bluuebunny/crossref_metadata_2025_split huggingface dataset:
Continuous hemodialysis with citrate anticoagulation and standard dialysate for managing acute kidney injury in patients with moderate to severe hyponatremia—A retrospective study
Authors: Hellman Tapio , Uusalo Panu , Järvisalo Mikko J. 
Published: February 2021

BackgroundThe safety of continuous veno‐venous hemodialysis (CVVHD) with citrate‐calcium anticoagulation for acute kidney injury (AKI) with coincident hyponatremia remains unclear. We aimed to explore the feasibility of CVVHD with standard dialysate and citrate‐calcium anticoagulation in hyponatremic critically ill AKI patients.MethodsThirty‐seven of the 493 critically ill AKI patients requiring CVVHD and admitted to our intensive care unit during a 10‐year period had hyponatremia (<130 mmol/L) and were included in this retrospective study. All patients received CVVHD with citrate‐calcium anticoagulation and standard commercial dialysate and plasma sodium concentrations were frequently controlled until death or CVVHD discontinuation. Clinical data, mortalities and cases of central pontine myelinolysis within one‐year follow‐up were recorded.ResultsMedian plasma sodium concentration was 127 (IQR 124‐129) mmol/L at CVVHD initiation. CVVHD duration was median 3 (IQR 1.5‐5.5) days and the mean daily sodium load of the trisodium citrate solution during the first 3 days of CVVHD was 1754 (SD 730) mmol. The plasma sodium concentration increased a median 8 (IQR 5‐10) mmol/L during the first 24 hours of CVVHD and excessively high plasma sodium correction (>8 mmol/L/24 h) was observed in 18 (48.6%) patients. However, increased mortality in association to rapid plasma sodium correction was not observed in this study.ConclusionsCVVHD using standard citrate‐calcium anticoagulation effectively increased plasma sodium concentration in this study. However, excessively high plasma sodium correction was observed in half of the patients and the sodium load provided by the standard citrate anticoagulation solutions was substantial.
Equity of colonoscopy provision and quality in Māori and New Zealand Europeans: a comparative retrospective study
Authors: Donachie Matthew , Bhat Sameer , Whiley Teri , MacFater Wiremu , Bissett Ian P. , Lill Marianne 
Published: February 2021

AbstractBackgroundHigh‐quality colonoscopy is essential for investigating suspected colorectal cancer and relies on endoscopists meeting key performance indicator (KPI) targets. The rising demand for colonoscopy raises concerns that Māori populations could be under‐served. This study aimed to compare rates of colonoscopy provision and colonoscopy KPIs between Māori and New Zealand (NZ) European patients.MethodsThis retrospective comparative study was conducted at Whanganui Hospital (NZ). Consecutive colonoscopies performed between September 2016 and March 2020 were included. Primary outcome was the rate of colonoscopy provision for the population. Secondary outcomes were the colonoscopy completion rate (CCR), colonoscope withdrawal time (CWT), polyp detection rate (PDR) and adenoma detection rate (ADR). Subgroup analysis of ADR in index symptomatic colonoscopies was also performed.ResultsA total of 2962 colonoscopies were analysed (385 Māori; 2577 NZ European). Rates of colonoscopy provision in participants aged ≥40 were significantly lower among Māori (6.1% versus 9.1%; P < 0.0001). The CCR (P = 1.00), CWT (P = 0.28) and PDR (P = 0.24) were similar. Whilst the ADR in the overall cohort was significantly lower in Māori (32.7% versus 40.0%; P = 0.028), this was not observed when stratified by 10‐year age cohorts. The ADR was similar on subgroup analysis of index symptomatic colonoscopies (P = 0.42).ConclusionsThis study found inequities in access to colonoscopy services for Māori compared to NZ European patients. Among those that did receive colonoscopy, there were no differences in colonoscopy quality after age stratification. Improving equity will require the addition of colonoscopy provision rates to other mandatory KPIs and reporting these by ethnicity in all endoscopy units.
Evaluation of tools to assess operative competence in endovascular procedures: a systematic review
Authors: Saricilar Erin C. , Freeman Anthony , Burgess Annette 
Published: February 2021

