bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of metabolically healthy obesity in primary infertile men: Results from a cross‐sectional study
Authors: Cazzaniga Walter , Candela Luigi , Boeri Luca , Capogrosso Paolo , Pozzi Edoardo , Belladelli Federico , Baudo Andrea , Ventimiglia Eugenio , Alfano Massimo , Abbate Costantino , Montorsi Francesco , Salonia Andrea 
Published: July 2020

AbstractBackgroundA number of studies showed that obesity may negatively impact on sperm quality and consequently couple's fertility. Recently, specific attention was given to a clinical condition known as metabolically healthy obesity (MHO).ObjectivesTo evaluate the effects of MHO on semen and hormonal parameters of men presenting for primary couple's infertility associated with pure male factor infertility (MFI).Materials and methodsData from a homogenous cohort of 512 white‐European primary infertile men belonging to couples with pure MFI have been cross‐sectionally analyzed. Semen analysis was based on 2010 WHO reference criteria. Patients were segregated into eugonadal, secondary hypogonadal, primary hypogonadal, and compensated hypogonadal. The Harmonized International Diabetes Federation criteria were used to define metabolic syndrome (MetS). Based on BMI and MetS, patients were further segregated into the following: (a) metabolically healthy non‐obese (MHNO); (b) metabolically unhealthy non‐obese (MUNO) (c) metabolically healthy obesity (MHO); and, (d) metabolically unhealthy obesity (MUHO). Main outcome measures were the prevalence of MHO and the impact of MHO on semen and hormonal parameters in this cohort of MFI primary infertile men.ResultsOverall, MHNO, MUNO, MHO, and MUHO were found in 462 (90%), 13 (2.5%), 27 (5.2%), and 10 (1.9%) men, respectively. MHO patients had lower total testosterone and SHBG levels (all P < .05) but higher E2 values (P < .005) compared with MHNO men. Groups did not differ in terms of semen parameters. At multivariable logistic regression, analysis MHO was associated with an increased risk of primary and secondary hypogonadism (all P ≤ .02) compared with MHNO, after accounting for age and comorbid conditions.Discussion and conclusionsMetabolically healthy obesity is threefold more prevalent than unhealthy obesity in primary infertile men. Despite semen parameters are comparable among groups, MHO patients show worse endocrine parameters and a higher risk of primary and secondary hypogonadism compared with metabolically healthy normal infertile men.
Clinical experience of using the NGENUITY three‐dimensional surgery system in ophthalmic surgical procedures
Authors: Liu Juping , Wu Di , Ren Xinjun , Li Xiaorong 
Published: July 2020

AbstractPurposeTo assess the clinical experience of using a three‐dimensional (3D) system for ophthalmic surgical procedures.MethodsWe retrospectively analysed video recordings of patients who underwent 3D ophthalmic surgery, using the NGENUITY® 3D visualization system, or traditional microsurgery at our hospital, from August 2017 to February 2018. Patients underwent phacoemulsification or phacoemulsification combined with vitrectomy. Diagnoses, operation type, duration of continuous curvilinear capsulorhexis (CCC), number of forceps nips during CCC and capsulorhexis complications were recorded. Five surgeons and four assistants answered a 3D surgery questionnaire.ResultsTwenty‐six of 46 patients who underwent 3D surgery, and 31 of 51 patients who underwent traditional microsurgery (control group) were enrolled. The mean CCC duration in the study and control groups was 31.2 ± 10.8 and 28.7 ± 13.2 seconds (p = 0.071), and the mean number of forceps nips was 5 ± 2 and 5 ± 2 (p = 0.634), respectively. The anterior capsular rupture rate of phacoemulsification under 3D and traditional conditions was 3.85% (1/26 cases) and 3.23% (1/31 cases), respectively. The complication rate was similar between the two groups (p > 0.999). Four of five surgeons and two of four assistants believed the clarity of 3D surgery was similar or better than that of traditional microsurgery. The occurrence of dizziness (p > 0.999), shoulder and neck pain (p = 0.262), backache (p = 0.471) and visual fatigue (p = 0.347) did not differ significantly between the two methods.ConclusionThe 3D surgical system facilitated similar operation speed and stability as the traditional microscope and provided reliable support for ophthalmic surgery.
A wearable lower extremity support for laparoscopic surgeons: A pilot study
Authors: Kawahira Hiroshi , Nakamura Ryoichi , Shimomura Yoshihiro , Oshiro Takashi , Okazumi Shinichi , Lefor Alan K. 
Published: July 2020

