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Massive Transfusion Protocols in Obstetric Hemorrhage: Theory versus Reality.

Am J Perinatol 2021 May 14. Epub 2021 May 14.

Depatment of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.

Objective:  Massive transfusion protocols are widely implemented in obstetrical practice in case of severe hemorrhage; however, different recommendations exist regarding the appropriate ratios of blood product components to be transfused. We report our extensive experience with massive component transfusion in a referral center in which the standard massive transfusion protocol is modified by ongoing clinical and laboratory evaluation.

Study Design:  A retrospective chart review of all patients who had massive transfusion protocol activation in a level 4 referral center for obstetrical practice was performed from January 2014 to January 2020. Read More

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Outcome in dedifferentiated chondrosarcoma for patients treated with multimodal therapy: Results from the EUROpean Bone Over 40 Sarcoma Study.

Eur J Cancer 2021 May 11;151:150-158. Epub 2021 May 11.

Department of Orthopaedics and Orthopaedic Oncology, University of Padova, Padova, Italy.

Introduction: The role of chemotherapy for patients with dedifferentiated chondrosarcoma (DDCS) is still under discussion. Here, we present the outcome in patients with DDCS treated with intensive chemotherapy from the EUROpean Bone Over 40 Sarcoma Study.

Materials And Methods: The chemotherapy regimen included doxorubicin, ifosfamide and cisplatin. Read More

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Modeling canopy interception under drought conditions: The relevance of evaporation and extra sources of energy.

J Environ Manage 2021 May 11;292:112710. Epub 2021 May 11.

Forest Science Department, Federal University of Lavras, MG, Brazil.

Modeling canopy interception is fundamental for understanding the forests' role in local and regional hydrology. In this study, canopy interception (CI), throughfall (TF), and stemflow (SF) were evaluated for a semi-deciduous Atlantic Forest (AFR) from 2013 to 2019, where a prolonged dry period occurred. The Gash and Liu models were analyzed in detail to determine the most appropriate for modeling CI throughout drought conditions. Read More

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A novel algorithm to reduce VTE in peri-operative patients on tamoxifen.

Breast 2021 May 6;58:88-92. Epub 2021 May 6.

Department of Plastic & Reconstructive Surgery, Department of Haematology, Guy's & St. Thomas' Hospitals NHS Foundation Trust, London, UK.

Introduction: Venous thromboembolism (VTE) is a serious adverse event associated with tamoxifen use, with a 2 to 3-fold increase incidence in users. We aimed to reduce the incidence of venous thromboembolism in patients undergoing breast related surgery by implementing a risk stratifying algorithm for the perioperative management of tamoxifen.

Methods: A retrospective control cohort was compared to a prospective interventional cohort to validate the algorithm which was created by a multidisciplinary team. Read More

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The association between natural environments and childhood mental health and development: A systematic review and assessment of different exposure measurements.

Int J Hyg Environ Health 2021 May 11;235:113767. Epub 2021 May 11.

Department of Forest and Conservation Sciences, Faculty of Forestry, University of British Columbia, 2424 Main Mall, Vancouver, BC, V6T 1Z4, Canada; School of Population and Public Health, Faculty of Medicine, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada; ISGlobal, Parc de Recerca Biomèdica de Barcelona, Carrer de Dr. Aiguader, 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra, Plaça de La Mercè, 10-12, 08002, Barcelona, Spain; Centro de Investigación Biomédica en Red Instituto de Salud Carlos III, Calle de Melchor Fernández Almagro, 3, 28029, Madrid, Spain.

Background: Several studies have assessed the relationship between exposure to natural environments (NEs) and childhood mental health and development. In most cases, a positive association has been found, but results are inconsistent, and the strength of association is unclear. This inconsistency may reflect the heterogeneity in measurements used to assess NE. Read More

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Integrating multi-omics data through deep learning for accurate cancer prognosis prediction.

Comput Biol Med 2021 May 9;134:104481. Epub 2021 May 9.

School of Computer Science and Engineering, Sun Yat-sen University, Guangzhou, 510000, China; Key Laboratory of Machine Intelligence and Advanced Computing (MOE), Sun Yat-sen University, Guangzhou, 510000, China. Electronic address:

Background: Genomic information is nowadays widely used for precise cancer treatments. Since the individual type of omics data only represents a single view that suffers from data noise and bias, multiple types of omics data are required for accurate cancer prognosis prediction. However, it is challenging to effectively integrate multi-omics data due to the large number of redundant variables but relatively small sample size. Read More

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HPLC-MS-based design of experiments approach on cocoa roasting.

