bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic treatments prior to urethroplasty: trends in management of urethral stricture disease
Authors: Moynihan Matthew J. , Voelzke Bryan , Myers Jeremy , Breyer Benjamin N. , Erickson Bradley , Elliott Sean P. , Alsikafi Nejd , Buckley Jill , Zhao Lee , Smith Thomas , Vanni Alex J. 
Published: June 2020

Abstract
Background
To determine if the number of endoscopic treatments of urethral stricture disease (USD) prior to urethroplasty has changed in the context of new AUA guidelines on management of USD. In addition to an increase in practicing reconstructive urologists and published reconstructive literature, the AUA guidelines regarding the management of male USD were presented in May 2016, advocating consideration of urethroplasty in patients with 1 prior failed endoscopic treatment.

Methods
A retrospective review of a prospectively maintained, multi-institutional urethral stricture database of high volume, geographically diverse institutions was performed from 2006 to 2017. We performed a review of relevant literature and evaluated pre-urethroplasty endoscopic treatment patterns prior to and after the AUA male stricture guideline.

Results
2964 urethroplasties were reviewed in 10 institutions. There was both a decrease in the number of endoscopic treatments prior to urethroplasty in the pre-May 2016 compared to post-May 2016 cohorts both for overall urethroplasties (2.3 vs 1.6, P = 0.0012) and a gradual decrease in the number of pre-urethroplasty endoscopic treatments over the entire study period.

Conclusion
There was a decrease in the number of endoscopic treatments of USD prior to urethroplasty in the observed period of interest. Declining endoscopic USD management is not likely to be a reflection of a solely unique influence of the guidelines as endoscopic treatment decreased over the entire study period. Further research is needed to determine if there will be a continued trend in the declining use of endoscopic treatment and elucidate the barriers to earlier urethroplasty in patients with USD.
Study rationale and design of the EANITIATE study (EmpAgliflozin compared to NPH Insulin for sTeroId diAbeTEs) - a randomized, controlled, multicenter trial of safety and efficacy of treatment with empagliflozin compared with NPH-insulin in patients with newly onset diabetes following initiation of glucocorticoid treatment
Authors: Klarskov Carina Kirstine , Holm Schultz Helga , Persson Frederik , Møller Christensen Tomas , Almdal Thomas Peter , Snorgaard Ole , Bagge Hansen Katrine , Pedersen-Bjergaard Ulrik , Lommer Kristensen Peter 
Published: June 2020

AbstractBackgroundA well-known metabolic side effect from treatment with glucocorticoids is glucocorticoid-induced diabetes mellitus (GIDM). Guidelines on the management of GIDM in hospitalized patients (in the non-critical care setting), recommend initiation of insulin therapy. The scientific basis and evidence for superiority of insulin therapy over other glucose lowering therapies is however poor and associated with episodes of both hypo- and hyperglycaemia. There is an unmet need for an easier, safe and convenient therapy for glucocorticoid-induced diabetes.MethodsEANITIATE is a Danish, open, prospective, multicenter, randomized (1:1), parallel group study in patients with new-onset diabetes following treatment with glucocorticoids (> 20 mg equivalent prednisolone dose/day) with blinded endpoint evaluation (PROBE design). Included patients are randomized to either a Sodium-Glucose-Cotransporter 2 (SGLT2) inhibitor or neutral protamin Hagedorn (NPH) insulin and followed for 30 days. Blinded continuous glucose monitoring (CGM) will provide data for the primary endpoint (mean daily blood glucose) and on glucose fluctuations in the two treatment arms. Secondary endpoints are patient related outcomes, hypoglycaemia, means and measures of variation for all values and for time specific glucose values. This is a non-inferiority study with the intent to demonstrate that treatment with empagliflozin is not inferior to treatment with NPH insulin when it comes to glycemic control and side effects.DiscussionThis novel approach to management of glucocorticoid-induced hyperglycemia has not been tested before and if SGLT2 inhibition with empaglifozin compared to NPH-insulin is a safe, effective and resource sparing treatment for GIDM, it has the potential to improve the situation for affected patients and have health economic benefits.Trial registrationwww.clinicaltrialsregister.euno.:2018–002640-82. Prospectively registered November 20th. 2018.Date of first patient enrolled:June 4th. 2019.This protocol article is based on the EANITATE protocol version 1.3, dated 29. January 2018.
An unusual case of infected uterus masculinus in a dog
Authors: Kyllar Michal , Čížek Petr 
Published: June 2020

Abstract
Background
Paraprostatic cysts are large structures that develop between the prostate gland and urinary bladder, usually in older, intact dogs. Their incidence is reported to be 1.1–5.3% in dogs with prostatic disease. The aetiology of paraprostatic cysts is not fully understood, but they are believed to develop from the uterus masculinus. Whereas the uterus masculinus has been reported to communicate with the urethra in men and horses, no communication between the uterus masculinus and urethra has been identified in dogs.

