bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maternal soluble PD‐1 levels are significantly increased in women with preeclampsia
Authors: Gu Yang , Morgan John , Lewis David F. , Cooper Danielle B. , McCathran Charles E. , Wang Yuping 
Published: October 2019

AbstractProblemProgrammed cell death‐1 (PD‐1) and its ligand (PD‐L1) have emerged as key players in regulating immune tolerance. Preeclampsia is associated with maladaptation of immune tolerance during pregnancy. This study aimed to determine if maternal soluble PD‐1 (sPD‐1) and soluble PD‐L1 (sPD‐L1) levels are altered in preeclampsia.Method of studyMaternal sPD‐1 and sPD‐L1 levels were measured by ELISA in 172 pregnant women (86 normotensive and 86 preeclampsia). The differences in sPD‐1 and sPD‐L1 levels between normotensive and preeclamptic pregnant women, <34 vs >34 weeks, and fetal gender differences were assessed. Data were analyzed by unpaired t test or chi‐square. A probability level of <.05 was considered statistically significant.ResultsMaternal sPD‐1 levels were significantly higher in preeclamptic than in normotensive pregnant women, 6262 ± 1860 vs 1134 ± 349 pg/mL, P < .01. sPD‐1 levels were not statistically different between <34 and >34 weeks of gestation in both normotensive and preeclamptic groups. sPD‐1 levels were relatively higher in mothers with female fetus than with male fetus in the preeclamptic group: 8104 ± 3054 vs 3802 ± 2177 pg/mL, but relatively lower in mothers with female fetus than with male fetus in the normotensive group: 425 ± 134 vs 625 ± 182 pg/mL. Maternal sPD‐L1 levels were relatively higher in preeclamptic than in normotensive pregnant women: 143 ± 52 vs 69 ± 13 pg/mL.ConclusionAberrant sPD‐1/sPD‐L1 signaling is present in preeclampsia. Whether increased maternal sPD‐1 and sPD‐L1 levels were associated with fetal gender difference or immune tolerance dissimilarity during pregnancy in women with preeclampsia warrants further investigation.
Utilisation of a NSW teratology information service by pharmacists and patients referred by a pharmacist from 2000 to 2018
Authors: Ritchie Helen Elizabeth , Saini Bandana , Twigg Michael J. , Kennedy Debra 
Published: October 2019

BackgroundMotherSafe is a free telephone counselling service for exposures during pregnancy and breastfeeding. As the last health professional seen prior to consumption of medicines, community pharmacists’ opinions on the use of medications in pregnancy/breastfeeding is likely to be particularly sought by women presenting in pharmacies. However, a recent qualitative study revealed that community pharmacists feel unsupported in their role as medicine information providers to pregnant/breastfeeding women.AimThe aim of the current study was to undertake a descriptive analysis of calls made by pharmacists or pharmacist‐referred patients to MotherSafe across the time period 2000–2018.Materials and MethodsA retrospective, descriptive study was conducted of call data from January 2000 to December 2018. Aggregate data were examined by type of caller, reason for call, pregnancy category and exposure type.ResultsMost calls (57%) related to pregnancy or breastfeeding (39%) with calls equally distributed throughout gestation. Calls regarding potential pregnancy exposures to uncategorised drugs were the most frequent (mainly complementary medicines). Unlike pharmacists, calls from pregnant consumers referred by pharmacists were also frequently regarding category A drugs.ConclusionsThis study highlights the need for reliable evidence‐based information sources regarding the use of prescribed medications, over‐the‐counter and complementary preparations during pregnancy and breastfeeding. There is a need for better education of pharmacists about appropriate information sources and the need to use evidence‐based resources other than the A‐X categories to advise their clients about the safety or otherwise of medications in pregnancy and breastfeeding.
The effect of melatonin on ultrasound markers of follicular development: A double‐blind placebo‐controlled randomised trial
Authors: Fernando Shavi , Wallace Euan Morrison , Rombauts Luk , White Nikki , Hong Jennifer , Vollenhoven Beverley , Lolatgis Nicholas , Hope Nicole , Wong Melissa , Lawrence Mark , Lawrence Anthony , Russell Chris , Leong Kenneth , Thomas Philip , da Silva Costa Fabricio 
Published: October 2019

