bluuebunny/crossref_metadata_2025_split huggingface dataset:
The burden of root caries: Updated perspectives and advances on management strategies
Authors: AlQranei Mohammed S. , Balhaddad Abdulrahman A. , Melo Mary A.S. 
Published: November 2020

BackgroundRoot caries has gained much attention in the last few years. As the world's population is ageing and people currently tend to retain more teeth compared with older generations, there is an increased prevalence of periodontal disease and gingival recession, which may accelerate the onset of root caries.ObjectiveThis review aims to summarise recent findings related to the diagnosis, prevention and treatment of root caries.Materials and MethodsMEDLINE (OVID) and Scopus (Elsevier) searches were performed to identify and discuss articles that address the pathogenicity and clinical management of root caries.ResultsRoot caries is a multifactorial disease. Cariogenic species involved in root caries are less dependent on carbohydrates since collagen degradation inside the dentinal tubules can provide nutrients and microcavities for the invading microorganisms. Furthermore, the root surface has fewer minerals in comparison with enamel, which may accelerate the onset of demineralisation. Root caries could be prevented by patient education, modification of risk factors, and the use of in‐office and home remineralisation tools. The use of non‐invasive approaches to control root caries is recommended, as the survival rate of root caries restorations is poor. When plaque control is impossible and a deep/large cavity is present, glass ionomer or resin‐based restorations can be placed.ConclusionThe assessment of root carious lesions is critical to determine the lesion activity and the required intervention. Dental practitioners should also be aware of different prevention and treatment approaches to design optimum oral health care for root caries–affected patients.
Impact of Chinese market segmentation on regional collaborative governance of environmental pollution: A new approach to complex system theory
Authors: Bian Yuanchao , Song Kaiyi , Bai Junhong 
Published: November 2020

AbstractThe market segmentation among local governments under decentralization of China not only directly triggered the “fragmentation” of regional development, but also hindered collaborative actions in environmental governance. This study adopts a new method to calculate regional environmental collaborative governance using a synergy degree model of a complex system, and then it empirically analyzes the impact of Chinese market segmentation. We find that the regional environmental collaborative governance in China shows a growing trend during the period of investigation, but the level is still low. Market segmentation has significantly inhibited the regional collaborative governance of environmental pollution among local governments of China. The effect of market segmentation on the order of personnel input and capital input is significantly negative, while the effect on the order of policy input and organizational input is not significant. In the areas where the air pollution and water pollution are serious, the effect of market segmentation is also significantly negative. The conclusions are helpful to understanding the institutional factors that hinder regional environmental collaborative governance in China more comprehensively, and provide insights for improving the performance of environmental governance.
Trigeminal neuralgia in children and adolescents: Experience of a tertiary pediatric headache clinic
Authors: Brameli Anna , Kachko Ludmyla , Eidlitz‐Markus Tal 
Published: November 2020

AbstractObjectivesTo describe the characteristics and treatment of trigeminal neuralgia in children attending a dedicated pediatric headache clinic.BackgroundData on trigeminal neuralgia as a cause of headache are largely derived from adult studies. Little is known about the etiology, symptoms, treatment, and outcome of the disorder in children and adolescents.MethodsA case series study was undertaken. The database of a headache clinic within a tertiary, university‐affiliated, pediatric medical center was searched for all patients aged 3–18 years presenting with clinical and epidemiological features of trigeminal neuralgia or trigeminal neuropathy from January 2015 to December 2019. The diagnosis was revised for the present study according to the criteria of the International Classification of Headache Disorders, third edition. Data on demographic parameters, clinical symptoms, treatment, and outcome were collected from the medical files.ResultsOf the 1040 patients who presented to our clinic during the study period, five (0.5%) were diagnosed with trigeminal neuralgia. Mean patient age was 15.1 ± 3.0 years (range 9.5–17.5; 95% CI 10.8–18.9). All had idiopathic type: purely paroxysmal in one and with concomitant continuous pain in four. Findings on herpes serology in all five and magnetic resonance imaging were normal in four patients. In the fifth, a vascular ring was noted from the superior cerebellar artery around the right trigeminal nerve without radiologic evidence of vascular nerve compression. All patients were initially treated with carbamazepine: one reported partial relief, two did not respond, and two had severe adverse effects. Three patients were switched to gabapentin but only one responded well. Three patients were treated with nerve block.ConclusionTrigeminal neuralgia accounted for only a small proportion of patients seeking treatment for headache in pediatric headache clinic over a 5‐year period. Unlike findings in adults, vascular compression was not the underlying mechanism in any of our patients. The response to pharmacologic treatment was poor. Nerve block may serve as an alternative when pharmacologic treatment fails.
Comparison of therapeutic outcomes of sorafenib and lenvatinib as primary treatments for hepatocellular carcinoma with a focus on molecular‐targeted agent sequential therapy: A propensity score‐matched analysis
Authors: Tomonari Tetsu , Sato Yasushi , Tani Joji , Hirose Akira , Ogawa Chikara , Morishita Akihiro , Tanaka Hironori , Tanaka Takahiro , Taniguchi Tatsuya , Okamoto Koichi , Sogabe Masahiro , Miyamoto Hiroshi , Muguruma Naoki , Uchida Kazushige , Masaki Tsutomu , Takayama Tetsuji 
Published: November 2020

