bluuebunny/crossref_metadata_2025_split huggingface dataset:
Empty pelvis syndrome: a systematic review of reconstruction techniques and their associated complications
Authors: Johnson Yanika L. , West Malcolm A. , Gould Laura E. , Drami Ioanna , Behrenbruch Corina , Burns Elaine M. , Mirnezami Alexander H. , Jenkins John T. 
Published: October 2021

AbstractAimEmpty pelvis syndrome is a major contributor to morbidity following pelvic exenteration. Several techniques for filling the pelvis have been proposed; however, there is no consensus on the best approach. We evaluated and compared the complications associated with each reconstruction technique with the aim of determining which is associated with the lowest incidence of complications related to the empty pelvis.MethodThe systematic review protocol was prospectively registered with PROSPERO (CRD42021239307). PRISMA‐P guidelines were used to present the literature. PubMed and MEDLINE were systematically searched up to 1 February 2021. A dataset containing predetermined primary and secondary outcomes was extracted.ResultsEighteen studies fulfilled our criteria; these included 375 patients with mainly rectal and gynaecological cancer. Only three studies had a follow‐up greater than 2 years. Six surgical interventions were identified. Mesh reconstruction and breast prosthesis were associated with low rates of small bowel obstruction (SBO), entero‐cutaneous fistulas and perineal hernia. Findings for myocutaneous flaps were similar; however, they were associated with high rates of perineal wound complications. Omentoplasty was found to have a high perineal wound infection rate (40%). Obstetric balloons were found to have the highest rates of perineal wound dehiscence and SBO. Silicone expanders effectively kept small bowel out of the pelvis, although rates of pelvic collections remained high (20%).ConclusionThe morbidity associated with an empty pelvis remains considerable. Given the low quality of the evidence with small patient numbers, strong conclusions in favour of a certain technique and comparison of these interventions remains challenging.
Distribution of cellular remnants of melanocytes in the nail plate: Clue to the diagnosis of subungual melanoma
Authors: Oh Se Jin , Lee Jongeun , Lee Jae Ho , Bae Jaihee , Park Ji‐Hye , Lee Jong Hee , Lee Dongyoun 
Published: October 2021

AbstractBackgroundPrevious studies reported that cellular remnants in the nail plate could be a diagnostic clue for subungual melanoma (SUM). We sought to characterize the histopathologic features of cellular remnants in the nail plates of SUM patients.MethodsA retrospective case‐control study was conducted in a single tertiary center from 2012 to 2019. Twenty‐three patients with pathologically diagnosed SUM and eight nail matrix nevi (NMN) patients were recruited. The analysis of the nail plate specimens focused on large cellular remnants of melanocytes (LCRMs). Longitudinal linear density and vertical distribution pattern of the LCRMs were scrutinized for possible features distinguishing SUM from NMN.ResultsThe median linear density of the LCRMs was significantly higher in the SUM samples than in the NMN samples. LCRMs in the SUM samples were more dorsally distributed than those in the NMN samples. In invasive SUM, LCRMs were more likely to be found in the dorsal part of the nail plate compared to SUM in situ.ConclusionNail plate specimens should not be overlooked in the histopathological examination of melanonychia. High‐density LCRMs with more dispersion to the dorsal side might be suggestive of SUM.
Evaluation of pharyngeal lidocaine anesthesia for esophagogastroduodenoscopy: Double‐blind randomized control trial
Authors: Martín‐Marcos Irene , Fernández‐Morte Nuria , Balsategui‐Martín María , Ortiz‐Cantero Alexandra , Bermúdez‐Ampudia Cristina , López‐Picado Amanda , Pérez‐Vaquero Pilar , Salvador‐Pérez Marta , Cristóbal‐Domínguez Estíbaliz 
Published: October 2021