BackgroundMelatonin is a potent oxygen scavenger and is capable of altering blood flow in various vascular beds.AimsWe aimed to determine the effect of melatonin on ovarian vascular indices during ovarian stimulation for in vitro fertilisation (IVF).Materials and MethodsThis is a pilot double‐blind placebo‐controlled randomised trial. Sixty‐nine women (mean age 35.8 ± 4.3 years) undergoing their first cycle of IVF were randomised to receive either placebo, 2, 4 or 8 mg of melatonin, twice a day. Each participant underwent a transvaginal ultrasound at days 6–10 assessing follicular number and size. The vascularisation index (VI), flow index (FI) and vascularisation‐flow index (VFI) were measured. These indices were then correlated with embryological outcomes. Informed consent was obtained from participants. This trial was registered with the Australia New Zealand Clinical Trials Registry (ACTRN12613001317785).ResultsThe number of follicles did not differ between groups (P = 0.4). There were no differences in the VI (P = 0.4), FI (P = 0.1) or VFI (P = 0.3) in the right ovary or the FI (P = 0.3) or VFI (P = 0.3) in the left ovary between groups. When comparing placebo to any dose of melatonin, there were no differences in any measured parameter. While there was correlation between the number of follicles on ultrasound and all measured embryological outcomes, there was no correlation between ovarian vascular indices and these important clinical outcomes.ConclusionsMelatonin does not appear to change ovarian vascular indices during ovarian stimulation. In addition, such vascular indices cannot predict the number or quality of oocytes or embryos obtained in an IVF cycle. These findings require confirmation in future larger studies.
Analgesic benefits and clinical role of the posterior suprascapular nerve block in shoulder surgery: a systematic review, meta‐analysis and trial sequential analysis
Authors: Cho N. , Kang R. S. , McCartney C. J. L. , Pawa A. , Costache I. , Rose P. , Abdallah F. W. 
Published: October 2019

SummaryThe posterior suprascapular nerve block has been proposed as an analgesic alternative for shoulder surgery based on the publication of several comparisons with interscalene block that failed to detect differences in analgesic outcomes. However, quantification of the absolute treatment effect of suprascapular nerve block on its own, in comparison with no block (control), to corroborate the aforementioned conclusions has been lacking. This study examines the absolute analgesic efficacy of suprascapular nerve block compared with control for shoulder surgery. We systematically sought electronic databases for studies comparing suprascapular nerve block with control. The primary outcomes included postoperative 24‐h cumulative oral morphine consumption and the difference in area under the curve for 24‐h pooled pain scores. Secondary outcomes included the incidence of opioid‐related side‐effects (postoperative nausea and vomiting) and patient satisfaction. Data were pooled using random‐effects modelling. Ten studies (700 patients) were analysed; all studies examined landmark‐guided posterior suprascapular nerve block performed in the suprascapular fossa. Suprascapular nerve block was statistically but not clinically superior to control for postoperative 24‐h cumulative oral morphine consumption, with a weighted mean difference (99%CI) of 11.41 mg (−21.28 to −1.54; p = 0.003). Suprascapular nerve block was also statistically but not clinically superior to control for area under the curve of pain scores, with a mean difference of 1.01 cm.h. Nonetheless, suprascapular nerve block reduced the odds of postoperative nausea and vomiting and improved patient satisfaction. This review suggests that the landmark‐guided posterior suprascapular nerve block does not provide clinically important analgesic benefits for shoulder surgery. Investigation of other interscalene block alternatives is warranted.
Systematic review with meta‐analysis: automated low‐flow ascites pump therapy for refractory ascites
Authors: Lepida Antonia , Marot Astrid , Trépo Eric , Degré Delphine , Moreno Christophe , Deltenre Pierre 
Published: October 2019

