bluuebunny/crossref_metadata_2025_split huggingface dataset:
Will implants with a fixed dental prosthesis in the molar region enhance the longevity of teeth adjacent to distal free‐end edentulous spaces?
Authors: Hatta Kodai , Takahashi Toshihito , Sato Hitomi , Murakami Shinya , Maeda Yoshinobu , Ikebe Kazunori 
Published: December 2020

AbstractObjectivesClinical evidence demonstrating the effectiveness of implants in preventing tooth loss is limited because of the many risk factors involved in tooth loss. This retrospective cohort study investigated whether an implant in the molar region of a distal free‐end edentulous space affects the loss of the most distal tooth after 6 years, adjusting for other risk factors associated with tooth loss using propensity score matching analysis.Material and MethodsA total of 571 subjects and 1,085 teeth adjacent to a distal free‐end edentulous space were evaluated. At baseline, the 1,085 teeth were divided into two groups according to the presence or absence of a molar implant with a fixed dental prosthesis in the distal free‐end edentulous space. Propensity score matching analysis was used to reduce the effects of bias by matching teeth with and without implants according to similar background factors at baseline. The adjusted variables were age group, occlusal support status, Kennedy classification, tooth position, tooth type, restoration status, dental caries, periodontal pocket depth, and condition of the opposing tooth.ResultsA total of 56 teeth (28 associated with a molar implant; 28 with no implant) were enrolled according to propensity score matching. Fisher's exact test showed that a molar implant significantly protected the tooth adjacent to the distal free‐end edentulous space (p = .01).ConclusionsWithin the limitations of this retrospective cohort study, it was found that implants in free‐end edentulous spaces may be beneficial in extending the longevity of adjacent teeth. Further research will be necessary to confirm this finding.
Effect of Crohn’s Disease on Villous Length and CYP3A4 Expression in the Pediatric Small Intestine
Authors: Vyhlidal Carrie A , Chapron Brian D. , Ahmed Atif , Singh Vivekanand , Casini Rebecca , Shakhnovich Valentina 
Published: December 2020

Changes in absorptive capacity and first‐pass metabolism in the small intestine affect oral drug bioavailability. Characterization of such changes as a consequence of inflammation is important for developing physiologically‐based pharmacokinetic (PBPK) models for inflammatory bowel disease. We sought to elucidate the impact of small intestinal Crohn’s disease (CD) on villous length and CYP3A4 expression in children. Freshly frozen duodenal and terminal ileum (TI) biopsies from 107 children (1–19 years) with and without CD were evaluated for active inflammation. Villous length and CYP3A4 mRNA/protein expression were compared among regions of active and inactive inflammation in CD and controls. A twofold reduction in villous length was observed in inflamed duodena and ilia of children with CD, but in the absence of regional inflammation, villi in CD were comparable in length to controls. Expression of CYP3A4 mRNA correlated significantly with villous length in the TI (P = 0.0003), with a trend observed in the duodenum that did not reach statistical significance. In the presence of active inflammation, a significant decrease in CYP3A protein expression was confirmed in the duodenum, where protein expression also correlated significantly with villous length across diagnoses (P < 0.0001). Our findings suggest that previous observations of decreased CYP3A4 expression and function in inflamed intestine may not be due solely to downregulation by inflammatory cytokines, but also to villous blunting and subsequent loss of surface area for protein expression. This information is relevant for PBPK model development and could aid with dose adjustment decisions for oral CYP3A4 substrates administered during CD flare (e.g., budesonide).
Sarcopenia in Patients With Normal Body Mass Index Is an Independent Predictor for Postoperative Complication and Long‐Term Survival in Gastric Cancer
Authors: Sun Xiangwei , Xu Jianfeng , Chen Xiaodong , Zhang Weiteng , Chen Wenjing , Zhu Ce , Sun Jing , Yang Xinxin , Wang Xiang , Hu Yingying , Cai Yiqi , Shen Xian 
Published: December 2020

