bluuebunny/crossref_metadata_2025_split huggingface dataset:
P096 Pregnancy outcomes in women attending a joint obstetric and rheumatology clinic in a tertiary centre over a 2-year period
Authors: David Trixy , Hum Ryan Malcolm , Lau Yen June , Thornber Sue , Simcox Louise , Bruce Ian N , Tower Clare , Ho Pauline 
Published: April 2021

Abstract
Background/Aims
The Lupus in Pregnancy Scanning (LIPS) clinic, a joint obstetrics and rheumatology clinic was established in 2010 at Saint Mary’s Hospital, Manchester, UK for women with systemic lupus erythematosus (SLE) and other complex rheumatological conditions. We aimed to describe pregnancy outcomes of women attending this clinic to establish a baseline for future changes aimed at improving the service.
Methods
Data were collected retrospectively from electronic records of patients who attended the LIPS clinic at least once between 1st January 2018 and 31st December 2019.
Results
Pregnancy outcomes were available in 105/125 (84%) women (Table). The median age [inter-quartile range] was 30.6 years [IQR 27.7 - 33.6] and 40 (38%) were of non-Caucasian background. Sixty-one (58%) had a connective tissue disease (CTD) of whom 36 (59%) had SLE. Other rheumatological diagnoses included inflammatory arthritis, primary anti-phospholipid syndrome (APS) and systemic vasculitis. Anti-Ro was found in 32 (31%) and anti-phospholipid antibodies in 25 (24%). During pregnancy, 65 (62%) received aspirin and 40 (38%) had low molecular weight heparin (LMWH). In the antenatal period, 43 (41%) took steroids, 52 (50%) had conventional disease modifying anti-rheumatic drugs and 8 (8%) received biologics. Active disease in the antenatal period was noted in 14 (13%) women. Regarding pregnancy outcomes (Table), still-births were low (0.95%). The rate of C-sections (45%) and assisted deliveries (19.6%) was comparable to previously published data from similar clinics. P096 Table 1:Pregnancy outcomes over a 2-year period in women attending the LIPS clinic at St. Mary's HospitalPregnancy Outcomen (%)Miscarriage3 (2.9)Deliveries• Live101 (96.2)• Still-birth1 (0.95)Median Gestation (weeks) [inter-quartile range (IQR)]38 [37 - 39]Sex of Neonate• Female57 (56)• Male45 (44)Mode of Delivery• Normal vaginal36 (35.3)• Assisted20 (19.6)• Elective Caesarean Section15 (14.7)• Emergency Caesarean Section31 (30.4)Median Neonatal Birth Weight (grams) [IQR]3137 [2724 - 3428]• Low Birth Weight &lt;2500g15 (15)Maternal Complications (Antenatal and Peri-Partum)• Infection22 (22)• Pre-Eclampsia1 (1)• Post-Partum Haemorrhage56 (55)Neonatal Intensive Care Admission7 (7)Neonatal Complications• Sepsis1 (1)• Congenital Heart Block2 (2)• Prematurity (&lt;36 weeks)39 (38)
Conclusion
In this cohort we report a high live birth rate and comparable rates of assisted delivery to similar cohorts. Infection and post-partum haemorrhage are maternal complications that are common, and reflect the complex clinical presentations and therapeutic regimes in these conditions. Overall this specialist clinic achieves favourable maternal and foetal outcomes in this high-risk population.
Disclosure
T. David: None. R. Hum: None. Y. Lau: None. S. Thornber: None. L. Simcox: None. I. Bruce: None. C. Tower: None. P. Ho: None.
P210 Tocilizumab versus prednisolone only treatment for giant cell arteritis: an observational study
Authors: Preston Hannah , Cronin Owen , Kuske Barbara , McKay Neil D , Hauser Barbara 
Published: April 2021