AbstractAimThe optimal choice between sorafenib (SOR) or lenvatinib (LEN) as the first‐line treatment for unresectable hepatocellular carcinoma (u‐HCC) remains debatable. Using propensity score matching, this study compares the outcomes of SOR and LEN in the molecular‐targeted agent (MTA) sequential treatment of u‐HCC patients.MethodsThis retrospective, multicenter, observational study recruited 137 u‐HCC patients who underwent primary treatment with LEN (n = 52) or SOR (n = 85) between June 2017 and June 2020 after regorafenib was approved as the secondary treatment for u‐HCC. Propensity score matching was used to reduce confounding, resulting in the selection of 104 patients (n = 52 for the SOR and LEN cohorts).ResultsThe median overall survival was 21.8 months for LEN and 20.4 months for SOR. LEN exhibited significantly greater therapeutic efficacy as compared to SOR (objective response rate: 3.8% [SOR] vs. 42.3% [LEN], p < 0.01; progression‐free survival: 10 months [LEN] vs. 5.1 months [SOR], p < 0.01). No significant intergroup differences were noted in the rate of transition to secondary MTA treatments (SOR: 58.7%; LEN: 48.4%), adverse events (SOR: 86%; LEN: 95%), and maintenance of the Child–Pugh (CP) score during treatment. Compared to non‐MTA treatments, secondary MTA treatment achieved a greater improvement in survival (4.3 vs. 2.8 months, p = 0.0047). Multivariate analysis demonstrated that the CP score (p < 0.01) and alpha‐fetoprotein level (p < 0.01) were independent prognostic factors.ConclusionsBoth SOR and LEN treatments showed a clinically comparable therapeutic efficacy as the first‐line treatments for u‐HCC patients in an MTA sequential therapy.
Effect of hydroxypropyl‐β‐cyclodextrin in fluid and semi‐solid submicron emulsions on physiological skin parameters during regular in vivo application
Authors: Pany Astrid , Wohlgenannt Marie , Klopprogge Safoura , Wolzt Michael , Heuser Thomas , Kotisch Harald , Valenta Claudia , Klang Victoria 
Published: November 2020

AbstractObjectiveThe aim of the present study was to evaluate the effect of hydroxypropyl‐β‐cyclodextrin (HP‐β‐CD) in cosmetic submicron emulsions and submicron emulsion gels on physiological skin parameters during regular application in a clinical set‐up.MethodsFormulation morphology was investigated using cryo‐transmission electron microscopy. Stability of the employed formulations was determined by photon correlation spectroscopy, measurement of pH and rheological properties. Effect on physiological skin parameters was evaluated during regular application over four weeks in a parallel group study (n = 15, healthy forearm skin) with a Corneometer, Sebumeter, skin‐pH‐Meter, Aquaflux and an Epsilon sensor. Confocal Raman spectroscopy was employed to monitor urea and NMF levels.ResultsBoth submicron emulsions and gels showed satisfying storage stability irrespective of cyclodextrin incorporation. No statistically significant effects on skin barrier function and any of the observed parameters were obtained, indicating good skin tolerability of all tested formulations.ConclusionResults suggest good skin tolerability of the developed cosmetic submicron emulsions and gels with HP‐β‐CD.
Impact of financial debt on borrower’s health based on gender
Authors: Chen Gengxuan , Jia Qinmin , Maskara Pankaj K. , Williams Albert 
Published: November 2020

