bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patterns of emergency department use in rural and metropolitan New South Wales from 2012 to 2018
Authors: Lower Tony , Kinsman Leigh , Dinh Michael M. , Lyle David , Cheney Richard , Allan Julaine , Munro Alice , Taylor Barbara , Wiggers John H. , Bailey Andrew , Weller Lauren , Jacob Alycia , Stephens Alexandre S. 
Published: September 2020

AbstractObjectiveTo explore the patterns of and investigate the factors associated with rises in emergency department presentations in rural and metropolitan New South Wales from 2012 to 2018.DesignA retrospective descriptive study of de‐identified data from the New South Wales Emergency Department Data Collection.SettingNew South Wales, Australia.ParticipantsAll individuals presenting to 99 New South Wales emergency departments, which continuously reported to the Emergency Department Data Collection between 2012 and 2018. A total of 2 166 449 presentations recorded throughout New South Wales in 2012 (rural 786 278; metropolitan 1 380 171) and 2 477 192 in 2018 (rural 861 761; metropolitan 1 615 431).Main outcome measuresTotal emergency department presentations, plus Poisson regression modelled annual changes in emergency department presentations over the period 2012‐2018.ResultsGrowth in emergency department presentations outpaced population growth in both rural and metropolitan New South Wales between 2012 and 2018. The patterns of age‐standardised rates of presentations were broadly similar between rural and metropolitan areas, with highest rates observed in the youngest (0‐4 years) and oldest (85+ years) cohorts. The rural sample also displayed a distinct third peak in ages 15‐39 years, and rates were higher across all age groups. Rural New South Wales displayed disproportionately higher emergency department presentations in the two most deprived socio‐economic status quintiles. While rural New South Wales displayed significant reductions in triage category 5 (non‐urgent cases) over time, the relative proportion remained approximately double that of metropolitan sites.ConclusionsThere are differences between rural and metropolitan emergency department presentations relating to demographic factors, triage levels, acuity and admissions. Detailed local investigations are required to determine specific contextual issues that impact on emergency department demand.
Quality of life in stable and progressive ‘early‐stage’ keratoconus patients
Authors: Steinberg Johannes , Bußmann Nils , Frings Andreas , Katz Toam , Druchkiv Vasyl , Linke Stephan J. 
Published: September 2020

AbstractPurposeTo analyse the vision‐related quality of life (vr‐QoL) in stable and progressive keratoconus (KC) patients with a still good visual acuity.MethodsCombined prospective/cross‐sectional study design. The Refractive Status and Vision Profile (RSVP) and the National Eye Institute Visual Functioning – 25 (NEI‐25) questionnaire were used in 16 emmetropic, 32 myopic and 56 KC patients, whereby KC patients with a stable (n = 26) and patients with a progressive stage (n = 30) and some of them before and after corneal cross‐linking (CXL; n = 10) were included. All patients had a DCVA in at least one eye of ≥0.7 (decimal chart).ResultsThe analyses revealed a minor decline of the vr‐QoL from emmetropes to myopes to early KC patients with a stable disease. Nonetheless, sociological subscales (i.e. ‘social functioning’, ‘role difficulties’ and ‘dependency’) did not display statistically significant differences comparing these groups. In progressive KC, we could demonstrate a statistically significant decline also of these sociological subscales, which did not improve after CXL.ConclusionDue to a still high and almost unaffected vr‐QoL in early KC patients and the distinct decline after progression without rehabilitation after CXL, a reconsideration of current strategies to perform CXL only after a progression is diagnosed should be re‐evaluated.
Laparoscopic patch repair of a Morgagni hernia in Menkes disease
Authors: Ceccanti Silvia , Mastrangelo Mario , Andreoli Gianmarco , Cozzi Denis A. 
Published: September 2020

AbstractThe association between Morgagni hernia and Menkes disease has not yet been described. Here, we report such a rare association in an 8‐year‐old boy who presented with subocclusive symptoms. He successfully underwent laparoscopic repair with a patch. The patch was fixed to the anterior abdominal wall by using transfascial sutures with extracorporeal knot tying and to the remaining edges of the diaphragmatic defect by using intracorporeal suturing and spiral tacks. At the 2‐year follow‐up, the child remained recurrence‐free and without gastrointestinal symptoms. The potential relationship between the two conditions and the controversial use of spiral tacks to affix the mesh to the diaphragm are also discussed.
Development and validation of the Adverse Inpatient Medication Event model (AIME)
Authors: Falconer Nazanin , Barras Michael , Abdel‐Hafez Ahmad , Radburn Sam , Cottrell Neil 
Published: September 2020