AbstractBackgroundWith an increase in the use of endovascular interventions as an alternative to open surgery and the unique technical skills required, current methods for assessing the competence of vascular surgery trainees may not be optimal, suggesting a need for a shift in assessment modalities. We conducted this systematic review to explore current assessment methods used in vascular surgery training to assess competence specific to endovascular procedures.MethodsA comprehensive literature search was performed with a structured search strategy using terms focusing on endovascular procedures and assessment. Inclusion and exclusion criteria were used in order to screen for suitable articles.ResultsWe identified 54 articles that satisfied the inclusion criteria. These included a single randomized controlled trial, a single systematic review, a single narrative review and a single literature review, with the vast majority having level 2 evidence. Global rating scales, proficiency assessments and written/oral examinations were described as standard current assessment tools. These modalities lack reproducibility and objectivity, neglecting the needs of assessment of endovascular procedures requiring specialized decision making and finger dexterity. Novel methods such as high fidelity simulation and virtual reality promote reproducible and objective assessment methods in the context of endovascular surgery, and have a promising future.ConclusionWhile current assessment methods in vascular surgery are widely supported the changing skills required of a vascular surgery trainee warrants a shift in assessment modalities to better align to these requirements. High fidelity simulations show promise, although they require more extensive research to understand their relative merits.
Quality of life after maternal near miss: A systematic review
Authors: von Rosen Ida E. W. , Shiekh Rayan M. , Mchome Bariki , Chunsen Wu , Khan Khalid S. , Rasch Vibeke , Linde Ditte S. 
Published: February 2021

AbstractIntroductionMaternal near miss is a major global health issue; approximately 7 million women worldwide experience it each year. Maternal near miss can have several different health consequences and can affect the women’s quality of life, yet little is known about the size and magnitude of this association. The aim of this study was to assess the evidence of the association between women who have experienced maternal near miss and quality of life and women who had an uncomplicated pregnancy and delivery.Material and methodsCochrane library, Embase, CINAHL, Web of Science, MEDLINE, Scopus and PubMed were searched for published studies. Studies were selected according to the PECO model (population, exposure, control and outcome) and were included if they investigated quality of life as an outcome after maternal near miss among women of all ages with no limitation on country or time (up to June 2020). Maternal near miss was defined as a life‐threatening condition arising from complications related to pregnancy and/or childbirth. The quality of the studies was assessed according to the Newcastle‐Ottawa scale and a Forest plot was constructed based on quality of life outcomes and study quality.PROSPERO registration number: CRD42020169232.ResultsFifteen studies were included in the review with a total of 31 558 women. Quality of life was reported in various ways, and 25 different confounders were controlled for. Compared with women who did not experience maternal near miss, women exposed to maternal near miss had an overall lower quality of life (n = 2/2), had poorer mental (n = 6/10) and social health (n = 2/3), and maternal near miss had negative economic consequences (n = 4/4). Maternal near miss was not associated with sexual dysfunction (n = 1/5). Ten of 15 studies were assessed as being of poor quality.ConclusionsEvidence shows that maternal near miss is negatively associated with various aspects of quality of life. This highlights the importance of addressing the adverse effects associated with maternal near miss and follow up maternal near miss after discharge. Quality of life is a multidimensional concept that is assessed in various ways, and the literature on the field is heterogeneous. More high‐quality studies are needed.
Cerebral oxygenation is stable in preterm infants transitioning to heated humidified high‐flow nasal cannula therapy
Authors: Sett Arun , Noble Elizabeth J. , Forster Danielle E. , Collins Clare L. 
Published: February 2021

AbstractAimTo assess cerebral oxygenation in premature infants who are transitioning from nasal continuous positive airway pressure (nCPAP) to heated humidified high‐flow nasal cannula therapy (HFNC).MethodsA prospective observational study done in a single‐centre neonatal intensive care unit (NICU). Regional cerebral oxygen saturations (RcSO2) were measured using frequency‐domain near‐infrared spectroscopy (FD‐NIRS) in very low birthweight (VLBW) premature infants born at <32 weeks transitioning from nCPAP to HFNC.ResultsMedian gestational age was 27 weeks and median birthweight was 924 g. Recordings were performed at a median gestational age of 30 weeks and a median postnatal age of 10 days. Median weight at study entry was 1111 g. Cerebral oxygenation was not significantly different in infants transitioning from nCPAP to HFNC (66% vs 66%).ConclusionNo difference in cerebral oxygenation in premature infants transitioning from nCPAP to HFNC was observed. This finding is reassuring and further supports the use of HFNC in preterm infants.
Differences between poison and venom: An attempt at an integrative biological approach
Authors: Jared Carlos , Luiz Mailho‐Fontana Pedro , Maria Antoniazzi Marta 
Published: February 2021

