bluuebunny/crossref_metadata_2025_split huggingface dataset:
Time to relapse after tildrakizumab withdrawal in patients with moderate‐to‐severe psoriasis who were responders at week 28: post hoc analysis through 64 weeks from reSURFACE 1 trial
Authors: Warren R.B. , Carrascosa J.M. , Fumero E. , Schoenenberger A. , Lebwohl M.G. , Szepietowski J.C. , Reich K. 
Published: September 2020

AbstractBackgroundAs treatment interruptions occur during psoriasis management in clinical practice, it is important to know the duration of clinical response after treatment withdrawal.ObjectivesTo report time to and predictors of relapse in patients who were tildrakizumab 100 and 200 mg responders (≥75% improvement in Psoriasis Area and Severity Index, PASI 75) at week 28 re‐randomized to placebo from reSURFACE 1 trial.MethodsPost hoc analysis of adult patients with moderate‐to‐severe plaque psoriasis from a 64‐week phase 3 trial. Relapse was primarily defined as loss of PASI 75 response. Both relapses defined as loss of PASI 90 and loss of absolute PASI < 2 response were included as sensitivity analyses. PASI 75, PASI 90 and PASI < 2 responders re‐randomized to placebo at week 28 and followed up until week 64 were included. The Kaplan–Meier (KM) estimates of the 64‐week relapse rate were calculated. The log‐rank test to compare KM curves from responders to tildrakizumab 100 and 200 mg was used. Independent predictors of relapse were explored.ResultsMedian time to loss of PASI 75/PASI 90/PASI < 2 response from week 28 was 142/111/112 days with tildrakizumab 100 mg and 172/140/113 days with tildrakizumab 200 mg, respectively (all not significant). Around 20% of patients did not relapse (either maintained a PASI 75 response or were lost to follow‐up) during the 36‐week period. Increase in body mass index (BMI) (hazard ratio, HR [95% confidence interval, CI] for loss of PASI 75 response: 1.0345 [1.0112–1.0582]) and increase in disease duration (HR [95% CI]: 1.0151 [1.0028–1.0275] for loss of PASI 75 response) were associated with an increased risk of relapse, regardless of the relapse definition.ConclusionsWhen treatment is interrupted, tildrakizumab provides durable maintenance of efficacy with a median time to loss of PASI 75 response of 5–6 months, irrespective of the dose. Interventions on modifiable risk factors for relapse, such as BMI, may improve personalized long‐term psoriasis management.
Comparing the use of a novel antibiotic‐free film‐forming topical wound dressing versus a topical triple antibiotic in dermatologic surgical procedures including Mohs micrographic surgery
Authors: Benedetto A.V. , Staidle J.P. , Schoenfeld J. , Benedetto E.A. , Benedetto P.X. 
Published: September 2020

AbstractBackgroundThere is no universally accepted protocol of topical wound care after cutaneous surgical procedures. The current practice is to use petrolatum‐based products, commonly containing topical antibiotics. The rise in antibiotic‐resistant bacteria and increased risk of allergic and contact dermatitis due to the use of topical antibiotics is well established.ObjectiveTo compare the prevalence of contact dermatitis, the infection rate and the subjective measures of healing of a novel, antibiotic‐free, film‐forming silicone‐based wound dressing to a topical triple antibiotic petrolatum‐based ointment in patients undergoing invasive dermatological interventions in two arms: (1) Mohs micrographic surgery (MMS) and (2) a combination of various routine dermatologic surgical procedures.DesignThe 231 patients were enrolled in this open‐label, randomized, single‐blinded study. Patients applied the products immediately after surgery and daily afterwards. Clinicians evaluated the surgical site for infection or contact dermatitis at all follow‐up visits. Acute wound healing progression was assessed using a rating scale against clinical experience and expected results from −4 (much worse) to +4 (much better).ResultsContact dermatitis was significantly decreased in the wound dressing group compared to the topical antibiotic group (0 vs 15.9%, P < 0.001). There was no difference between the study arms (Mohs vs. non‐Mohs, P = 0.242). Infection rate was not significantly different between the groups (P > 0.05) and between the study arms (P > 0.05). Assessor‐rated secondary outcomes like healing time, healing quality, erythema and new tissue quality were significantly better in the wound dressing group, while comfort and perceived overall satisfaction were better in the antibiotic group. Patient‐rated outcomes did not show any difference between groups and between study arms.ConclusionThe wound dressing used in this study is a topical silicone gel preparation and presents a viable alternative to topical antibiotics for postoperative wound care without enhancing the risk of infection.
Psoriasis severity: commonly used clinical thresholds may not adequately convey patient impact
Authors: Golbari N.M. , van der Walt J.M. , Blauvelt A. , Ryan C. , van de Kerkhof P. , Kimball A.B. 
Published: September 2020

