bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of peri‐implant tissues condition after 10–15 years of loading in treated chronic periodontitis patients attending a private practice setting: A retrospective study
Authors: Guarnieri Renzo , Di Nardo Dario , Di Giorgio Gianni , Miccoli Gabriele , Testarelli Luca 
Published: January 2021

AbstractObjectivesTo retrospectively evaluate the conditions of the peri‐implant tissues in treated patients with chronic periodontitis (CP) and in patients without chronic periodontitis (noCP).Materials and methodsA chart review was used to evaluate 267 implants, 134 placed in 42 CP treated patients and 133 placed in 46 noCP patients. The primary outcome was to evaluate the condition of the peri‐implant tissues (health, peri‐mucositis, and peri‐implantitis). The secondary outcome was to evaluate the possible association of some variables, such as, Plaque Index (PI), Bleeding Index (BI), probing pocket depth (PD), bleeding on probing (BoP), bone level (BL), loading time, type of implant placement and loading protocol, type of prosthesis, type of bone, implant manufacturer, and implant diameter and length, with the implant health condition.ResultsThe analysis of patient files revealed that after 10–15 years of loading (mean loading time 13.4 ± 2.07 years), six noCP patients (13%) experienced implant loss with a total of nine implants (6.7%) lost. The remaining 124 implants were classified: 54 (43.5%) as healthy, 45 (36.3%) with peri‐implant mucositis, and 25 (20.2%) with peri‐implantitis. Twelve CP subjects (28.5%) experienced implant loss with a total of 19 implants (14.1%) lost. The remaining 115 implants were classified: 34 (29.5%) as healthy, 40 (34.7%) with peri‐implant mucositis and 41 (35.6%) with peri‐implantitis. Compared with noCP subjects, only treated CP subjects with recurrent periodontal disease (RPD) showed differences statistically significant (p < .05).ConclusionsAfter 10–15 years of loading, in CP patients treated in a private practice setting, most implants (70.1%) were classified with some type of peri‐implant inflammation. In patients with RPD, a higher tendency for implant loss and peri‐implant biologic complications was found.
Dissolvable intranasal haemostatic agents for acute epistaxis: A systematic review and meta‐analysis
Authors: Milinis Kristijonas , Swords Chloe , Hardman John C. , Slovick Anna , Hutson Kristian , Kuhn Isla , Smith Matthew E. ,   INTEGRATE (The UK ENT Trainee Research Network)
Published: January 2021

AbstractIntroductionNasal packing is the mainstay of epistaxis management; however, packs cause patient discomfort and can lead to hospital admission. Absorbable haemostats provide clotting factors or act as a substrate to stimulate clotting and represent a potential treatment alternative. A systematic review was performed to evaluate the efficacy of topical haemostats in the management of epistaxis.MethodsA systematic literature search of 7 databases was performed. Only eligible randomised controlled trials (RCTs) and observational studies were included. The primary outcome was short‐term haemostatic success (<7 days). Secondary outcomes included long‐term haemostatic control (no rebleeding 7‐30 days), patient discomfort and adverse effects. Meta‐analysis was performed where possible.ResultsOf 2249 records identified, 12 were included in the qualitative synthesis and 4 RCTs were included in meta‐analysis. The following haemostats were reported: gelatin‐thrombin matrix (n = 8), aerosolised/gel tranexamic acid (n = 1), cellulose agents (n = 2) and fibrin sealants (n = 1). Studies involving tranexamic acid on removable delivery devices (eg, pledgets) were excluded. There was heterogeneity in outcome measures and inclusion criteria (coagulopathies/anticoagulants were excluded in 3 RCTs and 2 observational studies). The short‐term haemostatic success varied between studies (13.9% to 100%). No significant post‐procedural complications were reported. The meta‐analysis favoured absorbable haemostatic agent versus packing (risk ratio 1.20; 95% confidence interval 1.05 to 1.37; P = .007). The risk of bias across all studies was moderate to high.ConclusionsThe evidence suggests haemostatic agents are effective at managing acute epistaxis when compared with nasal packing. More data are required before recommendations can be made regarding management in patients on anticoagulants.
Factors impacting time to ileostomy closure after anterior resection: the UK closure of ileostomy timing cohort study (CLOSE‐IT)
Authors:   Dukes’ Club Research Collaborative
Published: January 2021