AbstractWe discuss the use of the terms venom and poison, in the context of integrative biology, with particular emphasis on behaviour and natural history. Our purpose is to reach a broad scientific audience, especially that dedicated to zoology. The meaning of the two terms is reviewed from the secretory perspective, mainly focussed on the reptiles and amphibians. We justify the use of the two words, based on biological and behavioural differences.
Impact of deprivation, dementia prevalence and regional demography on prescribing of antidementia drugs in England: A time trend analysis
Authors: Vohra Neha , Hadi Muhammad Abdul , Khanal Saval , Kurmi Om P. , Paudyal Vibhu 
Published: February 2021

AimThis study aimed to examine trends in prescribing of antidementia drugs in primary care in England between 2009 and 2019, and investigate the impact of deprivation, regional demography and disease prevalence on prescribing practices.MethodsAnalysis of publicly available government data from various sources pertaining to primary care prescribing and demographics was conducted. All primary care prescription data pertaining to antidementia drugs in England between 2009 and 2019 were extracted and adjusted for inflation and population changes. Data across English clinical commissioning regions were compared to explore the association between prescribing trend, deprivation, regional demography and dementia prevalence.ResultsThe number of prescription items for antidementia drugs in England increased by approximately 3‐fold (195.4%) from 24 items/1000 population in 2009 to 70.9 items/1000 population in 2019. In 2019, the least‐deprived areas had approximately twice the rate of prescribing of antidementia drugs compared to the most‐deprived areas (median [IQR] values of 46.7 [36.6‐64.8] vs 91.23 [76.2‐95.1] items/1000 population, respectively). In the multivariable analysis, the number of prescription items showed an inverse relationship with deprivation (coefficient −0.046, 95% CI −0.47 to −0.045) after adjustment for number of populations aged 65+ years and prevalence of dementia.ConclusionsThe 3‐fold rise in the number of prescription items for antidementia drugs in the study period reflects the policy emphasis on early diagnosis and treatment of dementia. Higher rates of prescribing in the least‐deprived areas may be reflective of better and early diagnoses and access to treatments. Such inequality in access to the treatments needs to be investigated further.
Ethics, public health and technology responses to COVID‐19
Authors: Miller Seumas , Smith Marcus 
Published: February 2021

AbstractThe COVID‐19 pandemic has infected millions around the world. Governments initially responded by requiring businesses to close and citizens to self‐isolate, as well as funding vaccine research and implementing a range of technologies to monitor and limit the spread of the disease. This article considers the use of smartphone metadata and Bluetooth applications for public health surveillance purposes in relation to COVID‐19. It undertakes ethical analysis of these measures, particularly in relation to collective moral responsibility, considering whether citizens ought, or should be compelled, to comply with government measures.
Benralizumab effect on severe chronic rhinosinusitis with nasal polyps (CRSwNP): A randomized double‐blind placebo‐controlled trial
Authors: Tversky Jody , Lane Andrew P. , Azar Antoine 
Published: February 2021

SummaryBackgroundChronic rhinosinusitis with nasal polyps (CRSwNP) can be a severe and debilitating disease associated with significant morbidity, loss of smell, sinus pressure and asthma exacerbations. Eosinophils play a role in the majority (85%) of patients. Benralizumab, an afucosylated monoclonal antibody directed against the IL‐5 receptor, has powerful apoptotic effects on eosinophils.ObjectiveWe sought to investigate the therapeutic benefit of inhibiting the IL‐5 receptor using benralizumab to treat severe rhinosinusitis with nasal polyps.MethodsPatients with severe NP (defined by endoscopic grade 5 or more out of 8) with elevated eosinophils and a history of previous surgical or endoscopic polypectomy met entry criteria and were randomized in a double‐blind fashion to receive 30 mg benralizumab SC or placebo. Endoscopic NP score was assessed at baseline and at treatment week 20. CT scan, SNOT‐22 survey and UPSIT smell test score changes were also evaluated.ResultsThirty‐three patients were screened, and twenty‐four (n = 24) were enrolled in the study. Compared with baseline, benralizumab significantly improved NP score (−0.9 ± 0.2, P = 0.004) whereas placebo did not (−0.3 ± 0.3, P = 0.166). Benralizumab induced polyp size reduction compared with placebo did not reach statistical significance (P = 0.103). Five of 12 benralizumab‐treated patients (42%) had improvements in all major outcomes (polyp score, CT, SNOT‐22 and smell test) versus 2 out of 12 placebo (17%). The ratio of blood eosinophil count to allergen skin test positivity correlated with polyp reduction.ConclusionBenralizumab was well‐tolerated and compared with baseline achieved a statistically significant reduction in nasal polyp size, sinus occupancy, symptoms and improved sensation of smell for most patients (83%).
The assessment of the effect of the size of lateral‐antrostomy in graftless balloon elevation of the maxillary sinus membrane with simultaneous implant placement (a randomized controlled clinical trial)
Authors: Aldahouk Ahmed , Elbeialy Ramy R. , Gibaly Amr , Shawky Mohamed , Atef Mohammed 
Published: February 2021