Food Chem 2021 Apr 28;360:129694. Epub 2021 Apr 28.

Department of Life Sciences and Chemistry, Jacobs University Bremen, Campus Ring 1, 28759 Bremen, Germany. Electronic address:

Modern statistical methods, such as the design of experiments and response surface methodology, are widely used to describe changes in multiparameter processes during the processing of food in both science and technology contexts. However, these approaches are described to a lesser degree in the case of cocoa roasting than other foods and processes. Our study aimed to use the design of experiments to establish a model of cocoa roasting for relevant flavor-related constituents. Read More

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Quantification of the impact of traffic incidents on speed reduction: A causal inference based approach.

Accid Anal Prev 2021 May 11;157:106163. Epub 2021 May 11.

School of Traffic and Transportation, Beijing Jiaotong University, Beijing, 100044, China.

This paper designs a systemic framework to quantify speed reduction induced by traffic incidents using a causal inference framework. The results can provide a reference to traffic managers for evaluating incident severities, thus take proper control measures after the incident in order not to underestimate or overestimate the negative impact. A two-phase scheme is proposed, including impacted region determination and speed reduction quantification. Read More

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Measuring the spatiotemporal evolution of accident hot spots.

Accid Anal Prev 2021 May 11;157:106133. Epub 2021 May 11.

Department of Civil & Environmental Engineering, E2509 Thomas & Nell Lafferre Hall, University of Missouri, Columbia, MO, 65211, USA; Department of Geography, 220 Stewart Hall, University of Missouri, Columbia, MO, USA; Institute for Data Science and Informatics, University of Missouri, Columbia, MO, USA. Electronic address:

One reality of transportation systems is that vehicular accidents can happen practically anywhere and at any time. An increasing body of research suggests though that spatial and/or temporal dependencies (i.e. Read More

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Continuous Infusion, Therapeutic Drug Monitoring and Outpatient Parenteral Antimicrobial Therapy with Ceftazidime-Avibactam: a Retrospective Cohort Study.

J Glob Antimicrob Resist 2021 May 11. Epub 2021 May 11.

Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, Liège, Belgium. Electronic address:

Background: Based on recent PK/PD evidence, continuous infusion (CI) of β-lactam administration is increasingly recommended for serious infections. Since 2016, the combination of ceftazidime and avibactam (CAZ/AVI) is administered per manufacturer prescription as an intermittent infusion of 2.5g q8h. Read More

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Proton pump inhibitor use is not strongly associated with SARS-CoV-2 related outcomes: A nationwide study and meta-analysis.

Clin Gastroenterol Hepatol 2021 May 11. Epub 2021 May 11.

Center of Research and Disruption of Infectious Diseases, Department of Infectious Diseases, Copenhagen University Hospital, Amager and Hvidovre, Hvidovre, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.

Background And Aims: Proton pump inhibitor (PPI) use has been associated with increased risk of SARS-CoV-2 infection and severe outcomes. However, meta-analyses show unclear results leading to uncertainty regarding the safety of PPI use during the ongoing COVID-19 pandemic.

Methods: We conducted a nationwide observational study including all SARS-CoV-2 cases (n=83,224) in Denmark as of December 1, 2020. Read More

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A rapid review of measures to support people in isolation or quarantine during the Covid-19 pandemic and the effectiveness of such measures.

Rev Med Virol 2021 May 14:e2244. Epub 2021 May 14.

Health Information and Quality Authority, Dublin 7, Ireland.

This rapid review aimed to identify measures available to support those in isolation or quarantine during the coronavirus disease 2019 (Covid-19) pandemic, and determine their effectiveness in improving adherence to these recommendations and or reducing transmission. The rapid review consisted of two elements, the first was a review of guidance published by national and international agencies relating to measures to support those in isolation (due to case status) or quarantine (due to close contact status) during the Covid-19 pandemic. Five categories of support measures were identified in the international guidance, they were: Psychological, addiction and safety supports, Essential supplies, Financial aid, Information provision and Enforcement. Read More

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Treatment Options for Scrotal Migration of Ventriculoperitoneal Shunts: Case Illustration and Systematic Review of 48 Cases.