AbstractSurgeons have increased physical stress during laparoscopic surgery due to operative site constraints. We developed a wearable device to reduce the physical stress on surgeons’ lower extremities. The device mechanically facilitates maintaining a near‐upright posture. The surgeon's knees are gently bent by a knee‐joint locking mechanism, and fixing and releasing are performed independently on each side. The subjects were one female and two male surgeons, who wore the device during laparoscopic inguinal hernia repair or high anterior resection. Surface electromyogram (EMG) was conducted for both iliopsoas muscles. Control values were determined with the subject not wearing the device. Participants completed a post‐procedure questionnaire. With the device, EMG activity had a tendency to decrease in the left iliopsoas muscle (P = .055), but it changed little on the right (P = .406). The post‐procedure questionnaire showed an overall positive impression, although subjects reported some difficulty walking. This device decreases EMG activity and may improve a surgeon's work environment.
Medication use among older people in Europe: Implications for regulatory assessment and co‐prescription of new medicines
Authors: Strampelli Anna , Cerreta Francesca , Vučić Katarina 
Published: July 2020

AimsThe aim of this study was to elucidate drug prescription patterns in older European people with the objective to support regulatory contextualisation of (1) the suitability of enrolment criteria for new clinical trials; and (2) the understanding of the potential interactions/incompatibilities of newly authorised medicines with those most frequently used by older people.MethodsMedicines agencies in Portugal, Poland, Slovakia and England were approached to provide a list of the 10 most frequent prescriptions in 2016 for systemically used medicines per active substances (i.e. ATC level 5), in older people. For each active substance and for the most common therapeutic subgroups (i.e. ATC level 2), the percentages of older patients receiving at least one prescription were calculated per older age categories (65–74; 75–84; 85+) and gender.ResultsThere was considerable alignment in the most commonly prescribed active substances and therapeutic subgroups represented; these were gastroprotectants (A02), lipid‐modifying agents (C10) and analgesics (N02). Some gender differences were observed (A02 and N02 were prescribed more frequently to women), but trends on age categories were consistent; A02 and N02 prescriptions continued to rise with age, while C10 slightly decreased in the 85+ age group in all countries.ConclusionsThe findings of this study are consistent with the major chronic diseases reported in the older European population. Evidence on co‐medication of newly applied medicines with the currently identified most commonly used medicines in older people should be generated during the (non)clinical development of new medicines to support regulatory assessment and adequate user information.
Patterns and factors influencing oral anticoagulant prescription in people with atrial fibrillation and dementia: Results from UK primary care
Authors: Mongkhon Pajaree , Alwafi Hassan , Fanning Laura , Lau Wallis C.Y. , Wei Li , Kongkaew Chuenjid , Wong Ian C.K. 
Published: July 2020

AimsOral anticoagulant (OAC) is recommended for preventing stroke in atrial fibrillation (AF). However, the OAC utilisation in AF patients with dementia or cognitive impairment (CI) is limited. This study aimed to examine the prevalence of OAC prescriptions in AF patients with dementia/CI and to identify factors associated with OAC treatment within 180 days after dementia/CI diagnosis.MethodsUsing The Health Improvement Network database, the annual trends of OAC between 2000 and 2015 were calculated. Multivariable logistic regression was performed to identify factors associated with OAC treatment.ResultsThe prevalence rate of OAC prescriptions increased from 6.1% in 2000 to 45.9% in 2015. Among OAC users, the proportion of direct oral anticoagulants (DOACs) use increased significantly from 0.1% in 2011 to 33.8% in 2015 (P‐trend < 0.001), while the proportion of vitamin K antagonist use decreased by 28.6% from 100% in 2000 to 71.4% in 2015 (P‐trend < 0.001). In the multivariable analysis, younger age, very old age, female sex, higher Charlson Comorbidity Index, having a HAS‐BLED score ≥3, a history of intracranial bleeding, falls and polypharmacy were significantly associated with lower odds of receiving OAC.ConclusionsIn UK primary care, OAC use increased from 2000 to 2015 in AF patients with dementia/CI, with a substantial increase in use of DOACs. Characteristics related to frailty are associated with lower odds of OAC prescription. Given the increasing use of DOACs in patients with dementia/CI, further studies are needed to investigate the safety and effectiveness of DOACs in this important patient group.
Long‐term survival following elective colon cancer surgery in the aged. A population‐based cohort study
Authors: Niemeläinen S. , Huhtala H. , Ehrlich A. , Kössi J. , Jämsen E. , Hyöty M. 
Published: July 2020

