bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cerebro placental ratio at 30–34 weeks’ gestation in the prediction of perinatal outcome in low-risk and high-risk pregnancy
Authors: Jaiprakash Patil Purnima , Sujani B K  , Urvashi  , Mamatha  , Devi Gavatri 
Published: May 2022

Doppler ultrasound velocimetry of umbilical and fetal vessels has become an established method of antenatal monitoring, allowing the non-invasive assessment of neonatal circulation. Cerebro placental ratio (CPR) is emerging as a significant predictor of adverse pregnancy outcome. To predict perinatal outcome in low and high-risk pregnancy in early and late-onset FGR using CPR. The study group comprised 410 pregnant women at 30-34 weeks, evaluated with ultrasound Doppler study, and other routine investigations and CPR were calculated. Women were categorized into high-risk and low-risk pregnancies and followed up until delivery, and fetal outcome was noted. Period of prolongation of pregnancy was significantly lower with high-risk patients than low-risk patients (31.09 ± 13.9 vs 37.79 ± 15.1, p=0.0003). NICU admissions significantly increased with high-risk patients than low-risk patients (22.22% vs 9.4%, p=0.002). Low-risk patients underwent significantly more vaginal deliveries as compared to high-risk patients (74.22% vs 44.87%, p &#60; 0.0001). Birth weight, period of prolongation of pregnancy, and gestation period were significantly lower in patients with abnormal CPR than normal CPR group (2.82 Kg vs 1.94 Kg, 37.56 weeks vs 14.64 weeks, 266.47 days vs 245.41 days, respectively). Doppler velocimetry becomes an important tool for high-risk cases and late-onset mild FGR(after 32 weeks). CPR is helpful in high-risk pregnancies and also to predict peripartum fetal distress.
A giant ovarian tumor in perimenopausal women: A case report and review of literature
Authors: Rani Anju Kumari , Pandey Jyotsna , Kapoor Deepa 
Published: May 2022

To remind clinicians of the challenges in diagnosis management, and precautions to be taken when performing surgery for giant ovarian tumor. Our reported case is a 50-year old multiparous perimenopausal woman presented with marked progressive abdominal distension, difficulty in breathing and amenorrhea at the gynaecology OPD General Hospital, Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow. The tumor was removed by laparotomy without any spill and her peroperative and Postoperative periods were uneventful. The details were collected by history-taking, clinical examination, laboratory investigations, abdominal ultrasonography, CECT abdomen and by histopathological study of the excised surgical specimen. The case was reported as a huge mucinous cystadenoma of ovary with good surgical outcome.: Such huge ovarian tumor is rare now a days because of awareness and accessibility to better imaging modalities. These tumors are potentially dangerous in its massive form if not timely diagnosed and managed. They have excellent surgical results and survival rates. Early detection of ovarian tumor is the key to success.
Life design group-based intervention fostering vocational identity, career adaptability, and career decision-making self-efficacy
Authors: Cardoso Paulo , Duarte Maria Eduarda , Pacheco Lisandra , Janeiro Isabel Nunes 
Published: May 2022

This study examines the process and outcome of a life design group intervention with grade 9 students. In a sample of 139 participants (91 girls and 48 boys), a quasi-experimental design was applied to analyse the intervention’s effectiveness at fostering vocational identity, career adaptability and career decision-making self-efficacy. Seventy and 69 participants were included in the experimental and control groups, respectively. Outcome measures were applied at the onset of the intervention, at the end of counselling and three months after the last session. A focus group involving 17 participants was conducted to determine participants’ perceptions of the intervention process and outcome. The findings support the empirical evidence on the effectiveness of life design group-based interventions to foster vocational identity, career adaptability and career decision-making self-efficacy. The focus group participants evaluated the intervention as useful by fostering reflexivity and a sense of direction. Overall, the findings suggest the relevance of life design practices in educational settings to foster reflexivity and, therefore, to facilitate students’ career construction. The research implications of the findings are also discussed.