AbstractBackgroundPsoriasis severity is usually evaluated using quantitative and qualitative measures, including per cent body surface area (BSA) involvement, the Psoriasis Area and Severity Index (PASI) and the Dermatology Life Quality Index (DLQI), a patient‐reported questionnaire. However, standardized definitions for psoriasis severity categories have not been well established. A PASI of 10 or 12 has remained the minimal severity threshold defining eligibility for psoriasis treatments. In the present study, the validity of this cut‐off was re‐evaluated in the context of quality of life.ObjectiveTo determine whether the thresholds commonly used to define moderate psoriasis (PASI of 10–12 and BSA of 10) are supported by patient‐reported DLQI data.MethodsA systematic review of randomized controlled trials that enrolled mild or moderate patients published between January 2000 and June 2017 was used to assess correlations between provider and patient‐generated severity at baseline.ResultsFor subject groups with high impact on quality of life (DLQI > 10), the mean weighted BSA was 7.6 (Range: 7.1–8.4) and the mean weighted DLQI was 11 (Range: 10.2–12.2). Similarly, the mean weighted PASI for patients with DLQI > 10 was 8.7 (Range: 7.1–10.1) and the mean weighted DLQI was 10.9 (Range: 10.1–12.2).ConclusionPatients with PASI or BSA scores less than 10 can have major quality of life impairment. In general, the objective measures of BSA and PASI alone, when excluding DLQI, may not fully capture the impact of disease severity.
Dementia and Falls Management in Underserved Populations: The Cognition and Mobility Care Management Program
Authors: Tan Zaldy S. , Hamade Wael , Menkin Josephine , de Pacheco Renee Guillen , Gans Daphna , Weintraub Nancy , Garcia Maribel , Guerrero Lourdes R. , Reuben David B. 
Published: September 2020

BACKGROUND/OBJECTIVESCognitive and mobility impairments are common and underdiagnosed chronic conditions that afflict community‐dwelling older adults. This study describes the organization, implementation, and evaluation of an intervention for underserved and ethnically diverse older patients with dementia and/or falls risk.DESIGNObservation, baseline and 1 year after intervention.SETTINGCommunity‐based primary care county clinics in inland southern California.PARTICIPANTSA total of 272 persons, aged 70 years and older, who screened positive for falls and/or dementia and enrolled in the Cognition and Mobility Care Management program during the study period.INTERVENTIONA nurse care manager performed a patient and caregiver evaluation and created and implemented a care plan with medical, behavioral, and psychosocial interventions in partnership with patients and their primary care providers.MEASUREMENTSProcess outcomes included rates of positive screening for dementia and fall risk, referral, enrollment, and visit completion. Patient outcomes included fall history, mobility and cognitive assessments, and depression scales. Patients and/or caregivers completed questionnaires rating perceived benefits of enrollment after 1 year in the program.RESULTSMedical assistants screened 573 patients aged 70 years and older during the study period; 78% screened positive for dementia and/or fall risk. Of the patients who screened positive, 94% were referred; 91% of contacted patients elected to enroll, and 272 patients completed an intake visit (meanage = 77 years; 65% female; 75% Latino; 10% African American). The patients and caregivers who completed satisfaction questionnaires 1 year after enrollment rated the program highly, and 92% would recommend the program to others.CONCLUSIONA primary care–based screening and comanagement program to identify and manage dementia and falls risk in primarily Latino and African American older adult patients living in an underserved area was well received, with high satisfaction and perceived benefit from patients and caregivers.
Assessing P‐T variability in mélange blocks from the Catalina Schist: Is there differential movement at the subduction interface?
Authors: Harvey Kayleigh M. , Penniston‐Dorland Sarah C. , Kohn Matthew J. , Piccoli Philip M. 
Published: September 2020