Malnutrition in patients with gastric cancer (GC) with normal body mass index (BMI) is often ignored. This study aimed to explore the role of sarcopenia in predicting postoperative complication and long‐term survival in patients with GC with normal BMI. We included patients with normal BMI (18.5 kg/m2 ≤ BMI < 23 kg/m2) who underwent radical gastrectomy between July 2014 and December 2016. Sarcopenia was assessed by muscle mass, handgrip strength, and gait speed. Kaplan–Meier survival analysis was used to analyze the association between sarcopenia and the prognosis of patients with GC. Univariate and multivariate analyses were used to identify risk factors contributing to postoperative complications and long‐term survival. Overall, 267 patients with GC with normal BMI were included in this study; of which 49 (18.35%) patients were diagnosed with sarcopenia. Patients with sarcopenia had higher incidence of a major postoperative complication, longer postoperative hospital stays, and greater hospital costs. The Kaplan–Meier survival analysis showed that patients with sarcopenia had poorer overall survival than non‐sarcopenia patients. Univariate and multivariate analyses showed that sarcopenia was an independent predictor for postoperative complication and long‐term survival in such patients. Sarcopenia is an independent predictor for postoperative complications and long‐term survival in patients with normal BMI after radical gastrectomy for GC. We recommend that patients with normal BMI should perform nutritional risk screening by sarcopenia.
Clinical Evaluation of an Investigational 5 mL Wearable Injector in Healthy Human Subjects
Authors: Woodley Wendy D. , Yue Wen , Morel Didier R. , Lainesse Audrey , Pettis Ronald J. , Bolick Natasha G. 
Published: December 2020

An investigational wearable injector (WI), the BD Libertas Wearable Injector (BD Libertas is a trademark of Becton, Dickinson and Company), was evaluated in an early feasibility clinical study for functional performance, tissue effects, subject tolerability, and acceptability of 5 mL, non‐Newtonian ~ 8 cP subcutaneous placebo injections in 52 healthy adult subjects of 2 age groups (18–64 years and ≥ 65 years). Randomized WI subcutaneous injections (n = 208, 4/subject) were delivered to the right and left abdomen and thigh of each subject, 50% (1 thigh and 1 abdomen) with a defined movement sequence during injection. Injector functional performance was documented. Deposition was qualified and quantified with ultrasound. Tissue effects and tolerability (pain) were monitored through 24 hours with corresponding acceptability questionnaires administered through 72 hours. WI (n = 205) automatically inserted the needle, delivered 5 mL ± 5% in 5.42 minutes (SD 0.74) and retracted. Depots were entirely (93.2%) or predominantly (5.4%) localized within the target subcutaneous tissue. Slight to moderate wheals (63.9%) and erythema (75.1%) were observed with ≥ 50% resolution within 30–60 minutes. Subject pain (100 mm Visual Analog Scale) peaked mid‐injection (mean 9.1 mm, SD 13.4) and rapidly resolved within 30 minutes (mean 0.4 mm, SD 2.6). Subjects’ peak pain (≥ 90.2%), injection site appearance (≥ 92.2%) and injector wear, size, and removal (≥ 92.1%) were acceptable (Likert responses) with 100% likely to use the injector if prescribed. Injection site preference was divided between none (46%), abdomen (25%), or thigh (26.9%). The investigational WI successfully delivered 5 mL viscous subcutaneous injections. Tissue effects and pain were transient, well‐tolerated and acceptable. Neither injection site, movement or subject age affected injector functional performance or subject pain and acceptability.
Long‐term endoscopic surveillance for Barrett's esophagus in Japan: Multicenter prospective cohort study
Authors: Norita Kazuaki , Koike Tomoyuki , Saito Masahiro , Shinkai Hirohiko , Ami Reiko , Abe Yasuhiko , Dairaku Naohiro , Inomata Yoshifumi , Kayaba Shoichi , Ishiyama Fumitake , Oikawa Tomoyuki , Ohyauchi Motoki , Ito Hirotaka , Asonuma Sho , Hoshi Tatsuya , Kato Katsuaki , Ohara Shuichi , Shimodaira Yosuke , Watanabe Kenta , Shimosegawa Tooru , Masamune Atsushi , Iijima Katsunori 
Published: December 2020

ObjectsAlthough a recent study showed the cancer incidence of Barrett's esophagus (BE) to be 1.2%/year in 251 patient‐years in Japan, the long‐term outcomes remain unclear. The present study estimated the cancer risk of BE in Japan using our original prospective multicenter cohort.MethodsA total of 98 patients with BE of maximum length of ≥2 cm were enrolled during the period of 2010–2012 and received at least one follow‐up endoscopy over 5 years thereafter. Cancer incidence rates with 95% confidence interval for occurrence of esophageal adenocarcinoma (EAC) were calculated as the number of events divided by patient‐years of follow‐up and were expressed as %/year.ResultsOverall, the median endoscopic follow‐up period was 59.9 (first and third quartiles, 48.5–60.8) months, constituting a total of 427 patient‐years of observation. Since two EAC cases developed, the cancer incidence was 0.47% (0.01%–1.81%)/year. The cancer incidence was 0.39% (−0.16% to 2.44%) in 232 patient‐years and 0.31% (−0.13% to 1.95%)/year in 318 patient‐years for 55 cases with specialized intestinal metaplasia and 70 with BE ≥3 cm (maximum), respectively. At the end of follow‐up, 12 of 92 patients (13.0%) died, but none died from EAC.ConclusionThis is the largest prospective follow‐up study with endoscopy to investigate the incidence of EAC in unequivocal BE with the maximum length of ≥2 cm in Japan. Although a further large‐scale study will be required to validate our results, the cancer risk of BE in Japan would be lower than previously reported (0.47% vs 1.2%/year).
Trends in prevalence and incidence of type 2 diabetes among adults in Beijing, China, from 2008 to 2017
Authors: Wang Zijing , Wu Yao , Wu Junhui , Wang Mengying , Wang Xiaowen , Wang Jiating , Wu Tao , Wu Yiqun , Hu Yonghua 
Published: December 2020