AbstractAimThe number of colorectal cancer patients increases with age. Long‐term data support personalized management due to heterogeneity within the older population. This registry‐ and population‐based study aimed to analyse long‐term survival, and causes of death, after elective colon cancer surgery in the aged, focusing on patients who survived more than 3 months postoperatively.MethodsThe data included patients ≥ 80 years who had elective surgery for Stage I–III colon cancer in four Finnish centres. The prospectively collected data included comorbidities, functional status, postoperative outcomes and long‐term survival. Univariate and multivariate Cox regression analysis were conducted to determine factors associated with long‐term survival.ResultsA total of 386 surgical patients were included, of whom 357 survived over 3 months. Survival rates for all patients at 1, 3 and 5 years were 85%, 66% and 55%, compared to 92%, 71% and 59% for patients alive 3 months postoperatively, respectively. Higher age, American Society of Anesthesiologists (ASA) score ≥ 4, Charlson Comorbidity Index ≥ 6, tumour Stage III, open compared to laparoscopic surgery and severe postoperative complications were independently associated with reduced overall survival. Higher age (hazard ratio 1.97, 1.14–3.40), diabetes (1.56, 1.07–2.27), ASA score ≥ 4 (3.27, 1.53–6.99) and tumour Stage III (2.04, 1.48–2.81) were the patient‐related variables affecting survival amongst those surviving more than 3 months postoperatively. Median survival time for patients given adjuvant chemotherapy was 5.4 years, compared to 3.3 years for patients not given postoperative treatment.ConclusionsFit aged colon cancer patients can achieve good long‐term outcomes and survival with radical, minimally invasive surgical treatment, even with additional chemotherapy.
A systematic review of CT chest in COVID‐19 diagnosis and its potential application in a surgical setting
Authors: Shao J. M. , Ayuso S. A. , Deerenberg E. B. , Elhage S. A. , Augenstein V. A. , Heniford B. T. 
Published: July 2020

AbstractAimThe aim of this work was to investigate the sensitivity and utility of CT of the chest in diagnosing active SARS‐Cov‐2 (COVID‐19) infection, and its potential application to the surgical setting.MethodA literature review was conducted using Google Scholar® and MEDLINE®/PubMed® to identify current available evidence regarding the sensitivity of CT chest compared with RT‐PCR for the diagnosis of COVID‐19‐positive patients. GRADE criteria and the QUADAS 2 tool were used to assess the level of evidence.ResultsA total of 20 articles were identified that addressed the question of sensitivity of CT for diagnosis of symptomatic and asymptomatic COVID‐19‐positive patients. Overall sensitivity of CT scan ranged from 57%–100% for symptomatic and 46%–100% for asymptomatic COVID‐19 patients, while that of RT‐PCR ranged from 39%–89%. CT chest was a better diagnostic modality and capable of detecting active infection earlier in the time course of infection than RT‐PCR in symptomatic patients. In asymptomatic patients, disease prevalence seems to play a role in the positive predictive value. Minimal evidence exists regarding the sensitivity of CT in patients who are asymptomatic.ConclusionsIn surgical patients, CT chest should be considered as an important adjunct for detection of COVID‐19 infection in patients who are symptomatic with negative RT‐PCR prior to any operation. For surgical patients who are asymptomatic, there is insufficient evidence to recommend routine preoperative CT chest for COVID‐19 screening.
Change in Student Perceptions of Course and Instructor Following Curriculum Change
Authors: Agrawal Vipin K. , Khanna Poonam , Agrawal Vijay K. , Hughes Larry W. 
Published: July 2020

ABSTRACTOngoing curriculum change in higher education is essential to enhance student learning and better prepare them for the job‐market. However, research shows that faculty are reluctant to implement such changes because students generally react adversely thereby negating any potential benefits, and moreover, sanction faculty through lower evaluations and future enrollment. Yet, understanding of the effect of curriculum changes on students’ course and instructor perceptions is limited. In this article we attempt to fill this gap. Drawing on two empirical findings—students’ motivation to attend college becoming increasingly extrinsic since the 1960s and their inability to recognize, ex ante, the value‐added by a curriculum change—and the norm life‐cycle theory, we argue that any effort‐increasing or grade‐threatening change is viewed as non‐normative and will lead to an adverse student reaction. However, this adverse reaction will dissipate over time once a critical mass of students is convinced of the merits of the new curriculum. We find support for our hypotheses by analyzing change in student perceptions following curriculum changes at a U.S. University. In addition, we also find that once the adverse reaction dissipates, students’ perceptions of the new curriculum become more positive than the old curriculum, only to be reversed once the revised curriculum is accepted as the new norm.
Global responses of health science librarians to the COVID‐19 (Corona virus) pandemic: a desktop analysis
Authors: Yuvaraj Mayank 
Published: July 2020