ObjectivesThe aim of this study was to assess whether the use of topical pharyngeal anesthesia improves endoscopist‐ and patient‐reported tolerance and satisfaction, the total dose of propofol used and the rate of adverse effects associated with this procedure.MethodsThis double‐blind randomized clinical trial was conducted in patients undergoing elective oesophagogastroduodenoscopy, who met the inclusion criteria. Patients were randomly assigned to receive five squirts of lidocaine 10% spray (50 mg, n = 268) or placebo (n = 271) 3 min before starting the procedure or sedation. The main outcome measures were patient‐ and endoscopist‐reported tolerance, and additionally, satisfaction with the procedure, adverse events and supplementary propofol used.ResultsIn the lidocaine group, it was twice (odds ratio [OR] 2.136, 95% confidence interval [CI] 1.228–3.715) or three times (OR 3.311, 95% CI 1.623–6.757) more likely that the endoscopist rated the procedure as well tolerated and easy to intubate than as well tolerated but the patient difficult to intubate or as poorly tolerated, respectively. Further, in these patients, less propofol was used (80 vs. 100 mg, P = 0.001). Controls were more likely to cough during the intubation (OR 2.172, 95% CI 1.378–3.423) and the procedure (OR 1.989, 95% CI 1.325–2.984), as well as more likely to retch (OR 3.582, 95% CI 1.667–7.7).ConclusionsTopical lidocaine may improve the procedure as rated by the endoscopist, as well as reduce the requirement for propofol and rate of adverse events such as retching and coughing. No adverse events associated with lidocaine administration were observed. ClinicalTrials registration no. NCT02733471.
The effect of bedtime snacks on fasting blood glucose levels in gestational diabetes mellitus
Authors: Henze Meg , Burbidge Hanna , Nathan Elizabeth , Graham Dorothy F. 
Published: October 2021

AbstractAimTo investigate the effect of different bedtime snacks (higher carbohydrate versus lower carbohydrate versus no snack) on first morning fasting blood glucose levels (BGLs) in women with diet‐controlled gestational diabetes mellitus (GDM) and borderline fasting glucose levels.MethodsThis prospective randomised crossover trial enrolled women with diet controlled GDM between 24 and 34 weeks gestation who had two or more first morning fasting BGLs between 4.7 and 5.4 mmol/L in the week prior to recruitment. The women were randomly allocated to 6 different orders of 5 days each of a standardised higher carbohydrate bedtime snack, a lower carbohydrate bedtime snack and no bedtime snack. The primary outcome was fasting capillary BGL as measured with a home glucometer, and the secondary outcome was requirement for insulin as assessed by a physician.ResultsA total of 68 women with GDM were enrolled in and completed the study at a median gestation of 30.8 weeks. Compared with no bedtime snack, the higher carbohydrate snack (4.96 vs 4.87 mmol/L, mean difference: 0.09 mmol/L, 95% CI 0.05–0.13,p < 0.001) and the lower carbohydrate snack (5.01 vs 4.87 mmol/L, mean difference: 0.14 mmol/L, 95% CI 0.09–0.18,p < 0.001) were both associated with a slightly higher fasting BGL the following morning.ConclusionsTaking a bedtime snack was associated with slightly higher fasting BGLs in women with diet‐controlled GDM compared with no bedtime snack (Clinical trial registration: ACTRN12617000659303).
Expression of CD47 in the pancreatic β‐cells of people with recent‐onset type 1 diabetes varies according to disease endotype
Authors: Leslie Kaiyven Afi , Richardson Sarah J. , Russell Mark A. , Morgan Noel G. 
Published: October 2021

AbstractAimsWe are studying the dialogue between β‐cells and the immune system in type 1 diabetes and have identified a cell surface receptor, signal regulatory protein‐alpha (SIRPα) as an important component in the regulation of β‐cell survival. SIRPα interacts with another protein, CD47, to mediate signalling. In the present work, we have studied the expression and role of CD47 in human islet cells in type 1 diabetes.MethodsClonal EndoC‐βH1 cells were employed for functional studies. Cells were exposed to pro‐inflammatory cytokines and their viability monitored by flow cytometry after staining with propidium iodide. Targeted knockdown of CD47 or SIRPα was achieved with small interference RNA molecules and the expression of relevant proteins studied by Western blotting or immunocytochemistry. Human pancreas sections were selected from the Exeter Archival Diabetes Biobank and used to examine the expression of CD47 by immunofluorescence labelling. Image analysis was employed to quantify expression.ResultsCD47 is abundantly expressed in both α and β cells in human pancreas. In type 1 diabetes, the levels of CD47 are increased in α cells across all age groups, whereas the expression in β‐cells varies according to disease endotype. Knockdown of either CD47 or SIRPα in EndoC‐βH1 cells resulted in a loss of viability.ConclusionsWe conclude that the CD47 plays a previously unrecognised role in the regulation of β‐cell viability. This system is dysregulated in type 1 diabetes suggesting that it may be targeted therapeutically to slow disease progression.
Effects of dipeptidyl peptidase‐4 inhibitors and sulphonylureas on cognitive and physical function in nursing home residents
Authors: Zullo Andrew R. , Duprey Matthew S. , Smith Robert J. , Gutman Roee , Berry Sarah D. , Munshi Medha N. , Dore David D. 
Published: October 2021