AimsMedication harm has negative clinical and economic consequences, contributing to hospitalisation, morbidity and mortality. The incidence ranges from 4 to 14%, of which up to 50% of events may be preventable. A predictive model for identifying high‐risk inpatients can guide a timely and systematic approach to prioritisation. The aim of this study is to develop and internally validate a risk prediction model for prioritisation of hospitalised patients at risk of medication harm.MethodsA retrospective cohort study was conducted in general medical and geriatric specialties at an Australian hospital over six months. Medication harm was identified using International Classification of Disease (ICD‐10) codes and the hospital's incident database. Sixty‐eight variables, including medications and laboratory results, were extracted from the hospital's databases. Multivariable logistic regression was used to develop the final risk model. Performance was evaluated using area under the receiver operative characteristic curve (AuROC) and clinical utility was determined using decision curve analysis.ResultsThe study cohort included 1982 patients with median age 74 years, of which 136 (7%) experienced at least one adverse medication event(s). The model included: length of stay, hospital re‐admission within 12 months, venous or arterial thrombosis and/or embolism, ≥ 8 medications, serum sodium < 126 mmol/L, INR > 3, anti‐psychotic, antiarrhythmic and immunosuppressant medications, and history of medication allergy. Validation gave an AuROC of 0.70 (95% CI: 0.65–0.74). Decision curve analysis identified that the AIME may be clinically useful to help guide decision making in practice.ConclusionWe have developed a predictive model with reasonable performance. Future steps include external validation and impact evaluation.
How often are antidepressants prescribed off‐label among older adults in Germany? A claims data analysis
Authors: Schäfer Wiebke , Reinders Tammo , Riedel Oliver , Haug Ulrike 
Published: September 2020

AimTo estimate the extent of off‐label prescribing of antidepressants in older adults and to characterize patients with off‐label vs on‐label prescriptions of antidepressants using a large German health claims database.MethodsUsing data from the German Pharmacoepidemiological Research Database (GePaRD), we conducted a cross‐sectional study in adults aged 65 years or older with a dispensation of an antidepressant between 1 January 2009 and 31 December 2015 after a period of 365 days without such a dispensation. We assessed the overall and annual proportion of off‐label prescriptions of antidepressants by class and individual substance.ResultsAmong 263 276 incident users of antidepressants, the proportion of off‐label prescribing was 43.6% (95% CI 43.4‐43.8%) with little variation between 2009 and 2015 (42.2‐44.4%). The proportion of off‐label use was higher in men (49%) than women (41%). While the proportion of off‐label prescriptions was highest for tri‐ and tetracyclic antidepressants with 56.2% (amitriptyline 54.6%, maximum 65.9% for trimipramine), it amounted to 41.8% for selective serotonin reuptake inhibitors (citalopram 41.6%, maximum 46.0% for escitalopram) and was 51.2% for mirtazapine. Indicators of overall morbidity were similar in both groups, eg, pain was coded in 72% of off‐label users vs 77% of on‐label users (insomnia 20% vs 24%).ConclusionOur study suggests a high prevalence of off‐label antidepressant use among older adults in Germany, which was not restricted to certain classes of antidepressants or individual antidepressants. Given the unclear risk‐benefit ratio, studies investigating the safety of off‐label use among older adults for individual antidepressants are urgently needed.
Impact of spironolactone exposure on prostate cancer incidence amongst men with heart failure: A Pharmacoepidemiological study
Authors: Hiebert Brett M. , Janzen Bryan W. , Sanjanwala Rohan M. , Ong Aldrich D. , Feldman Ross D. , Kim Julian O. 
Published: September 2020

