bluuebunny/crossref_metadata_2025_split huggingface dataset:
Caesarean birth in public maternities in Argentina: a formative research study on the views of obstetricians, midwives and trainees
Authors: Perrotta Carla , Romero Mariana , Sguassero Yanina , Straw Cecilia , Gialdini Celina , Righetti Natalia , Betran Ana Pilar , Ramos Silvina 
Published: January 2022

ObjectivesTo explore obstetricians’, midwives’ and trainees’ perceptions of caesarean section (CS) determinants in the context of public obstetric care services provision in Argentina. Our hypothesis is that known determinants of CS use may differ in settings with limited access to essential obstetric services.SettingWe conducted a formative research study in 19 public maternity hospitals in Argentina. An institutional survey assessed the availability of essential obstetric services. Subsequently, we conducted online surveys and semistructured interviews to assess the opinions of providers on known CS determinants.ResultsObstetric services showed an adequate provision of emergency obstetric care but limited services to support women during birth. Midwives, with some exceptions, are not involved during labour. We received 680 surveys from obstetricians, residents and midwives (response rate of 63%) and interviewed 26 key informants. Six out of 10 providers (411, 61%) indicated that the use of CS is associated with the complexities of our caseload. Limited pain management access was deemed a potential contributing factor for CS in adolescents and first-time mothers. Providers have conflicting views on the adequacy of training to deal with complex or prolonged labour. Obstetricians with more than 10 years of clinical experience indicated that fear of litigation was also associated with CS. Overall, there is consensus on the need to implement interventions to reduce unnecessary CS.ConclusionsPublic maternity hospitals in Argentina have made significant improvements in the provision of emergency services. The environment of service provision does not seem to facilitate the physiological process of vaginal birth. Providers acknowledged some of these challenges.
Prevalence of olfactory dysfunction and quality of life in hospitalised patients 1 year after SARS-CoV-2 infection: a cohort study
Authors: Tan Hui Qi Mandy , Pendolino Alfonso Luca , Andrews Peter J , Choi David 
Published: January 2022

ObjectivesTo determine the long-term prevalence of olfactory and/or gustatory dysfunction (OD±GD), associated risk factors and impact on quality of life (QoL) in previously hospitalised patients with COVID-19 1 year after infection.DesignA single-centre cohort study.SettingPatients admitted at a large central London hospital with COVID-19 infection between 10 February 2020 and 22 May 2020.Participants150 adult subjects with previously confirmed SARS-CoV-2 infection were recruited between 10 December 2020 and 29 January 2021. Participants were predominantly male (102/150, 68.0%); mean age 58.0±15.9 years and 41.2% (56/136) were of black, Asian and minority ethnic backgrounds.Main outcome measuresEQ-5D-5L values and Sino-Nasal Outcome Test-22 (SNOT-22) scores.ResultsLong-term prevalence of OD±GD was 12.8% (19/149) at median time of 264.5 days following SARS-CoV-2 infection onset. Patients with OD±GD had a significantly higher median total SNOT-22 score (46.1; Q1–Q3: 23.0–60.0; 95% CI 23.0 to 60.0) compared with those without (16.0; Q1–Q3: 5.0–30.5; 95% CI 12.0 to 18.0) (p=0.0002), reflecting poorer QoL, particularly psychological well-being (p=0.0004), which was not alleviated with time (p=0.4977). Median EQ-5D-5L value was not significantly different between patients with OD±GD (0.70; Q1–Q3: 0.38–0.83; 95% CI 0.38 to 0.83) and those without (0.83; Q1–Q3: 0.61–0.94; 95% CI 0.75 to 0.89) (p=0.0627). Age, sex, ethnicity, smoking status, highest C reactive protein value, intubation and ventilation, and oxygen supplementation were not found to influence OD±GD (p>0.05).Conclusions12.8% of previously hospitalised patients with COVID-19 in London still report persistent problems with smell or taste up to a year after infection, impacting their QoL. Increased holistic support including psychological therapy and olfactory rehabilitation for affected patients may help to reduce long-term morbidity.
Gastric emergencies in older adults: not always the same old story! A tertiary care emergency department observational cohort study
Authors: Rosa Fausto , Covino Marcello , Fransvea Pietro , Cozza Valerio , Quero Giuseppe , Fiorillo Claudio , Simeoni Benedetta , La Greca Antonio , Sganga Gabriele , Gasbarrini Antonio , Franceschi Francesco , Costamagna Guido , Alfieri Sergio 
Published: January 2022