AbstractIn subduction‐related tectonic mélange, thermobarometry on individual blocks can in principle constrain the scale of lithological mixing along the subduction interface. Previous thermobarometric investigation of the tectonic amphibolite facies mélange unit in the Catalina Schist, Santa Catalina Island, California, USA, has suggested relatively limited mixing among blocks (≤12 km). Here we further investigate scales of mixing among metamorphically disparate (‘exotic’) blocks within epidote‐amphibolite and lawsonite‐blueschist facies mélange of the Catalina Schist using field and petrographic observations, Zr‐in‐rutile thermometry, and quartz‐in‐garnet elastic barometry. A new statistically based method is presented for calculating elastic barometry maximum pressures. The exotic blocks record peak metamorphic temperatures between 580 and 735°C and peak pressures between 1.16 and 1.65 GPa. Temperatures primarily fall in between those recorded by rocks in the amphibolite facies and epidote amphibolite facies units (643–735°C and 553–596°C respectively). The pressure estimates encompass those recorded by blocks from the amphibolite facies mélange (1.34–1.44 GPa), although the exotic blocks record a much larger range of pressures. The large range of recorded temperatures and pressures suggests that blocks within the epidote amphibolite unit were sourced from and mixed along a 20–30 km region of the subduction interface while an exotic block from the lawsonite blueschist facies unit appears to have been sourced from at least 70 km deeper than the unit it is hosted in. Metre‐ to kilometre‐scale variations in matrix mineral rheology likely control strain partitioning at the interface and permit differential transport of mélange blocks over variable length scales.
Multiple oral granulomatous nodules to hyaluronic acid filler
Authors: Caldas Pozuelo Carmen , Domínguez De Dios Julia , Mota Rojas Xenia 
Published: September 2020

AbstractA 74‐year‐old Caucasian woman presented with a 2‐week history of multiple nodules in both lips and perioral region that caused her mild discomfort while eating. The patient reported hyaluronic acid infiltration on both lips 5 months prior to presentation. The examination revealed multiple, well‐defined, millimetric, and firm nodules on both lips and oral mucosa. An excisional biopsy of one of the nodules was performed under local anesthesia. Histopathological analysis demonstrated acute eosinophilic inflammation, fibrosis, and granulomas on mucoid material, positive for colloidal iron stain and Alcian blue stain, alongside a minor salivary gland showed mild atrophy, fibrosis, and fat infiltration. Enhancement of the aged lip using hyaluronic acid, to restore the bulkiness and elasticity that have been lost with age, is very common. Nevertheless, soft tissue fillers are used in a wide age range. Hyaluronic acid represents 78% of the dermal filler injections in the United States, been the second most popular nonsurgical cosmetic procedure after botulinum toxin injection. Foreign body granulomatous reaction is a rare delayed complication that has been well documented elsewhere and it has been associated with poor injection technique. Although it also has been related to hypersensitivity reactions that may be caused by impurities developed during the bacterial fermentation process, treatment of granulomatous reactions with hyaluronidase is recommended.
Fusidic acid cream comparatively minimizes signs of inflammation and postinflammatory hyperpigmentation after ablative fractional CO2 laser resurfacing in Chinese patients: A randomized controlled trial
Authors: Wei Min , Li Li , Zhang Xiao Feng , Li Mengna , Wang Baoxi , Yan Yan 
Published: September 2020