AbstractThe COVID‐19 pandemic has posed significant challenges for health science librarians. During this pandemic, librarians are playing an active role by increasing the public’s awareness of the virus, maintaining document delivery services and providing research support. This paper uses the method of desktop analysis of the websites of selected library associations to identify the responses of health science librarians to the COVID‐19 pandemic. The study highlights significant initiatives taken by some health science librarians which can be replicated by others to meet the needs of library users in the COVID‐19 health crisis.J.M
A nomogram prediction for mandibular molar survival in Chinese patients with periodontitis: A 10‐year retrospective cohort study
Authors: Shi Shuwen , Meng Yang , Li Wenjing , Jiao Jian , Meng Huanxin , Feng Xianghui 
Published: July 2020

AbstractAimsTo develop a nomogram prediction model of mandibular molar survival by comprehensively analysing clinical and radiographic risk factors of mandibular molar loss.Materials and MethodsFour hundred and seventy‐eight mandibular molars of 139 subjects who underwent non‐surgical periodontal treatment were examined retrospectively within a mean follow‐up period of 11.1 years. The association of risk factors including clinical and radiographic parameters with mandibular molar loss was assessed using univariate and multivariate Cox regression analyses. A nomogram prediction model was developed, and the validation and discriminatory ability of it were analysed.ResultsHundred and four molars were lost in this study. Probing depth (PD), attachment loss (AL), furcation involvement (FI), bleeding on probing (BOP), tooth mobility and radiographic bone loss were significantly associated with tooth loss (p < .01). A gradient effect of degree of FI on mandibular molar loss existed increasing from degree Ⅱ (HR = 2.37, 95% CI: 1.48, 3.79) to Ⅲ (HR = 5.61, 95% CI: 3.01, 10.45) versus none & degree Ⅰ. The area under the curve (AUC) of the model was 0.891. The calibration curve and decision curve analysis demonstrated good performance and high net benefit of nomogram, respectively.ConclusionsA specific nomogram could be adopted to predict the mandibular molar survival and formulate tailored treatment plans in Chinese.
Clinical inertia in patients with type 2 diabetes treated with oral antidiabetic drugs: Results from a Japanese cohort study (JDDM53)
Authors: Maegawa Hiroshi , Ishigaki Yasushi , Langer Jakob , Saotome‐Nakamura Ai , Andersen Marc ,   the Japan Diabetes Clinical Data Management (JDDM) Study Group
Published: July 2020

AbstractAims/IntroductionTreatment intensification is commonly delayed in people with type 2 diabetes, resulting in poor glycemic control for an unacceptable length of time and increased risk of complications.Materials and MethodsThis retrospective study investigated clinical inertia in 33,320 Japanese adults with type 2 diabetes treated with oral antidiabetic drugs (OADs) between 2009 and 2018, using data from the Computerized Diabetes Care (CoDiC®) database.ResultsThe median time from first reported glycated hemoglobin (HbA1c) ≥7.0% (≥53 mmol/mol) to treatment intensification was considerably longer and HbA1c levels were higher the more OADs the patient was exposed to. For patients receiving three OADs, the median times from HbA1c ≥7.0% (53 mmol/mol) to intensification with OAD, glucagon‐like peptide‐1 receptor agonist or insulin were 8.1, 9.1 and 6.7 months, with a mean HbA1c level at the time of intensification of 8.4%, 8.9% and 9.3%, respectively. The cumulative incidence for time since the first reported HbA1c ≥7.0% (≥53 mmol/mol) to intensification confirmed the existence of clinical inertia, identifying patients whose treatment was not intensified despite poor glycemic control. HbA1c levels ≥7.0% (≥53 mmol/mol) after ≥6 months on one, two or three OADs were observed in 42%, 51% and 58% of patients, respectively, showing that approximately 50% of patients are above HbA1c target regardless of how many OADs they take.ConclusionsReal‐world data here show clinical inertia in Japanese adults with type 2 diabetes from early diabetes stages when they are receiving OADs, and illustrate a need for earlier, more effective OADs or injectable treatment intensification and better communication around the existence of clinical inertia.
The heterochronic geneOryza sativa LIKE HETEROCHROMATIN PROTEIN 1modulates miR156b/c/i/e levels
Authors: Cui Yongtao , Cheng Jingfei , Ruan Shuang , Qi Peipei , Liu Wei , Bian Hongwu , Ye Luhuan , Zhang Yuping , Hu Jiang , Dong Guojun , Guo Longbiao , Zhang Yijing , Qian Qian , Hu Xingming 
Published: July 2020

