bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pathological and oncological outcomes in patients with sarcomatoid differentiation undergoing cystectomy
Authors: Almassi Nima , Vertosick Emily A. , Sjoberg Daniel D. , Wong Nathan C. , Huang Chun , Pietzak Eugene J. , Cha Eugene K. , Donahue Timothy F. , Dalbagni Guido , Bochner Bernard H. , Iyer Gopa , Rosenberg Jonathan E. , Bajorin Dean F. , Al‐Ahmadie Hikmat , Goh Alvin C. 
Published: April 2021

ObjectiveTo evaluate whether urothelial carcinoma (UC) with sarcomatoid differentiation is associated with a lower pathological response rate to neoadjuvant chemotherapy (NAC) and worse oncological outcomes compared to UC without variant histology among patients undergoing radical cystectomy.Patients and MethodsPatients with UC undergoing cystectomy from 1995 to 2018 at the Memorial Sloan Kettering Cancer Centre were identified. Patients with sarcomatoid differentiation at transurethral resection (TUR) or cystectomy, and patients without variant histology were selected. Downstaging from ≥cT2 to ≤pT1N0 defined partial response and pT0N0 defined complete response. Recurrence‐free, cancer‐specific and overall survival were modelled.ResultsWe identified 131 patients with sarcomatoid differentiation and 1722 patients without variant histology, of whom 25 with sarcomatoid histology on biopsy and 313 without variant histology received NAC. Those with sarcomatoid differentiation presented with higher consensus tumour stage (94% ≥T2 vs 62%; P < 0.001) and were, therefore, more likely to receive NAC (29% vs 18%; P = 0.003). We found no evidence to support a difference in partial (24% vs 31%) or complete (20% vs 24%) response between patients with sarcomatoid histology and those with pure UC at TUR (P = 0.6). Among patients with sarcomatoid differentiation, 5‐year recurrence‐free survival was 55% (95% confidence interval [CI] 41–74) among patients receiving NAC and 40% (95% CI 31–52) among patients undergoing cystectomy alone (P = 0.1). Adjusting for stage, nodal involvement, margin status and receipt of NAC, sarcomatoid differentiation was associated with worse recurrence‐free (hazard ratio [HR] 1.82, 95% CI 1.39–2.39), disease‐specific (HR 1.66, 95% CI 1.23–2.22), and overall survival (HR 1.37, 95% CI 1.06–1.78).ConclusionsSarcomatoid differentiation was associated with higher stage at presentation and independently associated with worse survival. Given similar pathological response rates if sarcomatoid differentiation is detected at initial resection, and greater survival among patients receiving NAC, treatment with NAC appears warranted. Other drivers of the poor outcomes of this histology must be investigated.
Analysis of T and NK cell subsets in the Sicilian population from young to supercentenarian: The role of age and gender
Authors: Ligotti Mattia Emanuela , Aiello Anna , Accardi Giulia , Aprile Stefano , Bonura Floriana , Bulati Matteo , Gervasi Francesco , Giammanco Giovanni M , Pojero Fanny , Zareian Nahid , Caruso Calogero , Farzaneh Farzin , Candore Giuseppina 
Published: April 2021

SummaryAgeing dramatically affects number and function of both innate and adaptive arms of immune system, particularly T cell subsets, contributing to reduced vaccination efficacy, decreased resistance to infections and increased prevalence of cancer in older people. In the present paper, we analysed the age-related changes in the absolute number of lymphocytes in 214 Sicilian subjects, and in the percentages of T and natural killer (NK) cells in a subcohort of donors. We compared these results with the immunophenotype of the oldest living Italian supercentenarian (aged 111 years). The results were also sorted by gender. The correlation between number/percentage of cells and age in all individuals. and separately in males and females, was examined using a simple linear regression analysis. We did not record the increase in the rate of inversion of the CD4/CD8 ratio, frequently reported as being associated with ageing in literature. Our observation was the direct consequence of a flat average trend of CD4+ and CD8+ T cell percentages in ageing donors, even when gender differences were included. Our results also suggest that CD4+ and CD8+ subsets are not affected equally by age comparing females with males, and we speculated that gender may affect the response to cytomegalovirus (CMV) infection. The supercentenarian showed a unique immunophenotypic signature regarding the relative percentages of her T cell subsets, with CD4+ and CD8+ T cell percentages and CD4+ naive T cell values in line with those recorded for the octogenarian subjects. This suggests that the supercentenarian has a naive ‘younger’ T cell profile comparable to that of a &gt;80-year-old female.
Prevalence of biochemical osteomalacia in adults undergoing vitamin D testing
Authors: Bolland Mark J. , Avenell Alison , Grey Andrew 
Published: April 2021

