bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stress Analysis of Implant-Supported Removable Partial Denture with Anterior Fixed Prostheses and Conventional Implant-Supported Overdentures in the Edentulous Mandible
Authors: Ozel Gulsum Sayin , Ozyilmaz Ozgun Yusuf , Inan Ozgur 
Published: August 2021

Aim: To compare new design implant-supported removable partial dentures retained with anterior fixed prosthesis with a conventional locater and bar attached implant overdenture prostheses retained by two or four implants via photoelastic stress analysis. Materials and Methods: Seven edentulous mandibuler acryclic models prepared and divided into two main groups; two to four implant models, subgroup separation as stated; for two implant models overdenture with locator attachment, crown design retained removable prosthesis with clasp retention, bridge design retained removable prosthesis with clasp retention, bridge design retained removable prosthesis with precision attachment retention; and for four implant models prosthesis with bar attachment overdenture, fixed bridge design retained removable prosthesis with clasp retention, fixed retained removable prosthesis with precision attachment retention. A 300 N load was applied to the first premolars. Photoelastic stress analysis method that is a specific method concerning stress visualization, and does not require statistical analysis, was used. The stress distributions were seen in optically using a poloriscope. Results: In the models with two implant-retained removable partial dentures, the stress distribution was found to be lower than that with the four implant-retained removable partial dentures. Nonsplinted implants caused high stress around the distal implant on the loading side. Conclusion: The stress loads were transmitted to other implants by splinting. Implant-supported removable partial dentures with an anterior fixed prosthetic design show lower stress distributions compared with bar retained prosthesis. These dentures appear to be advantageous in terms of stress transmission.
Epidemiology of Shoulder Injuries in Schoolboy Rugby Union in Ireland
Authors: Leahy Therese M. , Kenny Ian C. , Campbell Mark J. , Warrington Giles D. , Cahalan Roisin , Harrison Andrew J. , Lyons Mark , Glynn Liam G. , O’Sullivan Kieran , Purtill Helen , Comyns Thomas M. 
Published: August 2021

Background: The shoulder has been reported as a frequent location of injury in adult professional and amateur rugby, with match injury incidence rates ranging from 1.8 to 3 per 1000 player-hours (h). An increased understanding of the incidence and mechanism of shoulder injuries in school rugby players is vital to establish effective injury preventive strategies and advise on appropriate rehabilitation. Purpose: To describe the incidence, nature, and severity of shoulder injuries in schoolboy rugby in Ireland. Study Design: Descriptive epidemiology study. Methods: Injury surveillance was carried out for Senior Cup teams across two seasons (N = 665 players aged 17-19 years) in Ireland from 2018 to 2020. Match and training injury data were recorded using an online system by trained nominated injury recorders. Match exposure was also recorded. Results: Shoulder match injury incidence was 12.2 per 1000 h (95% CI, 9.1-16.2), with a mean severity of 47 days’ time loss and an overall burden of 573 days per 1000 h. In total, 47 match and 5 training shoulder injuries were recorded. The most common injuries were shoulder dislocations/subluxations (34%), followed by acromioclavicular joint sprains (30%). Shoulder dislocations/subluxations represented the most burdensome injury (280 days per 1000 h). The tackle accounted for the majority (81%) of shoulder injuries. Forwards sustained a significantly higher incidence of shoulder injuries (8.3/1000 h) in comparison with backs (3.9/1000 h), with a rate ratio of 2.13 (95% CI, 1.15-3.94; P = .015). Conclusion: We found a notably higher injury incidence rate in schoolboy rugby as compared with the adult amateur and professional game. Shoulder injuries were responsible for more days lost than any other injury, and shoulder dislocations were the most severe. This is of particular concern so early in a player’s career and warrants further investigation into potential risk factors and mechanisms associated with shoulder injuries in school-age players.
A Vascular Variation in Radial Forearm Free Flap Harvesting: Distal Branching of the Radial Artery—A Case Report
Authors: Wüster Jonas , Beck-Broichsitter Benedicta , Koerdt Steffen , Heiland Max , Goedecke Maximilian 
Published: August 2021