Keywords: Life design, vocational identity, career adaptability, reflexivity, adolescents
Experiences of Canadian Female Orthopaedic Surgeons in the Workplace
Authors: Hiemstra Laurie A. , Kerslake Sarah , Clark Marcia , Temple-Oberle Claire , Boynton Erin 
Published: May 2022

Background:
Only 13.6% of orthopaedic surgeons in Canada are women, even though there is nothing inherent to the practice of orthopaedic surgery that favors men over women. Clearly, there is a need to identify, define, and measure the barriers faced by women in orthopaedic surgery.

Methods:
An electronic survey was distributed to 330 female-identifying Canadian orthopaedic surgeons and trainees and included the validated Gender Bias Scale (GBS) and questions about career burnout. The barriers for women in Canadian orthopaedics were identified using the GBS. The relationships between the GBS and burnout were investigated. Open-text questions explored the barriers perceived by female orthopaedic surgeons.

Results:
The survey was completed by 220 female orthopaedic surgeons and trainees (66.7%). Five barriers to gender equity were identified from the GBS: Constrained Communication, Unequal Standards, Male Culture, Lack of Mentoring, and Workplace Harassment. Career burnout correlated with the GBS domains of Male Privilege (r = 0.215; p < 0.01), Disproportionate Constraints (r = 0.152; p < 0.05), and Devaluation (r = 0.166; p < 0.05). Five main themes emerged from the open-text responses, of which 4 linked closely to the barriers identified in the GBS. Work-life integration was also identified qualitatively as a theme, most notably the difficulty of balancing disproportionate parental and childcare responsibilities alongside career aspirations.

Conclusions:
In this study, 5 barriers to workplace equity for Canadian female orthopaedic surgeons were identified using the validated GBS and substantiated with qualitative assessment using a mixed-methods approach. Awareness of these barriers is a necessary step toward dismantling them and changing the prevailing culture to be fair and equitable for all.

Clinical Relevance:
A just and equitable orthopaedic profession is imperative to have healthy and thriving surgeons who are able to provide optimal patient care.
Geomechanical Model for Frictional Contacting and Intersecting Fracture Networks: An Improved 3D Displacement Discontinuity Method
Authors: Fan Hongzhuo , Shao Jianfu , Li Sanbai 
Published: May 2022

Summary
The displacement discontinuity method (DDM) is widely used in large-scale engineering problems, such as hydraulic fracturing stimulation in unconventional reservoirs and enhanced geothermal systems, due to its convenient calculation and high precision. Although the 3D-DDM based on triangular elements can more accurately describe intrinsically geometric characteristics of artificial/natural fractures, due to the disadvantage of constant DDM, it will still produce large errors when calculating frictional contacting, close-spacing, and intersecting fractures, which greatly limits the universality of DDM in complex fracture networks. To the best of the authors’ knowledge, few DDM-based models are capable of tackling partially contacting fracture networks with arbitrary intersecting angles. In this paper, we propose a more efficient 3D-DDM algorithm via integrating the analytical solution, the 20-point Gaussian quadrature formula for standard triangles (GQSTS) integration algorithm, and the adaptive Gaussian-Kronrod integration algorithm. Then, combining the “local mesh refinement” grid, the Mohr-Coulomb correction for negative fracture aperture, and two rough fracture deletion strategies, the optimized 3D-DDM algorithm with broader versatility is established. All optimization measures are validated by the relevant fracture model. In the optimized 3D-DDM algorithm, (1) the “local mesh refinement” technique effectively improves the calculation accuracy of intersecting fractures; (2) the adaptive Gaussian-Kronrod integration algorithm not only improves the integration accuracy of high oscillation functions but is also 50% faster than the traditional Gaussian integration algorithm; (3) the Mohr-Coulomb criterion serves as a rigorous constraint for frictional contacting fractures to avoid the occurrence of negative fracture aperture; and (4) using the rough “deep deletion” or “shallow deletion” strategy to replace the ultrahigh-quality mesh generation can more conveniently maintain the accuracy of the complex fractures model. This optimized 3D-DDM algorithm may serve as a basis for simulating nonplanar 3D fracture swarms’ evolution, allowing for frictional contacting, closespacing, and intersecting fractures.
Genomics of SOX13 gene is dynamic in Type 1 Diabetes
Authors: Choudhury Shouhartha 
Published: May 2022