Abstract
Background/Aims
Giant cell arteritis (GCA) is a medical emergency that requires prolonged high dose glucocorticoids (GC). Tocilizumab (TCZ) is currently approved for GCA in combination with GC tapering for those at high risk of glucocorticoid toxicity, who relapse or have refractory disease. The aim is to evaluate indications and characteristics of patients who were started on TCZ and to assess the rate of relapse and steroid tapering for patients on TCZ compared with an age matched prednisolone (PDN) only treated control group (CTRL).
Methods
Retrospective review of electronic patient health record data of patients who were diagnosed and treated for GCA in a single rheumatology centre from January 2017- July 2020. All patients were initially treated with high dose PDN (40-60 mg/day) with subsequent steroid tapering with or without TCZ (162 mg/week).
Results
We included 36 GCA patients who were treated with TCZ+PDN and 26 patients with PDN only. Mean age of patients started on TCZ was 69.3±6.8, 81% were female. There was no significant demographic difference to the CTRL group.The most common reason for starting TCZ (50%) was a GCA relapse requiring uptitration of PDN. 13 patients (36%) started TCZ as they had developed significant steroid side effects including steroid-induced diabetes, hypertension and osteoporosis related fragility fractures. Almost one fifth of patients (19.4%) who were started on TCZ had imaging evidence of large vessel involvement.The mean PDN dose of patients who started TCZ was 26.6±13.1 mg/day. Patients who started TCZ were able to approximately half the PDN dose every 3 months. The average daily PDN dose was 11.3±7.0 mg after 3 months, 6.0±4.3 mg after 6 months, and 3.3±4.7 mg after 12 months of starting TCZ. When compared with the CTRL group (4%), significantly more TCZ patients (41.7%) were able to reduce the PDN dose to a low dose (0-5 mg) after 6 months treatment (p = 0.001).During the course of treatment more CTRL patients (34.6%) relapsed than patients receiving TCZ (11.1% vs CTRL, p = 0.013). The majority of TCZ patients (88.9%) stayed in remission and 2 (5.6%) patients completed 12 months treatment and have ceased therapy. 4 (11.1%) patients stopped Tocilizumab due to side effects (diarrhoea, diverticulitis, scalp irritation) and 2 stopped due to concerns over long term risks.
Conclusion
Our real-world study shows that TCZ is predominantly initiated in those who relapse or develop GC related side effects. Patients who received TCZ were able to half their PDN dose every 3 months and had lower 6 and 12-month PDN requirements compared to those on PDN solely. The relapse rate was significantly higher in the PDN only treated group than in the TCZ group. TCZ is a good option as steroid sparing agent for the treatment of GCA.
Disclosure
H. Preston: None. O. Cronin: None. B. Kuske: None. N.D. McKay: None. B. Hauser: Honoraria; Dr Hauser has received speaker fees from Roche.
Esophageal Gland RNA-Seq Resource of a Virulent and Avirulent Population of the Soybean Cyst Nematode Heterodera glycines
Authors: Maier Tom R. , Masonbrink Rick E. , Vijayapalani Paramasivan , Gardner Michael , Howland Amanda D. , Mitchum Melissa G. , Baum Thomas J. 
Published: April 2021

The soybean cyst nematode Heterodera glycines is the most economically devastating pathogen of soybean in the United States and threatens to become even more damaging through the selection of virulent nematode populations in the field that can overcome natural resistance mechanisms in soybean cultivars. This pathogen, therefore, demands intense transcriptomic/genomic research inquiries into the biology of its parasitic mechanisms. H. glycines delivers effector proteins that are produced in specialized gland cells into the soybean root to enable infection. The study of effector proteins, thus, is particularly promising when exploring novel management options against this pathogen. Here, we announce the availability of a gland cell–specific RNA-seq resource. These data represent an expression snapshot of gland cell activity during early soybean infection of a virulent and an avirulent H. glycines population, providing a unique and highly valuable resource for scientists examining effector biology and nematode virulence. [Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Strategies for Transfer From Methadone to Buprenorphine for Treatment of Opioid Use Disorders and Associated Outcomes: A Systematic Review
Authors: Lintzeris Nicholas , Mankabady Baher , Rojas-Fernandez Carlos , Amick Halle 
Published: April 2021

Objectives:
To review the currently available evidence on transfer strategies from methadone to sublingual buprenorphine used in clinical trials and observational studies of medication for opioid use disorder treatment, and to consider whether any strategies yield better clinical outcomes than others.

Methods:
Six medical and public health databases were searched for articles and conference abstracts. The Cochrane Central Register of Controlled Trials and the World Health Organization International Clinical Trials Registry Platform were used to identify unpublished trial results. Records were dually screened, and data were extracted and checked independently. Results were summarized qualitatively and, when possible, analyzed quantitatively.

Results:
Eighteen studies described transfer from methadone to buprenorphine. Transfer protocols were extremely varied. Most studies reported successful rates of transfer, even among studies involving transfer from high methadone doses, although lower pretransfer methadone dose was significantly associated with higher rate of successful transfer. Precipitated withdrawal was not reported frequently. A range of innovative approaches to transfer from methadone to buprenorphine remains untested.

