bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-Managed Medication Abortion: Implications for Clinical Practice
Authors: Cirucci Christina A. 
Published: December 2022

Medication abortion represents more than 50 percent of abortions in the United States (US). Since its approval in the US in 2000, the Food and Drug Administration (FDA) has progressively relaxed the prescribing requirements such that currently, no office visit, in-person dispensing, or ultrasound is required. Obtaining medication for abortion online without medical supervision or evaluation is also possible. This article reviews the complications of medication abortion by examining major studies and delineates the risks specific to self-managed abortion to inform clinicians in caring for women. Summary Medication abortion has become the most common abortion method in the United States. This document provides a detailed history of the relaxation requirements on medication abortion and reviews the major studies on medication abortion complications including a discussion of their limitations. Finally, the paper delineates the ease of access to medication abortion without a health care provider and the risks associated with self-managed abortion. This paper is intended to provide information for clinicians who likely will be encountering increasing number of patients with such complications.
Is There Someone in the Hereafter? Mediumship Accuracy of 100 Readings Obtained with a Triple Level of Blinding Protocol
Authors: Tressoldi Patrizio , Liberale Laura , Sinesio Fernando 
Published: December 2022

The accuracy of information obtained by 28 self-claimant mediums related to 100 readings obtained with a triple level of blinding was examined across three indices: percentage of correct reading identified by the sitters, global score of readings and percentage of difference between correct and incorrect information. All three indices showed statistical differences of the intended versus the control readings: correct identification 65%; global score: intended readings, mean = 2.4, SD = 1.5; control readings, mean = 1.7, SD = 1.2; percentage difference between correct and incorrect information: intended readings, mean = −7.9%, SD = 38.7%; control readings, mean = −27.3%, SD = 38%. Our results using a very large sample, confirm previous results, supporting the hypothesis that self-claimant mediums are able to retrieve correct information about deceased people without knowing and interacting with the sitters having access with only to the deceased persons’ first name.
Protamine titration to optimize heparin antagonization after cardiopulmonary bypass
Authors: Foubert Ruben , Van Vaerenbergh Geert , Cammu Guy , Buys Sara , De Mey Nathalie , Lecomte Patrick , Bouchez Stefaan , Rex Steffen , Foubert Luc 
Published: December 2022

Objectives To optimize protamine titration for heparin antagonization after weaning from cardiopulmonary bypass (CPB). Design A prospective, observational trial. Setting Single-center, non-university teaching hospital. Participants Forty patients presenting for elective on-pump coronary artery bypass grafting with or without single valve surgery. Interventions At the end of CPB, the residual amount of heparin in the patient was estimated using a Bull-curve. The total protamine dose was calculated as 1 unit of protamine for 1 unit of heparin. Protamine was administered as 5 aliquots containing 20% of the total protamine dose each, with 2-min intervals. Measurements and main results Activated Clotting Time (ACT) values were measured 2 min after administration of each aliquot. ROTEM(®)-analysis was performed after the full dose of protamine had been administered. After 60% of the total protamine dose had been administered, ACT values were normalized in 86.5% of patients. After the complete dose of protamine had been administered, 61.1% of patients displayed signs of protamine overdose on ROTEM(®)-analysis. Conclusions In patients who present for on-pump coronary artery bypass grafting with or without single valve surgery, a 0.6-to-1 ratio of protamine-to-heparin to antagonize heparin may be sufficient and beneficial for patients.
Social Disparities in Mental Health Service Use Among Children and Youth in Ontario: Evidence From a General, Population-Based Survey
Authors: Kamali Mahdis , Edwards Jordan , Anderson Laura N. , Duku Eric , Georgiades Katholiki 
Published: December 2022