AbstractObjectiveProlonged severe vitamin D deficiency can cause osteomalacia, but the 25‐hydroxyvitamin D (25OHD) concentration below which this occurs is unknown. We investigated the prevalence of biochemical osteomalacia in adults with a measurement of 25OHD.Design, Measurement, and Patients25OHD results between 1/1/2009 and 15/6/2020 were obtained from the regional laboratory database, together with measurements of serum calcium, parathyroid hormone (PTH) and alkaline phosphatase (ALP) within 6 months of the index 25OHD. We defined biochemical osteomalacia as all 3 of: albumin‐adjusted serum calcium (aCa)<2.0 mmol/L, PTH>7.3 pmol/L and ALP>150 IU/L. Possible osteomalacia was 2/3 criteria with the other test not done. 25OHD measurements associated with significant renal impairment, elevated hepatic transaminases or hypercalcaemia were excluded.Results110,046 25OHD measurements were identified over the 11.5 years period. After removal of ineligible measurements, 42,171 25OHD measurements from 32,386 individuals with at least 2 of aCa, PTH and ALP were included in analyses. Median 25OHD was 63 nmol/L; 8% were <25 nmol/L, and 33% were <50 nmol/L. Five index 25OHD measurements met the definition of biochemical osteomalacia, and another 11 were possible osteomalacia. After reviewing available clinical records for these 16 episodes, we classified 9 cases as osteomalacia and 7 as other diagnoses. Thus, the prevalence of biochemical osteomalacia was 0.02% (9/42,171) for 25OHD measurements and 0.23% (8/3432) for 25OHD<25 nmol/L. All cases of osteomalacia with 25OHD measurements prior to supplementation had 25OHD≤18 nmol/L.ConclusionThe prevalence of biochemical osteomalacia is very low, even in individuals with 25OHD<25 nmol/L.
Comprehensive peri‐implant tissue evaluation with ultrasonography and cone‐beam computed tomography: A pilot study
Authors: Siqueira Rafael , Sinjab Khaled , Pan Ying‐Chun , Soki Fabiana , Chan Hsun‐Liang , Kripfgans Oliver 
Published: April 2021

AbstractObjectivesThe aim of the present study was to explore the feasibility of ultrasonography (US) for clinical imaging of peri‐implant tissues.Material and MethodsPatients with ≥1 implant, a cone‐beam computed tomography (CBCT) scan, an US scan, and clinical photographs taken during the surgery were included. The crestal bone thickness (CBT) and facial bone level (FBL) were measured on both US and CBCT modalities, and direct FBL measurements were also made on clinical images. US measurements were compared with CBCT and direct readings.ResultsA total of eight implants from four patients were included. For FBL measurements, US and direct (r2 = 0.95) as well as US and CBCT (r2 = 0.85) were highly correlated, whereas CBCT correlated satisfactorily with the direct reading (r2 = 0.75). In one implant without facial bone, CBCT was not able to measure CBT and FBL accurately. The estimated bias for CBT readings was 0.17 ± 0.23 mm (p = .10) between US and CBCT. US blood flow imaging was successfully recorded and showed a wide dynamic range among patients with different degrees of clinical inflammation.ConclusionUS is a feasible method to evaluate peri‐implant facial crestal bone dimensions. Additional US features, for example, functional blood flow imaging, may be useful to estimate the extent and severity of inflammation.
A Computational Evaluation of Two Models of Retrieval Processes in Sentence Processing in Aphasia
Authors: Lissón Paula , Pregla Dorothea , Nicenboim Bruno , Paape Dario , van het Nederend Mick L. , Burchert Frank , Stadie Nicole , Caplan David , Vasishth Shravan 
Published: April 2021