AbstractAimsDipeptidyl peptidase‐4 inhibitors (DPP4Is) may mitigate hypoglycaemia‐mediated declines in cognitive and physical functioning compared with sulphonylureas (SUs), yet comparative studies are unavailable among older adults, particularly nursing home (NH) residents. We evaluated the effects of DPP4Is versus SUs on cognitive and physical functioning among NH residents.Materials and MethodsThis new‐user cohort study included long‐stay NH residents aged ≥65 years from the 2007‐2010 national US Minimum Data Set (MDS) clinical assessments and linked Medicare claims. We measured cognitive decline from the validated 6‐point MDS Cognitive Performance Scale, functional decline from the validated 28‐point MDS Activities of Daily Living scale, and hospitalizations or emergency department visits for altered mental status from Medicare claims. We compared 180‐day outcomes in residents who initiated a DPP4I versus SU after 1:1 propensity score matching using Cox regression models.ResultsThe matched cohort (N = 1784) had a mean ± SD age of 80 ± 8 years and 73% were women. Approximately 46% had no or mild cognitive impairment and 35% had no or mild functional impairment before treatment initiation. Compared with SU users, DPP4I users had lower 180‐day rates of cognitive decline [hazard ratio (HR) = 0.61, 95% confidence interval (CI) 0.31‐1.19], altered mental status events (HR = 0.71, 95% CI 0.39‐1.27), and functional decline (HR = 0.89, 95% CI 0.51‐1.56), but estimates were imprecise.ConclusionsRates of cognitive and functional decline may be reduced among older NH residents using DPP4Is compared with SUs, but larger studies with greater statistical power should resolve the remaining uncertainty by providing more precise effect estimates.
Two Epichloë festucae var. lolii endophytes in Lolium perenne reduce larval populations of the wheat sheath miner, Cerodontha australis
Authors: Jensen Joanne G. , Miller Taryn A. , Cave Vanessa M. , Johnson Richard D. , Scott Barry , Popay Alison J. 
Published: October 2021

AbstractThe wheat sheath miner, Cerodontha australis Malloch (Diptera: Agromyzidae), is a small leaf‐ and stem‐mining fly that is native to New Zealand and eastern Australia where it feeds on grasses and cereals. Although not considered to be a major insect pest of pastures in New Zealand, it can be abundant during spring and summer in Waikato, New Zealand, and infests tillers of the introduced pasture plant, perennial ryegrass, Lolium perenne L. (Poaceae). Cerodontha australis is not deterred from feeding on L. perenne infected with commercially available strains of the fungal endophyte Epichloë festucae var. lolii, which have been shown to provide protection from a range of other insect pests. In this study, three‐pot trials and periodic examination over 18 months of field‐collected L. perenne tillers showed that two Epichloë endophyte strains, AR47 and AR48, reduced the survival and feeding damage by C. australis larvae, but there was no evidence of an effect on adult female feeding or oviposition. Compared to other strains of E. festucae var. lolii endophytes tested, plants infected with AR47 and AR48 had fewer and smaller larvae and less larval mining. The number of tillers with mining was reduced in AR47 relative to endophyte‐free (Nil) by 57.1% (ranging from 25.0 to 92.5% across trials) and in AR48 by 67.1% (26.3–100%). Larvae in AR47 and AR48 were found further from the base of the tiller where they were less likely to damage the meristem and cause tiller death. The number of larvae and pupae in pseudostems was reduced in AR47 and AR48 compared with Nil by 78.4 and 82.0%, respectively, in the field trial. Very few larvae survived to pupation in AR47 and AR48 plants, with a reduction compared to Nil of over 81.5% in AR47 and over 97% in AR48 in each of the four trials presented here.
Feeding strategies and diet variation in livebearing fishes of the genusLimia(Cyprinodontiformes: Poeciliidae) in the Greater Antilles
Authors: Rodriguez‐Silva Rodet , Spikes Montrai , Iturriaga Manuel , Bennett Kerri‐Ann , Josaphat James , Torres‐Pineda Patricia , Bräger Stefan , Schlupp Ingo 
Published: October 2021