ObjectiveTo analyse and compare the clinical outcomes between patients ≥80 years and 65–79 years, who presented to our emergency department (ED) with the two most common gastric emergency (GE) clinical presentation, that is, gastric bleeding and gastric perforation.DesignSingle-centre retrospective cohort study.ParticipantsA total of 1011 patients were enrolled: 421 patients aged ≥80 years were compared with a group of 590 patients aged 65–79 years.Primary and secondary outcome measuresThe primary outcome was to compare the overall mortality. Secondary outcomes included major complications, in-hospital length of stay (LOS) and need for surgical procedures.ResultsPatients ≥80 years with GE had different presentations at ED compared with younger patients: they had higher gastrointestinal bleeding (24.9% vs 16.3%, p=0.001), anemisation (14.5% vs 8.8%, p=0.005) and shock (10.9% vs 5.1%, p=0.001) rates. Median LOS, cumulative major complications and mortality rates were similar among the two groups.Multivariate analysis identified shock, gastric malignancy and gastric fistula as independent predictors for survival.ConclusionsPatients ≥80 years with GE did not have a higher mortality rate and cumulative major complications as compared to younger elderly patients. Invasive treatments were not associated with a different prognosis in this age group.
Practices and trends in clinical trial registration in the Pan African Clinical Trials Registry (PACTR): a descriptive analysis of registration data
Authors: Ndwandwe Duduzile Edith , Runeyi Sinazo , Pienaar Elizabeth , Mathebula Lindi , Hohlfeld Ameer , Wiysonge Charles Shey 
Published: January 2022

BackgroundThe Pan African Clinical Trials Registry (PACTR) is a WHO International Clinical Trials Registry Platform primary register, which caters for clinical trials conducted in Africa. PACTR is the first and, at present, the only member of the Network of WHO Primary Registers in Africa. The aim is to describe and report on the trends of trial records registered in PACTR.MethodsPACTR was established in 2007 as the AIDS, Tuberculosis, and Malaria Clinical Trials Registry. The scope of the registry was then expanded in 2009 to include all diseases. This is a cross-sectional study of trials registered in PACTR from inception to 18 August 2021. A descriptive analysis of the use and trends of the following data fields: study intervention, disease condition, sex of the participants, sample size, ethics, funding and availability of results was conducted using Microsoft Excel.ResultsThe number of trials registered has increased year on year, reaching 606 trials registered in 2020. The total number of trials registered at the time of the analysis was 2998. More than half of the trials in the registry (1655 of 2998, ie, 55%) were prospectively registered. Ethical approval was received by 90% (2691 of 2998) of the registered trials. Factorial assignment as an intervention model was in 20% (589 of 2998) of the trials registered. There were 36% (1083 of 2998) completed trials, of which 3% (94 of 1083) had results available in the registry. The most dominant funding source indicated was self-funding in 23% (693 of 2998) of the registered trials, and 55% (1639 of 2998) had no funding.ConclusionRegistration on PACTR continues to grow; however, our analysis shows that researchers’ capacity-building is needed to understand the importance of the registry and how this information informs healthcare decisions. Promoting prospective trial registration remains critical to avoid selective reporting bias to inform research gaps.
Enhanced oxidative stress and presence of ventricular aneurysm for risk prediction in cardiac sarcoidosis
Authors: Yoshitomi Ryosuke , Kobayashi Shigeki , Yano Yasutake , Nakashima Yusuke , Fujii Shohei , Nanno Takuma , Ishiguchi Hironori , Fukuda Masakazu , Yoshiga Yasuhiro , Okamura Takayuki , Suga Kazuyoshi , Kawano Reo , Yano Masafumi 
Published: January 2022

