive pulmonary disease (COPD) is a systemic disease which may cause end organ damage.ObjectivesIn this study, we aimed to investigate the radial peripapillary capillary (RPC) density and retinal nerve fibre layer (RNFL) thickness changes in patients with COPD.MethodsThe right eyes of 35 patients with COPD and 35 healthy controls were evaluated with optical coherence tomography angiography (OCTA). RPC density values and RNFL thicknesses were measured and compared.ResultsThe mean inside disc vascular density and the mean peripapillary vascular density values were lower in the COPD group (p = 0.002, p < 0.001, respectively). When the peripapillary area was evaluated independently as eight different quadrants, the RPC density values were lower in the COPD group in all of the quadrants except superotemporal and temporal superior quadrants. RNFL was thinner in all quadrants in the COPD group compared to the control group. But this difference was significant only in the nasal superior and inferonasal quadrants (p = 0.03, p = 0.04, respectively). Although, there was no correlation between the mean RPC density and the mean peripapillary RNFL thickness of the patients, FEV1 values for all patients were found to be correlated with the mean peripapillary RPC density (r = 0.406, p = 0.015).ConclusionOCTA may have a potential to be used in the follow‐up of COPD patients.
Impact of the metabolic syndrome on peripheral nerve structure and function in type 2 diabetes
Authors: Issar Tushar , Tummanapalli Shyam S. , Borire Adeniyi A. , Kwai Natalie C. G. , Poynten Ann M. , Arnold Ria , Markoulli Maria , Krishnan Arun V. 
Published: March 2021

AbstractBackground and purposeThere is a strong association between the metabolic syndrome in diabetes and the development of peripheral neuropathy; however, the pathophysiological mechanisms remain unknown.MethodsParticipants with type 2 diabetes and metabolic syndrome (T2DM/MetS, n = 89) and type 2 diabetes alone (T2DM; n = 59) underwent median nerve ultrasound and excitability studies to assess peripheral nerve structure and function. A subset of T2DM/MetS (n = 24) and T2DM (n = 22) participants underwent confocal microscopy to assess central and inferior whorl corneal nerve structure. Neuropathy severity was assessed using the modified Toronto Clinical Neuropathy Score (mTCNS). Diabetes groups were similar for age, sex distribution, diabetes duration, hemoglobin A1c, insulin treatment, and renal function. Sixty healthy controls similar for age and sex distribution were recruited for comparison.ResultsParticipants with T2DM/MetS manifested with a greater mTCNS compared to T2DM (p < 0.05). Median nerve cross‐sectional area was larger in the T2DM/MetS group compared to the T2DM cohort (p < 0.05). Participants with T2DM/MetS had reductions in central (all p < 0.01) and inferior whorl (all p < 0.05) nerve measures. Compared to T2DM, the T2DM/MetS group demonstrated more severe changes in nerve excitability measures, which was due to reduced sodium channel permeability and sodium–potassium pump function. In comparison, only sodium channel permeability was reduced in the T2DM group.ConclusionsCompared to participants with type 2 diabetes alone, those with diabetes and metabolic syndrome manifested greater alterations in peripheral nerve structure and function, which may be due to reduced function of the sodium–potassium pump.