Study Design: Case report. Objective: By reporting such a rare vascular variation of the radial artery, we aim to make other surgeons aware of comparable vascular variations in radial forearm free flap harvesting. Methods: In this case report, we present an 84-year-old male patient, with a rare distal branching of the radial artery into the deep palmar branch, approximately 7 cm from the wrist. In order to visualize the vascular variation, intraoperative photo documentation took place. Results: The radial free flap harvesting was successful and no postoperative complications were noted. Conclusions: Distal branching of the radial artery into the deep palmar branch may occur in radial forearm free flap harvesting. Since no restrictions in flap perfusion and/or hand perfusion were observed in our case, we recommend radial forearm free flap raising in the traditional way. No changes concerning the design and the positioning of the skin paddle need to be made.
Traumatised, angry, abandoned but some empowered: a national survey of experiences of family caregivers bereaved by motor neurone disease
Authors: Aoun Samar M. , Noonan Kerrie , Thomas Geoff , Rumbold Bruce 
Published: August 2021

Background: There are few illnesses as disruptive as motor neurone disease, a fatal neurodegenerative condition, where diagnosis introduces a clinical narrative of inevitable decline through progressive immobilisation into death. Recent evidence suggests that bereaved motor neurone disease family caregivers are more likely to be at moderate or high risk of complicated grief. Methods: Qualitative data from an anonymous national survey of bereaved motor neurone disease caregivers ( n = 393) was examined through thematic analysis to explore the experiences of people who are at low, moderate, and high risk of complicated grief. Up to 40% responded to three open-ended questions: How caregivers viewed their coping strategies; the advice they had for others and what had been positive about their experience. Results: Ten themes informed the narratives of illness and loss. All three groups shared similar experiences but differed in their capacity to address them. The low-risk group seemed to recognise the uncertainty of life and that meaning needed to be created by them. For the moderate-risk group, while motor neurone disease was a major disruption, they could with support, regroup and plan in different ways. The high-risk group did not have many resources, external or internal. They felt let down when professionals did not have answers and could not see or did not know how to change their ways of responding to this unwanted situation. Conclusion: The differences in these three profiles and their narratives of loss should alert health and community service providers to identify and address the caregivers’ support needs early and throughout the caregiving journey. Motor Neurone Disease Associations are involved throughout the illness journey and need to invest in a continuum of care incorporating end-of-life care and bereavement support. Community grief literacy and enhancement of social networks are keys to improved support from families and friends that can enable the focus to be on feelings of empowerment rather than abandonment.
Increased levels of NETosis in myeloproliferative neoplasms are not linked to thrombotic events
Authors: Schmidt Stefan , Daniliants Dimitri , Hiller Elisabeth , Gunsilius Eberhard , Wolf Dominik , Feistritzer Clemens 
Published: August 2021