ObjectiveSudden cardiac death (SCD) is the major cause of death in cardiac sarcoidosis (CS). We aimed to identify the prognostic markers for sustained ventricular tachycardia (sVT) and SCD in patients with CS.MethodsWe performed a prospective observational cohort study for patients with CS diagnosed according to the Japanese or Heart Rhythm Society guidelines between June 2008 and March 2020 in our hospital. The primary endpoint was a composite of the first sVT and SCD. The levels of urinary 8-hydroxy-2′-deoxyguanosine (U-8-OHdG), a marker of oxidative DNA damage that reflects the inflammatory activity of CS, other biomarkers, and indices of cardiac function and renal function were measured on admission.ResultsEighty-nine consecutive patients with CS were enrolled; 28 patients with no abnormal18F-fluorodeoxyglucose (18F-FDG) accumulation in the heart were excluded and 61 patients with abnormal18F-FDG accumulation were followed up for a median of 46 months (IQR: 20–84). During the follow-up period, 15 of 61 patients showed sVT (n=12) or SCD (n=3). A Cox proportional hazard model showed that U-8-OHdG concentration and presence of ventricular aneurysm (VA) were independent predictors of first sVT/SCD. The cut-off U-8-OHdG concentration for predicting first sVT/SCD was 14.9 ng/mg·Cr. Patients with U-8-OHdG concentration ≥14.9 ng/mg·Cr and VA showed a significantly increased risk of sVT/SCD.ConclusionsU-8-OHdG and presence of VA were powerful predictors of first sVT/SCD in patients with CS, facilitating the stratification of cardiac events and providing relevant information about the substrates of ventricular tachycardia.
Differential levels of plasma biomarkers of neurodegeneration in Lewy body dementia, Alzheimer’s disease, frontotemporal dementia and progressive supranuclear palsy
Authors: Chouliaras Leonidas , Thomas Alan , Malpetti Maura , Donaghy Paul , Kane Joseph , Mak Elijah , Savulich George , Prats-Sedano Maria A , Heslegrave Amanda J , Zetterberg Henrik , Su Li , Rowe James Benedict , O'Brien John Tiernan 
Published: January 2022

ObjectivesThis longitudinal study compared emerging plasma biomarkers for neurodegenerative disease between controls, patients with Alzheimer’s disease (AD), Lewy body dementia (LBD), frontotemporal dementia (FTD) and progressive supranuclear palsy (PSP).MethodsPlasma phosphorylated tau at threonine-181 (p-tau181), amyloid beta (Αβ)42, Aβ40, neurofilament light (NfL) and glial fibrillar acidic protein (GFAP) were measured using highly sensitive single molecule immunoassays (Simoa) in a multicentre cohort of 300 participants (controls=73, amyloid positive mild cognitive impairment (MCI+) and AD dementia=63, LBD=117, FTD=28, PSP=19). LBD participants had known positron emission tomography (PET)-Aβ status.ResultsP-tau181 was elevated in MCI+AD compared with all other groups. Aβ42/40 was lower in MCI+AD compared with controls and FTD. NfL was elevated in all dementias compared with controls while GFAP was elevated in MCI+AD and LBD. Plasma biomarkers could classify between MCI+AD and controls, FTD and PSP with high accuracy but showed limited ability in differentiating MCI+AD from LBD. No differences were detected in the levels of plasma biomarkers when comparing PET-Aβ positive and negative LBD. P-tau181, NfL and GFAP were associated with baseline and longitudinal cognitive decline in a disease specific pattern.ConclusionThis large study shows the role of plasma biomarkers in differentiating patients with different dementias, and at monitoring longitudinal change. We confirm that p-tau181 is elevated in MCI+AD, versus controls, FTD and PSP, but is less accurate in the classification between MCI+AD and LBD or detecting amyloid brain pathology in LBD. NfL was elevated in all dementia groups, while GFAP was elevated in MCI+AD and LBD.
Benefit and risk of intravenous alteplase in patients with acute large vessel occlusion stroke and low ASPECTS
Authors: Broocks Gabriel , McDonough Rosalie , Bechstein Matthias , Hanning Uta , Brekenfeld Caspar , Flottmann Fabian , Kniep Helge , Nawka Marie Teresa , Deb-Chatterji Milani , Thomalla Götz , Sporns Peter , Yeo Leonard LL , Tan Benjamin YQ , Gopinathan Anil , Kastrup Andreas , Politi Maria , Papanagiotou Panagiotis , Kemmling Andre , Fiehler Jens , Meyer Lukas 
Published: January 2022