AbstractCan sentence comprehension impairments in aphasia be explained by difficulties arising from dependency completion processes in parsing? Two distinct models of dependency completion difficulty are investigated, the Lewis and Vasishth (2005) activation‐based model and the direct‐access model (DA; McElree, 2000). These models' predictive performance is compared using data from individuals with aphasia (IWAs) and control participants. The data are from a self‐paced listening task involving subject and object relative clauses. The relative predictive performance of the models is evaluated using k‐fold cross‐validation. For both IWAs and controls, the activation‐based model furnishes a somewhat better quantitative fit to the data than the DA. Model comparisons using Bayes factors show that, assuming an activation‐based model, intermittent deficiencies may be the best explanation for the cause of impairments in IWAs, although slowed syntax and lexical delayed access may also play a role. This is the first computational evaluation of different models of dependency completion using data from impaired and unimpaired individuals. This evaluation develops a systematic approach that can be used to quantitatively compare the predictions of competing models of language processing.
A single dose of pre‐operative pregabalin reduces post‐operative opioid use after orthotopic liver transplantation
Authors: Knorr John P. , Barlow Ashley , Reinaker Travis S. , Zaki Radi F. 
Published: April 2021

AbstractMultimodal pain management strategies including pregabalin (PGB) have been shown to reduce pain and opioid use after many types of surgeries. This was a single‐center, retrospective study aimed to determine whether a single pre‐operative dose of PGB reduces opioid requirements and post‐operative pain after orthotopic liver transplantation (OLT). Outcomes included the mean morphine milligram equivalents used; the proportion of patients with no pain documented; and the maximum level of pain documented within the first 24h and in the 24‐72h following OLT. A total of 44 patients received PGB vs 57 who received standard of care. Baseline demographics were comparable between groups. Patients who received PGB required 70% and 54% less opioids within the first 24h and subsequent 24‐72h post‐OLT, respectively (p‐values < .001). In the first 24h post‐OLT, there were more patients with no documented pain, and fewer with severe pain in the PGB group, but these were not significant. A greater proportion in the PGB group reported a maximum of mild pain (p = .039). This study demonstrated that a single dose of pre‐operative PGB significantly reduced opioid use in the first 72 h after OLT. Larger studies will help determine the safety and efficacy of PGB in this setting.
Immunoglobulin, nucleos(t)ide analogues and hepatitis B virus recurrence after liver transplant: A meta‐analysis
Authors: Lai Quirino , Mennini Gianluca , Giovanardi Francesco , Rossi Massimo , Giannini Edoardo G. 
Published: April 2021

AbstractBackgroundProphylaxis with hepatitis B immunoglobulin (HBIG) represents an efficient strategy for reducing the risk of hepatitis B virus (HBV) recurrence after liver transplantation (LT). Unfortunately, the long‐term use of HBIG presents high costs. Therefore, the use of prophylaxis based only on nucleos(t)ide analogues (NUC) has been recently postulated. The present meta‐analysis aimed to evaluate the impact of HBIG ± NUC vs HBIG alone or NUC alone in post‐LT HBV recurrence prophylaxis.Materials and methodsA systematic literature search was performed using PubMed and Cochrane databases. The primary outcome investigated was the HBV recurrence after LT. Three analyses were done comparing the effect of (a) HBIG + NUC vs HBIG alone; (b) HBIG+NUC vs NUC alone; and (c) HBIG alone vs NUC alone. Sub‐analyses were also performed investigating the effect of low and high genetic barrierto‐recurrence NUC.ResultsFifty‐one studies were included. The summary OR (95%CI) showed a decreased risk with the combination of HBIG + NUC vs HBIG alone for HBV recurrence, being 0.36 (95% CI = 0.22‐0.61; P < .001). HBIG + NUC combined treatment reduced HBV reappearance respect to NUC alone (OR = 0.22; 95% CI = 0.16‐0.30; P < .0001). Similarly, HBIG alone was significantly better than NUC alone in preventing HBV recurrence (OR = 0.20; 95% CI = 0.09‐0.44; P < .0001).ConclusionsProphylaxis with HBIG is relevant in preventing post‐LT HBV recurrence. Its combination with NUC gives the best results in terms of protection. The present results should be considered in light of the fact that also old studies based on lamivudine use were included. Studies exploring in detail high genetic barrier‐to‐recurrence NUC and protocols with definite use of HBIG are needed.
NDNF is selectively expressed by neocortical, but not habenular neurogliaform cells
Authors: Webster Jack F. , Vroman Rozan , Beerens Sanne , Sakata Shuzo , Wozny Christian 
Published: April 2021