SummaryBackgroundFew effective treatments are available for patients with cirrhosis and refractory ascites. New treatment modalities are needed for these patients.AimTo synthesise the available evidence on the efficacy and safety of automated low‐flow ascites pump therapy in patients with cirrhosis and refractory ascites.MethodsElectronic databases were searched for trials evaluating automated low‐flow ascites pump therapy in patients with refractory ascites.ResultsNine studies were included. Eight were case series, one was a randomised controlled trial. Pooled estimate rates were 0.62 (95% CI = 0.49‐0.74) for the absence of requirement of large volume paracentesis (LVP) after pump insertion, 0.30 (95% CI = 0.17‐0.47) for acute kidney injury, 0.27 (95% CI = 0.13‐0.49) for bacterial peritonitis and 0.20 (95% CI = 0.09‐0.37) for urinary tract infection. There was high heterogeneity between studies which was often reduced or eliminated in sensitivity analyses by excluding studies of patients with a mean or median model for end‐stage liver disease (MELD) score > 15. Results of sensitivity analyses were similar to those of overall analyses. Mean increase in serum creatinine level after pump insertion was 23 µmol/L (95% CI = 10‐35) with no heterogeneity between studies. The pooled estimate rate for pump‐related side effects was 0.77 (95% CI = 0.64‐0.87) with low heterogeneity between studies.ConclusionThis meta‐analysis demonstrates that most patients treated with automated low‐flow ascites pump therapy do not require LVP after pump insertion. Acute kidney injury occurs in 30% of patients and creatinine levels increase by a mean of 23 µmol/L after pump insertion. Bacterial peritonitis and urinary tract infection occur in 27% and 20% of patients respectively.
Standardising the interpretation of liver biopsies in non‐alcoholic fatty liver disease clinical trials
Authors: Pai Rish K. , Kleiner David E. , Hart John , Adeyi Oyedele A. , Clouston Andrew D. , Behling Cynthia A. , Jain Dhanpat , Kakar Sanjay , Brahmania Mayur , Burgart Lawrence , Batts Kenneth P. , Valasek Mark A. , Torbenson Michael S. , Guindi Maha , Wang Hanlin L. , Ajmera Veeral , Adams Leon A. , Parker Claire E. , Feagan Brian G. , Loomba Rohit , Jairath Vipul 
Published: October 2019

SummaryBackgroundThere is substantial variation in how histologic definitions and scoring systems of non‐alcoholic fatty liver disease (NAFLD) are operationalised.AimTo develop a consensus‐based framework for standardising histologic assessment of liver biopsies in clinical trials of NAFLD.MethodsAn expert panel of 14 liver pathologists and three hepatologists was assembled. Using modified RAND/University of California Los Angeles appropriateness methodology, 130 items derived from literature review and expert opinion were rated by each panel member on a 1‐9 scale. Disagreement was defined as ≥5 ratings in the lowest (1‐3) and highest (7‐9) categories. Items were classified as inappropriate (median 1‐3.5 without disagreement), uncertain (median 3.5‐6.5 or any median with disagreement) or appropriate (median 6.5‐9 without disagreement). Survey results were discussed as a group before voting.ResultsCurrent measures of disease activity and fibrosis may not fully capture important features of non‐alcoholic steatohepatitis (NASH). Alternative methods to evaluate ballooning degeneration are needed. Panellists were uncertain whether portal inflammation, degree of steatosis and Mallory‐Denk bodies are important measures of disease activity. Furthermore, it was felt that current staging systems do not capture the full spectrum of fibrosis in NASH. A consensus definition and sub‐stages for bridging fibrosis are needed. The severity of perisinusoidal fibrosis should be captured at all stages. Lastly, a method to evaluate features of fibrosis regression should be developed.ConclusionThe operating properties of the modifications proposed should be evaluated prospectively to determine reliability and responsiveness.
Data reduction prior to inference: Are there consequences of comparing groups using a t‐test based on principal component scores?
Authors: Bedrick Edward J. 
Published: October 2019