AimsAldosterone has been found to influence cancer cell growth, cell cycle regulation and cell migration, including in prostate cancer cells. Spironolactone is an aldosterone antagonist used for managing chronic heart failure (HF) with known antiandrogenic effects. We examined the effect of spironolactone exposure amongst men with HF on the incidence of prostate cancer.MethodsThis retrospective cohort study utilized provincial clinical and administrative databases from the Manitoba Centre for Health Policy. Incident cases of prostate cancer were identified from the provincial cancer registry, and spironolactone exposure was quantified from pharmacare databases. A multivariable proportional hazards model was used to assess the time‐dependent impact of spironolactone exposure on prostate cancer incidence.ResultsA total of 18 562 men with newly diagnosed HF from 2007 to 2015 with a median age of 72 years (interquartile range: 61–81) and a median follow‐up from HF diagnosis to prostate cancer incidence of 2.7 years (interquartile range: 1.1–4.9) were included. A time‐dependent multivariable analysis of spironolactone exposure following HF diagnosis found a reduced the risk of prostate cancer hazard ratio 0.55 (95% confidence interval 0.31–0.98, P = .043).ConclusionSpironolactone exposure significantly reduced the incidence of prostate cancer amongst men with HF. These findings support the plausibility of aldosterone as a promoter of prostate cancer growth and development. Prospective clinical trials are warranted to further assess the role of spironolactone or other mineralocorticoid receptor antagonists as a means to prevent prostate cancer development or as an adjunctive measure to prostate cancer treatments.
A sufficiency threshold is not a harm principle: A better alternative to best interests for overriding parental decisions
Authors: Saunders Ben 
Published: September 2020

AbstractDouglas Diekema influentially argues that interference with parental decisions is not in fact guided by the child’s best interests, but rather by a more permissive standard, which he calls the harm principle. This article first seeks to clarify this alternative position and defend it against certain existing criticisms, before offering a new criticism and alternative. This ‘harm principle’ has been criticized for (i) lack of adequate moral grounding, and (ii) being as indeterminate as the best interest standard that it seeks to replace. I argue that these are not serious problems. I take Diekema’s negative point to be right—our actual standard for intervention is not literally the best interests of the child—but I disagree with his proposed replacement. First, Diekema’s proposed harm threshold should be more carefully distinguished from Mill’s harm principle. Second, there is no reason to assume that the standard for permissible intervention coincides with the threshold for harm (or serious harm). Thus, I propose that the best alternative to the best interests standard is not a harm principle, but rather a sufficiency threshold between adequate (or ‘good enough’) and inadequate (or ‘substandard’) parenting.
Women’s agenda for the improvement of childbirth care: Evaluation of the Babies Born Better survey data set in Spain
Authors: Benet Marta , Escuriet Ramon , Palomar‐Ruiz Laura , Ruiz‐Berdún Dolores , Leon‐Larios Fatima 
Published: September 2020

AbstractBackgroundPublic patient involvement (PPI) generates knowledge about the health‐illness process through the incorporation of people's experiences and priorities. The Babies Born Better (BBB) survey is a pan‐European online questionnaire that can be used as a PPI tool for preliminary and consultative forms of citizens' involvement. The purpose of this research was to identify which practices support positive birth experiences and which ones women want changed.MethodsThe BBB survey was distributed in virtual communities of practice and through social networks. The version launched in Spain was used to collect data in 2014 and 2015 from women who had given birth in the previous 5 years. A descriptive, quantitative analysis was applied to the sociodemographic data. Two open‐ended questions were analyzed by qualitative content analysis using a deductive and inductive codification process.ResultsA total of 2841 women participated. 41.1% of the responses concerned the category “Care received and experienced,” followed by “Specific interventions and procedures” (26.6%), “Involved members of care team” (14.2%), and “Environmental conditions” (9%). Best practices were related to how care is provided and received, and the main areas for improvement referred to specific interventions and procedures.ConclusionsThis survey proved a useful tool to map the best and poorest practices reported. The results suggest a need for improvement in some areas of childbirth care. Women's reports on negative experiences included a wide range of routine clinical interventions, avoidable procedures, and the influence exerted by professionals on their decision‐making.
Cabozantinib plus docetaxel and prednisone in metastatic castration‐resistant prostate cancer
Authors: Madan Ravi A. , Karzai Fatima H. , Al Harthy Munjid , Petrylak Daniel P. , Kim Joseph W. , Arlen Philip M. , Rosner Inger , Theoret Marc R. , Cordes Lisa , Bilusic Marijo , Peer Cody J. , Dawson Nancy A. , Couvillon Anna , Hankin Amy , Williams Moniquea , Chun Guin , Owens Helen , Marte Jennifer L. , Lee Min‐Jung , Tomita Yusuke , Yuno Akira , Trepel Jane B. , Lee Sunmin , Steinberg Seth M. , Gulley James L. , Figg William D. , Dahut William L. 
Published: September 2020