AbstractAimsTo describe secular trends in diagnosed type 2 diabetes prevalence and incidence in Beijing, China.MethodsUsing health insurance claims for 17.7 million adults ≥20 years in 2008–2017, we identified people with diabetes using hospital diagnoses and drug prescriptions. Results were age‐standardised using data for Beijing from China's 2010 census. Trends in prevalence and incidence were analysed using Joinpoint regression analysis.ResultsFrom 2008 to 2017, we identified 2,104,159 people diagnosed with type 2 diabetes. Type 2 diabetes prevalence increased from 3.7% [95% CI: (3.6, 3.8)] to 6.6% (6.4, 6.7), but the annual rate of increase slowed from 18.1% (14.4, 22.0) to 1.5% (0.8, 2.2) before and after 2011 respectively. Women had a higher diabetes prevalence than men, for all years. The yearly increase in prevalence was greater in people younger than 40 years, with an average annual percentage change of 13.6% (10.7, 16.5) compared to 6.5% (5.6, 7.4) in those over 40 years. Over the 10 years, the overall incidence decreased from 24.3 (24.2, 24.4) to 11.5 (11.5, 11.6) per 1000 person‐years, but it increased in people younger than 40 years. The average age at diabetes diagnosis dropped from 62 to 56 years (p < 0.001). Among incident cases of diabetes, the percentage of people under 40 years increased from 3.0% to 10.9% (p < 0.001).ConclusionsThe prevalence of diagnosed type 2 diabetes in Beijing increased continuously over the 10 years, the incidence decreased, except in people under 40 years. Continuous efforts are needed to prevent diabetes in China.
Evaluation of pregnancy outcomes in women with GCK‐MODY
Authors: López Tinoco Cristina , Sánchez Lechuga Begoña , Bacon Siobhan , Colclough Kevin , Ng Nicholas , Wong Eleanor , Goulden Eirena L. , Edwards Jackie , Fleming Aileen , Byrne Bridgette , Byrne Maria M. 
Published: December 2020

AbstractAimsTo determine the fetal and maternal outcomes in pregnant women with Glucokinase‐Maturity onset diabetes of the young (GCK‐MODY).MethodsWe studied the obstetric and perinatal outcomes in 99 pregnancies of 34 women with GCK‐MODY. The mutation status of the offspring was known in 29 and presumed in 33. Clinical outcomes were determined and compared between affected (n = 39) and unaffected (n = 23) offspring.Results59% of pregnancies were treated with diet alone and 41% received insulin. Birthweight, percentage of large for gestational age (LGA) and caesarean section (CS) in GCK‐unaffected offspring was significantly higher than in GCK‐affected offspring (4.0 ± 0.7 vs. 3.4 ± 0.4 kg, p = 0.001), 15 (65%) vs. 5(13%) (p = 0.00006) and 17 (74%) vs. 11 (28%) (p = 0.001), respectively. We observed an earlier gestational age at delivery on insulin in unaffected offspring (38.3 ± 1.0 vs. 39.5 ± 1.5 weeks, p = 0.03) with no significant change in LGA (9 (82%) vs. 6 (50%); p = 0.12), and a higher rate of CS (8 [73%] vs. 3 [11%]; p < 0.001), and no change in small for gestational age (0 [0%] vs. 4 [14%]; p = 0.30) in affected offspring.ConclusionInsulin therapy in unaffected offspring did not reduce LGA and was associated with earlier gestational age at delivery. Insulin treatment in GCK‐affected offspring was associated with an increased incidence of CS, but did not adversely affect fetal outcome. Fetal genotype determines birthweight rather than treatment. Pre‐pregnancy diagnosis of GCK‐MODY, use of continuous glucose monitoring and non‐invasive fetal genotyping may enable further investigation of targeted therapy in this condition.
Topsy‐turvy heart: A first recorded case report with intracardiac anomaly
Authors: Alkhateeb Areej , Mansour Amr , Tanidir Ibrahim Cansaran 
Published: December 2020