Objectives To examine differences in mental health-related service contacts between immigrant, refugee, racial and ethnic minoritized children and youth, and the extent to which social, and economic characteristics account for group differences. Methods The sample for analyses includes 10,441 children and youth aged 4–17 years participating in the 2014 Ontario Child Health Study. The primary caregiver completed assessments of their child's mental health symptoms, perceptions of need for professional help, mental health-related service contacts, experiences of discrimination and sociodemographic and economic characteristics. Results Adjusting for mental health symptoms and perceptions of need for professional help, children and youth from immigrant, refugee and racial and ethnic minoritized backgrounds were less likely to have mental health-related service contacts (adjusted odds ratios ranged from 0.54 to 0.79), compared to their non-immigrant peers and those who identified as White. Group differences generally remained the same or widened after adjusting for social and economic characteristics. Large differences in levels of perceived need were evident across non-migrant and migrant children and youth. Conclusion Lower estimates of mental health-related service contacts among immigrant, refugee and racial and ethnic minoritized children and youth underscore the importance and urgency of addressing barriers to recognition and treatment of mental ill-health among children and youth from minoritized backgrounds.
Too Close for Comfort? Attitudes of Gynecologic Oncologists Toward Caring for Dying Patients
Authors: Hmaidan Sarah , Goulder Alison , Bos Lia , Shen Megan J. , Wellman JD , Prescott Lauren , Brown Alaina 
Published: December 2022

Purpose To assess gynecologic oncologists’ attitudes relating to palliative care referrals among advanced cancer patients. Methods Gynecologic oncologists were surveyed using validated measures to assess stigmatizing attitudes toward palliative care, anticipated stigma of palliative care, acceptance of palliative care, and willingness to refer to palliative care. Descriptive statistics were calculated. Analysis was performed using linear regression. Results 1200 physicians received the survey and 108 (9%) completed it. Most were female (69.4%) and white (82.4%). Most practiced in academics (64.8%) in urban environments (71.3%). Respondents did not have anticipated stigma surrounding palliative care referral (mean score 1.89, range 1-7, higher score indicating more stigma), were accepting of palliative care (mean score 1.45, range 1-7, higher score indicating less acceptance), and were willing to refer patients to palliative care (mean score 5.75, range 1-7, higher score indicating more willingness to refer). Linear regression demonstrated females had less anticipated stigma surrounding palliative care (B = −.213, P = .04) and higher acceptance of palliative care (B = −.244, P = .01). Most surveyed derived satisfaction from work with advanced cancer patients (83%). Nineteen percent were depressed by managing advanced cancer patients. One fourth felt emotionally burned out by dealing with too many deaths. Conclusions Most gynecologic oncologists did not exhibit stigma surrounding palliative care and derive satisfaction from their work. Some gynecologic oncologists experience depression and burnout related to their profession. This close connection with patients as they transition to the end of life may take a toll on providers.
Seagull wings appearance on optical coherence tomography: A case of peripapillary detachment in pathologic myopia
Authors: Giannuzzi Federico , Boselli Francesco , Savastano Maria Cristina , Savastano Alfonso , Kilian Raphael , Rizzo Stanislao 
Published: December 2022

Purpose To report the case of a patient who presented with a peripapillary retinal detachment caused by pathological myopia. Observations A 73-year-old female with a clinical history of high myopia was admitted to our ophthalmic department complaining of vision loss in her right eye. Her best-corrected visual acuity was 20/25 in the right eye and 20/400 in the left eye. The refractive error was −9.00 D in both eyes. The anterior segment and pupillary reflex were normal. Dilated fundus examination revealed myopic retinopathy in both eyes and a yellow peripapillary lesion, distinct from the myopic conus and encircling almost the whole optic disc, in her right eye. The left eye displayed macular atrophy with macular pigmentation due to a previous myopic choroidal neovascularization. Optical coherence tomography showed a localized retinal detachment in the peripapillary area, adjacent to the inferior edge of the optic disc, giving a strange “seagull wings” appearance. Conclusions and Importance In case of peripapillary neuroepithelial detachment the presence of PDPM in high myopic patients should always be excluded. Further research is due in order to better understand this clinical entity's pathogenesis and prognosis.
Functionality of retinal vessels in central serous retinopathy: A comparison between eplerenone and photodynamic therapy
Authors: Tombolini Beatrice , Battista Marco , Sacconi Riccardo , Servillo Andrea , Camisa Ludovica , Bandello Francesco , Querques Giuseppe 
Published: December 2022