Abstract
Morbidity and mortality of Philadelphia chromosome–negative myeloproliferative neoplasms (MPNs) are mainly determined by thromboembolic complications. Thrombus formation is facilitated by a neutrophil-specific form of cell death linked to neutrophil extracellular trap (NET) formation (NETosis). Preclinical and clinical data suggested a potential link between NETosis and thrombosis in MPNs. In this study, we aimed to define the impact of NETosis on clinical end points in a large MPN cohort. NETosis was induced in vitro by ionomycin and quantified by enzyme-linked immunosorbent assay–based nucleosome release assays as well as fluorescent staining of free DNA in samples from 103 MPN patients and 28 healthy donors. NETosis rate was correlated with a broad set of clinical data, such as MPN subtype, mutational status, laboratory variables, history of thrombotic events, and treatment types. Triggered NETosis levels were clearly higher in MPN patients than in healthy donors. Positivity for JAK2 V617F or exon 12 as well as CALR mutations correlate with increased NET formation. However, neither JAK2 allelic burden nor history of thromboembolic complication nor the presence of other risk factors for thrombosis (eg, leukocytosis) were associated with the rate of NETosis. In addition, none of the analyzed laboratory parameters nor the type of treatment significantly impacted the rate of NETosis formation. The biology of MPNs has an impact on NET formation because genetic driver mutations favor induction of NETosis, but this does not seems to translate into important clinical end points such as thromboembolic complications. Therefore, NETosis may play a role in facilitating thrombosis, but it is not a sole causative determinant in MPN-associated thrombophilia.
Prognostic model of long-term advanced stage (IIIB-IV) EGFR mutated non-small cell lung cancer (NSCLC) survivors using real-life data
Authors: Gutiérrez Lourdes , Royuela Ana , Carcereny Enric , López-Castro Rafael , Rodríguez-Abreu Delvys , Massuti Bartomeu , González-Larriba José Luis , García-Campelo Rosario , Bosch-Barrera Joaquim , Guirado María , Camps Carlos , Dómine Manuel , Bernabé Reyes , Casal Joaquín , Oramas Juana , Ortega Ana Laura , Sala Mª. Angeles , Padilla Airam , Aguiar David , Juan-Vidal Oscar , Blanco Remei , del Barco Edel , Martínez-Banaclocha Natividad , Benítez Gretel , de Vega Blanca , Hernández Ainhoa , Saigi Maria , Franco Fernando , Provencio Mariano 
Published: August 2021

Abstract
Background
There is a lack of useful diagnostic tools to identify EGFR mutated NSCLC patients with long-term survival. This study develops a prognostic model using real world data to assist clinicians to predict survival beyond 24 months.

Methods
EGFR mutated stage IIIB and IV NSCLC patients diagnosed between January 2009 and December 2017 included in the Spanish Lung Cancer Group (SLCG) thoracic tumor registry. Long-term survival was defined as being alive 24 months after diagnosis. A multivariable prognostic model was carried out using binary logistic regression and internal validation through bootstrapping. A nomogram was developed to facilitate the interpretation and applicability of the model.

Results
505 of the 961 EGFR mutated patients identified in the registry were included, with a median survival of 27.73 months. Factors associated with overall survival longer than 24 months were: being a woman (OR 1.78); absence of the exon 20 insertion mutation (OR 2.77); functional status (ECOG 0–1) (OR 4.92); absence of central nervous system metastases (OR 2.22), absence of liver metastases (OR 1.90) or adrenal involvement (OR 2.35) and low number of metastatic sites (OR 1.22). The model had a good internal validation with a calibration slope equal to 0.781 and discrimination (optimism corrected C-index 0.680).

Conclusions
Survival greater than 24 months can be predicted from six pre-treatment clinicopathological variables. The model has a good discrimination ability. We hypothesized that this model could help the selection of the best treatment sequence in EGFR mutation NSCLC patients.
Prescribing of direct oral anticoagulants and warfarin to older people with atrial fibrillation in UK general practice: a cohort study
Authors: Mitchell Anneka , Snowball Julia , Welsh Tomas J. , Watson Margaret C. , McGrogan Anita 
Published: August 2021

Abstract
Background
Anticoagulation for stroke prevention in atrial fibrillation (AF) has, historically, been under-used in older people. The aim of this study was to investigate prescribing of oral anticoagulants (OACs) for people aged ≥ 75 years in the UK before and after direct oral anticoagulants (DOACs) became available.

Methods
A cohort of patients aged ≥ 75 years with a diagnosis of AF was derived from the Clinical Practice Research Datalink (CPRD) between January 1, 2003, and December 27, 2017. Patients were grouped as no OAC, incident OAC (OAC newly prescribed) or prevalent OAC (entered study on OAC). Incidence and point prevalence of OAC prescribing were calculated yearly. The risk of being prescribed an OAC if a co-morbidity was present was calculated; the risk difference (RD) was reported. Kaplan-Meier curves were used to explore persistence with anticoagulation. A Cox regression was used to model persistence with warfarin and DOACs over time.