Oper Neurosurg (Hagerstown) 2021 May 14. Epub 2021 May 14.

Department of Neurosurgery, Kepler University Hospital, Neuromedcampus, Linz, Austria.

Background: Scrotal migration of intact or disconnected tubing is a rare complication of ventriculoperitoneal shunts. While some illustrative case reports can be found in the literature, a systematic review on treatment options is lacking.

Objective: To propose the first literature-based treatment algorithm on scrotal shunt migration. Read More

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CrossTalkeR: Analysis and Visualisation of Ligand Receptor Networks.

Bioinformatics 2021 May 14. Epub 2021 May 14.

Institute for Computational Genomics, Joint Research Center for Computational Biomedicine, RWTH Aachen University Medical School, Germany.

Motivation: Ligand-receptor (LR) network analysis allows the characterization of cellular crosstalk based on single cell RNA-seq data. However, current methods typically provide a list of inferred LR interactions and do not allow the researcher to focus on specific cell types, ligands or receptors. In addition, most of these methods cannot quantify changes in crosstalk between two biological phenotypes. Read More

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Characterization of geographic mobility among participants in facility- and community-based tuberculosis case finding in urban Uganda.

PLoS One 2021 14;16(5):e0251806. Epub 2021 May 14.

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.

Background: International and internal migration are recognized risk factors for tuberculosis (TB). Geographic mobility, including travel for work, education, or personal reasons, may also play a role in TB transmission, but this relationship is poorly defined. We aimed to define geographic mobility among participants in facility- and community-based TB case finding in Kampala, Uganda, and to assess associations between mobility, access to care, and TB disease. Read More

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Etiology of acute meningitis and encephalitis from hospital-based surveillance in South Kazakhstan oblast, February 2017-January 2018.

PLoS One 2021 14;16(5):e0251494. Epub 2021 May 14.

Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States of America.

Encephalitis and meningitis (EM) are severe infections of the central nervous system associated with high morbidity and mortality. The etiology of EM in Kazakhstan is not clearly defined, so from February 1, 2017 to January 31, 2018 we conducted hospital-based syndromic surveillance for EM at the Shymkent City Hospital, in the South Kazakhstan region. All consenting inpatients meeting a standard case definition were enrolled. Read More

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Potent Acid Suppression With Vonoprazan vs Proton Pump Inhibitors Does Not Have Higher Association With Clostridioides difficile Infection.

Am J Gastroenterol 2021 May 13. Epub 2021 May 13.

Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan.

Introduction: Proton pump inhibitors (PPIs) are associated with the onset of Clostridioides difficile infection (CDI). Although a new potassium-competitive acid blocker, vonoprazan, consistently shows a more potent acid inhibitory effect in comparison to PPIs, the risk of CDI in vonoprazan-treated patients relative to those treated with PPIs is unknown. In this retrospective case-control study, using a nationwide hospital-based administrative database in Japan, we investigated the association of the onset of CDI in patients treated with vonoprazan. Read More

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The changing landscape of cardiac rehabilitation; .

Authors:
John P Buckley

Disabil Rehabil 2021 May 14:1-8. Epub 2021 May 14.

Centre for Active Living, University Centre Shrewsbury/University of Chester, Chester, UK.

Aim: This paper aims to demonstrate how the rationale and delivery of cardiac rehabilitation (CR), in those countries with long term established standards of practice, has changed over the past eight decades.

Methods: A narrative report based on the evolution of key published guidelines, systematic reviews and medical policies since the 1940s.

Results: Case reports of the value of exercise in cardiac disease can be dated back to 1772. Read More

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Randomized Phase III Trial of Gemcitabine and Cisplatin With Bevacizumab or Placebo in Patients With Advanced Urothelial Carcinoma: Results of CALGB 90601 (Alliance).

J Clin Oncol 2021 May 14:JCO2100286. Epub 2021 May 14.

Memorial Sloan Kettering Cancer Center, New York, NY.

Purpose: The combination of gemcitabine and cisplatin (GC) is a standard therapy for metastatic urothelial carcinoma. Based on data that angiogenesis plays a role in urothelial carcinoma growth and progression, a randomized placebo-controlled trial was performed with the primary objective of testing whether patients treated with GC and bevacizumab (GCB) have superior overall survival (OS) than patients treated with GC and placebo (GCP).