AbstractBackgroundThe overlying maxillary sinus frequently restrains the height of the posterior maxillary bones.PurposeEvaluating the effect of downsizing the antrostomy side‐window on the stability of the installed implants and vertical bone gain, after employing a graftless antral membrane balloon elevation (AMBE).Materials and methodsThe study is a randomized controlled clinical trial conducted on 20 patients with 30 deficient maxillary alveolar ridges underwent graftless (AMBE) after being allocated into a (5 mm) entry antrostomy group (the test group) and a (10 mm) entry antrostomy group (the control group) implementing a radiographic linear bone height and implant stability quotations (ISQ) comparison among both groups immediately after the placement of 38 Implants and 6 months after.ResultsRadiographic bone gain of the test group (5.55 ± 0.93 mm) was significantly higher than the control group (2.86 ± 0.60 mm) (p <0.001). There was no significant difference in primary stability between the test (65 ± 5.32) and control groups (62.67 ± 4.46) (p = 0.202); while the test group (73.43 ± 4.39) showed significantly higher secondary stability than the control group (64.83 ± 6.05) (p <0.001). ISQ values recorded at 6 months were significantly higher than those recorded at insertion in the test group (p <0.001), while they were insignificant in the control group (p = 0.148).ConclusionUndersizing the antrostomy window deemed beneficial concerning the vertical bone gain and the simultaneously placed root form dental implants' secondary stability.
It's elemental! Siliceous diatom frustules producing sarcoid‐like granulomas in the subcutis
Authors: Morales‐Neira Diego 
Published: February 2021

AbstractSilica granulomas have been described on the skin and are rare; however, this is the first report of a sarcoid‐like granulomatous reaction because of siliceous diatom frustules in the subcutis, making this an unprecedented case. A 41‐year‐old female presented with a subcutaneous nodule on the right forearm clinically suggestive of cyst, foreign body, or lipoma. Excisional biopsy revealed subcutis with a sarcoid‐like granulomatous reaction in a background of fibrosis, containing abundant semitransparent, exquisitely geometric particles, mildly refringent under polarized light, highlighted by phase contrast microscopy; special stains were negative for microorganisms. Definitive characterization of the peculiar fragments was accomplished by confocal laser microscopy, scanning electron microscopy, and energy dispersive X‐ray spectroscopy, revealing them as diatom frustules made of silicon dioxide (SiO2) or silica. Diatoms are unicellular algae, their skeletons (frustules) made of silica have collected on the bottom of rivers, lakes, and oceans for thousands or millions of years and form what we know as diatomite or diatomaceous earth, which is widely used in different industries and easily available in the market. The mechanism whereby diatom frustules gained access to the patient's subcutis is enigmatic.
S2k‐Leitlinie Therapie pathologischer Narben (hypertrophe Narben und Keloide) –Update 2020
Authors: Nast Alexander , Gauglitz Gerd , Lorenz Kerstin , Metelmann Hans‐Robert , Paasch Uwe , Strnad Vratislav , Weidmann Michael , Werner Ricardo Niklas , Bauerschmitz Jürgen 
Published: February 2021

Beteiligte Fachgesellschaften
Deutsche Dermatologische Gesellschaft (DDG)
Deutsche Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC)
Deutsche Gesellschaft für Allgemein‐ und Viszeralchirurgie (DGAV)
Deutsche Gesellschaft für Mund‐, Kiefer‐ und Gesichtschirurgie (DGMKG)
Deutsche Gesellschaft für Radioonkologie (DEGRO)
Deutsche Gesellschaft für Verbrennungsmedizin (DGV)
Berufsverband der Deutschen Dermatologen (BVDD)
Deutsche Dermatologische Lasergesellschaft (DDL)
Deutsche Gesellschaft für Dermatochirurgie (DGDC)
Atopische Hautdiathese ist stärker mit spezifischen Kontaktallergien assoziiert als atopische Dermatitis
Authors: Forkel Susann , Cevik Naciye , Schill Tillmann , Worm Margitta , Mahler Vera , Weisshaar Elke , Vieluf Dieter , Pfützner Wolfgang , Löffler Harald , Schön Michael P. , Geier Johannes , Buhl Timo 
Published: February 2021