ObjectiveTo evaluate the safety and efficacy of cabozantinib combined with docetaxel.Patients and MethodsThis was a phase 1/2 multicentre study in patients with metastatic castration‐resistant prostate cancer (mCRPC). Docetaxel (75 mg/m2 every 3 weeks with daily prednisone 10 mg) was combined with escalating doses of daily cabozantinib (20, 40 and 60 mg). Based on the results of the phase 1 study, the investigation was expanded into a randomized study of docetaxel with prednisone (hereafter 'docetaxel/prednisone') plus the maximum tolerated dose (MTD) of cabozantinib compared with docetaxel/prednisone alone.ResultsA total of 44 men with mCRPC were enrolled in this phase 1/2 trial. An MTD of 40 mg cabozantinib plus docetaxel/prednisone was determined. Dose‐limiting toxicities were neutropenic fever and palmar‐plantar erythrodysesthesia, and there was one death attributable to a thromboembolic event. In addition, grade 3 or 4 myelosuppression, hypophosphataemia and neuropathy were seen in three or more patients. In the phase 1 study, the median time to progression (TTP) and overall survival (OS) time were 13.6 and 16.3 months, respectively. In the phase 2 study, which was terminated early because of poor accrual, the median TTP and OS favoured the combination (n = 13) compared to docetaxel/prednisone alone (n = 12; 21.0 vs 6.6 months; P = 0.035 and 23.8 vs 15.6 months; P = 0.072, respectively).ConclusionDespite the limited number of patients in this study, preliminary data suggest that cabozantinib can be safely added to docetaxel/prednisone with possible enhanced efficacy.
LDL receptors, caveolae and cholesterol in endothelial dysfunction: oxLDLs accomplices or victims?
Authors: Luchetti Francesca , Crinelli Rita , Nasoni Maria Gemma , Benedetti Serena , Palma Francesco , Fraternale Alessandra , Iuliano Luigi 
Published: September 2020

Oxidized LDLs (oxLDLs) and oxysterols play a key role in endothelial dysfunction and the development of atherosclerosis. The loss of vascular endothelium function negatively impacts vasomotion, cell growth, adhesiveness and barrier functions. While for some of these disturbances, a reasonable explanation can be provided from a mechanistic standpoint, for many others, the molecular mediators that are involved are unknown. Caveolae, specific plasma membrane domains, have recently emerged as targets and mediators of oxLDL‐induced endothelial dysfunction. Caveolae and their associated protein caveolin‐1 (Cav‐1) are involved in oxLDLs/LDLs transcytosis, mainly through the scavenger receptor class B type 1 (SR‐B1 or SCARB1). In contrast, oxLDLs endocytosis is mediated by the lectin‐like oxidized LDL receptor 1 (LOX‐1), whose activity depends on an intact caveolae system. In addition, LOX‐1 regulates the expression of Cav‐1 and vice versa. On the other hand, oxLDLs may affect cholesterol plasma membrane content/distribution thus influencing caveolae architecture, Cav‐1 localization and the associated signalling. Overall, the evidence indicate that caveolae have both active and passive roles in oxLDL‐induced endothelial cell dysfunction. First, as mediators of lipid uptake and transfer in the subendothelial space and, later, as targets of changes in composition/dynamics of plasma membrane lipids resulting from increased levels of circulating oxLDLs. Gaining a better understanding of how oxLDLs interact with endothelial cells and modulate caveolae‐mediated signalling pathways, leading to endothelial dysfunction, is crucial to find new targets for intervention to tackle atherosclerosis and the related clinical entities.LINKED ARTICLESThis article is part of a themed issue on Oxysterols, Lifelong Health and Therapeutics. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v178.16/issuetoc
Clinical and radiographic outcomes of reentry lateral sinus floor elevation after a complete membrane perforation
Authors: Wang Da , Tian Jiehua , Wang Ying , Wei Donghao , Lin Ye 
Published: September 2020