AbstractTopsy‐turvy heart is a rare congenital anomaly; it has a specific characteristic of cardiac malrotation and superior–inferior arrangement of right/left ventricles. A five‐day‐old patient was diagnosed antenatally with hypoplastic left heart and right hydronephrosis and had been admitted to the hospital with symptoms of respiratory distress. The postnatal imaging studies revealed an abnormal ventricular arrangement with a large aortopulmonary window, ventricular septal defect (VSD), and the upside‐down orientation resulting in the posterior–inferior displacement of the common arterial confluence and, in turn, the left main bronchial stenosis. For the first time, the diagnosis of a topsy‐turvy heart with the intracardiac anomaly (VSD) was confirmed.
Odd one in: Oddity within mixed‐species shoals does not affect shoal preference by vagrant tropical damselfish in the presence or absence of a predator
Authors: Paijmans Kai C. , Booth David J. , Wong Marian Y. L. 
Published: December 2020

AbstractGrouping behaviour displayed by animals is usually attributed to predation and foraging‐related benefits. The mechanisms of predator protection and foraging efficiency are diverse and often produce conflicting drivers of grouping behaviour. One key conflict is that between group size and phenotypic oddity. Theoretically, individuals should choose the largest available group due to multiple mechanisms associated with “safety in numbers”. However, individuals should also choose the most phenotypically similar group members due to the “predator confusion effect”. This conflict is particularly important within the context of mixed‐species groups because, while their formation may facilitate large group size, phenotypic differences between species may be costly due to oddity. To investigate the interacting effects of shoal size, composition and predator presence on grouping decisions, choice experiments were conducted using displaced tropical damselfish,Abudefduf vaigiensis, settling in temperate south‐eastern Australia (termed vagrants) as a model species. Contrary to predictions,A. vaigiensisdisplayed no preference for single‐ over mixed‐species shoals, with or without a predator present. These results suggest that shoal composition may not be an important driver of shoal choice in this system. Further,A. vaigiensisshowed no preference for larger mixed‐species shoals over smaller single‐species shoals. These outcomes are discussed within the context of climate change‐driven redistribution ofA. vaigiensisin temperate south‐eastern Australia.
Influenza A virus infection‐induced macroautophagy facilitates MHC class II‐restricted endogenous presentation of an immunodominant viral epitope
Authors: Deng Jieru , Lu Chunni , Liu Chuanxin , Oveissi Sara , Fairlie W. Douglas , Lee Erinna F. , Bilsel Pamuk , Puthalakath Hamsa , Chen Weisan 
Published: December 2020

CD4+T cells recognize peptides presented by major histocompatibility complex class II molecules (MHC‐II). These peptides are generally derived from exogenous antigens. Macroautophagy has been reported to promote endogenous antigen presentation in viral infections. However, whether influenza A virus (IAV) infection‐induced macroautophagy also leads to endogenous antigen presentation through MHC‐II is still debated. In this study, we show that IAV infection leads to endogenous presentation of an immunodominant viral epitope NP311–325by MHC‐II to CD4+T cells. Mechanistically, such MHC‐II‐restricted endogenous IAV antigen presentation requiresde novoprotein synthesis as it is inhibited by the protein synthesis inhibitor cycloheximide, and a functional ER‐Golgi network as it is totally blocked by Brefeldin A. These results indicate that MHC‐II‐restricted endogenous IAV antigen presentation is dependent onde novoantigen and/or MHC‐II synthesis, and transportation through the ER‐Golgi network. Furthermore, such endogenous IAV antigen presentation by MHC‐II is enhanced by TAP deficiency, indicating some antigenic peptides are of cytosolic origin. Most importantly, the bulk of such MHC‐II‐restricted endogenous IAV antigen presentation is blocked by autophagy inhibitors (3‐MA and E64d) and deletion of autophagy‐related genes, such asBeclin1andAtg7. We have further demonstrated that in dendritic cells, IAV infection prevents autophagosome–lysosome fusion and promotes autophagosome fusion with MHC class II compartment (MIIC), which likely promotes endogenous IAV antigen presentation by MHC‐II. Our results provide strong evidence that IAV infection‐induced autophagosome formation facilitates endogenous IAV antigen presentation by MHC‐II to CD4+T cells. The implication for influenza vaccine design is discussed.
Anthropogenic litter is a novel habitat for aquatic macroinvertebrates in urban rivers
Authors: Wilson Hazel L. , Johnson Matthew F. , Wood Paul J. , Thorne Colin R. , Eichhorn Markus P. 
Published: December 2020

Abstract

Anthropogenic litter (solid manufactured waste) is an understudied but pervasive element of river systems worldwide. Its physical structure generally differs from natural substrates, such as gravel and cobbles (hereafter rocks). Consequently, anthropogenic litter could influence ecological communities in urban rivers by providing novel habitats.