Conclusions:
Few studies have used designs that enable comparison of different approaches to transfer patients from methadone to buprenorphine. Most international clinical guidelines provide recommendations consistent with the available evidence. However, clinical guidelines should be perceived as providing “guidance” rather than “protocols,” and clinicians and patients need to exercise judgment when attempting transfers.
Blood Prestin Levels in Normal Hearing and in Sensorineural Hearing Loss: A Scoping Review
Authors: Iliadou Eleftheria , Kikidis Dimitrios , Pastiadis Konstantinos , Plack Christopher J. , Bibas Athanasios 
Published: April 2021

Objectives:
Recently, it has been hypothesized that blood prestin concentration levels may reflect cochlear damage and thus serve as an easily measurable, early sensorineural hearing loss (HL) biomarker. This is a scoping review aiming to identify and critically appraise current evidence on prestin blood levels and their temporal variation in rodents and humans with normal hearing and with sensorineural HL.

Design:
This study was designed and held according to PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. With no limitation with regards to study type, animal and human studies focusing on prestin blood levels in normal hearing and in sensorineural HL were sought in major databases such as Medline, Central Scopus, PROSPERO, and Clinicaltrials.gov. Results were then hand-searched. A data charting form was developed including the parameters of interest.

Results:
Seven studies focusing on measuring prestin blood levels by means of ELISA in rodents and human subjects with normal hearing and noise-induced, drug-induced, or idiopathic sudden HL were found eligible and were included in the analysis. According to these proof-of-concept studies, prestin can be detected in the circulation of subjects with no HL; however, normal ranges remain unclear. After cochlear damage, blood prestin levels seem to initially rise and then return to near or below baseline. The degree of their change relates with subjects’ degree of HL, damaged cochlear region and recovery. Prestin blood levels and their temporal variation seem to correlate with cochlear damage; however, methodological weaknesses, such as small sample size, lack of detailed phenotyping, insufficient exclusion of confounding factors, and short follow-up, do not allow for robust conclusions.

Conclusions:
Current findings support the value of studying blood prestin levels in normal hearing and HL and highlight a need for larger-scale longitudinal research.
Humeral Head Ossification Growth Prediction: Can This Method Be Reproduced?
Authors: Lopyan Alexander H. , Gagnier Joel J. , Gagnet Paul , Wallace Nicholas , Stepanovich Matthew , Farley Frances , Li Ying 
Published: April 2021

Background:
Radiographically assessing skeletal maturity is of paramount importance to guide appropriate management for patients with adolescent idiopathic scoliosis. The reported advantages of the Humeral Head Ossification System (HHOS) are an even distribution around peak growth age (PGA), the presence of an optimal view of the humeral head in most scoliosis radiographs, and an interobserver and intraobserver reliability of 0.95 and 0.96, respectively. The goal of this study was to determine whether similar reliability could be achieved at an institution other than the one at which the HHOS was originally described.

Methods:
Six raters used the HHOS to stage the humeral head on 30 deidentified posteroanterior spine radiographs. This process was repeated 2 weeks later. All raters were provided with a document demonstrating the radiographic parameters of each stage, as well as annotations to aid with classification. Intraclass coefficients were calculated. A secondary analysis was then performed grouping stages 1-2 as “pre-PGA” and 3-5 as “post-PGA.”

Results:
Fair to moderate interobserver and intraobserver reliability was achieved when determining each individual HHOS stage. This improved to good to excellent when the humeral was classified as pre-PGA or post-PGA. Subanalysis did not show any correlation between intraobserver reliability and level of orthopaedic experience.

Conclusions:
We found fair to moderate interobserver and intraobserver reliability with the HHOS and this was independent of level of orthopaedic experience. This is much lower than reported by the authors who developed the system, and suggests that the HHOS might not be as easy to incorporate into a scoliosis management algorithm as previously noted. The improved reliability achieved when staging the humeral head as pre-PGA or post-PGA might be the true benefit of this system.

Level of Evidence:
Level III—diagnostic.
Safety of Tumescent Liposuction Under Local Anesthesia in 9,002 Consecutive Patients
Authors: Boeni Roland , Waechter-Gniadek Paul v. 
Published: April 2021

BACKGROUND
Liposuction has become one of the most popular aesthetic procedures today. Among the different anesthesia methods, tumescent local anesthesia (TLA) has been shown to be the safest. Liposuction is typically performed as an outpatient procedure under minimal oral sedation and without the need for any intravenous (IV) fluid administration.