Purpose To investigate retinal vessels functionality in patients with acute central serous chorioretinopathy (CSC) undergoing oral eplerenone or photodynamic therapy (PDT) using Retinal Vessel Analyzer (RVA) and Dynamic Vessel Analyzer (DVA), respectively. Methods Treatment naïve acute CSC patients presenting between May 2017 and June 2017 were recruited. A complete ophthalmological examination was performed in all participants before and after oral eplerenone (eplerenone group) or half-dose PDT (PDT group). Results Eighteen eyes of 18 patients affected by acute CSC underwent either oral eplerenone (10 eyes of 10 patients, 47.6 ± 8.9 years old) or half-dose PDT (8 eyes of 8 patients, 57.4 ± 6.2 years old), respectively. After 2 months of treatment, non-significant variations of static retinal vessels analysis, dynamic arterial and venous dilatation were reported in eplerenone group. Similarly, in PDT group non-significant variations of static retinal vessels analysis, dynamic arterial and venous dilatation were found after 2 months of treatment. Conclusions Static and dynamic retinal functionalities in acute CSC may not be significantly improved by oral eplerenone and half-dose PDT. Although their choroidal effects, these treatments could not exert a significant effect on retinal vessels motility. Thus, both local and systemic therapies might not help avoiding the onset of vascular and other retinal known alterations of CSC.
Measurement of the Balance Stability Angle to Predict the Stability Ratio in Patients With Recurrent Anterior Shoulder Dislocation: A Novel Computed Tomography–Based Protocol
Authors: Hu Qingxiang , Zhang Guangcheng , Wu Di , Zhang Haoyu , Hu Hai , Zhan Shi , He Yaohua 
Published: December 2022

Background: The stability ratio (SR) is an important biomechanical parameter for evaluating glenoid stability in patients with recurrent anterior shoulder dislocation (RASD), and it cannot be practically and conveniently measured in clinical scenarios. Purpose: To investigate a novel computed tomography (CT)–based protocol to estimate the SR efficiently. Study Design: Descriptive laboratory study. Methods: A total of 102 patients with RASD were included. Demographic information, CT scans, and bone defect area (BDA) were collected. The new protocol, based on balance stability angle (BSA) measurements on CT, was conducted to estimate the SR (SRCT) by 2 surgeons independently. Biomechanical testing was then performed on patient-specific 3-dimensional (3D)–printed glenoid models to calculate the SR (SR3Dprint), which was used to (1) analyze the reliability of SRCT and (2) examine if the BDA could predict SR3Dprint. To validate whether the 3D-printed glenoid could reflect the actual biomechanical properties of the shoulder, the SR from 5 cadaveric glenoid specimens (SRcadaver) was also calculated and compared with that from the 3D-printed glenoid (SR3Dprint) under 6 osteotomy conditions. Linear regression and intraclass correlation coefficients (ICCs) were used for statistical analysis. Results: The interrater reliability of SRCT measurements was high (ICC = 0.95). SRCT was highly correlated with SR3Dprint ( R 2 = 0.86; ICC = 0.92). The mean BDA was 11.44% ± 6.72% by the linear ratio method, with a weak correlation with SR3Dprint ( R 2 = 0.31; ICC = -0.46). The cadaveric validation experiment indicated that SRcadaver was highly correlated with SR3Dprint ( R 2 = 0.86; ICC = 0.77). Conclusion: Results indicated that (1) the proposed CT-based protocol of obtaining BSA measurements is promising for the SR estimation in patients with RASD, (2) the BDA was not an effective parameter to predict the biomechanical SR, and (3) the 3D-printed glenoid could reflect the biomechanical properties of cadaveric shoulders regarding the SR estimation. Clinical Relevance: Traditional BDA measurements cannot accurately reflect the biomechanical stability of the glenoid. The newly proposed CT-based protocol is practical for surgeons to estimate the SR.
Interventions to Improve Social Climate in Acute Mental Health Inpatient Settings: Systematic Review of Content and Outcomes
Authors: Dickens Geoffrey L. , Johnson Alisha , Steel Kelly , Everett Bronwyn , Tonkin Matthew 
Published: December 2022