AbstractThe lateral habenula (LHb) is a brain structure which is known to be pathologically hyperactive in depression, whereby it shuts down the brains' reward systems. Interestingly, inhibition of the LHb has been shown to have an antidepressant effect, hence making the LHb a fascinating subject of study for developing novel antidepressant therapies. Despite this however, the exact mechanisms by which inhibitory signalling is processed within the LHb remain incompletely understood. Some studies have proposed the existence of locally targeting inhibitory interneuron populations within the LHb. One such population is believed to be akin to neocortical neurogliaform cells, yet specific molecular markers for studying these neurons are sparse and hence their function remains elusive. Recently, neuron‐derived neurotrophic factor (NDNF) has been proposed as one such marker for neocortical neurogliaform cells. Using a combination of histological, physiological and optogenetic tools, we hence sought to first validate if NDNF was selectively expressed by such inhibitory neurons within the neocortex, and then if it was confined to a similar population within the LHb. While we report this to be true for the neocortex, we find no such evidence within the LHb; rather that NDNF is expressed without restriction to a particular neuronal subpopulation. These results hence indicate that molecular markers can represent broadly diverse populations of neurons on a region‐to‐region basis and that therefore each population as defined by molecular marker expression should be validated in each brain structure.
What changes in prescription patterns of antiemetic medications in pregnant women in France?
Authors: Hurault‐Delarue Caroline , Araujo Mélanie , Vabre Clémentine , Benevent Justine , Damase‐Michel Christine , Lacroix Isabelle 
Published: April 2021

AbstractBackgroundIn France, few data are available on the prescription patterns of antiemetic medications in pregnant women.ObjectivesThe purpose of this study was to describe antiemetic medication prescriptions and trends over time. Can we observe significant changes in pregnant woman prescriptions in recent years?MethodsWe conducted a drug utilization study among pregnant women using data from the EFEMERIS database, including 135 574 pregnant women who had a pregnancy outcome between 2004 and 2017 in Haute‐Garonne (France).ResultsDuring the study period, 40 028 women (29.5%) received at least one antiemetic prescription during pregnancy. Metoclopramide (56.6%), domperidone (34.9%), and metopimazine (28.5%) were the most commonly prescribed antiemetics, whatever the trimester of pregnancy. Prescriptions of ondansetron only concerned 53 women (0.1%). The prevalence of women who received at least one prescription for an antiemetic decreased from 32.5% in 2010 to 21.6% in 2017. This decline mainly concerned domperidone prescriptions (from 13.1% in 2010 to 1.2% in 2017). Metoclopramide prescriptions also decreased slightly (18.3% in 2010 and 14.0% in 2017). Metopimazine prescriptions increased lowly (8.0% in 2010 and 9.0% in 2017).ConclusionThis study showed a decrease of antiemetic prescriptions between 2010 and 2017, linked to the sharp decrease in domperidone use from 2011, probably related to warnings about the risk of cardiovascular adverse effects following exposure to domperidone. We could not observe real switches to other antiemetic medications. No switches to ondansetron could be noted either, with only rare exposure during pregnancy, contrary to other countries, like the United States.
Validation of the FibroScan‐aspartate aminotransferase score by vibration‐controlled transient and B‐mode ultrasound elastography
Authors: Hirooka Masashi , Koizumi Yohei , Yano Ryo , Sunago Kotarou , Watanabe Takao , Yoshida Osamu , Tokumoto Yoshio , Abe Masanori , Hiasa Yoichi 
Published: April 2021

AbstractAimThe FibroScan‐aspartate aminotransferase (FAST) score comprises an easy and feasible method for identifying advanced non‐alcoholic steatohepatitis. Recently, shear‐wave elastography and attenuation coefficient measurement on B‐mode ultrasound (US) have become widely utilized. We investigated the diagnostic accuracy of the FAST score as calculated using US‐elastography compared with that using vibration‐controlled transient elastography (VCTE).MethodsPatients with chronic liver disease who underwent VCTE, point‐shear‐wave elastography with attenuation coefficient measurement, and liver biopsy on the same day between January 2015 and September 2020 were retrospectively reviewed.ResultsOf 189 patients, 94 underwent VCTE using both M and XL probes. The C‐statistics were similar for VCTE (0.846) and US‐elastography (0.814; p = 0.251), and for M (0.857) and XL probes (0.833; p = 0.412). Scatter and Bland–Altman plots showed good reproducibility for the FAST score. For VCTE, a cut‐off of ≤0.35 had a sensitivity of 92.3%, negative predictive value of 85.5%, and negative likelihood ratio of 0.14, and a cut‐off of ≥0.67 had a specificity of 90.6%, positive predictive value of 88.1%, and positive likelihood ratio of 6.03, for ruling out and in advanced non‐alcoholic steatohepatitis, respectively. For US‐elastography, a cut‐off of ≤0.35 had a sensitivity of 90.4%, negative predictive value of 83.3%, and negative likelihood ratio of 0.16, and a cutoff of ≥0.67 had a specificity of 91.8%, positive predictive value of 85.1%, and positive likelihood ratio of 4.67, for ruling out and in advanced non‐alcoholic steatohepatitis, respectively.ConclusionsThe FAST score is highly reproducible, even when different echo equipment or probes are used.
Objective assessment of Platelet‐Rich Plasma (PRP) potentiality in the treatment of Chronic leg Ulcer: RCT on 80 patients with Venous ulcer
Authors: Helmy Yasser , Farouk Nehal , Ali Dahy Asmaa , Abu‐Elsoud Ahmed , Fouad khattab Rania , Elshahat Mohammed Sahar , Abdullbary Gad Lamia , Altramsy Ayman , Hussein Emad , Farahat Ayman 
Published: April 2021