AbstractThis study investigated whether self‐reported impact of financial debt on health is different for women as compared with men. We found that female respondents are more likely to report that debt has affected their health. The results persisted when the analysis was performed on subsamples of employed individuals, married households and those with underwater mortgage (i.e., outstanding balance on mortgage is higher than the current value of the home). Prior studies have found that for a given level of debt, females are more likely to perceive higher levels of stress. When we controlled for stress perception, the health impact of debt was not higher for females. Some types of debt like credit card debt, student debt and loans from friends and family are known to result in higher levels of stress. Our findings persisted when we limited our sample to top users of credit card debt, to those with student debt or to those with loan(s) from friends and family. Prior studies have shown that mortgage debt is associated with lower levels of stress as compared with other types of debt. We found that in households with underwater mortgage, health impact of debt was higher for females even after we accounted for gender differential in stress perception. Our findings suggest that women’s tendency to experience higher levels of stress for a given level of debt mediates the increased likelihood of women reporting that debt has affected their health. However, there exists a possibility that some types of debt in some situations impact health of women more than men for reasons other than debt‐related stress.
Higher coagulation activity in hip fracture patients: A case‐control study using rotational thromboelastometry
Authors: Tsantes Andreas G. , Trikoupis Ioannis G. , Papadopoulos Dimitrios V. , Tsante Konstantina A. , Mavrogenis Andreas F. , Koulouvaris Panagiotis , Savvidou Olga D. , Kontogeorgakos Vasilios A. , Piovani Daniele , Kriebardis Anastasios G. , Bonovas Stefanos , Papagelopoulos Panayiotis J. , Tsantes Argirios E. 
Published: November 2020

AbstractIntroductionTrauma‐induced coagulopathy has been extensively investigated in the multitrauma setting, but only sparsely following moderate orthopedic trauma. The purpose of this study was to evaluate changes in the hemostatic profile of patients with hip fractures, using rotational thromboelastometry (ROTEM).Methods198 patients with hip fractures who underwent surgery were included in the study. A matched group of 52 healthy individuals was also enrolled. Demographics, conventional laboratory assays, and ROTEM parameters were recorded and compared between patients and healthy adults. The preoperative and postoperative ROTEM values of fractured patients were also compared.ResultsThe conventional coagulation assays were similar for the 2 groups. However, several ROTEM parameters including EXTEM MCF (P < .001), EXTEM alpha angle (P < .001), INTEM MCF (P < .001), INTEM A10 (P < .001), and INTEM alpha angle (P < .001) significantly differed between the 2 groups indicating a higher coagulation potential following hip fractures. Also, fractured patients had significantly lower INTEM and EXTEM CT values (P = .008 and P = .012, respectively) and significantly lower INTEM and EXTEM CFT values (P < .001). Adjusted analysis for confounders further confirmed the direct relationship between hip fracture and higher coagulation activity. Last, INTEM CT and CFT significantly decreased (P = .008 and P < .001, respectively), while INTEM MCF, A10, and alpha angle significantly increased (P < .001) postoperatively, indicating that surgery further increases the coagulation potential.ConclusionA higher coagulation activity following hip fractures and surgical treatment can be detected by ROTEM shortly after the injury, even when this is undetectable by conventional coagulation assays.
Negative pressure wound therapy in spinal fusion patients
Authors: Akhter Asad S. , McGahan Benjamin G. , Close Liesl , Dornbos David , Toop Nathaniel , Thomas Nicholas R. , Christ Elizabeth , Dahdaleh Nader S. , Grossbach Andrew J. 
Published: November 2020