Introduction Quantification of the social climate of mental health care environments has received considerable attention. Investigations of the resulting measures indicate that social climate is associated with individual outcomes including patient satisfaction and staff burnout. Interest has grown in developing interventions to improve social climate in anticipation of subsequent related benefits. This study aimed to identify and critically review research about the effectiveness of interventions for improving social climate in inpatient adult acute mental health settings. Methods Systematic review reported in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses. Comprehensive terms were used to search multiple electronic databases from inception to July 2019. Information about intervention type(s), complexity was extracted and study quality was assessed. Results Twenty-three papers met inclusion criteria of which 20 used a pretest–posttest study design and three employed randomized and/or controlled designs. Interventions were environmental/structural, operational/process-oriented and developmental/person-oriented in nature and they ranged in complexity. The Ward Atmosphere Scale was the most common outcome measure used. Following quality assessment, six studies were judged to be sufficiently robust in terms of quality, theory-base, user-inclusion, and outcomes evaluation to contribute credibly to the evidence base. Of these, four complex person- and process-oriented intervention studies and two less complex structural/environmental intervention studies resulted in positive outcomes. Conclusion There is limited strong evidence that interventions positively influence measures of ward social climate in acute adult mental health settings. Such measures should not be the sole criterion of success when evaluating change. Decisions about implementing change to improve social climate should be informed by meaningful proxy measures including the views and preferences of service users and other stakeholders. Studies using stronger designs are required to establish the ability of interventions to improve social climate.
Overlapping features of therapy-related and de novo NPM1-mutated AML
Authors: Othman Jad , Meggendorfer Manja , Tiacci Enrico , Thiede Christian , Schlenk Richard , Dillon Richard , Stasik Sebastian , Venanzi Alessandra , Bertoli Sarah , Delabesse Eric , Dumas Pierre-Yves , Pigneux Arnaud , Bidet Audrey , Gilkes Amanda F. , Thomas Ian , Voso Maria Teresa , Rambaldi Alessandro , Brunetti Lorenzo , Perriello Vincenzo M. , Andresen Vibeke , Gjertsen Bjorn T. , Martelli Maria Paola , Récher Christian , Röllig Christoph , Bornhäuser Martin , Serve Hubert , Müller-Tidow Carsten , Baldus Claudia D. , Haferlach Tortsten , Russell Nigel , Falini Brunangelo 
Published: December 2022

Abstract
NPM 1-mutated acute myeloid leukemia (AML) shows unique features. However, the characteristics of “therapy-related” NPM1-mutated AML (t-NPM1 AML) are poorly understood. We compared the genetics, transcriptional profile, and clinical outcomes of t-NPM1 AML, de novo NPM1-mutated AML (dn-NPM1 AML), and therapy-related AML (t-AML) with wild-type NPM1 (t-AML). Normal karyotype was more frequent in t-NPM1 AML (n = 78/96, 88%) and dn-NPM1 (n = 1986/2394, 88%) than in t-AML (n = 103/390, 28%; P &lt; .001). DNMT3A and TET2 were mutated in 43% and 40% of t-NPM1 AML (n = 107), similar to dn-NPM1 (n = 88, 48% and 30%; P &gt; 0.1), but more frequently than t-AML (n = 162; 14% and 10%; P &lt; 0.001). Often mutated in t-AML, TP53 and PPM1D were wild-type in 97% and 96% of t-NPM1 AML, respectively. t-NPM1 and dn-NPM1 AML were transcriptionally similar, (including HOX genes upregulation). At 62 months of median follow-up, the 3-year overall survival (OS) for t-NPM1 AML (n = 96), dn-NPM1 AML (n = 2394), and t-AML (n = 390) were 54%, 60%, and 31%, respectively. In multivariable analysis, OS was similar for the NPM1-mutated groups (hazard ratio [HR] 0.9; 95% confidence interval [CI], 0.65-1.25; P = .45), but better in t-NPM1 AML than in t-AML (HR, 1.86; 95% CI, 1.30-2.68; P &lt; .001). Relapse-free survival was similar between t-NPM1 and dn-NPM1 AML (HR, 1.02; 95% CI, 0.72-1.467; P = .90), but significantly higher in t-NPM1 AML versus t-AML (HR, 1.77; 95% CI, 1.19-2.64; P = .0045). t-NPM1 and dn-NPM1 AML have overlapping features, suggesting that they should be classified as a single disease entity.
Investigation on the applicability of a long-range reverse-transcription quantitative polymerase chain reaction assay for the rapid detection of active viruses
Authors: Yasuura Masato , Nakaya Yuki , Ashiba Hiroki , Fukuda Takashi 
Published: December 2022