AbstractBackgroundChronic venous leg ulcer reduces the patients’ activities and their overall quality of life. Platelet‐rich plasma (PRP) was previously investigated as promising less invasive management for leg ulcers.This study aimsTo re‐assess the efficacy and safety of PRP in the management of chronic leg ulcers due to venous factors.Patients/MethodsRCT enrolled 80 patients who clinically presented with chronic venous leg ulcers. Forty patients were allocated randomly for the treatment with autologous platelet‐rich plasma (PRP). Intradermal and subdermal injection of PRP by 27guage syringe weekly, in all edges and in the granular floor of the ulcer for 4–6 sessions. Another 40 patients managed by conventional treatment by compression and dressing for the same period were allocated as Group B. Objective assessment achieved by the percentage of reduction of the size of the ulcer area, rate of healing, incidence of recurrence, and if side effects have been reported.ResultsPRP therapy showed better results and high p value significance when compared to conventional therapy.ConclusionThis study shows that PRP is effective and significant in promoting the wound healing process in chronic leg venous ulcers. PRP is simple, safe, and has a short learning curve technique.
An improved method for selection of wheat genotypes for tolerance to crown rot caused by Fusarium pseudograminearum
Authors: Kelly Alison , Macdonald Bethany , Percy Cassandra , Davies Philip 
Published: April 2021

AbstractAchieving genetic gain when selecting for genotypes with favourable grain production traits in the presence of the fungal pathogen Fusarium pseudograminearum can involve potentially competitive objectives of breeding for tolerance and breeding for resistance. A method for the selection of genotypes for both tolerance and resistance to crown rot in wheat, caused by this fungal pathogen, is presented through a combined analysis of grain yield and symptoms of disease severity across inoculated and uninoculated treatments. The symptoms of disease severity are measured as basal stem browning in the plant, and this trait provides a measure of resistance in this study. The measurement of grain yield in uninoculated and inoculated treatments provides a measure of yield potential and yield in the presence of disease, respectively. Interpretation of analysis results through the regression inherent in the statistical model allows us to derive and select for three traits of interest. Firstly, yield retention can be derived from a random regression of yield of genotypes in inoculated versus uninoculated treatments, independently of yield potential in that environment. Secondly, severity of disease symptoms in inoculated treatments can be used to select genotypes with superior resistance. Finally, a tolerance measure can be derived from the yield retention, when it is assessed independently of the disease severity measured as stem browning. In theory, this method is superior to traditional approaches of forming a yield difference or a percentage yield loss calculation. In practice, genetic gain can be made for tolerance through accurate phenotyping of the trait, independently of resistance in that environment.
Mental health nursing and autism: I am a mental health nurse so why did it take me so long to realize I’m autistic?
Authors: Sweetmore Victoria 
Published: April 2021

Accessible SummaryWhat is known on the subject?

Women with autistic spectrum disorder are likely to be diagnosed with other mental health needs and to have experienced trauma.

Mental health nurses are likely to encounter women who possibly fit the criteria for a autistic spectrum diagnosis, but who have not been offered appropriate support or signposting.

What the paper adds to existing knowledge

Using my own lived experience as a late diagnosed woman with autism and as a mental health nurse, I identify some of the gaps in training and knowledge that mental health nurses have.

What are the implications for practice?

Suggestions are made as to how improvements in mental health nurses’ knowledge of autistic spectrum disorder in women could enhance mental wellbeing for this group of people.