OBJECTIVE
To record complications in a larger series of patients undergoing liposuction in TLA.

MATERIALS AND METHODS
Between 2003 and 2020, 9,002 consecutive patients underwent liposuction in TLA with the same team of surgeons. The occurrence of complications was recorded in detail.

RESULTS
There were neither fatal complications nor damage to deeper structures such as nerves, blood vessels, muscles, lungs, abdominal organs, nor permanent lymphedema. A total of 19 of the following side effects, mainly minor, required closer follow-up or intervention: allergic drug reaction to doxycycline (0.06%), seroma (0.04%), large hematoma (0.03%), erysipelas (0.02%), transient acrocyanosis (0.02%), deep vein thrombosis (0.01%), skin necrosis (0.01%), and generalized edema (0.01%)

CONCLUSION
Liposuction in TLA is a reliable and safe procedure if it is performed by an experienced surgeon and the guidelines of care are strictly followed.
Prospective Clinical Trial of the Latest Generation of Noninvasive Monopolar Radiofrequency for the Treatment of Facial and Upper Neck Skin Laxity
Authors: Angra Kunal , Alhaddad Marwan , Boen Monica , Lipp Michael B. , Kollipara Ramya , Hoss Elika , Goldman Mitchel P. 
Published: April 2021

BACKGROUND
Aging of the face and upper neck is a complex process characterized by loss of collagen and elastic fibers, resulting in clinical skin laxity. Noninvasive interventions such as monopolar capacitively coupled radiofrequency (MRF) have gained popularity, offering a safer and more convenient alternative to traditional surgical face lift. The latest MRF device features larger tips, vibration, cooling, and impedance matching.

OBJECTIVE
We performed the first open-label clinical trial, measuring the efficacy, safety, and patient satisfaction of this device for noninvasive lifting and tightening of the face and upper neck.

MATERIALS AND METHODS
Forty subjects 30 to 60 years of age with mild/moderate skin laxity of the face and upper neck were enrolled. After pretreatment with ketorolac 60 mg intramuscular injection, subjects underwent treatment with MRF. Follow-up evaluations were performed on Days 30, 60, and 180.

RESULTS
Our study demonstrated that the newest generation MRF produced statistically significant improvement in skin laxity 6 months post-treatment, especially in the jowls and melolabial folds. According to the Investigator Global Aesthetic Improvement Score, 73% of subjects had improvement at 6 months post-treatment. Subject satisfaction and improvement questionnaires supported these findings.

CONCLUSION
Our data coupled with the excellent adverse effect profile validates MRF as an attractive treatment modality for facial and upper neck skin laxity.
Moisture Response Films Versus the Starch Iodine Test for the Detection of Palmar Hyperhidrosis
Authors: Shehadeh Waseem , Bar-Ilan Efrat , Mehrabi Joseph N. , Sprecher Eli , Artzi Ofir 
Published: April 2021

BACKGROUND
The starch iodine test (SIT) is the gold-standard diagnostic tool for primary palmar hyperhidrosis (PPH).

OBJECTIVE
This study aimed to evaluate the clinical effectiveness and safety profile of a novel approach for the detection of PPH by moisture response films (MRF) in comparison to the SIT.

METHODS
This prospective comparative study of the 2 tests was conducted on 17 patients with PPH. Disease severity was evaluated by the SIT and the MRF methods during 4 sessions (twice before and twice after botulinum toxin [BTX] injections) on different days and by different investigators. The physician's global assessment (PGA) scoring of the comparable visual results was evaluated by 2 blinded independent dermatologists. The Hyperhidrosis Disease Severity Scale (HDSS) scores of the patients at baseline and after the BTX injections were correlated with the SIT and MRF results.

RESULTS
The objective PGA scoring of the SIT results demonstrated poor correlation, whereas the objective PGA scoring of the MRF results correlated highly with the patients' HDSS scores both at baseline and after the BTX injections.

CONCLUSION
Analysis of palmar hyperhidrosis by means of MRF was superior to SIT and was demonstrated to be more efficient, convenient, and accurate.
Early Experience With Ahmed Clear Path Glaucoma Drainage Device in Childhood Glaucoma
Authors: Elhusseiny Abdelrahman M. , VanderVeen Deborah K. 
Published: April 2021

Purpose:
The aim was to evaluate the short-term outcomes of Ahmed clear path (ACP) valveless glaucoma drainage device in childhood glaucoma.