Case presentation
An entire male dog was presented with a bloody discharge from its penis and tenesmus of 5 days’ duration. A diagnosis of cystic uterus masculinus was made on the basis of the findings of abdominal ultrasonography and histopathology of tissues obtained during an exploratory laparotomy. In addition, a Sertoli cell tumour affecting both testes was diagnosed following scrotal castration. The cystic uterus masculinus was completely resected, after which the tenesmus and bloody discharge resolved. Thus, cystic uterus masculinus should be considered as a differential diagnosis for a paraprostatic cyst when such a lesion develops as part of the feminising effect of a Sertoli cell tumour.

Conclusions
Cystic uterus masculinus should be considered as a differential diagnosis for tenesmus and penile discharge, and for structures resembling paraprostatic cysts. This case report confirms that a uterus masculinus can communicate with the urethra in dogs, as in other species, and demonstrates endocrine responsiveness, manifesting as epithelial and glandular metaplasia and mucus production, with the potential for subsequent infection.
Hospitalization for heart failure incidence according to the transition in metabolic health and obesity status: a nationwide population-based study
Authors: Lee You-Bin , Kim Da Hye , Kim Seon Mee , Kim Nan Hee , Choi Kyung Mook , Baik Sei Hyun , Park Yong Gyu , Han Kyungdo , Yoo Hye Jin 
Published: June 2020

Abstract
Background
We aimed to investigate the hazard of hospitalization for heart failure (hHF) according to the transitions in metabolic health and obesity status.

Methods
The Korean National Health Insurance Service datasets from 2002 to 2017 were used for this nationwide, longitudinal, population-based study. The hazard of hHF was analyzed according to the eight groups stratified by stability in metabolic health and transition in obesity status among initially metabolically healthy adults who underwent two cycles of health examinations in 2009–2010 and 2013–2014 (N = 7,148,763).

Results
During two examinations, 48.43% of the initially metabolically healthy obese (MHO) individuals and 20.94% of the initially metabolically healthy non-obese (MHNO) individuals showed changes in their metabolic health and obesity status. During a mean follow-up of 3.70 years, 3151 individuals were hospitalized for HF. When stable MHNO individuals were set as the reference, transition to metabolically unhealthy phenotype was associated with an increased hazard of hHF; the hazard ratio (HR) and 95% confidence interval (CI) in the individuals who transformed from MHO to metabolically unhealthy non-obese was 2.033 (1.579–2.616). The constant MHO group had a 17.3% increased hazard of hHF compared with the stable MHNO group [HR (95% CI) 1.173 (1.039–1.325)]. Individuals who shifted from MHO to MHNO showed a 34.3% lower hazard of hHF compared with those who maintained the MHO category [HR (95% CI) 0.657 (0.508–0.849)].

Conclusion
Dynamic changes in metabolic health and obesity status were observed during a relatively short interval of 3–5 years. Loss of metabolic health was significantly associated with an increased hazard of hHF. Even if metabolic health was maintained, persistent obesity remained as a risk factor for hHF, and transition from MHO to MHNO had a protective effect against hHF. Therefore, the prevention and control of obesity while maintaining metabolic health would be crucial in preventing hHF.
Peripheral arterial endothelial dysfunction predicts future cardiovascular events in diabetic patients with albuminuria: a prospective cohort study
Authors: Koo Bo Kyung , Chung Woo-Young , Moon Min Kyong 
Published: June 2020

Abstract
Background
Reactive hyperemia-peripheral arterial tonometry (RH-PAT) is a noninvasive and simple test for evaluating the endothelial function. There has been sparse evidence on the usefulness of the RH-PAT index (RHI) in predicting future cardiovascular diseases among diabetic patients.

Methods
Asymptomatic diabetic patients with albuminuria were selected; their medical history and laboratory findings were evaluated every 3 to 4 months, respectively. The primary outcome was a composite of three-point major adverse cardiovascular events (3-point MACE): death from cardiovascular causes, acute coronary events, or nonfatal stroke. On the contrary, secondary outcomes included a composite of 3-point MACE, hospitalization for heart failure, or chronic kidney disease (CKD) progression. RHI was measured using the Endo-PAT2000 at the baseline. RHI < 1.67 was considered to indicate peripheral endothelial dysfunction (PED).