BackgroundThe benefit of best medical treatment including intravenous alteplase (IVT) before mechanical thrombectomy (MT) in patients with acute ischemic stroke and extensive early ischemic changes on baseline CT remains uncertain. The purpose of this study was to evaluate the benefit of IVT for patients with low ASPECTS (Alberta Stroke Programme Early CT Score) compared with patients with or without MT.MethodsThis multicenter study pooled consecutive patients with anterior circulation acute stroke and ASPECTS≤5 to analyze the impact of IVT on functional outcome, and to compare bridging IVT with direct MT. Functional endpoints were the rates of good (modified Rankin Scale (mRS) score ≤2) and very poor (mRS ≥5) outcome at day 90. Safety endpoint was the occurrence of symptomatic intracranial hemorrhage (sICH).Results429 patients were included. 290 (68%) received IVT and 168 (39%) underwent MT. The rate of good functional outcome was 14.4% (95% CI 7.1% to 21.8%) for patients who received bridging IVT and 24.4% (95% CI 16.5% to 32.2%) for those who underwent direct MT. The rate of sICH was significantly higher in patients with bridging IVT compared with direct MT (17.8% vs 6.4%, p=0.004). In multivariable logistic regression analysis, IVT was significantly associated with very poor outcome (OR 2.22, 95% CI 1.05 to 4.73, p=0.04) and sICH (OR 3.44, 95% CI 1.18 to 10.07, p=0.02). Successful recanalization, age, and ASPECTS were associated with good functional outcome.ConclusionsBridging IVT in patients with low ASPECTS was associated with very poor functional outcome and an increased risk of sICH. The benefit of this treatment should therefore be carefully weighed in such scenarios. Further randomized controlled trials are required to validate our findings.
Surface flow–interflow-coupled nitrogen loss in gray fluvo-aquic farmland soils in the Anhui Section of the Huaihe River Basin, China
Authors: Wang Hui , Gao Liangmin , Pang Zhendong , Yang Jie , Chen Xiaoqing , Zhang Jinxin , Wang Shuo , Tong Rongrong , Shi Chuang , Chen Xudong 
Published: January 2022

To reveal the characteristics of nitrogen loss and their coupling relations in the process of surface flow and interflow under various rainfall intensities in gray fluvo-aquic soil areas, the coupling loss characteristics of total nitrogen (TN), nitrate nitrogen (NO3−-N), and ammonium nitrogen (NH4+-N) in the surface flow and interflow under three rainfall intensities (60, 80, and 110 mm·h−1) at a slope of 5° were studied using an artificial rainfall simulation. The results showed that (1) runoff yield and TN concentration were proportional to the rainfall intensity, with higher runoff concentrations of TN in the initial stage, and (2) surface flow yield, which was the main output mode of farmland runoff, was higher than interflow yield under a range of rainfall intensities. The average concentration of NO3−-N in surface flow decreased with increasing rainfall intensity, whereas the opposite was true in interflow. The main loss path of NO3−-N was interflow, whereas the main loss path of NH4+-N was the surface flow; NO3−-N was the main form of TN loss. The surface flow was the main loss path of soil nitrogen loss in farmland, and the runoff yield was an important factor in controlling nitrogen loss.
Alpha-gamma decay studies of $$^{247}$$Md
Authors: Heßberger F. P. , Antalic S. , Giacoppo F. , Andel B. , Ackermann D. , Block M. , Heinz S. , Khuyagbaatar J. , Kojouharov I. , Venhart M. 
Published: January 2022