AbstractAimDelay to closure of ileostomy following anterior resection for rectal cancer may impair postoperative bowel function and quality of life. We analysed time to ileostomy closure across the UK and investigated factors delaying closure.MethodsFor the retrospective cohort we assessed time to closure and incidence of non‐closure for patients who underwent anterior resection with defunctioning ileostomy during 2015. Multivariate linear/Cox regression analyses were performed. For the prospective cohort we captured patients undergoing ileostomy closure during a 3‐month period in 2018 to validate retrospective findings.ResultsThe retrospective cohort involved 788 patients of whom 669 (84.9%) had bowel continuity restored, median time to closure 259 days. Recognized factors associated with delay and risk of non‐closure included anastomotic leak (hazard ratio [HR] 3.65, 2.61–5.08), chemotherapy (HR 2.62, 2.17–3.15) and cancer progression (HR 2.05, 1.62–2.58). Crucially, specific aspects of the surgical pathway were associated with time to closure; for example, waiting list entry prior to outpatient clinic review/imaging was associated with an estimated 133‐day shorter interval to closure (P < 0.001). In the prospective cohort 288 patients underwent closure, at a median of 271 days. Chemotherapy use and cancer progression were associated with delay to closure while listing for surgery prior to clinic and imaging was associated with an estimated shorter interval to closure of 168 days (P = 0.008).ConclusionsDelays to closure of ileostomy are common in the UK. Listing patients for surgery only after follow‐up outpatient appointment, imaging or chemotherapy delays closure. Findings will inform consensus guidelines towards an optimum treatment pathway to reduce delay and improve post‐closure quality of life.
Endothelial dysfunction and vascular maladaptation in atrial fibrillation
Authors: Qin Shuguang , Boidin Maxime , Buckley Benjamin J. R. , Lip Gregory Y. H. , Thijssen Dick H. J. 
Published: January 2021

AbstractAtrial fibrillation (AF) is the most common arrhythmia and is associated with worsened morbidity and mortality. The prevalence of AF is estimated to increase with an ageing population resulting in an ever‐increasing burden on the healthcare system. Despite improvements in AF treatment, several questions remain unanswered in relation to the development and progression of AF. In this review, we discuss the evidence supporting the presence of vascular dysfunction in the development of AF, but also as a final common pathway explaining why AF constitutes a markedly increased risk of cardiovascular morbidity and mortality. Specifically, we summarise the work performed in humans related to the impact of AF on vascular structure and function, and whether measures of vascular function predict AF progression and the development of cardiovascular events. Subsequently, we discuss the potential mechanisms linking AF to the development of vascular dysfunction. Finally, we propose future perspectives of vascular health and AF, advocating a strong focus on regular exercise training as a safe and effective strategy to improve vascular function and, hence, reduce the risk for development and progression of AF and its associated risk for cardiovascular events.
Treating secondary antibody deficiency in patients with haematological malignancy: European expert consensus
Authors: Jolles Stephen , Michallet Mauricette , Agostini Carlo , Albert Michael H. , Edgar David , Ria Roberto , Trentin Livio , Lévy Vincent 
Published: January 2021

AbstractObjectivesSecondary antibody deficiency (SAD), associated with severe, recurrent or persistent infections, is common in patients with haematological malignancies (HM), but unifying guidance on immunoglobulin replacement therapy (IgRT) in these patients is lacking. We aimed to develop consensus statements for the use of IgRT in patients with HM.MethodsA Delphi exercise was employed to test the level of agreement on statements developed by a Task Force based on available data and their clinical experience. In Round 1, an Expert Panel, comprising specialist EU physicians caring for patients with HM, helped to refine the statements. In Round 2, experts rated their agreement with the statements. In Round 3, experts who had scored their agreement as ≤4 were invited to review their agreement based on the overall feedback.ResultsThree definitions and 20 statements were formulated and tested for consensus, covering measurement of IgG levels, initiation and discontinuation of IgRT, dosing, and the use of subcutaneous IgG. Consensus (agreement ≥70% on Likert‐type scale) was reached for all three definitions and 18 statements.ConclusionsRecommendations have been developed with the aim of providing guidance for the use of IgRT to prevent severe, recurrent or persistent infections in patients with HM and SAD.
Central retinal artery occlusion as a neuro‐ophthalmological emergency: the need to raise public awareness
Authors: Hoyer Carolin , Kahlert Christian , Güney Resul , Schlichtenbrede Frank , Platten Michael , Szabo Kristina 
Published: January 2021