AbstractThe juvenile‐to‐adult transition in plants involves changes in vegetative growth and plant architecture; the timing of this transition has important implications for agriculture. The microRNA miR156 regulates this transition and shoot maturation in plants. InArabidopsis thaliana, deposition of histone H3 trimethylation on lysine 27 (H3K27me3, a repressive mark) at theMIR156A/Cloci is regulated by Polycomb Repressive Complex 1 (PRC1) or PRC2, depending on the developmental stage. The levels of miR156 progressively decline during shoot maturation. The amount of H3K27me3 atMIR156A/Cloci affects miR156 levels; however, whether this epigenetic regulation is conserved remains unclear. Here, we found that in rice (Oryza sativa), the putative PRC1 subunit LIKE HETEROCHROMATIN PROTEIN 1 (OsLHP1), with the miR156–SQUAMOSA PROMOTER BINDING PROTEIN‐LIKE (SPL) module, affects developmental phase transitions. Loss of OsLHP1 function results in ectopic expression ofMIR156B/C/I/E, phenocopy of miR156 overexpression, and reduced H3k27me3 levels atMIR156B/C/I/E. This indicates thatOsLHP1has functionally diverged fromArabidopsis LHP1. Genetic and transcriptome analyses of wild‐type, miR156b/c‐overexpression, andOslhp1‐2mutant plants suggest that OsLHP1 acts upstream of miR156 and SPL during the juvenile‐to‐adult transition. Therefore, modifying the OsLHP1–miR156–SPL pathway may enable alteration of the vegetative period and plant architecture.
Nursing handoffs and clinical judgments regarding patient risk of deterioration: A mixed‐methods study
Authors: Lavoie Patrick , Clarke Sean P. , Clausen Christina , Purden Margaret , Emed Jessica , Cosencova Lidia , Frunchak Valerie 
Published: July 2020

AbstractAims and objectivesTo explore how change‐of‐shift handoffs relate to nurses' clinical judgments regarding patient risk of deterioration.BackgroundThe transfer of responsibility for patients' care comes with an exchange of information about their condition during change‐of‐shift handoff. However, it is unclear how this exchange affects nurses' clinical judgments regarding patient risk of deterioration.DesignA sequential explanatory mixed‐methods study reported according to the STROBE and COREQ guidelines.MethodsOver four months, 62 nurses from one surgical and two medical units at a single Canadian hospital recorded their handoffs at change of shift. After each handoff, the two nurses involved each rated the patient's risk of experiencing cardiac arrest or being transferred to an intensive care unit in the next 24 hr separately. The information shared in handoffs was subjected to content analysis; code frequencies were contrasted per nurses' ratings of patient risk to identify characteristics of information that facilitated or hindered nurses' agreement.ResultsOut of 444 recorded handoffs, there were 125 in which at least one nurse judged that a patient was at risk of deterioration; nurses agreed in 32 cases (25.6%) and disagreed in 93 (74.4%). These handoffs generally included information on abnormal vital signs, breathing problems, chest pain, alteration of mental status or neurological symptoms. However, the quantity and seriousness of clinical cues, recent transfers from intensive care units, pain without a clear cause, signs of delirium and nurses' knowledge of patient were found to affect nurses' agreement.ConclusionsNurses exchanged more information regarding known indicators of deterioration in handoffs when they judged that patients were at risk. Disagreements most often involved incoming nurses rating patient risk as higher.Relevance to clinical practiceThis study suggests a need to sensitise nurses to the impact of certain cues at report on their colleagues' subsequent clinical judgments. Low levels of agreement between nurses underscore the importance of exchanging impressions regarding the likely evolution of a patient's situation to promote continuity of care.