Methods:
Retrospective chart review of all patients 16 years or below with childhood glaucoma who had ACP implantation at Boston Children’s Hospital from December 2019 to June 2020 with at least 6 months follow-up period.

Results:
The study included 7 eyes of 5 patients implanted by a single surgeon. The median follow-up was 12 months. The mean intraocular pressure (IOP) was reduced from 36±3.5 mm Hg on a mean of 2.7±0.6 glaucoma medications preoperatively to a mean IOP of 12.4±2.8 mm Hg (P<0.001) on a mean of 0.7±0.8 medications postoperatively at final follow-up (P=0.0009). Complete success was achieved in 4 eyes while qualified success was achieved in 3 eyes.

Conclusion:
The ACP glaucoma drainage device provided good short-term IOP control and technical advantages for implantation for pediatric eyes were observed.
Tissue Preservation Techniques for Bone-Anchored Hearing Aid Surgery
Authors: Holmes Sean , Hamiter Mickie , Berry Camille , Mankekar Gauri 
Published: April 2021

Objective:
Compare outcomes of surgical techniques in percutaneous bone-anchored hearing implant surgery.

Study Design:
Matched retrospective cohort study.

Setting:
Tertiary referral center.

Patients:
Electronic review of adult and pediatric patients who underwent bone conduction device surgery by either the Minimally-invasive Ponto Surgery (MIPS) technique or the linear incision with no soft tissue removal (LnSTR) technique or between August 2015 and April 2018 at our facility.

Intervention:
Patients in MIPS group underwent Minimally invasive Ponto Surgery (MIPS) technique, while those in LnSTR group underwent LnSTR technique.

Main Outcome Measure:
Major outcome was presence/severity of localized skin reaction. Secondary outcomes included cosmetic outcome, revision surgery, minor adverse events, device utilization, and postoperative aided speech recognition thresholds (SRTs) across 250 to 4000 Hertz (Hz).

Results:
Fifty patients met inclusion criteria. There was a significantly lower rate of localized cutaneous reactions for the MIPS group (4.5%) compared with LnSTR group (33.3%; p = 0.026). Rate of revision surgery was significantly less for MIPS (13.6%) compared with LnSTR (20.8%; p = 0.008). Occurrence of poor cosmetic outcome was noted significantly less for the MIPS group (9.1%) compared with LnSTR patients (20.8%; p = 0.005). Minor adverse events and aided SRTs were comparable between groups.

Conclusions:
MIPS leads to a statistically significant decrease in localized cutaneous reaction compared with LnSTR. Both the LnSTR and MIPS techniques are safe and effective in the treatment of hearing loss, however MIPS may be superior in certain cases by offering improved healing, decreasing needs for wound care, and possibly decreasing need for frequent follow up.
Risk Factors for Facial Nerve and Other Nonauditory Side Effects Following Cochlear Implantation
Authors: Alnafjan Fadwa , Hasan Zubair , Sanli Halit , da Cruz Melville J. 
Published: April 2021

Objective:
The purpose of this study was to characterize a cohort of patients with nonauditory side-effects (NASx) following cochlear implant (CI) surgery.

Study Design:
Retrospective case review.

Setting:
Tertiary referral center.

Patients:
One hundred twenty three multichannel CI recipients with intraoperative facial nerve stimulation (FNS).

Intervention(s):
Intraoperative electrical auditory brainstem responses (eABR) during CI surgery.

Main Outcome Measure(s):
Nonauditory side effects post-CI activation.

Results:
Intraoperative FNS was identified in 2.26% of patients (123/5441), of whom, 34% (42/123) experienced VII stimulation on CI activation. Pain was experienced by 22% (27/123) and vestibular dysfunction was experienced by 4% (5/123) of cases. All case who experienced pain and/or vestibular NASx also experienced VII stimulation. The majority of cases were managed by CI remapping or observation and habituation.
Significant relationships were found between etiology of hearing loss and presence of FNS upon initial activation (p < 0.05). No significance was found between FNS intraoperatively and at initial activation for all assumed mechanisms of hearing loss (p > 0.05) with the exceptions of acquired hearing loss of undetermined etiology and toxic etiology group (p < 0.05).
There was no significant impact of implant array design (p > 0.05).

Conclusions:
This study has characterized patients with NASx in a large cohort of CI patients. One third of cases identified with FNS intraoperatively, developed NASx post-CI activation. Risk factors for NASx postactivation include high-risk etiologies and intraoperative objective measures (i.e., eABR). This may assist surgeons and audiologists to identify at-risk patients who may need modifications in CI program planning.