AbstractFeeding specialisations are known to play an important role in the ecology and evolution of many organisms. In this study, we performed a comparative analysis based on the data of the gut content of eight species of the genusLimia(family Poeciliidae) to explore the potential role of feeding ecology in the radiation of this genus in the Caribbean. We analysed the feeding strategies using the modified Costello's graphical method. In addition, we estimated the contribution of each food item to the diet by calculating the alimentary index of six different functional categories that summarised the variation in main type of consumed items. We also compared the niche breadth for all analysed species and the niche breadth variation between wet and dry seasons in four species we were able to sample in both periods of the year. Most of the analysed species showed preference for detritus and algae. Species that exhibited a more omnivorous diet such asL. versicolorandL. perugiaerevealed moderate levels of consumption of terrestrial and aquatic invertebrates. Nonetheless, some species such asL. yaguajaliandL. nigrofasciatashowed specialisations towards detritus as the dominant food item found in the gut content analysis. In general, niche breadth values were higher in the wet season than in the dry period. Our study showed that the majority of species analysed tend to be feeding generalists, but some degree of specialisation occurs in some species from Hispaniola where the diversity of the genusLimiais remarkably higher compared to the rest of the Greater Antilles.
Non‐invasive brain stimulation in modulation of mental rotation ability: A systematic review and meta‐analysis
Authors: Veldema Jitka , Gharabaghi Alireza , Jansen Petra 
Published: October 2021

AbstractMental rotation, the ability to manipulate mental images, is an important function in human cognition. This systematic review and meta‐analysis investigates the potential of non‐invasive brain stimulation in modulation of this component of visuo‐spatial perception. The PubMed database was reviewed prior to 31 September 2020 on randomized controlled trials investigating the effects of repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), and transcranial alternating current stimulation (tACS) on the mental rotation ability in healthy persons. A total of 17 studies (including 485 subjects) matched our inclusion criteria. Within their scope, overall, 46 sham‐controlled experiments were performed. Methodology and results of each experiment are presented in a meta‐analysis. The data show a large variety of methods and effects. The influence of (1) stimulation‐technique (tDCS, tACS, and rTMS), (2) stimulation protocol (anodal, cathodal, bilateral tDCS, tACS, high‐frequency rTMS, low‐frequency rTMS, paired pulse rTMS, and theta burst stimulation), (3) stimulation timing (preconditioning and simultaneous), (4) stimulation location (left, right hemisphere, frontal, and parietal area), and (5) stimulus type (bodily and non‐bodily) is discussed. The data indicate a beneficial effect of anodal tDCS and of tACS and no effect of cathodal tDCS on the mental rotation ability. Bilateral tDCS protocols both improved and worsened the parameters assessed. The small effect sizes obtained in mostly rTMS experiments require cautious interpretation.
A genetically based ecological trade‐off contributes to setting a geographic range limit
Authors: Mauro Alexander A. , Torres‐Dowdall Julián , Marshall Craig A. , Ghalambor Cameron K. 
Published: October 2021

AbstractUnderstanding the ecological factors that shape geographic range limits and the evolutionary constraints that prevent populations from adaptively evolving beyond these limits is an unresolved question. Here, we investigated why the euryhaline fish, Poecila reticulata, is confined to freshwater within its native range, despite being tolerant of brackish water. We hypothesised that competitive interactions with a close relative, Poecilia picta, in brackish water prevents P. reticulata from colonising brackish water. Using a combination of field transplant, common garden breeding, and laboratory behaviour experiments, we find support for this hypothesis, as P. reticulata are behaviourally subordinate and have lower survival in brackish water with P. picta. We also found a negative genetic correlation between P. reticulata growth in brackish water versus freshwater in the presence of P. picta, suggesting a genetically based trade‐off between salinity tolerance and competitive ability could constrain adaptive evolution at the range limit.
The predictive value of the CTA Vasospasm Score on delayed cerebral ischaemia and functional outcome after aneurysmal subarachnoid hemorrhage
Authors: van der Harst J. Joep , Luijckx Gert‐Jan R. , Elting Jan Willem J. , Lammers Thijs , Bokkers Reinoud P. H. , van den Bergh Walter M. , Eshghi Omid S. , Metzemaekers Jan D. M. , Groen Rob J. M. , Mazuri Aryan , Veeger Nic J. G. M. , van Dijk J. Marc C. , Uyttenboogaart Maarten 
Published: October 2021