AbstractAlpha
decay and spontaneous fission of the ground-state and the isomeric state of $$^{247}$$

247

Md were investigated with specific emphasis to identify the ground-state of the daughter nucleus $$^{243}$$

243

Es. The decay studies were accompanied by measuring $$\alpha $$
α
-$$\gamma $$
γ
coincidences. On the basis of the measured data an improved decay scheme of $$^{247}$$

247

Md is proposed. Spontaneous fission half-lives of $$^{247g}$$

247
g

Md and $$^{247m}$$

247
m

Md were determined and the fission hindrance of the high spin ground-state (7/2$$^{-}$$

-

) relative to the low spin isomeric state (1/2$$^{-}$$

-

) was estimated.
Collateral Status and Clinical Outcomes after Mechanical Thrombectomy in Patients with Anterior Circulation Occlusion
Authors: Xu Yuzhu , Guo Songtao , Jiang Hao , Han Hui , Sun Jian , Wu Xi 
Published: January 2022

Background. Successful mechanical thrombectomy (MT) requires reliable, noninvasive selection criteria. We aimed to investigate the association of collateral status and clinical outcomes after MT in patients with ischemic stroke due to anterior circulation occlusion. Methods. 109 patients with poor collaterals and 110 aged, sex-matched patients with good collaterals were enrolled in the study. Collateral circulation was estimated by the CT angiography with a 0–3 scale. The collateral status was categorized as poor collaterals (scores 0–1) and good collaterals (scores 2-3). The reperfusion was assessed by the modified Treatment in Cerebral Infarction scale (mTICI, score 0/1/2a/2b/3). The clinical outcomes included the scores on the modified Rankin scale (mRS, ranging from 0 to 6) and death 90 days after mechanical thrombectomy. Results. Patients with greater scores of collateral status were more likely to achieve successful reperfusion (mTICI 2b/3). Patients with good collaterals were significantly associated with a higher chance of achieving mRS of 0–1 at 90 days (adjusted ORs: 4.55; 95% CI: 3.17–7.24; and

P

< 0.001) and a lower risk of death at 90 days (adjusted ORs: 0.87; 95% CI: 4.0%–28.0%; and

P

= 0.012) compared to patients with poor collaterals. In subgroup analyses, patients with statin use seem to benefit more from the effect of collateral status on good mRS (≤2). Conclusion. Among patients with acute ischemic stroke caused by anterior circulation occlusion, better collateral status is associated with higher scores on mRS and lower mortality after mechanical thrombectomy. Statin use might have an interaction with the effect of collateral status.
Artificial Intelligence Algorithm-Based MRI in Evaluating the Treatment Effect of Acute Cerebral Infarction
Authors: He Xiaojie , Liu Guangxiang , Zou Chunying , Li Rongrui , Zhong Juan , Li Hong 
Published: January 2022