Abstract
The encoded SOX13 gene from the HMG-box genes family is testis associated with the HMG-box domain bound with DNA. The HMG-box associated genes play a dominant role during the growth. Precisely, SOX13 is an insulin-dependent gene located on chromosome 1. The insulin is substantial proof of the genomics variance of the SOX13 gene illustrates the statement of sensibility in type-1 diabetes (T1D). SOX13 identified in islets also exocrine pancreas and initiated as a vital auto-antigen (ICA12). The beta-cell antigens stimulate the mechanisms of peripheral tolerance. The approval of the SOX13 gene as an auto-antigen is an effective marker for autoimmunity. So, I aimed to an analysis of SOX13 gene from the family of SRY-related HMG-box genes in the mammal. Therefore, I performed bioinformatics and computational application for experimentation of particular gene and their family in two different organisms. My finding provided a genomic variability of the SOX13 gene is sensitive in T1D. Therefore, I documented the SOX13 gene and their molecular mechanism and total HMG-box domains in Homo sapiens and Mus musculus. A computational and bioinformatics analysis demonstrated that SOX13 is an insulin-dependent gene. The series of reports suggested unique aspects of SRY-related HMG-box genes during the growth of organisms. My findings justified that the HMG-box genes play essential roles during the development of mammals. In contrast, the high mobility group (HMG-box) of the SOX13 is an insulin-dependent gene.
The importance of children and young person involvement in scoping the need for a paediatric glucocorticoid-associated patient reported outcome measure
Authors: Singhal Shabnam , Sm Eve MD , Roper Louise , Pain Clare 
Published: May 2022

Abstract
Background: For many children and young people (CYP) with paediatric rheumatic conditions, glucocorticoid medications and their associated side-effects have a substantial impact on disease experience. Whilst there are physician-rated measures of glucocorticoid toxicity, no parallel patient reported measure has been developed to date for CYP with rheumatic disease. This manuscript describes a series of public patient involvement (PPI) events to inform the development of a future paediatric glucocorticoid-associated patient reported outcome measure (PROM). Methods: One large group PPI event was advertised to CYP with experience of glucocorticoid medication use and their parents through clinicians, charities and existing PPI groups. This featured education on the team’s research into glucocorticoid medication and interactive polls/structured discussion to help participants share their experiences. Further engagement was sought for PPI group work to co-develop future glucocorticoid studies, including development of a glucocorticoid associated PROM. Quantitative and qualitative feedback was collected from online questionnaires. The initiative was held virtually due to the Covid-19 pandemic.Results: Nine families (n=15) including 6 CYP joined the large group PPI event. Online pre-attendance and post-attendance questionnaires showed improvement in mean self-reported confidence [1=not at all confident, 5=very confident] in the following: what steroid medications are (pre=3.9, post=4.8), steroid side effects (pre=3.8, post=4.6), patient-reported outcome measures (pre=2.0, post=4.5), available research on steroids (pre=2.2, post=3.5). Five families (n=7) were involved in a monthly PPI group who worked alongside the research team to identify priorities in glucocorticoid research, produce age-appropriate study materials, identify barriers to study participation (e.g. accessibility & convenience) and recommend appropriate modalities for dissemination. The participants found discussing shared experiences and learning about research to be the most enjoyable aspects of the initiative.Conclusions: This PPI initiative provided a valuable forum for families, including young children, to share their perspectives. Here, the authors explore the effective use of PPI in a virtual setting and provide a unique case study for the involvement of CYP in PROM development. The monthly PPI group also identified a need for the development of a new PROM related to glucocorticoid medication use and provided unique insights into how such a study could be structured. Trial Registration: Not Applicable
Evaluation of metal contamination in surface sediments and macroalgae in mangrove and port complex ecosystems on the Brazilian Equatorial Margin
Authors: Cutrim Marco Valério Jansen , Corrêa James Jordan Marques 
Published: May 2022