Results
In total, 149 subjects were included (mean age, 61.8 ± 9.2 years; duration of diabetes was 12 years). During the follow-up period (median, 49.7 months), of the 149 subjects, primary outcomes were detected in 12 (1 [2.3%] and 11 [10.5%] of those without and with PED, respectively). The presence of PED in baseline measurements significantly increased both primary and secondary outcomes, following adjustment for age, sex, hypertension, glycated hemoglobin, low-density lipoprotein cholesterol, triglyceride, systolic blood pressure, baseline estimated glomerular filtration rate, overt proteinuria, duration of diabetes, premedical history of ischemic events, anti-platelet agents, and smoking history (hazard ratio [HR]: 10.95; 95% confidence interval CI 1.00–119.91 for the primary outcome; HR, 4.12; 95% CI 1.37–12.41 for secondary outcome). In addition, PED could predict secondary outcomes independent of the risk score according to the American College of Cardiology/American Heart Association (HR: 3.24; 95% CI 1.14–9.17).

Conclusions
PED can independently predict future cardiovascular events among diabetic patients with albuminuria.
Impact of diabetes mellitus on left ventricular longitudinal function of patients with non-ischemic dilated cardiomyopathy
Authors: Tanaka Hidekazu , Tatsumi Kazuhiro , Matsuzoe Hiroki , Matsumoto Kensuke , Hirata Ken-ichi 
Published: June 2020

Abstract
Background
Left ventricular (LV) longitudinal dysfunction has been identified in type 2 diabetes mellitus (T2DM) patients with preserved LV ejection fraction (LVEF). However, the impact of T2DM on LV longitudinal function or the association of LV longitudinal function with outcome for dilated cardiomyopathy (DCM) remains unclear.

Methods
We retrospectively studied 206 patients with non-ischemic DCM, mean age of 59 ± 17 years and LVEF of 31 ± 8% (all < 45%). All patients underwent a standard echocardiographic examination, and LV longitudinal function was assessed in terms of global longitudinal strain (GLS). Long-term outcomes were assessed, with a median follow-up period of 6.2 years, as primary endpoints of death from or hospitalization for deteriorating heart failure.

Results
GLS of DCM patients with T2DM (n = 55) was significantly lower than that in DCM patients without T2DM (n = 151) in spite of similar conventional LV function (7.0 ± 2.0% vs. 7.8 ± 2.2%, p = 0.03). Kaplan–Meier curves indicated that long-term outcomes for DCM patients without T2DM were better than for those with T2DM (log-rank p = 0.001). Subdividing the two groups into four with by using the median value of GLS (7.9%) showed long-term outcome was worst for DCM patients with T2DM and low GLS. Cox proportional hazards analyses demonstrated an independent association of T2DM, GLS and left atrial volume index with long-term outcome. Moreover, multiple regression analysis for the association of GLS showed that T2DM was the independent determinant parameter for GLS as well as for LVEF and left atrial volume index.

Conclusion
Management of DCM patients with T2DM may be improved by using GLS guidance.
ε2 allele and ε2-involved genotypes (ε2/ε2, ε2/ε3, and ε2/ε4) may confer the association of APOE genetic polymorphism with risks of nephropathy in type 2 diabetes: a meta-analysis
Authors: Shi Jikang , Cheng Zhaorui , Qiu Shuang , Cui Heran , Gu Yulu , Zhao Qian , Ren Yaxuan , Zhang He , Sun Helin , Liu Yunkai , Li Yong , Qiao Yichun , Hu Yueyang , Liu Yawen , Cheng Yi 
Published: June 2020

Abstract
Background
Diabetic nephropathy (DN) contributes to end-stage renal failure. Microvascular injury resulted from reactive oxygen species is implicated in the pathogenesis of DN. Genetic polymorphism of Apolipoprotein E (APOE) influences the antioxidative properties of the protein. The relationship of APOE polymorphism with the risks of nephropathy in type 2 diabetes (T2DN) remains elusive.

Methods
An up-to-date meta-analysis was conducted on the basis of studies selected from PubMed, WanFang database, Embase, Vip database, Web of Science, Scopus, and CNKI database.