AbstractBackgroundInflammation and postinflammatory hyperpigmentation (PIH) are two adverse side effects of ablative fractional CO2 laser (ablative Fr CO2) treatment for both rejuvenation and acne scars.AimsTo evaluate the efficacy of fusidic acid cream versus erythromycin ointment as postoperative therapy in patients who underwent ablative Fr CO2 treatment for atrophic acne scars.MethodsSixty Chinese patients who fulfilled the study criteria were recruited and randomly assigned to an experimental group treated with fusidic acid cream or a control group treated with erythromycin ointment. Postoperative treatment lasted for 7 days in each group. Each patient had two follow‐up visits at 8 and 12 weeks. In total, three patients dropped out of the study, one in the experimental group at week 8 and two in the control group at weeks 8 and 12. Baseline and postoperative inflammation and PIH were assessed by facial examination, photographs, and questionnaires. Besides, PIH was evaluated by the Hyperpigmentation Activity and Severity Index (HASI) and a five‐point grading system.ResultsModerate‐to‐severe PIH was observed in both groups. However, the mean HASI score and severity of PIH in the experimental group were lower than those of the control group at weeks 8 and 12 (P < 0.05). In the control group, one patient developed postoperative abscesses and one had papules, whereas no inflammation was observed in the experimental group participants.ConclusionFusidic acid cream shows promise as a common treatment after ablative Fr CO2 therapy to reduce postoperative inflammation and PIH.
Constructing a problem and marketing solutions: A critical content analysis of the nature and function of industry‐authored oral health educational materials
Authors: Grundy Quinn , Cussen Cliodna , Dale Craig 
Published: September 2020

AbstractAims and objectivesTo document the nature of industry‐authored educational materials focused on oral health; and analyse how they construct the relationships between nurses and industry.BackgroundNurses frequently rely on pharmaceutical and medical device companies for continuing education. However, industry‐sponsored education is a key aspect of multi‐faceted promotional campaigns and may introduce bias into clinical decision‐making.DesignCritical qualitative content analysis reported according to the COREQ checklist.MethodsWe purposively sampled educational documents from the websites of 4 major manufacturers of oral health products for acute care. Two researchers analysed each document using an open‐ended coding form. We conducted an interpretive analysis using inductive coding methods.ResultsWe included 63 documents that emphasised the importance of education in the form of training, expert guidance, evidence syntheses and protocols to support oral care practices. Industry promoted its relationship with nursing as an oral health authority through three dominant messages: (1) Pneumonia is a source of morbidity, mortality and treatment costs, which informed nurses about a critical problem; (2) Comprehensive oral care reduces pneumonia risk, which instructed nurses about product‐oriented solutions; and (3) Frequent oral care is important, which emphasised compliance to standardised protocols. These messages formed an accountability logic that prompted clinicians to address a problem for which the company's products served as a solution. In doing so, industry validated dominant administrative concerns including compliance, while promoting product uptake.ConclusionsIndustry‐authored educational materials may promote industry interests, rather than nursing or patient agendas. Dependence on industry's information and product solutions may have unintended, negative consequences for nursing practice.Relevance to clinical practiceThough industry's educational materials present as convenient, helpful and evidence‐based, they may serve to redirect care processes in ways that reinforce company goals rather than clinical priorities. Nurses should seek independent sources of continuing education where possible.
Effects of perioperative exercise interventions on lung cancer patients: An overview of systematic reviews
Authors: Zhou Weijiao , Woo Seoyoon , Larson Janet L. 
Published: September 2020

AbstractAims and ObjectivesTo identify, appraise and summarise systematic reviews of exercise interventions for surgical lung cancer patients.BackgroundLow exercise capacity, reduced pulmonary function, impaired health‐related quality of life and postoperative pulmonary complications are common in surgical lung cancer patients. Numerous systematic reviews address these health problems and examine the effects of exercise intervention. However, differences in the quality and scope of the systematic reviews and discordant findings from the reviews make it difficult for decisions‐makers to interpret the evidence and establish best practices in the clinical settings.DesignOverview of systematic reviews.MethodsThis overview was conducted following the PRISMA guideline. A literature search of PubMed, CINAHL, EMBASE, Cochrane Library, SPORTDiscus and PEDro was conducted (October 2019). Peer‐reviewed systematic reviews of randomised controlled trials focusing on the effects of exercise interventions for lung cancer patients who underwent surgery were included. The methodological quality of included reviews was assessed using AMSTAR 2. The results of reviews with meta‐analysis were synthesised and presented by each health outcome.ResultsSeven systematic reviews published between 2013 and 2019 were included. High/moderate‐quality evidence showed that postoperative exercise interventions could increase the exercise capacity and muscle strength, and low/very‐low‐quality evidence showed that postoperative exercise interventions may increase the physical component of health‐related quality of life and decease dyspnoea. Low‐quality evidence showed that preoperative exercise interventions may increase exercise capacity and pulmonary function, decrease the risk of postoperative pulmonary complications and reduce the length of hospital stay.ConclusionsPostoperative and preoperative exercises have the potential to improve health outcomes in surgical lung cancer patients. Further research is needed to evaluate the effects of different types of exercise and varying amounts of exercise.Relevance to clinical practiceThis study provides evidence to support the implementation of exercise interventions for surgical lung cancer patients.
Feeling safe or unsafe in prehospital emergency care: A qualitative study of the experiences of patients, carers and healthcare professionals
Authors: Péculo‐Carrasco Juan‐Antonio , De Sola Helena , Casal‐Sánchez María‐del‐Mar , Rodríguez‐Bouza Mónica , Sánchez‐Almagro César‐Pedro , Failde Inmaculada 
Published: September 2020