AbstractBackground and purposeDelayed cerebral ischaemia (DCI) is a severe complication of aneurysmal subarachnoid hemorrhage that can significantly impact clinical outcome. Cerebral vasospasm is part of the pathophysiology of DCI and therefore a computed tomography angiography (CTA) Vasospasm Score was developed and an exploration was carried out of whether this score predicts DCI and subsequent poor outcome after aneurysmal subarachnoid hemorrhage.MethodsThe CTA Vasospasm Score sums the degree of angiographic cerebral vasospasm of 17 intradural arterial segments. The score ranges from 0 to 34 with a higher score reflecting more severe vasospasm. Outcome measures were cerebral infarction due to DCI (CI‐DCI), radiological and clinical DCI, and unfavorable functional outcome defined as a modified Rankin Scale >2 at 6 months. Receiver operating characteristic analyses were used to assess predictive value and to determine optimal cut‐off scores. Inter‐rater reliability was evaluated by Cohen's kappa coefficient.ResultsThis study included 59 patients. CI‐DCI occurred in eight patients (14%), DCI in 14 patients (24%) and unfavorable outcome in 12 patients (20%). Median CTA Vasospasm Scores were higher in patients with (CI‐)DCI and poor outcome. Receiver operating characteristic analysis revealed the highest area under the curve on day 5: CI‐DCI 0.89 (95% confidence interval [CI] 0.79–0.99), DCI 0.68 (95% CI 0.50–0.87) and functional outcome 0.74 (95% CI 0.57–0.91). Cohen's kappa between the two raters was moderate to substantial (0.57–0.63).ConclusionsThis study demonstrates that the CTA Vasospasm Score on day 5 can reliably identify patients with a high risk of developing (CI‐)DCI and unfavorable outcome.
Ocrelizumab treatment in multiple sclerosis: A Danish population‐based cohort study
Authors: Pontieri Luigi , Blinkenberg Morten , Bramow Stephan , Papp Viktoria , Rasmussen Peter V. , Kant Matthias , Schäfer Jakob , Mathiesen Henrik K. , Jensen Michael B. , Sirakov Georgi , Berg Jonas M. , Kopp Tine I. , Joensen Hanna , Sellebjerg Finn , Magyari Melinda 
Published: October 2021

AbstractBackground and purposeReal‐world evidence regarding the effectiveness and safety of ocrelizumab for the treatment of multiple sclerosis (MS) is limited. The aim was to evaluate the effectiveness and safety of ocrelizumab treatment for MS in a real‐world setting.MethodsA nationwide population‐based cohort study was conducted where clinical and magnetic resonance imaging data of MS patients enrolled prospectively in the Danish Multiple Sclerosis Registry who initiated ocrelizumab treatment between January 2018 and November 2020 were analyzed.ResultsA total of 1104 patients (85.7% relapsing–remitting MS [RRMS], 8.8% secondary progressive MS [SPMS], 5.5% primary progressive MS [PPMS]) were included, with a median follow‐up period of 1.3 years. At baseline, the mean age was 41.4 years in the RRMS group, 44.5 years in the PPMS group and 50.3 years in the SPMS group. Median Expanded Disability Status Scale score was 2.5, 3.5 and 5.5, respectively. Most RRMS and SPMS patients had received previous disease‐modifying therapies (87.5% and 91.8%, respectively), whereas PPMS patients were mostly treatment naïve (78.7%). After ocrelizumab initiation, 9.3% of the patients experienced a relapse and 8.7% a 24 weeks confirmed disability worsening. Conversely, 16.7% showed a 24 weeks confirmed disability improvement. After ~1 year of treatment, most patients (94.5%) were free of magnetic resonance imaging activity. Ocrelizumab was generally well tolerated, as side effects were only reported for 10% of patients, mostly consisting of infusion‐related reactions and infections.ConclusionsIt is shown that most MS patients treated with ocrelizumab are clinically stabilized and with an adverse event profile consistent with the experience from the pivotal clinical trials.