Results
A total of 33 studies conferring 3266 cases and 3259 controls were selected on the basis of criteria of inclusion and exclusion in this meta-analysis. For APOE alleles, the pooled odds ratio (OR) of ε2 vs. ε3 was 1.89 (95% confidence intervals [95% CI]: 1.49–2.38, P < 0.0001). With regard to APOE genotypes, ε2/ε2, ε2/ε3, and ε2/ε4 increased the risk of T2DN (ε2/ε2 vs. ε3/ε3: OR = 2.32, 95% CI: 1.52–3.56, P = 0.0001; ε2/ε3 vs. ε3/ε3: OR = 1.97, 95% CI: 1.50–2.59, P<0.0001; ε2/ε4 vs. ε3/ε3: OR = 1.69, 95% CI: 1.18–2.44, P = 0.0046).

Conclusions
This meta-analysis found that the APOE ε2 allele and the ε2-involved genotypes (ε2/ε2, ε2/ε3, and ε2/ε4) are the risk factors of T2DN.
Impact of HIV infection on consolidative radiotherapy for non-Hodgkin diffuse large B-cell lymphoma
Authors: Medici Carolina Trindade Mello , Mauro Geovanne Pedro , Casimiro Lucas Coelho , Weltman Eduardo 
Published: June 2020

Abstract
Objectives
Even though frequent, it is not known how HIV infection and treatment impact in the consolidation by radiotherapy of non-Hodgkin diffuse large B-cell lymphomas (DBCL). This article aim to assess that difference that HIV makes on radiation treatment.

Patients and methods
A retrospective cohort of all DBCL patients treated with chemotherapy and consolidative radiotherapy at a single institution between 2010 and 2018 was assessed. All patients had biopsy-proven lymphoma and were included if radiation was part of the treatment and had at least 6 months of follow-up or were followed until death.

Results
Three-hundred fifty-nine (359) patients were selected, with a median age at diagnosis of 57.7 years (13–90 years). Twenty-eight patients (7.8%) were HIV positive. Median follow-up was 48.0 months. Female patients were 51.3% and most had a good performance in the ECOG scale (78.8% are ECOG 0–1). Median overall survival was not reached, but mean OS was 50.1 months with 86 deaths. Median progression-free survival was 48.7 months. HIV infection had no impact on OS (p = 0.580) or PFS (p = 0.347) among patients treated with RT. HIV positive patients were more frequently staged only with CT (p > 0.05) with no impact on PFS (p = 0.191). No HIV positive patient received rituximab due to local policy restrictions and HIV positive patients were more prone to receive CHOP-like chemotherapy (p < 0.05), specially ones with etoposide (CHOEP). CHOP was associated with better survival (p = 0.015) in the overall population and in the HIV negative population (p = 0.002), but not in the HIV positive population (p = 0.982). RT toxicities were not overall more frequent in the HIV positive population (p = 0.567), except for fatigue (p < 0.05) and hematological toxicities (p = 0.022).

Conclusion
HIV status did not influence on survival when patients were treated with consolidative radiotherapy. HIV infection was a bias on our sample for staging methods and chemotherapy regimens choices. For HIV positive patients there was an increase in fatigue and hematological toxicities of any grade with radiation.
Improving the surgical consenting process for patients with acute hip fractures: a pilot quality improvement project
Authors: Singh Kirit , Assaf Ali , Bayley Morgan , Gillespie Gordon 
Published: June 2020

Abstract
Background
Consenting patients for trauma procedures following hip fracture is a key stage in the treatment pathway from admission to the operating theatre. Errors in this process can result in delayed procedures which may negatively impact patient recovery. The aim of this project was to identify and reduce errors in our consenting process for patients with capacity.

Methods
Consent forms for all adult patients with capacity admitted for surgical repair of traumatic hip fracture were reviewed over a 4-week period. The baseline measurement (n = 24), identified errors in three key process measures: clarity of documentation, failure to record procedure-specific risks and not offering a copy of the consent form to the patient. Pre-printed stickers and targeted teaching were then introduced as quality improvement measures. Their impact was evaluated over subsequent 4-week review of the same patient demographic, with further refinement of these interventions being carried out and re-evaluated for a final cycle.

Results
Cycle 1 (n = 26) following targeted teaching demonstrated a reduction in abbreviations from 38 to 20%, while doubling the documentation of discussion of procedure-specific risks from 31 to 72%. More patients were offered a copy of their consent form, rising from 12 to 48%. Cycle 2 (n = 24) saw the introduction of pre-printed “risk of procedure” stickers. Although clarity measures continued to improve, quality of pre-procedure risk documentation remained static while the number of forms being offered to patients fell to 8%.