AbstractBackground and purposeCentral retinal artery occlusion (CRAO) is a neuro‐ophthalmological emergency necessitating adequate and comprehensive diagnosis. Its optimal management and treatment, however, are still under debate. This study aimed at identifying respective areas for improvement.MethodsWe retrospectively analysed the medical records of patients with CRAO treated in our stroke unit between January 2016 and August 2020.ResultsDuring the observational period, 101 patients with CRAO were admitted. We observed an increase in the rate of patients primarily admitted to the stroke unit from 52.2% to 97.4%. In addition, the thrombolysis rate – with thrombolysis performed on an individual basis – rose from 0% to 14.1%, coinciding with the implementation of an in‐hospital management guideline. Almost 60% of all patients presented outside of the 4.5‐h time window for thrombolysis; by far the most common reason not to deliver intravenous thrombolysis in our cohort was a prehospital delay to presentation (58.8%), with 44.4% of patients having consulted a private‐practice ophthalmologist first. A total of 25 (32.5%) of 77 patients who underwent magnetic resonance imaging (MRI) had accompanying acute ischaemic stroke lesions on diffusion‐weighted MRI of the brain. A possible aetiology of CRAO was identified in 41.4% of patients.DiscussionPublic awareness of sudden unilateral visual loss as a presenting sign for stroke should be raised, increasing the chances for timely recognition in a hospital with ophthalmological expertise and a stroke centre. This is essential for ongoing and future prospective trials on this subject.
The pharmacokinetics of a fentanyl matrix patch applied at three different anatomical locations in horses
Authors: Skrzypczak Heather , Reed Rachel , Brainard Benjamin , Sakai Daniel , Barletta Michele , Quandt Jane , Smyth Carly , Ruch Melanie , Knych Heather 
Published: January 2021

AbstractBackgroundMatrix fentanyl patches have not been investigated in horses and may represent an effective means of providing analgesia over an extended time period without venous catheterisation.ObjectivesTo describe the pharmacokinetics of a matrix transdermal fentanyl patch in horses.Study designRandomised experiment, Latin‐square design.MethodsSix adult horses were given each of three treatments with a 96‐hour washout. For each treatment, two 100 µg/h matrix fentanyl patches were applied to the inguinal region (TXA), metacarpus (TXM) or ventral tail base (TXT) for 72 hours. Blood samples for fentanyl analysis were obtained and heart rate (HR), respiratory rate (RR) and rectal temperature (RT) were measured at various time points for 96 hours. Fentanyl plasma concentrations were measured with LC‐MS/MS for pharmacokinetic analysis. A mixed‐effects model was used to analyse pharmacodynamic variables.ResultsThe time to maximum plasma concentration, maximum plasma concentration and area under the curve extrapolated to infinity were 10 ± 3.79, 14.3 ± 5.13 and 10.3 ± 4.8 hours; 2.07 ± 0.74, 1.55 ± 0.53 and 2.07 ± 0.72 ng/mL; and 46.6 ± 9.3, 44.6 ± 6.0 and 46.2 ± 7.68 ng hours/mL for TXA, TXM and TXT respectively. There was no significant difference among groups. There was no significant change from baseline or among treatment groups with regard to HR, RR or RT (P > .1 for all).Main limitationsThere was no intravenous treatment group for determination of bioavailability.ConclusionsFentanyl was rapidly absorbed and persisted in the plasma for up to 96 hours. No adverse effects of treatment on HR, RR or RT were observed. Further controlled prospective studies are needed to determine what plasma concentration, if any, of fentanyl achieves an analgesic effect in horses when administered via a transdermal patch system.
Brassica carinata: Biology and agronomy as a biofuel crop
Authors: Seepaul Ramdeo , Kumar Shivendra , Iboyi Joseph E. , Bashyal Mahesh , Stansly Theodor L. , Bennett Rick , Boote Kenneth J. , Mulvaney Michael J. , Small Ian M. , George Sheeja , Wright David L. 
Published: January 2021