AbstractBackgroundAlthough small perforation of the maxillary sinus schneiderian membrane is a well‐documented complication during lateral sinus floor elevation (LSFE), complete perforations larger than 10 mm often result in discontinuation of surgery. Reports on reentry LSFE and its long‐term outcomes are sparse.PurposeTo evaluate the long‐term outcomes of reentry LSFE following complete membrane perforation to elucidate the technical details of the reentry procedure.Materials and methodsWe assessed the medical records of all patients receiving LSFE from 2008 to 2017 in the Department of Oral Implantology, Peking University Hospital of Stomatology. Twenty‐two patients receiving reentry LSFE after complete membrane perforation were enrolled. Data were recorded using cone beam computer tomography: including the residual bone height, membrane thickness of the sinus prior to surgery (MT1), and before reentry (MT2), and height of the bone graft during the reentry procedure (HBG). Cumulative survival rate of implants (CSR), marginal bone loss (MBL), and subsequent complications were also recorded.ResultsFrom 2008 to 2017, 2023 consecutive patients (2262 sinuses) who underwent LSFE were screened. Complete membrane perforation occurred in 28 patients and resulted in discontinuation of surgery (1.2%). Twenty two patients were enrolled and received reentry LSFE within 3‐6 months. Two patients undergoing the reentry procedure were suspended due to excessive membrane perforation, while the other 20 finished reentry sinus bone graft. In the reentry procedure, the HBG was 9.73 ± 2.67 mm with 34 implant placements. The MT1 and MT2 were 1.03 ± 0.43 and 1.91 ± 1.45 mm, respectively, showing a statistically significant difference (P < .05). After a follow‐up of 2‐10 years, CSR was 97.1%, and MBL was 0.64 ± 0.50 mm.ConclusionsThe long‐term outcome of reentry LSFE is predictable and reentry LSFE offers a reliable alternative following complete membrane perforation. However, the procedure is relatively sensitive and should be performed by experienced surgeons.
Michael Soulé (1936–2020) on spirituality, ethics, and conservation biology
Authors: Taylor Bron 
Published: September 2020

AbstractMichael Soulé is best known for his scientific contributions and central role in founding the Society for Conservation Biology and its flagship journal. Less well known are his childhood experiences, his affinity for Zen Buddhism and Arne Naess’ deep ecology philosophy, and his contributions as an environmental activist to efforts to protect biodiversity and rewild ecosystems. Also less well known is the extent to which he was an interdisciplinary environmental studies scholar, struggling to understand what promotes and hinders proenvironmental behaviors. In this regard, his life and that of many other conservation scientists provide important clues, but no easy answers. By attempting to integrate the humanities, with its quest for a meaningful and fulfilling human existence, with naturalistic nature spirituality and ecocentric values, as well as the social and natural sciences, Soulé sought to solve the riddle as to why human beings seemed unable to understand, slow, and halt negative anthropogenic environmental change. He thus modeled what interdisciplinary environmental studies is at its best. Those advocating the conservation of biological diversity have much to learn from Michael Soulé, not only from his scientific findings but also from his way of seeing, the questions he asked, and his love of the living world.
Laparoscopic rectal dissection preserves erectile function after ileal pouch–anal anastomosis: a two‐centre study
Authors: Picaud Olivier , Beyer‐Berjot Laura , Parc Yann , Karsenty Gilles , Creavin Ben , Berdah Stéphane , Lefevre Jérémie H. 
Published: September 2020

AbstractAimFew studies have been published on erectile function after ileal pouch–anal anastomosis (IPAA) and, unlike in women, male fertility after IPAA has never been assessed. The primary objective was to assess the impact of IPAA on erectile function. The secondary objective was to assess the impact of IPAA on male fertility.MethodsAll of the male patients who underwent IPAA in two university care centres between 2003 and 2017, aged 70 years or less at the time of operation, were included. Forty‐eight per cent of the patients responded to the international index of erectile function, the Jorge–Wexner score and a fertility questionnaire. All demographic and perioperative data were prospectively collected. Fertility results were compared with those of a control group undergoing appendectomy, matched for age at the time of operation, desire for paternity and length of follow‐up.ResultsOne hundred and thirty‐nine patients were included, among which 46 (33%) presented with erectile dysfunction and 14 (10%) with severe erectile dysfunction. Age older than 50 years (OR 0.27, 95% CI 0.12–0.62, P = 0.002) and rectal dissection performed by open surgery (OR 4.16, 95% CI 1.62–10.65, P = 0.003) were independent risk factors for erectile dysfunction. There was no infertility after IPAA compared with controls: indeed, 23 (16%) IPAA patients presented with pregnancy in their couple versus 27 (22%) controls (P = 0.29), whereas 36 (26%) IPAA patients and 34 (28%) controls (P = 0.80) expressed paternity desire.ConclusionA total laparoscopic approach, including rectal dissection, should be preferred to preserve erectile function. Male fertility is not impaired after IPAA.