bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison between two cell collecting methods for liquid-based brush biopsies: a consecutive and retrospective study
Authors: Gaida Kristin , Deuerling Lena , Neumann Heinrich , Remmerbach Torsten W. 
Published: April 2021

Abstract
Background
This study compares two different cell collectors, the Orcellex Brush (rigid brush) and the Cytobrush GT (nylon brush), using liquid-based cytology. A comparison of their obtainment procedures was also considered. The aim was to determine the diagnostic accuracy for detection of malignancy in oral brush biopsies. PICO-Statement: In this consecutive and retrospective study we had as population of interests, patients with oral lesions, the intervention was the brush biopsy with two different cell collectors and the control was healthy oral mucosa. The outcome of the study was to compare both cell collectors.

Methods
From 2009 to 2018, 2018 patients with oral lesions were studied using the nylon brush (666 cases) and rigid brush (1352 cases). In the first cohort five smears per patient were taken with the nylon brush, while each patient received one smear with the rigid brush in the second cohort. These were further processed in a liquid-based procedure. Cytological evaluations were categorised into ‘negative’, which were considered as negative, whereas ‘doubtful’, ‘suspicious’ and ‘positive’ cytological results were overall considered as positive for malignancy in comparison to the final histological diagnoses. Additionally, the clinical expenditure for each collector was estimated.

Results
2018 clinically and histologically proven diagnoses were established, including 181 cases of squamous cell carcinomas, 524 lichen, 454 leukoplakias, 34 erythroplakias and 825 other benign lesions. The sensitivity and specificity of the nylon brush was 93.8% (95% CI 91.6–95.5%) and 94.2% (95% CI 91.8–95.5%) respectively, whereas it was 95.6% (95% CI 94.4–96.6%) and 84.9% (95% CI 83.8–87.5%) for the rigid brush. The temporal advantage using the plastic brushes was 4×  higher in comparison to the nylon brush. The risk suffering from a malignant oral lesion when the result of the brushes was positive, suspicious, or doubtful was significantly high for both tests (nylon brush OR: 246.3; rigid brush OR: 121.5).

Conclusions
Both systems have a similar sensitivity, although only the rigid brush achieved a satisfactory specificity. Additional methods, such as DNA image cytometry, should also be considered to improve the specificity. Furthermore, the rigid brush proved to be more effective at taking a sufficient number of cells, whilst also being quicker and presenting less stress for the patient.
An Integrated eDiagnosis Approach (IeDA) versus standard IMCI for assessing and managing childhood illness in Burkina Faso: a stepped-wedge cluster randomised trial
Authors: Sarrassat Sophie , Lewis James J. , Some Arsene S. , Somda Serge , Cousens Simon , Blanchet Karl 
Published: April 2021

Abstract
Background
The Integrated eDiagnosis Approach (IeDA), centred on an electronic Clinical Decision Support System (eCDSS) developed in line with national Integrated Management of Childhood Illness (IMCI) guidelines, was implemented in primary health facilities of two regions of Burkina Faso. An evaluation was performed using a stepped-wedge cluster randomised design with the aim of determining whether the IeDA intervention increased Health Care Workers’ (HCW) adherence to the IMCI guidelines.

Methods
Ten randomly selected facilities per district were visited at each step by two trained nurses: One observed under-five consultations and the second conducted a repeat consultation. The primary outcomes were: overall adherence to clinical assessment tasks; overall correct classification ignoring the severity of the classifications; and overall correct prescription according to HCWs’ classifications. Statistical comparisons between trial arms were performed on cluster/step-level summaries.

Results
On average, 54 and 79% of clinical assessment tasks were observed to be completed by HCWs in the control and intervention districts respectively (cluster-level mean difference = 29.9%; P-value = 0.002). The proportion of children for whom the validation nurses and the HCWs recorded the same classifications (ignoring the severity) was 73 and 79% in the control and intervention districts respectively (cluster-level mean difference = 10.1%; P-value = 0.004). The proportion of children who received correct prescriptions in accordance with HCWs’ classifications were similar across arms, 78% in the control arm and 77% in the intervention arm (cluster-level mean difference = − 1.1%; P-value = 0.788).

Conclusion
The IeDA intervention improved substantially HCWs’ adherence to IMCI’s clinical assessment tasks, leading to some overall increase in correct classifications but to no overall improvement in correct prescriptions. The largest improvements tended to be observed for less common conditions. For more common conditions, HCWs in the control districts performed relatively well, thus limiting the scope to detect an overall impact.