AbstractThe environmental consequences of using nonrenewable fossil fuels have motivated a global quest for sustainable alternatives from renewable sources. Carinata has been developed as a low carbon intensity, non‐food oilseed biomolecular platform to produce advanced drop‐in renewable fuels, meal, and co‐products. The crop is widely adaptable to grow in the humid subtropical and humid continental climatic regions of Asia, Africa, North America, South America, Europe, and Australia as a spring or winter crop. Carinata is heat tolerant, resistant to diseases and seed shattering with lower water‐use requirements than other oilseed brassicas. Adopting carinata in double‐cropping systems would require continuing research to integrate crop biology with agronomy, to understand growth and development and its interaction with agricultural inputs and management. Site‐specific best management agronomic practices and crop improvement research to develop frost‐tolerant, early‐maturing, nutrient use‐efficient, and high yielding varieties with desirable oil content and fatty acid profile will enhance the crop's adaptability and economic viability. The exploitation of intra‐ and interspecific and intra‐ and intergeneric diversity will further enhance carinata productivity and resistance to biotic and abiotic stresses. This review attempts to present a comprehensive description of carinata's biology, beginning with its origin and current state of distribution, availability of genetic and genomic resources, and a discussion of its morphology, phenology, and reproduction. A detailed analysis of the agronomy of the crop, including planting and germination and management practices, is presented in the context of crop growth and development. This will facilitate global adoption, sustainable production, and commercialization of carinata as a dedicated biofuel oilseed crop in diverse cropping systems and growing regions of the world, including the Southeast United States.
Citizens' conceptions of the genome: Related values and practical implications in a citizen forum on the use of genomic information
Authors: Mayeur Chloé , van Hoof Wannes 
Published: January 2021

AbstractBackgroundThe development of large data sets, including genomic data, coupled with rapid advances in personalized medicine where citizens increasingly face complex choices about the use of their genomic information implies that citizens are essential stakeholders in genomics. They should be engaged in the ethical, legal and societal issues to produce a framework that fosters trust and allows them to guide the technology based on their values.ObjectiveThis article highlights that citizens' conceptions of the human genome inform about and make sense of their main values regarding the use of genomic information, which is critical for policymakers, experts and stakeholders to understand to maintain the public support in genomics.MethodThrough an inductive thematic approach, we reanalysed data collected for the Belgian citizen forum, which aimed to produce recommendations for the Ministry of Public Health and other stakeholders.ResultsCitizens expressed four conceptions of the genome that determined which uses of genomic information they supported: the most intimate part of individuals; ‘I am more than my genome’; the individual's property vs the common good; and uncertainty and fear.ConclusionDiversity in their conceptions reveals remaining conflicts of values among citizens, mainly regarding a conception of the genome as an individual property or a common good. However, despite differing conceptions, shared values emerged such as solidarity, privacy, no genetic discrimination and the right to an open future, where individual and common interests coexist.Patient or public contributionThe panel of the citizen forum consisted of 32 citizens.
‘Triadic’ shared decision making in mental health: Experiences and expectations of service users, caregivers and clinicians in Germany
Authors: Schuster Florian , Holzhüter Fabian , Heres Stephan , Hamann Johannes 
Published: January 2021

AbstractBackgroundShared decision making (SDM) in mental health may contribute to greater patient satisfaction and is sometimes associated with better health outcomes. Here, SDM should not only involve service users and clinicians but also involve the service users' caregivers.AimThis study aimed to achieve better insight into the current SDM patterns of triads of service users, caregivers and clinicians in inpatient mental health care and the three parties' expectations towards the prospects of triadic SDM.DesignThe current research uses data from a representative cross‐sectional study on caregivers in psychiatric inpatient treatment. We analysed data on n = 94 triads of service users, their caregivers and their clinicians.ResultsAll three parties acknowledge caregivers to be of great support to monitor the progress with mental disease. The caregiver's role during consultations is most often described as being an expert, receiving or providing information and supporting service users. However, caregivers at times try to seek support for themselves during caregiver‐clinician interaction, or their behaviour was described as unhelpful. The potential prospects of caregiver involvement are clearly acknowledged despite the low implementation of caregiver involvement in this sample (only in one‐third of the cases).ConclusionTriadic SDM rarely takes place in routine inpatient care. First, there should be a focus on interventions aiming at inviting caregivers to consultations. Only in the second step should a better conceptualisation of triadic SDM be undertaken.Public ContributionEarly results were discussed with a local peer support group for caregivers of individuals living with mental illness.
MYC status in HIV‐associated plasmablastic lymphoma: dual‐colour CISH, FISH and immunohistochemistry
Authors: Pather Sugeshnee , Mashele Thembi , Willem Pascale , Patel Moosa , Perner Yvonne , Motaung Mantoa , Nagiah Natasha , Waja Faadil , Philip Vinitha , Lakha Atul , Hale Martin J 
Published: January 2021