Abstract
This study evaluated metal contamination in surface sediments and macroalgae of mangroves and port complexes on the Brazilian equatorial margin. Samples were collected between August 2020 and February 2021 at seven points in a mangrove swamp under the influence of port activity and at two points without port activity. Metal concentrations in the macroalgae and sediments were determined using inductively coupled plasma optical emission spectrometry. All macroalgal species bioaccumulated metals, as demonstrated by their bioaccumulation factors. The geochemical contamination indices indicated that the estuarine complex was influenced by port activity as moderately contaminated by Pb, Cr, Mn, and Fe, and considerably contaminated by Zn and Cu. The enrichment factor confirmed significant mineral enrichment of Zn and Cu in this environment. The concentrations of the metals in the sediment followed the order Fe > Mn > Cr > Zn > Cu > Pb at most collection points. Cladophoropsis membranacea recorded the highest bioaccumulation values for Pb (0.44), Rhizoclonium africanum for Zn (1.08), Cr (0.55), and Fe (0.30), and Bostrychia radicans for Mn (2.22). The bioaccumulation pattern of metals in the most abundant macroalgal species followed the order Bostrychia radicans (Mn > Zn > Cu > Cr > Pb > Fe) and Rhizoclonium africanum (Zn > Mn > Cr > Cu > Pb > Fe).
Severe hyperlactatemia in unselected surgical patients. Retrospective analysis of prognostic outcome factors.
Authors: Spiegelberg Julia , Lederer Ann-Kathrin , Claus Sibylla , Runkel Mira , Utzolino Stefan , Fichtner-Feigl Stefan , Kousoulas Lampros 
Published: May 2022

Abstract
BACKGROUNDEtiology of hyperlactatemia in ICU patients is heterogeneous - septic, cardiogenic or hemorrhagic shock seem to be predominant reasons. Multiple studies show hyperlactatemia as an independent predictor for ICU mortality. Only limited data exists about the etiology of hyperlactatemia and lactate clearance and their influence on mortality. The goal of this single-center retrospective study, was to evaluate the effect of severe hyperlactatemia and reduced lactate clearance rate on the outcome of unselected ICU surgical patients. METHODSOverall, 239 surgical patients with severe hyperlactatemia (>10 mmol/L) who were treated in the surgical ICU at the University Medical Center Freiburg between June 2011 and August 2017, were included in this study. The cause of the hyperlactatemia as well as the postoperative course and the patient morbidity and mortality were retrospectively analyzed. Lactate clearance was calculated by comparing lactate level 12h after first measurement of >10mmol/L.RESULTSThe overall mortality rate in our cohort was 82.4%. Severe hyperlactatemia was associated with death in the ICU (p<0.001). The main etiologic factor was sepsis (51.9%), followed by mesenteric ischemia (15.1%), hemorrhagic shock (13.8%) and liver failure (9.6%). Higher lactate levels at ICU admission were associated with increased mortality (p< 0.001). Lactate clearance after 12h was found to predict ICU mortality (ANOVA p<0.001) with an overall clearance of under 50% within 12h. The median percentage of clearance was 60.3% within 12h for the survivor and 29.1% for the non-survivor group (p < 0.001). CONCLUSIONLactate levels appropriately reflect disease severity and are associated with short-term mortality in critically ill patients. The main etiologic factor for surgical patients is sepsis. When elevated lactate levels persist more than 12h, survival chances are low and the benefit of continued maximum therapy should be evaluated.
Developing an Explainable Machine Learning Algorithm to Predict the Mechanical Ventilation Duration of Patients with ARDS in Intensive Care Units
Authors: Wang Zichen , Zhang Luming , Huang Tao , Yang Rui , Wang Hao , Yin Haiyan , Lyu Jun 
Published: May 2022