The study is aimed at exploring the application of artificial intelligence algorithm-based magnetic resonance imaging (MRI) in the diagnosis of acute cerebral infarction, expected to provide a reference for diagnosis and effect evaluation of acute cerebral infarction. In this study, 80 patients diagnosed with suspected acute cerebral infarction per Diagnostic Criteria for Cerebral Infarction were selected as the research subjects. MRI images were reconstructed by deep dictionary learning to improve their recognition ability. At the same time, the same diagnostic operation was performed by Computed Tomography (CT) images to compare with MRI. The results of the interalgorithm comparison showed the image reconstruction effect of the deep dictionary learning model is significantly better than SAE reconstruction, single-layer dictionary reconstruction model, and KAVD reconstruction. After comparison, the results of MRI based on artificial intelligence algorithm and CT evaluation were statistically significant (

P
<
0.05

). In the lesion image, the diameter of MRI lesions (

3.81
±
0.77

cm) based on artificial intelligence algorithm and the diameter of lesions in CT (

3.66
±
1.65

cm) also had significant statistical significance (

P
<
0.05

). The results showed that MRI based on deep learning was more sensitive than CT imaging for diagnosis and evaluation of patients with acute cerebral infarction, with only 1 case misdiagnosed. The rate of disease detection and lesion image quality had a higher improvement. The results can provide effective support for the clinical application of MRI based on artificial intelligence algorithm in the diagnosis of acute cerebral infarction.
HotspotESR1Mutations Are Multimodal and Contextual Modulators of Breast Cancer Metastasis
Authors: Li Zheqi , Wu Yang , Yates Megan E. , Tasdemir Nilgun , Bahreini Amir , Chen Jian , Levine Kevin M. , Priedigkeit Nolan M. , Nasrazadani Azadeh , Ali Simak , Buluwela Laki , Arnesen Spencer , Gertz Jason , Richer Jennifer K. , Troness Benjamin , El-Ashry Dorraya , Zhang Qiang , Gerratana Lorenzo , Zhang Youbin , Cristofanilli Massimo , Montanez Maritza A. , Sundd Prithu , Wallace Callen T. , Watkins Simon C. , Fumagalli Caterina , Guerini-Rocco Elena , Zhu Li , Tseng George C. , Wagle Nikhil , Carroll Jason S. , Jank Paul , Denkert Carsten , Karsten Maria M. , Blohmer Jens-Uwe , Park Ben H. , Lucas Peter C. , Atkinson Jennifer M. , Lee Adrian V. , Oesterreich Steffi 
Published: January 2022

AbstractConstitutively active estrogen receptor α (ER/ESR1) mutations have been identified in approximately one-third of ER+ metastatic breast cancers. Although these mutations are known as mediators of endocrine resistance, their potential role in promoting metastatic disease has not yet been mechanistically addressed. In this study, we show the presence of ESR1 mutations exclusively in distant but not local recurrences in five independent breast cancer cohorts. In concordance with transcriptomic profiling of ESR1-mutant tumors, genome-edited ESR1 Y537S and D538G-mutant cell models exhibited a reprogrammed cell adhesive gene network via alterations in desmosome/gap junction genes and the TIMP3/MMP axis, which functionally conferred enhanced cell–cell contacts while decreasing cell-extracellular matrix adhesion. In vivo studies showed ESR1-mutant cells were associated with larger multicellular circulating tumor cell (CTC) clusters with increased compactness compared with ESR1 wild-type CTCs. These preclinical findings translated to clinical observations, where CTC clusters were enriched in patients with ESR1-mutated metastatic breast cancer. Conversely, context-dependent migratory phenotypes revealed cotargeting of Wnt and ER as a vulnerability in a D538G cell model. Mechanistically, mutant ESR1 exhibited noncanonical regulation of several metastatic pathways, including secondary transcriptional regulation and de novo FOXA1-driven chromatin remodeling. Collectively, these data provide evidence for ESR1 mutation–modulated metastasis and suggest future therapeutic strategies for targeting ESR1-mutant breast cancer.Significance:Context- and allele-dependent transcriptome and cistrome reprogramming in mutant ESR1 cell models elicit diverse metastatic phenotypes related to cell adhesion and migration, which can be pharmacologically targeted in metastatic breast cancer.