AimsWe utilised chromogenic and fluorescence in‐situ hybridisation (CISH and FISH) to evaluate MYC gene copy numbers and rearrangements within HIV‐associated plasmablastic lymphomas (PBLs). Thereafter, clinicopathological features were explored retrospectively.Methods and resultsSixty‐seven (n = 67) patients were included and the HIV seropositive status was confirmed in 98% (63 of 64) with a median viral load of 55 587 (IQR 273 582) copies/ml and median CD4 count of 170 (IQR 249) cells/µl. The mean age was 41 ± 10.1 years and females comprised 54%. PBL was documented predominantly at extra‐oronasal topographic regions. Starry‐sky (SS) appearance was evident in 33% in association with monomorphic morphology (P‐value 0.02). c‐MYC protein was expressed in 81% and latent EBV infection was detected in 90%. EBER ISH‐positive status and MYC rearrangement occurred in 67% of HIV PBL. MYC aberrations included MYC rearrangement (70%), low‐level increase in MYC gene copy numbers (43%), concurrent MYC rearrangement and increased MYC gene copy numbers (49%) as well as low‐level chromosome 8 polysomy (6%). MYC aberrations in HIV PBLs were significantly associated with SS appearance (P ‐0.01), monomorphic morphology (P ‐ 0.03), c‐MYC protein expression ≥40% (P ‐ 0.03) and mortality (P ‐ 0.03). There was advanced stage (Ann Arbor III/IV) at presentation (77%) and the median overall survival for HIV PBL was 75 days (95% CI 14–136).ConclusionMajority of the HIV‐associated PBL tumours harbour MYC aberrations. Due to the persistently inferior survival outcome of HIV‐associated PBL in the era of antiviral treatment, targeted and/or intensified therapy of oncogenic MYC may need to be explored in future.
p16 overexpression and Rb loss correlate with high‐risk HPV infection in oropharyngeal squamous cell carcinoma
Authors: Jiromaru Rina , Yamamoto Hidetaka , Yasumatsu Ryuji , Hongo Takahiro , Nozaki Yui , Nakano Takafumi , Hashimoto Kazuki , Nakagawa Takashi , Oda Yoshinao 
Published: January 2021

Aimsp16 is a sensitive surrogate marker for transcriptionally active high‐risk human papillomavirus (HR‐HPV) infection in oropharyngeal squamous cell carcinoma (OPSCC), but it is not sufficient in all clinical settings.Methods and resultsWe examined the p16 and Rb expression status in 177 OPSCC cases by immunohistochemistry and the presence of transcriptionally active HR‐HPV infection by mRNA in‐situ hybridisation. The 177 cases were divided into p16+/HPV+ (n = 105, 59.3%), p16+/HPV− (n = 8, 4.5%) and p16−/HPV− (n = 64, 36.2%) groups. The p16+/HPV− and p16−/HPV− groups had a trend towards worse overall survival (OS) or significantly worse OS than the p16+/HPV+ group (n = 105) (P = 0.0610, P = 0.0004, respectively). We divided the Rb status into preserved expression (> 90%, n = 68), partial loss (PL) (10–90%, n = 97) and complete loss (CL) (< 10%, n = 12). Among the HPV‐positive cases (n = 105), the Rb pattern was typically PL (n = 97, 92.4%) and rarely CL (n = 8, 7.6%), but never preserved expression (0%). In contrast, among the HPV‐negative cases (n = 72), the Rb pattern was typically preserved expression (n = 68, 94.4%) and rarely CL (n = 4, 5.6%), but never PL (0%). Compared to p16 alone, the combination of p16 overexpression and Rb‐PL/CL showed equally excellent sensitivity (each 100%) and improved specificity (97.2 versus 88.9%) and positive predictive values (98.1 versus 92.9%).ConclusionsThese results suggest that the combined use of p16 and Rb immunohistochemistry could be a reliable, cost‐effective method to predict HR‐HPV infection in OPSCCs; however, HPV specific testing is necessary on inconclusive cases. We propose a diagnostic algorithm for practical use of these markers.