AbstractResearchers often use a two‐step process to analyze multivariate data. First, dimensionality is reduced using a technique such as principal component analysis, followed by a group comparison using a ‐test or analysis of variance. Although this practice is often discouraged, the statistical properties of this procedure are not well understood, starting with the hypothesis being tested. We suggest that this approach might be considering two distinct hypotheses, one of which is a global test of no differences in the mean vectors, and the other being a focused test of a specific linear combination where the coefficients have been estimated from the data. We study the asymptotic properties of the two‐sample ‐statistic for these two scenarios, assuming a nonsparse setting. We show that the size of the global test agrees with the presumed level but that the test has poor power. In contrast, the size of the focused test can be arbitrarily distorted with certain mean and covariance structures. A simple method is provided to correct the size of the focused test. Data analyses and simulations are used to illustrate the results. Recommendations on the use of this two‐step method and the related use of principal components for prediction are provided.
Exploring the use and quality of Internet discussion forums in pregnancy: A qualitative analysis
Authors: Ellis Leila , Roberts Lesley 
Published: October 2019

AbstractBackgroundThe Internet is widely used as a source of health information to assist decision making in pregnancy. Concerningly, the quality of information shared on online pregnancy forums is unclear. Our objectives were to explore online pregnancy forum health‐related use and evaluate quality of information shared.MethodsThis retrospective qualitative study had two phases of data collection and analysis. First, thematic analysis of a representative sample (n = 480) of posts explored motivators for forum use. Second, a subgroup (n = 153) of threads with clinical content was assessed for congruence with reputable sources.ResultsCommon motivators for forum engagement were a desire for lived experience, unlimited access, and the opportunity to express emotions. Of 1098 responses sharing advice, information, or experience, 601 (54.7%) were accurate; 230 (20.9%) were erroneous, incomplete, or misleading; and 267 (24.3%) lacked credible evidence. Of these, 60 (5.5%) were potentially harmful. Responses often directed women to a health care practitioner, but concerningly, failed to refer ten women in need of urgent medical assessment. Few discussions were self‐regulating, with only 12 of 230 (5.2%) poor‐quality messages subsequently rectified.ConclusionsExchange of information and emotional support among peers are key functions of online pregnancy forums. There is a modest prevalence of poor‐quality or potentially harmful information but more concerningly a lack of peer moderation. We suggest health care practitioners ensure pregnant women have a clear understanding of when clinical consultation is required. Clinicians may wish to discuss the supportive community aspects of online forums in cases where offline support is lacking.
Urban Heat: Rising Temperatures as Critique in India's Air‐Conditioned City
Authors: Frazier Camille 
Published: October 2019

AbstractBengaluru's clement weather has long been a defining factor of the urban imaginary, earning it the title of India's naturally “air‐conditioned city.” Over the past three decades, escalating temperatures have changed the urban climate and challenged this understanding of the city. The “rising temperatures narrative” has become a common form of lament among native and long‐term middle‐class residents of Bengaluru (Bangalore). This narrative links hotter temperatures with the past three decades of rapid urbanization to critique uncontrolled urban growth and associated changes in the urban ecology. In telling a story about the effects of urbanization on local weather patterns, the rising temperatures narrative refuses the spatial and temporal effects of global climate change in favor of more locally and politically salient attributions. Yet the critique that this narrative generates is anchored in class‐specific experiences and historical relationships to the city. In its nostalgic descriptions of the city that came before, the rising temperatures narrative draws a line of distinction between “old” and “new” middle‐class residents of Bengaluru. The rising temperatures narrative thus exposes the ambiguities and complexities of middle‐class life in the rapidly developing city.
Use of standardized methods to improve extinction‐risk classification
Authors: Mothes Caitlin C. , Clements Stephanie L. , Hewavithana Dishane K. , Howell Hunter J. , David Aaron S. , Leventhal Nicole D. , Searcy Christopher A. 
Published: October 2019