Results
The cohort comprised 165,596 patients (66,859 no OAC; 47,916 incident OAC; 50,821 prevalent OAC). Incidence of OAC prescribing increased from 111 per 1000 person-years in 2003 to 587 per 1000 person-years in 2017. Older patients (≥ 90 years) were 40% less likely to receive an OAC (RD −0.40, 95% CI −0.41 to −0.39) than younger individuals (75–84 years). The likelihood of being prescribed an OAC was lower with a history of dementia (RD −0.34, 95% CI −0.35 to −0.33), falls (RD −0.17, 95% CI −0.18 to −0.16), major bleeds (RD −0.17, 95% CI −0.19 to −0.15) and fractures (RD −0.13, 95% CI −0.14 to −0.12). Persistence with warfarin was higher than DOACs in the first year (0–1 year: HR 1.25, 95% CI 1.17–1.33), but this trend reversed by the third year of therapy (HR 0.75, 95% CI 0.63–0.89).

Conclusions
OAC prescribing for older people with AF has increased; however, substantial disparities persist with age and co-morbidities. Whilst OACs should not be withheld solely due to the risk of falls, these results do not reflect this national guidance. Furthermore, the under-prescribing of OACs for patients with dementia or advancing age may be due to decisions around risk-benefit management.

Trial registration
EUPAS29923﻿. First registered on: 27/06/2019.
Label propagation-based semi-supervised feature selection on decoding clinical phenotypes with RNA-seq data
Authors: Jiang Xue , Chen Miao , Song Weichen , Lin Guan Ning 
Published: August 2021

AbstractBackgroundClinically, behavior, cognitive, and mental functions are affected during the neurodegenerative disease progression. To date, the molecular pathogenesis of these complex disease is still unclear. With the rapid development of sequencing technologies, it is possible to delicately decode the molecular mechanisms corresponding to different clinical phenotypes at the genome-wide transcriptomic level using computational methods. Our previous studies have shown that it is difficult to distinguish disease genes from non-disease genes. Therefore, to precisely explore the molecular pathogenesis under complex clinical phenotypes, it is better to identify biomarkers corresponding to different disease stages or clinical phenotypes. So, in this study, we designed a label propagation-based semi-supervised feature selection approach (LPFS) to prioritize disease-associated genes corresponding to different disease stages or clinical phenotypes.MethodsIn this study, we pioneering put label propagation clustering and feature selection into one framework and proposed label propagation-based semi-supervised feature selection approach. LPFS prioritizes disease genes related to different disease stages or phenotypes through the alternative iteration of label propagation clustering based on sample network and feature selection with gene expression profiles. Then the GO and KEGG pathway enrichment analysis were carried as well as the gene functional analysis to explore molecular mechanisms of specific disease phenotypes, thus to decode the changes in individual behavioral and mental characteristics during neurodegenerative disease progression.ResultsLarge amounts of experiments were conducted to verify the performance of LPFS with Huntington’s gene expression data. Experimental results shown that LPFS performs better in comparison with the-state-of-art methods. GO and KEGG enrichment analysis of key gene sets shown that TGF-beta signaling pathway, cytokine-cytokine receptor interaction, immune response, and inflammatory response were gradually affected during the Huntington’s disease progression. In addition, we found that the expression of SLC4A11, ZFP474, AMBP, TOP2A, PBK, CCDC33, APSL, DLGAP5, and Al662270 changed seriously by the development of the disease.ConclusionsIn this study, we designed a label propagation-based semi-supervised feature selection model to precisely selected key genes of different disease phenotypes. We conducted experiments using the model with Huntington’s disease mice gene expression data to decode the mechanisms of it. We found many cell types, including astrocyte, microglia, and GABAergic neuron, could be involved in the pathological process.
Development of a core evaluation framework of value-added medicines: report 1 on methodology and findings
Authors: Petykó Zsuzsanna Ida , Kaló Zoltán , Espin Jaime , Podrazilová Kateřina , Tesař Tomáš , Maniadakis Nikos , Fricke Frank-Ulrich , Inotai András 
Published: August 2021