AbstractPost‐operative wound complications are some of the most common acute complications following spine surgery. These surgical site infections (SSI) contribute to increased healthcare related costs. Negative pressure wound therapy (NPWT) has long been used for treatment of soft tissue injury or defects. NPWT may reduce the incident of SSI following spinal fusion procedures; however, its potential applications need further clarification. Thus, we conducted a retrospective analysis of two cohorts to compare NPWT to traditional sterile dressings following spinal fusions in regards to post‐operative outcomes. Following institutional review board approval, 42 patients who had a NPWT were matched by type of surgery to 42 patients who had traditional dressings. A retrospective chart‐review was completed. Outcome measures, particularly SSI and need for reoperation, were analyzed using one‐way ANOVA for both univariate and multivariate analysis. When controlled for sex and body‐mass index, the use of a NPWT was independently correlated with decreased SSI (P = .035). Superficial dehiscence, seroma, need for additional outpatient care, and need for operative revision were all found to occur at higher rates in the traditional dressing cohort. Closed incisional negative pressure wound therapy provides a cost‐effective method of decreasing surgical site infection for posterior elective spine surgeries.
COMBINED CHLORAMBUCIL AND PREDNISOLONE TREATMENT OF FIVE PATIENTS WITH WEGENER'S GRANULOMATOSIS
Authors: Berglund G. , Hansson L. , Persson B. , Vikgren P. 
Published: November 2020

AbstractFive patients with Wegener's granulomatosis have been treated with chlorambucil and prednisolone. Three patients are in good general condition 48, 14 and 8 months after commencement of this therapy and with improved of stable renal function. Two patients died. For one of the latter, therapy was started late in the course In the disease and could not prevent the fatal outcome. In the other fatal case chlorambucil could not be maintained at an adequate dosage because of complicating hemorrhagic diathesis. On the basis of the experience gained from our own and earlier reported results, a rational treatment of the disease is proposed.
GLUCOSE TOLERANCE, PLASMA INSULIN AND LIPIDS IN RELATION TO ADIPOSE TISSUE CELLULARITY IN MEN AFTER MYOCARDIAL INFARCTION
Authors: Berchtold Peter , Björntorp Per , Gustafson Anders , Lindholm Björn , Tibblin Gösta , Wilhelmsen Lars 
Published: November 2020

AbstractGlucose and insulin values in plasma after a peroral glucose tolerance test, triglycerides and cholesterol in plasma, body composition and adipose tissue fat cell diameter were determined in nonselected men surviving a myocardial infarction and were compared with the same variables in randomly selected men from the same region of equivalent age. The patients with myocardial infarction were characterized by a diminished glucose tolerance and elevated plasma lipids when compared with controls. The diminished glucose tolerance was more pronounced in patients with signs suggesting severe myocardial damage or complications to the myocardial infarction. Body fat, fat cell size or insulin values during glucose tolerance test were, however, not increased in patients with myocardial infarction. Fat cell size and fasting insulin or the sum of plasma insulin during the glucose tolerance test correlated positively in both groups of older men. Plasma triglycerides showed significant, positive correlations with the sum of insulin and glucose values during the glucose tolerance test. Patients with endogenous hypertriglyceridemia had higher insulin and blood glucose values and more body fat than patients without plasma lipid abnormalities. It was suggested that increased plasma triglycerides in patients with myocardial infarction are combined with decreased glucose tolerance and an increased insulin secretion associated with enlargement of adipose tissue fat cells.
ALPRENOLOL AS MAINTENANCE THERAPY FOR THE PROTECTION AGAINST ARRHYTHMIA RELAPSE IN PATIENTS WITH DC‐CONVERTED CHRONIC ATRIAL FIBRILLATION
Authors: Rydén L. , Nyberg G. , Saetre H. , Karlsson L. , Lindén L. , Sjöholm J. , Sundquist O. 
Published: November 2020