AbstractStandardized classification methods based on quantifiable risk metrics are critical for evaluating extinction threats because they increase objectivity, consistency, and transparency of listing decisions. Yet, in the United States, neither federal nor state agencies use standardized methods for listing species for legal protection, which could put listing decisions at odds with the magnitude of the risk. We used a recently developed set of quantitative risk metrics for California herpetofauna as a case study to highlight discrepancies in listing decisions made without standardized methods. We also combined such quantitative metrics with classification tree analysis to attempt to increase the transparency of previous listing decisions by identifying the criteria that had inherently been given the most weight. Federally listed herpetofauna in California scored significantly higher on the risk‐metric spectrum than those not federally listed, whereas state‐listed species did not score any higher than species that were not state listed. Based on classification trees, state endemism was the most important predictor of listing status at the state level and distribution trend (decline in a species’ range size) and population trend (decline in a species’ abundance at localized sites) were the most important predictors at the federal level. Our results emphasize the need for governing bodies to adopt standardized methods for assessing conservation risk that are based on quantitative criteria. Such methods allow decision makers to identify criteria inherently given the most weight in determining listing status, thus increasing the transparency of previous listing decisions, and produce an unbiased comparison of conservation threat across all species to promote consistency, efficiency, and effectiveness of the listing process.
Sufficient hepatic artery flow compensates for poor portal vein flow after liver transplantation in patients with portal vein thrombosis
Authors: Sasaki Kazunari , McVey John C. , Firl Daniel J. , Andreatos Nikolaos , Moro Amika , Coromina Hernandez Laia , Matsushima Hajime , Teresa Diago Uso , Fujiki Masato , Aucejo Federico N. , Quintini Cristiano , Kwon Choon‐Hyuck D. , Eghtesad Bijan , Miller Charles M. , Hashimoto Koji 
Published: October 2019

AbstractObjectivePortal vein thrombosis (PVT) does not preclude liver transplantation (LT), but poor portal vein (PV) flow after LT remains a predictor of poor outcomes. Given the physiologic tendency of the hepatic artery (HA) to compensate for low PV flow via vasodilation, we investigated whether adequate HA flow would have a favorable prognostic impact among patients with low PV flow following LT.MethodsThis study included 163 patients with PVT who underwent LT between 2004 and 2015. PV and HA flow were categorized into quartiles, and their association with 1‐year graft survival (GS) and biliary complication rates was assessed. For both the HA and the PV, patients at the lowest two quartiles were categorized as having low flow and the remainder as having high flow.ResultsThe median MELD score was 22 and 1‐year GS was 87.3%. As expected, GS paralleled PV flow with patients at the lowest flow quartile faring the worst. In combination of PV and HA flows, high HA flow was associated with improved 1‐year GS among patients with low PV flow (P = .03). Similar findings were observed with respect to biliary complication rates.ConclusionsSufficient HA flow may compensate for poor PV flow. Consequently, meticulous HA reconstruction may be central to achieving optimal outcomes in PVT cases.
Shared reproduction and sex ratio adjustment to clutch size in a socially polymorphic orchid bee
Authors: Friedel Anna , Lattorff H. Michael G. , Quezada‐Euán José Javier G. , Boff Samuel 
Published: October 2019

AbstractNests of the primitively eusocial orchid beeEuglossa viridissimaare generally founded by a solitary female but can be reactivated by female offspring, in the presence or absence of the mother. The population therefore exists of solitary and social nests that co‐occur in an area. A female can stay as a subordinate helper under a dominant female or disperse to become a solitary foundress. Yet, the costs and benefits of the different social phenotypes are so far little understood. Here, we compared solitary and social nests of orchid bees. We used offspring of solitary and social nests to calculate offspring sex ratio, and applied molecular markers to calculate intranidal relatedness, infer maternity and test whether sociality may have a genetic component. We found that social nests had on average more brood than solitary nests. The overall sex ratio in the population did not differ from 1:1. However, social nests tended to produce a split sex ratio with some nests producing mainly males and others mainly female offspring. Regardless of social phenotype, the number of offspring was correlated with the sex ratio, with smaller nests having a more female‐biased offspring. In social nests, not all offspring resulted from a single‐mated mother, which was also the case for some solitary nests. This suggests shared reproduction in social nests and may be an indication that intraspecific parasitism and nest takeover are not uncommon. Structure analyses did not reveal different genetic background of the two social phenotypes. Our results suggest that there is no clear benefit that favours one of the two social phenotypes over the other and that the population is kept at balance in terms of sex ratio.