AbstractAims and objectivesTo determine the feelings of safety among patients taken to hospital after requesting urgent care, based on their experiences and those of their carers and prehospital emergency care professionals.BackgroundLittle research has been performed into the perception of safety in prehospital emergency care settings worldwide, from either the perspective of the patients or from that of healthcare professionals.DesignExploratory qualitative study using focus groups in Spain.MethodsThe participants were patients that requested care through the emergency telephone service, their carers and the professionals of the emergency care teams. The structured sampling design was based on an intentional, nonprobability selection following pragmatic criteria. Seven groups of patients/carers and two groups of professionals were formed (65 participants). The recordings were fully transcribed before their validation and codes were assigned to ensure anonymity. The ATLAS.ti software was used for the analysis. The authors took into account the COREQ checklist for qualitative studies.FindingsNeither group provided a clear definition of the meaning of feeling safe. It appeared easier to give examples that had a positive or negative influence on their perception of feeling safe. During the analysis of the discourse, six categories were detected after grouping the related codes.ConclusionsFor most of the patients’ feeling of being safe or very safe arose from the perception of calmness, trust and protection. Defining the perception of safety was not easy. The factors with the greatest effect on feeling safe were related to Information and communication, Person‐centred care and Professional competency, without losing sight of other factors such as Accessibility and response times of the emergency teams, Equipment and Healthcare setting.Relevance to clinical practiceThe findings could be used as a knowledge base in future research and for implementing procedures for improving perceptions of safety among patients.
Comparison of midwives’ self‐perceived essential competencies between low and high maternal mortality ratio provinces in China
Authors: Huang Jing , Lu Hong , Li Jie , Zhou Nan , Zang Yu , Ren Lihua , Wang Jianying 
Published: September 2020

AbstractAims and objectivesTo present and compare midwives’ self‐perceived essential competencies in regions with different maternal mortality ratios, and explore possible competency‐related factors.BackgroundIn China, there is an urgent need for high‐quality maternal health care with equal access, as the regional disparity in the maternal mortality ratio remains a big challenge. Midwives’ essential competencies refer to the minimum knowledge, skills, and professional behaviours required by midwives, and directly affect the quality of maternal care they provide. However, there is very limited literature evaluating Chinese midwives’ essential competencies, especially for midwives working in regions with high maternal mortality ratios.DesignA cross‐sectional survey design.MethodsThe national cross‐sectional study using an online questionnaire was conducted with a convenience sample of 2,022 midwives working in regions with different maternal mortality ratios. The STROBE guideline for cross‐sectional studies was used in this study.ResultsMidwives rated themselves higher on their essential competencies in intrapartum care and lower on their essential competencies in assisting or performing the operative vaginal delivery. Specifically, when compared to those from regions of low maternal mortality ratios, midwives from regions with high maternal mortality ratios reported comparatively poor self‐perceived essential competencies, especially in the area of detecting and treating pregnancy and childbirth‐related complications. The factors influencing midwives’ self‐perceived essential competencies included majors, education levels, years of experience as a midwife, participation in teaching, and access to in‐service training.ConclusionIn regions with high maternal mortality ratios, improving midwives’ essential competencies is a key priority. Furthermore, it is recommended that midwifery education could be conducted in universities, and relevant regulations could be developed to enable midwives to provide a wider scope of care, thereby promoting the development of the midwifery workforce in China.Relevance to clinical practiceUnderstanding self‐perceived essential competencies of Chinese midwives working in regions with different maternal mortality ratios could guide the midwifery workforce, management, especially midwives’ capability building.