Conclusions
Our project would suggest that while pre-printed stickers can be useful memory aids, specific teaching on consenting produces the greatest benefit. The usage of such tools should therefore be limited, as adjuncts only to specific training.
Serological evaluation of selected vector-borne pathogens in owned dogs from northern Spain based on a multicenter study using a commercial test
Authors: Díaz-Regañón David , Roura Xavier , Suárez María L. , León Marta , Sainz Ángel 
Published: June 2020

Abstract
Background
Environmental conditions in northern Spain allow the development of different arthropods involved in the transmission of significant canine vector-borne pathogens. The aim of the study was to systematically assess seroprevalence rates for Leishmania infantum, Ehrlichia canis, Anaplasma spp., Dirofilaria immitis and Borrelia burgdorferi, and risk factors in dogs from all regions of the north of Spain.

Methods
A total of 556 dogs were included in this study between January 2017 and December 2018, belonging to 30 practices covering all regions in northern Spain (Galicia, Asturias, Cantabria, Basque Country, Navarra, Aragon and Catalonia). All practices were located in the north of every region. Blood samples were analyzed using the 4DX SNAP® test (IDEXX Laboratories, Westbrook, Maine, USA) for the detection of D. immitis antigen and E. canis, B. burgdorferi and Anaplasma spp. antibodies. Leishmania SNAP® test (IDEXX Laboratories) was used for detection of L. infantum antibodies. Associations between prevalence of canine vector-borne pathogens, epidemiological and clinical signs data were statistically analyzed.

Results
The overall prevalence rates were 8.99% for L. infantum, 1.26% for Anaplasma spp., 0.9% for E. canis, 0.72% for B. burgdorferi, and 0.18% for D. immitis. Globally, 11.33% of the dogs included in the study were positive to any tested vector-borne pathogen. Leishmania infantum seroprevalence was the highest and the only one detected in all the regions. Leishmania infantum seropositivity was associated with age > 10 years-old, outdoor access, anemia, fever, dermatological signs, lympadenomegaly, muscular atrophy, ocular signs and renal disease. Ehrlichia canis seropositivity was associated with the summer season and living in urban areas. Apathy, weakness, anorexia, weight loss, anemia, fever and gastrointestinal clinical signs were also associated with E. canis antibody detection. Living in a rural area was also a risk factor for Anaplasma spp. and B. burgdorferi seropositivity.

Conclusions
To our knowledge, this is the first multicenter survey performed in northern Spain assessing different canine vector-borne diseases from all regions. Results show the presence of autochthonous cases of these diseases. The vector-borne pathogens found in this study should be included in the differential diagnosis in dogs from some areas previously considered non-endemic for these pathogens.
Blood parasites in vectors reveal a united blackfly community in the upper canopy
Authors: Chakarov Nayden , Kampen Helge , Wiegmann Anja , Werner Doreen , Bensch Staffan 
Published: June 2020

Abstract
Background
The behaviour of blood-sucking arthropods is a crucial determinant of blood protozoan distribution and hence of host-parasite coevolution, but it is very challenging to study in the wild. The molecular identification of parasite lineages in vectors can be a useful key to understand the behaviour and transmission patterns realised by these vectors.

Methods
In this study, we collected blackflies around nests of three raptor species in the upper forest canopy in central Europe and examined the presence of vertebrate DNA and haemosporidian parasites in them. We molecularly analysed 156 blackfly individuals, their vertebrate blood meals, and the haemosporidian parasite lineages they carried.

Results
We identified nine species of Simulium blackflies, largely belonging to the subgenera Nevermannia and Eusimulium. Only 1% of the collected specimens was visibly engorged, and only 4% contained remains of host DNA. However, in 29% of the blackflies Leucocytozoon lineages were identified, which is evidence of a previous blood meal on an avian host. Based on the known vertebrate hosts of the recorded Leucocytozoon lineages, we can infer that large and/or abundant birds, such as thrushes, crows, pigeons, birds of prey, owls and tits are the main targets of ornithophilic blackflies in the canopy. Blackfly species contained similar proportions of host group-specific parasite lineages and thus do not appear to be associated with particular host groups.

Conclusions
The Leucocytozoon clade infecting thrushes, crows, and pigeons present in most represented blackfly species suggests a lack of association between hosts and blackflies, which can increase the probability of host switches of blood parasites. However, the composition of the simuliid species differed between nests of common buzzards, goshawks and red kites. This segregation can be explained by coinciding habitat preferences between host and vector, and may lead to the fast speciation of Leucocytozoon parasites. Thus, subtle ecological preferences and lack of host preference of vectors in the canopy may enable both parasite diversification and host switches, and enforce a habitat-dependent evolution of avian malaria parasites and related haemosporidia.