AbstractBackgroundAlthough conventional polymerase chain reaction (PCR) methods are widely used in diagnosis, the titer of the pathogenic virus is difficult to determine based on the PCR. In our prior report, a long-range reverse-transcription quantitative PCR (LR-RT-qPCR) assay was developed to assess the titer of UV-irradiated influenza A virus (IAV) rapidly. In this research, we focused on whether the LR-RT-qPCR assay could evaluate the titer of IAV inactivated by other methods.MethodsIAV was inactivated by: heating at 100 °C for periods ranging from 1 to 15 min, treating with 0.12% sodium hypochlorite for periods ranging from 3 to 30 min, or treating with 70% ethanol for periods ranging from 10 to 30 min. Fifty percent tissue culture infectious dose (TCID50) assay was performed to confirm the efficacy of the inactivation methods, followed by LR-RT-qPCR to investigate the correlation between infectivity and copy number.ResultsOne minute heating, 3 min sodium hypochlorite treatment, or 10 min ethanol treatment was sufficient to deactivate IAV. Changes before and after the inactivations in the copy numbers on LR-RT-qPCR were significantly different among the inactivation methods. Heat-inactivation drastically decreased the copy number to below the cutoff value around 5 copies/μL after 5 min treatment. The inactivation time of heating estimated using LR-RT-qPCR was marginally higher than that determined using TCID50. However, the treatments with sodium hypochlorite or ethanol moderately and minimally affected the copy numbers obtained using LR-RT-qPCR (~ 1 digit or no copy number decrease), respectively.ConclusionsIn addition to good applicability in UV-irradiation previously reported, the LR-RT-qPCR method is suitable for evaluating the effect of heat-inactivation on IAV infectivity. However, minor modifications may be made and investigated in the future to reduce the time intervals with TCID50. Although this method is not applicable for the ethanol inactivation, rapid evaluation of the effects of chlorination on IAV can be determined by comparing copy numbers before and after treatment using the LR-RT-qPCR method.
Transcriptome analysis provides insights into light condition effect on paclitaxel biosynthesis in yew saplings
Authors: Li Taotao , Li Bingbing , Liao Chunli , Zhang Huamin , Wang Lianzhe , Fu Taotao , Xue Shouyu , Sun Tao , Xu Xiaolan , Fan Xin , Li Le , Liu Genglin , Yang Fengling , Ma Xuan 
Published: December 2022

Abstract

Background
Taxus is a rare gymnosperm plant that is the sole producer of the anticancer drug paclitaxel. The growth and development of Taxus is affected by environmental factors such as light. However, little is known about how light conditions affect growth and metabolic processes, especially paclitaxel biosynthesis.

Results
In this study, we applied three different light conditions to Taxus chinensis young saplings and investigated the physiological response and gene expression. Our observations showed that exposure to high light led to oxidative stress, caused photoinhibition, and damaged the photosynthetic systems in T. chinensis. The paclitaxel content in T. chinensis leaves was significantly decreased after the light intensity increased. Transcriptomic analysis revealed that numerous genes involved in paclitaxel biosynthesis and phenylpropanoid metabolic pathways were downregulated under high light. We also analyzed the expression of JA signaling genes, bHLH, MYB, AP2/ERF transcription factors, and the CYP450 families that are potentially related to paclitaxel biosynthesis. We found that several CYP450s, MYB and AP2/ERF genes were induced by high light. These genes may play an important role in tolerance to excessive light or heat stress in T. chinensis.

Conclusions
Our study elucidates the molecular mechanism of the effects of light conditions on the growth and development of T. chinensis and paclitaxel biosynthesis, thus facilitating the artificial regeneration of Taxus and enhancing paclitaxel production.