Abstract
Background
Medicines that are based on known molecules and are further developed to address healthcare needs and deliver relevant improvement for patients, healthcare professionals and/or payers are called value-added medicines (VAMs). The evaluation process of VAMs is heterogeneous across countries, and it has been primarily designed for originator pharmaceuticals with confirmatory evidence collected alongside pivotal clinical trials. There is a mismatch between evidence requirements by public decision-makers and evidence generated by manufacturers of VAMs. Our objective was to develop a core evaluation framework for VAMs.

Methods
Potential benefits offered by VAMs were collected through a systematic literature review and allocated to separate domains in an iterative process. The draft list of domains and their applicability were validated during two consecutive virtual workshops by health policy experts representing countries with different economic statuses, geographical and decision-making contexts.

Results
Based on 158 extracted studies, the final consensus on the evaluation framework resulted in 11 value domains in 5 main clusters, including unmet medical needs, health gain (measured by health care professionals), patient-reported outcomes, burden on households, and burden on the health care system.

Conclusions
The proposed framework could reduce the heterogeneity in value assessment processes across countries and create incentives for manufacturers to invest in incremental innovation. However, some domains may not be equally relevant or accepted in all countries, therefore the core framework needs thorough adaptation in specific jurisdictions.
Community supported agriculture plus nutrition education improves skills, self-efficacy, and eating behaviors among low-income caregivers but not their children: a randomized controlled trial
Authors: Seguin-Fowler Rebecca A. , Hanson Karla L. , Jilcott Pitts Stephanie B. , Kolodinsky Jane , Sitaker Marilyn , Ammerman Alice S. , Marshall Grace A. , Belarmino Emily H. , Garner Jennifer A. , Wang Weiwei 
Published: August 2021

Abstract
Background
Adults and children in the U.S. consume inadequate quantities of fruit and vegetables (FV), in part, due to poor access among households with lower socioeconomic status. One approach to improving access to FV is community supported agriculture (CSA) in which households purchase a ‘share’ of local farm produce throughout the growing season. This study examined the effects of cost-offset (half-price) CSA plus tailored nutrition education for low-income households with children.

Methods
The Farm Fresh Foods for Healthy Kids (F3HK) randomized controlled trial in New York, North Carolina, Vermont, and Washington (2016–2018) assigned caregiver-child dyads (n = 305) into cost-offset CSA plus education intervention or control (delayed intervention) groups. Following one growing season of CSA participation, changes in children’s diet quality, body mass index (BMI), and physical activity; caregivers’ nutrition knowledge, attitudes, behaviors, and diet quality; and household food access and security were examined using multiple linear or logistic regression, with adjustment for baseline value within an intent-to-treat (ITT) framework in which missing data were multiply imputed.

Results
No significant net effects on children’s dietary intake, BMI, or physical activity were observed. Statistically significant net improvements were observed after one growing season for caregivers’ cooking attitudes, skills, and self-efficacy; FV intake and skin carotenoid levels; and household food security. Changes in attitudes and self-efficacy remained one-year after baseline, but improvements in caregiver diet and household food security did not. The number of weeks that participants picked up a CSA share (but not number of education sessions attended) was associated with improvements in caregiver FV intake and household food security.

Conclusions
Cost-offset CSA plus tailored nutrition education for low-income households improved important caregiver and household outcomes within just one season of participation; most notably, both self-reported and objectively measured caregiver FV intake and household food security improved. Households that picked up more shares also reported larger improvements. However, these changes were not maintained after the CSA season ended. These results suggest that cost-offset CSA is a viable approach to improving adult, but not child, FV intake and household food security for low-income families, but the seasonality of most CSAs may limit their potential to improve year-round dietary behavior and food security.

Trial registration
ClinicalTrials.gov. NCT02770196. Registered 5 April 2016. Retrospectively registered.