ZusammenfassungHintergrundDer Zusammenhang zwischen atopischer Dermatitis (AD) und allergischer Kontaktdermatitis ist nach wie vor nicht abschließend geklärt. Studien ergeben sehr unterschiedliche Resultate; sie reichen vom Fehlen jeglichen Zusammenhangs bis hin zu einer vermehrten Sensibilisierung auf multiple Allergene. Konsistente Assoziationen mit bestimmten Allergenen wurden jedoch bisher nicht gefunden.ZielWir haben eine große Kohorte von Patienten, stratifiziert nach atopischer Hautdiathese gemäß dem Erlanger Atopiescore (EAS), unabhängig von einer aktiven Hauterkrankung, durch Epikutantests untersucht.MethodenRetrospektive Multicenter‐Datenanalyse aus fünf dermatologischen Zentren in Deutschland mit 4.509 Patienten. Die Patienten wurden nach dem EAS eingeteilt in eine Gruppe ohne atopische Hautdiathese (n = 2.165) und eine mit atopischer Hautdiathese (n = 1.743).ErgebnisseIn der Gruppe mit atopischer Hautdiathese zeigten signifikant mehr Personen mindestens eine positive Epikutantest‐Reaktion in der Standardreihe als in der Gruppe ohne atopische Hautdiathese (49,1 % vs. 38,3 %). In der logistischen Regressionsanalyse war die atopische Hautdiathese mit einem signifikant erhöhten Sensibilisierungsrisiko gegen Methylchloroisothiazolinon/Methylisothiazolinon (OR 2.383) und Methylisothiazolinon (OR 1.891), Thiuram‐Mix (OR 1.614) sowie Nickel (OR 1.530), Kobalt (OR 1.683) und Chrom (OR 2.089) assoziiert.SchlussfolgerungenDie atopische Hautdiathese zeigte sich als der wichtigste intrinsische Risikofaktor für eine Kontaktsensibilisierung gegen einige spezifische Antigene. Eine frühere oder derzeit bestehende AD erwies sich als weniger relevante Größe.
Research in practice: Disturbance in intracellular nucleic acid metabolism promotes lupus erythematosus
Authors: Günther Claudia 
Published: February 2021

SummaryLupus erythematosus (LE) is an autoimmune disease with a broad spectrum of cutaneous manifestations. It is characterized by a loss of tolerance to nuclear antigens, including endogenous nucleic acids, autoantibody formation and upregulation of the type I interferon pathway. This can be induced by an immune response to unrestricted extracellular self‐antigens. In addition, the molecular characterization of rare monogenic subtypes of LE has revealed insights into the role of cell‐intrinsic sensing of endogenous self‐nucleic acids in inducing a type I interferon response. This pathway can also initiate and sustain LE. The enhanced understanding of innate and adaptive immune responses in LE is a prerequisite for the development of more targeted therapies.
What does the Chilean Constitution say about euthanasia?
Authors: Álvarez Gálvez Íñigo 
Published: February 2021

AbstractWhat does the Chilean Constitution say about euthanasia? When we read the Chilean Constitution we cannot find the word “euthanasia” in the text, and there is no such thing as a right to die, therefore the answer should apparently be that the Constitution does not say anything about euthanasia and, in short, euthanasia is not allowed. However, on a second reading we can find out some statements from which we can infer another answer. My aim is to show that there is room for the acceptance of euthanasia in the Chilean Constitution, and in other similar Constitutions and international regulations in which freedom of conscience is granted.
Trade openness and political distortions
Authors: Grechyna Daryna 
Published: February 2021

AbstractIn this paper, we explore the relationship between international trade openness and two major political distortions, political uncertainty, and political polarization. We consider two measures of trade openness, the trade expenditures and the number of trade partners, as well as their volatility. As political distortions and trade characteristics of the country are endogenously related, we instrument the political uncertainty by the standard deviation of the effective political leaders’ ages of a country and the minimum age of the political leaders of a country's neighbors. We find that political uncertainty reduces the level of trade openness and increases the volatility of trade openness while political polarization negatively affects both the level and the volatility of trade openness. We propose a simple theoretical model that provides the intuition on the relationship between political distortions and trade openness.