Patients And Methods: Between July 2009 and December 2014, 506 patients with metastatic urothelial carcinoma without prior chemotherapy for metastatic disease and no neoadjuvant or adjuvant chemotherapy within 12 months were randomly assigned to receive either GCB or GCP. Read More

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pH-Switchable Latexes Based on the Nonionic Amphiphilic Diblock Copolymer with a Chargeable End-Group on the Core-Forming Block.

Langmuir 2021 May 14. Epub 2021 May 14.

College of Chemistry and Chemical Engineering, Southwest Petroleum University, Chengdu 610500, P. R. China.

Reversible addition-fragmentation transfer (RAFT) dispersion polymerization of styrene was performed in an ethanol-water mixture using a Z-group carboxylated poly(-acryloylmorpholine) (PNAM) macro-RAFT agent, and dialysis was performed against water to produce the PNAM-PS-COOH (PS = polystyrene) diblock copolymer latexes. This new formula is developed for the fabrication of pH-switchable copolymer latexes through an end-group response approach. The PNAM-PS-COOH latex is unstable at suitably low pH values (pH ≤ 4), and these aggregated spherical nanoparticles are redispersed successfully by adding base as determined by analysis of their dynamic light scattering (DLS) diameters and transmission electron microscopy (TEM) data. Read More

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The Treatment of Bone Marrow Lesions Associated with Advanced Knee Osteoarthritis: Comparing Intraosseous and Intraarticular Injections with Bone Marrow Concentrate and Platelet Products.

Pain Physician 2021 May;24(3):E279-E288

Regenexx, LLC, Des Moines, IA.

Background: Bone marrow lesions are a radiographic indication of bony pathology closely associated with advanced osteoarthritis of the adjacent joint. Injection of autologous orthobiologic products, including bone marrow concentrate and platelet-rich plasma, have demonstrated safety and efficacy in treating both advanced osteoarthritis (via intraarticular injection) and associated bone marrow lesions (via intraosseous injection). The relative efficacy of intraarticular versus intraosseous injection of orthobiologics has not been evaluated at the present time. Read More

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Evaluation of suitability of wind speed probability distribution models: a case study from Tamil Nadu, India.

Environ Sci Pollut Res Int 2021 May 14. Epub 2021 May 14.

Center for Engineering Research, King Fahd University of Petroleum and Minerals, P.O. 31261, Dahran, Saudi Arabia.

The optimal design and performance monitoring of wind farms depend on the precise assessment of spatial and temporal distribution of wind speed. The aim of this research is to investigate the appropriateness of nine popular probability distribution models (exponential, gamma, generalised extreme value, inverse Gaussian, Kumaraswamy, log-logistic, lognormal, Nakagami, and Weibull) for the assessment of wind speed distribution (WSD) at 10 sites situated at topographically distinct locations in Tamil Nadu, India, based on 39 years of data. The results suggest that a single distribution cannot produce best fit for all the stations. Read More

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Intercultural Training in Tense Times: Cultural Identities and Lived Experiences Within a Community of Practice of Youth Mental Health Care in Montréal.

Cult Med Psychiatry 2021 May 14. Epub 2021 May 14.

Division of Social and Transcultural Psychiatry, McGill University, Montreal, Canada.

This article presents an analysis of the lived experiences of youth mental health practitioners taking part in Transcultural Interinstitutional and Interdisciplinary Case Discussion Seminars (TIICDS), an intercultural training initiative developed in Montréal (Québec, Canada), while considering the current context of increasing social polarizations. Using insights from the community of practice (CoP) framework and drawing on the analysis of 21 seminar sessions and 26 semi-structured individual interviews, this article examines the relation between the local sociopolitical context, the participants' verbalization about their identities, and the affect and cognition evoked by the training. Results indicate that TIICDSs present several features of a CoP and that intercultural training needs to build on both theoretical and experiential knowledge, while considering local contextual elements. Read More

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Towards an enhanced indication of provisioning ecosystem services in agro-ecosystems.

Environ Monit Assess 2021 May 14;193(Suppl 1):269. Epub 2021 May 14.

Leibniz Centre for Agricultural Landscape Research (ZALF), Eberswalder Straße 84, 15374, Müncheberg, Germany.