Abstract
Objective: This study aimed to develop an explainable model for predicting mechanical ventilation (MV) duration in patients with acute respiratory distress syndrome (ARDS) using on a machine learning (ML) approach.Method: Of the 4443 patients with ARDS in the Medical Information Mart for Intensive Care-IV database, 2702 were selected to construct feature set A (age at admission, BMI, Acute Physiology Score III [APS-III], Sequential Organ Failure Assessment [SOFA] score, and other features at MV initiation), and 2228 patients remained for construct feature sets B (age, APS-III, SOFA score, and remaining features after 24 hours MV) and C (A+B). After feature sets were randomly assigned with 70% in a training cohort and 30% in a testing cohort, tenfold cross-validation was conducted on training cohort to determine the best performing model, which was accessed in the related testing cohort and explained using SHapley Additive exPlanations (SHAP).Result: The tenfold cross-validation results indicated that the Extreme Gradient Boosting model had the best performance on the training set (root-mean-square error [RMSE]=5.78 days [SD=0.52 days]) among six algorithms. The Bland–Altman plot and paired sample t-test results indicated that the predicted and actual values of the optimal model were consistent, with RMSE=6.85 days. The SHAP results indicated that the three most important features for the model were APS-III, age, and BMI, and there was an obvious effect of the interaction between APS-III and age on the SHAP value.Conclusion: ML models can accurately predict the MV duration of patients with ARDS in intensive care units. The feature set based at MV initiation had better predictive performance than the feature set at 24 hours after MV.
The Association of Serum RANKL Levels with disease activity and Hematological Parameters in Syrian Patients with Rheumatoid Arthritis
Authors: Hussein Rama , Abokhamis Imad 
Published: May 2022

Abstract
Our study aims to detect whether the serum RANKL could be a novel potential biomarker for activity and diagnosis of rheumatoid arthritis (RA). It included fifty-eight of RA patients and thirty of equal age and sex matched controls. Disease activity was determined by using DAS28-ESR. Serum Levels of RANKL were assayed by ELISA and compared with parameters such as ESR, CRP, Rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibodies (ACPA). The serum RANKL levels were higher in RA patients compared to controls. There was an increase in its levels mean among post-menopausal patients compared to post-menopausal healthy group. RANKL levels were also higher in ACPA positive patients than ACPA negative. Our study found a correlation between RANKL levels and some parameters: DAS28, ACPA and symptom duration. No correlation was observed with ESR, TJC, SJC, RF, VAS, CRP. There was a moderate inverse correlation between RANKL levels and BMD. By ROC curve, our results displayed that the best cutoff value of serum RANKL was 178.99 pg/ml (sensitivity 79.31%; specificity 90%) to differentiate between RA patients and controls. In conclusion, elevated serum RANKL can be used as an indicator of disease activity and a diagnostic new biomarker in patients with early RA.
Early clonal expansion of tumor-infiltrating lymphocytes predicts response to immune checkpoint therapy
Authors: Kidman Joel , Zemek Rachael , Principe Nicola , Correa Debora , Sheikh Fezaan , Fear Vanessa , Forbes Catherine , Chopra Abha , Boon Louis , de Jong Emma , Zaitouny Ayham , Holt Robert , Jones Matt , Millward Michael , Lassmann Timo , Forrest Alistair , Nowak Anna , Watson Mark , Lake Richard , Lesterhuis W.Joost , Chee Jonathan 
Published: May 2022

Abstract
Immune checkpoint therapy (ICT) causes durable tumor responses in a subgroup of patients. Profiling T cell receptor beta (TCRβ) repertoire structure in ICT responders and non-responders provides mechanistic insight into what constitutes an effective anti-tumor response, and could result in the development of predictive biomarkers of response to identify and stratify patients for ICT. To examine how the TCRβ repertoire dynamics contribute to ICT response, we utilized an established murine model that excludes variation in host genetics, environmental factors and tumor mutation burden, limiting variation between animals to naturally diverse TCRβ repertoires. Oligoclonal expansion of TCRβ clonotypes that corresponded with a low TCRβ diversity was observed in responding tumors prior to ICT. We modeled TCRβ cluster dynamics during ICT and found that select clonotypes expanded slower in responders compared to non- responders. Clonally expanded CD8+ tumor infiltrating T cells in non-responders exhibited a T cell exhaustion phenotype. We conclude that an early burst of clonal expansion followed by a contraction during ICT is associated with response.