AbstractThere is a constant search for new drugs, free from side‐effects, to maintain sinus rhythm following DC‐conversion of atrial fibrillation. Adrenergicβ‐receptor blockers have been tried with rather disappointing results, possibly due to the relatively low dosage used. The present trial Was performed in order to evaluate the efficacy of a dose almost twice the one earlier used. By incrementing the dose, alprenolol 100 mg q.i.d. was given to 66 patients and 75 mg q.i.d. to two others. No patient converted spontaneously on alprenolol. After DC‐conversion 80% of the patients reverted to sinus rhythm. Further follow‐up showed a relapse rate of 17% after 24 hours, 65% after one month, 79% after three months, and 85% after six months. In comparison with previously reported studies, these figures are all higher than usual. Possible reasons for this are discussed. The incidence of post‐conversion arrhythmias remained low despite uninterrupted digitalis therapy. Sinus node depression following DC‐conversion, as has been reported in propranolol studies, did not occur, and in our experience it is not necessary to discontinue alprenolol prior to DC‐conversion. Ten patients who relapsed were subsequently treated with a combination of alprenolol and quinidine, but the results were disappointing. In a few cases treatment was stopped with the onset of bradycardia due to sinus node depression. Although generally, adrenergicβ‐receptor blockade appears ineffective in preventing relapse following DC‐conversion, it should be considered in selected cases where it may prove to be a valuable alternative, as illustrated by one of the treated patients.
ON THE METABOLISM OF FAT AND CARBOHYDRATE IN A PATIENT WITH REFRACTORY SIDEROBLASTIC ANAEMIA
Authors: Hagenfeldt Lars , Hellström Kjell , Rosenqvist Urban 
Published: November 2020

AbstractA patient with an acquired refractory sideroblastic anaemia has been studied. The anaemia had many features in common with pernicious anaemia, but high level of vitamin B12and a normal urinary excretion of methylmalonate excluded vitamin B12deficiency. A decreased pyruvate utilization and an increased urinary ex‐creation of acetate were demonstrated. Studies in vitro with white blood cells indicated a decreased efficiency of tricarboxylic acid cycle oxidation due to a low citrate synthetase activity. All serum lipid fractions were low, and a decreased lipolytic response to exercise and isoprenaline infusion was observed. The pathogenesis of these changes is discussed.
DISSEMINATED INTRAVASCULAR COAGULATION, UREMIA AND LIVER DAMAGE AFTER INTRAVENOUS CRUDE OPIUM
Authors: Bernheim Jan L. , Cate Jan W. ten , van der Heide Roelof M. 
Published: November 2020

AbstractA 21‐year‐old man is described who—after two intravenous injections of a self‐prepared suspension of crude opium—developed a syndrome of disseminated intravascular coagulation (DIC) with severe kidney and less severe liver injury. The condition could have been caused by transient endotoxinemia (though bacteriemia could not be demonstrated), and another pathogenic role may be ascribed to the particulate character of the drug suspension. The analogy with the generalized Sanarelli‐Shwartzman reaction is stressed.
COMPOSITION OF PERICARDIAL FLUID IN CHOLESTEROL PERICARDITIS
Authors: Eisalo Antti , Konttinen Aarne 
Published: November 2020

AbstractTwo cases of cholesterol pericarditis have been described. The cholesterol content of the pericardial fluid was in one case 798 and in the other 138 mg/100 ml, but the triglyceride content was very low. Lipid electrophoresis of the pericardial fluid, although it differed from that of the serum, gave inconsistent results. Protein electrophoresis gave similar results in the serum and the pericardial fluid, and the electrolytes were similar in pericardial fluid and serum. Of the enzymes studied, only the lactate dehydrogenase activity (LDH) showed elevated values in the pericardial fluid, with a preponderance of LDH5 isoenzyme.
LACTATE DEHYDROGENASE AND MECHANICAL TRAUMA OF ERYTHROCYTES
Authors: Dale Jon , Myhre Erik 
Published: November 2020

AbstractIntravascular hemolysis develops in most patients after prosthetic heart valve replacement. The serum lactate dehydrogenase activity (LDH) is elevated in these patients; it has been shown that the enzyme level correlates fairly well with the degree of red blood cell destruction. The heme pigments and LDH content of erythrocytes have been determined in ten normals and ten patients with prosthetic heart valves by hemolysing blood diluted in plasma. The red blood cells from the same subject were exposed to a standardized mechanical trauma by rotating the blood in a cylindrical chamber. The LDH activity and heme pigment concentration were estimated in plasma before and after the rotation. The patients' red blood cells, subjected to the traumatic effect of the implanted valves, contained significantly less LDH than the normal erythrocytes. The in vitro experiments demonstrated that erythrocytes subjected to a mechanical trauma lost proportionally much more of their LDH activity than of their heme pigments. This indicates that when the pigment loss is due to cell lysis alone, the LDH is derived also from erythrocytes remaining in circulation.