Provisioning ecosystem services play a vital role in sustaining human well-being. Agro-ecosystems contribute a significant share of these services, besides food and fodder and also fuel and fibre as well as regulating and cultural ecosystem services. Until now, the indication of provisioning ecosystem services of agro-ecosystems has been based almost only on yield numbers of agricultural products. Read More

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Cerebellar ataxia and myeloradiculopathy associated with AP3B2 antibody: a case report and literature review.

J Neurol 2021 May 14. Epub 2021 May 14.

Department of Neurology, Peking Union Medical College Hospital, Beijing and Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China.

Background: AP3B2 is one of the subunits of vesicle coat protein AP3 and is specifically expressed in central nervous system neurons. AP3B2 antibody has been reported in patients with autoimmune cerebellar ataxia and various extracerebellar symptoms. However, there have been few reports on its clinical features and treatment response. Read More

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Superluminal and slow femtosecond laser pulses in hyperbolic metamaterials in epsilon-near-zero regime.

Opt Lett 2021 May;46(10):2276-2279

Flourish of optics of hyperbolic metamaterials (HMMs) is stimulated by their exotic optical properties. Here, we demonstrate resonant changes of the group retardation and superluminal-like propagation of femtosecond laser pulses in nanorod-based HMMs in the vicinity of epsilon-near-zero spectral point responsible for the transition between topologically distinct elliptic and hyperbolic light dispersions. Resonant dynamics of ultrashort pulses appears in a unique case when their spectral components are in both dispersion regimes simultaneously. Read More

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Validated Outcome Measures and Postsurgical Scar Assessment Instruments in Eyelid Surgery: A Systematic Review.

Dermatol Surg 2021 May 11. Epub 2021 May 11.

Case Western Reserve University School of Medicine, Cleveland, Ohio; Western University of Health Sciences, College of Osteopathic Medicine of the Pacific, Northwest, Lebanon, Oregon; Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio; Department of Ophthalmology and Visual Sciences, University Hospitals, Case Western; Reserve University School of Medicine, Cleveland, Ohio.

Background: Determining which postsurgical scar assessment instruments, if any, cover important eyelid outcome measures can either attest to the strength of one or more instruments or reveal the need for a more comprehensive scale.

Objective: To systematically review validated outcome measures after eyelid surgery and postsurgical scar assessment tools to see whether any individual or combination of 2 assessment tools encompass all relevant, validated eyelid outcome measures.

Methods: Systematic reviews of validated eyelid outcome measures and postsurgical scar assessment tools were conducted using PubMed/MEDLINE and Ovid. Read More

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Constructing Within-City Neighborhood Health Rankings in Philadelphia by Using Data From the 500 Cities Project.

Prev Chronic Dis 2021 May 13;18:E48. Epub 2021 May 13.

Mecklenburg County Health Department, Charlotte, North Carolina.

Introduction: Profound geographic disparities in health exist in many US cities. Most reporting on these disparities is based on predetermined administrative districts that may not reflect true neighborhoods. We undertook a ranking project to describe health at the neighborhood level and used Philadelphia, Pennsylvania, as our case study. Read More

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An initial analysis of the UK Medical Cannabis Registry: Outcomes analysis of first 129 patients.

Neuropsychopharmacol Rep 2021 May 14. Epub 2021 May 14.

Imperial College London, London, UK.

Aim: Cannabis-based medicinal products (CBMPs) are prescribed with increased frequency, despite a paucity of high-quality randomized controlled trials. The aim of this study is to analyze the early outcomes of the first series of patients prescribed CBMPs in the UK with respect to effects on health-related quality of life and clinical safety.

Methods: A prospective case series was performed using the UK Medical Cannabis Registry. Read More

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Glassy carbon microelectrode arrays enable voltage-peak separated simultaneous detection of dopamine and serotonin using fast scan cyclic voltammetry.

Analyst 2021 May 14. Epub 2021 May 14.

NanoFAB.SDSU Lab, Department of Mechanical Engineering, San Diego State University, San Diego, CA, USA. and Center for Neurotechnology (CNT), Bill & Melinda Gates Center for Computer Science & Engineering, Seattle, WA 98195, USA.

Progress in real-time, simultaneous in vivo detection of multiple neurotransmitters will help accelerate advances in neuroscience research. The need for development of probes capable of stable electrochemical detection of rapid neurotransmitter fluctuations with high sensitivity and selectivity and sub-second temporal resolution has, therefore, become compelling. Additionally, a higher spatial resolution multi-channel capability is required to capture the complex neurotransmission dynamics across different brain regions. Read More

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