This study compares the macroinvertebrates recorded on anthropogenic litter with those on rocks to test whether the different substrates support distinct communities. Macroinvertebrates were collected from individual rocks and anthropogenic litter, predominantly plastic, metal, and glass, in three U.K. rivers.

Macroinvertebrate communities on anthropogenic litter were consistently more diverse than those found on rocks, reflecting its greater surface complexity, but the density of macroinvertebrates was similar among substrates. The community composition also varied between substrates, with five taxa only recorded on anthropogenic litter. Community differences largely reflected greater abundances of common taxa on anthropogenic litter, which were relatively insensitive to environmental quality. Plastic and fabric anthropogenic litter communities were the most dissimilar to those on rocks, probably due to their flexibility, which could replicate the physical structure of aquatic macrophytes.

Our findings indicate that anthropogenic litter supports a distinct and diverse community of macroinvertebrates in urban rivers, which are otherwise relatively homogenous in habitat structure.

Removal of anthropogenic litter from urban rivers may not be beneficial for local biodiversity. Understanding the functional habitats provided by anthropogenic litter could help better manage urban rivers to replace habitat lost through urbanisation.
Caspofungin combined with TMP/SMZ as a first‐line therapy for moderate‐to‐severe PCP in patients with human immunodeficiency virus infection
Authors: Tian Q , Si J , Jiang F , Xu R , Wei B , Huang B , Li Q , Jiang Z , Zhao T 
Published: December 2020

ObjectivesThe effectiveness of trimethoprim/sulfamethoxazole (TMP/SMZ) for pneumocystis pneumonia (PCP) is limited with adverse events. Caspofungin, by inhibiting the cyst form of Pneumocystis jirovecii, may be an alternative therapy for PCP. However, the availability of clinical data about caspofungin combined with TMP/SMZ in the treatment of PCP in HIV‐infected patients is limited. Thus, we aimed to examine the clinical effectiveness and safety of caspofungin combined with TMP/SMZ as a first‐line therapy for moderate‐to‐severe PCP in HIV‐infected patients.MethodsFrom January 2017 to December 2019, data of HIV‐infected patients with moderate‐to‐severe PCP who received either TMP/SMZ alone or caspofungin combined with TMP/SMZ as first‐line therapy were retrospectively reviewed to assess the effectiveness and safety of each regimen. The Kaplan–Meier curve and log‐rank test were used for survival analysis.ResultsA total of 278 patients met the criteria. The overall positive response rate of PCP treatment was 48.92%, and the overall all‐cause in‐hospital mortality rate was 33.09%. Patients who received combination therapy consisting of caspofungin and TMP/SMZ had a better positive response rate (59.44% vs. 37.78%, P < 0.001) and lower all‐cause in‐hospital mortality rate (24.48% vs. 42.22%, P = 0.003). Also, patients who received combination therapy had higher survival rate during a hospital stay (75.52% vs. 57.78%, P = 0.004), and those who received longer combination therapy were more likely to have higher survival rate (P = 0.042). We found that age (P = 0.019), CD4 cell count (P = 0.001) and therapeutic regimen (P = 0.002) were significant risk factors for all‐cause in‐hospital mortality rate in univariate analysis. In multivariate analysis, only CD4 cell count and therapeutic regimen were statistically significant factors associated with all‐cause in‐hospital mortality rate. Patients with a CD4 count of > 30 cells/µL and patients who received combination therapy consisting of caspofungin and TMP/SMZ were more likely to survive from PCP (P = 0.011 and P = 0.002, respectively). There were no additional severe adverse events caused by adding caspofungin.ConclusionsFor HIV‐infected patients with moderate‐to‐severe PCP, combination therapy with caspofungin and TMP/SMZ is an effective and promising first‐line therapy with no greater number of adverse events compared with TMP/SMZ monotherapy. Patients who received caspofungin had better positive response rates and lower all‐cause in‐hospital mortality rates. Also, we recommend early initiation of caspofungin.