Trial registration
ClinicalTrials.gov NCT02341469; First submitted August 272,014, posted January 19, 2015.
Analysis of single nucleotide polymorphisms in chronic beryllium disease
Authors: Frye Björn C. , Gaede Karoline I. , Saltini Cesare , Rossman Milton D. , Monos Dimitri S. , Rosenman Ken D. , Schuler Christine R. , Weston Ainsley , Wegner Ralf , Noth Rainer , Zissel Gernot , Schreiber Stefan , Nothnagel Michael , Müller-Quernheim Joachim 
Published: April 2021

AbstractSarcoidosis and chronic beryllium disease (CBD) are phenocopies, however the latter one has a clear trigger factor that is beryllium exposure. This study analyses single nucleotide polymorphisms (SNPs) in a large cohort for beryllium-exposed persons. SNPs were chosen for their relevance in sarcoidosis. Even though one of largest cohorts of beryllium-exposed persons was analysed, no statistically relevant association between any SNP and CBD could be verified. Notably, some SNPs exhibit inverse OR for beryllium sensitization and CBD with nominally statistical significance, which allows hypothesizing about pathophysiological role of genes for the disease triggering and development.
Nanomaterials and hepatic disease: toxicokinetics, disease types, intrinsic mechanisms, liver susceptibility, and influencing factors
Authors: Sun Ting , Kang Yiyuan , Liu Jia , Zhang Yanli , Ou Lingling , Liu Xiangning , Lai Renfa , Shao Longquan 
Published: April 2021

AbstractThe widespread use of nanomaterials (NMs) has raised concerns that exposure to them may introduce potential risks to the human body and environment. The liver is the main target organ for NMs. Hepatotoxic effects caused by NMs have been observed in recent studies but have not been linked to liver disease, and the intrinsic mechanisms are poorly elucidated. Additionally, NMs exhibit varied toxicokinetics and induce enhanced toxic effects in susceptible livers; however, thus far, this issue has not been thoroughly reviewed. This review provides an overview of the toxicokinetics of NMs. We highlight the possibility that NMs induce hepatic diseases, including nonalcoholic steatohepatitis (NASH), fibrosis, liver cancer, and metabolic disorders, and explore the underlying intrinsic mechanisms. Additionally, NM toxicokinetics and the potential induced risks in the livers of susceptible individuals, including subjects with liver disease, obese individuals, aging individuals and individuals of both sexes, are summarized. To understand how NM type affect their toxicity, the influences of the physicochemical and morphological (PCM) properties of NMs on their toxicokinetics and toxicity are also explored. This review provides guidance for further toxicological studies on NMs and will be important for the further development of NMs for applications in various fields.
Addressing gender imbalance in intensive care
Authors: Vincent Jean-Louis , Juffermans Nicole P. , Burns Karen E. A. , Ranieri V. Marco , Pourzitaki Chryssa , Rubulotta Francesca 
Published: April 2021

AbstractThere is a large gender gap in critical care medicine with women underrepresented, particularly in positions of leadership. Yet gender diversity better reflects the current critical care community and has multiple beneficial effects at individual and societal levels. In this Viewpoint, we discuss some of the reasons for the persistent gender imbalance in critical care medicine, and suggest some possible strategies to help achieve greater equity and inclusion. An explicit and consistent focus on eliminating gender inequity is needed until gender diversity and inclusion become the norms in critical care medicine.
The association between cardiorespiratory fitness, liver fat and insulin resistance in adults with or without type 2 diabetes: a cross-sectional analysis
Authors: Sabag Angelo , Keating Shelley E. , Way Kimberley L. , Sultana Rachelle N. , Lanting Sean M. , Twigg Stephen M. , Johnson Nathan A. 
Published: April 2021

Abstract
Background
Exercise-induced improvements in cardiorespiratory fitness (CRF) often coincide with improvements in insulin sensitivity and reductions in liver fat content. However, there are limited data concerning the relationship between CRF and liver fat content in adults with varying degrees of metabolic dysfunction.

Methods
The aim of this study was to examine the association between CRF, liver fat content, and insulin resistance in inactive adults with obesity and with or without type 2 diabetes (T2D), via cross-sectional analysis. CRF was determined via a graded exercise test. Liver fat content was assessed via proton magnetic resonance spectroscopy and insulin resistance was assessed via homeostatic model of insulin resistance (HOMA-IR). A partial correlation analysis, controlling for age and gender, was performed to determine the association between CRF, demographic, cardiometabolic, and anthropometric variables. Independent t tests were performed to compare cardiometabolic outcomes between participants with T2D and participants without T2D.

Results
Seventy-two adults (46% male) with a mean age of 49.28 ± 10.8 years, BMI of 34.69 ± 4.87 kg/m2, liver fat content of 8.37 ± 6.90%, HOMA-IR of 3.07 ± 2.33 and CRF of 21.52 ± 3.77 mL/kg/min participated in this study. CRF was inversely associated with liver fat content (r = − 0.28, p = 0.019) and HOMA-IR (r = − 0.40, p < 0.001). Participants with T2D had significantly higher liver fat content (+ 3.66%, p = 0.024) and HOMA-IR (+ 2.44, p < 0.001) than participants without T2D. Participants with T2D tended to have lower CRF than participants without T2D (− 1.5 ml/kg/min, p = 0.094).

Conclusion
CRF was inversely associated with liver fat content and insulin resistance. Participants with T2D had lower CRF than those without T2D, however, the difference was not statistically significant. Further longitudinal studies are required to elucidate the relationship between CRF and the progression of obesity-related diseases such as T2D.
Registration: ACTRN12614001220651 (retrospectively registered on the 19th November 2014) and ACTRN12614000723684 (prospectively registered on the 8th July 2014).
Cold agglutinin-induced hemolytic anemia during room temperature fluid resuscitation: a case report
Authors: Kawai Yosuke , Deguchi Miyoshi , Mizouchi Naoko , Yoshida Satoru , Kumagai Ken , Hirose Yasuo 
Published: April 2021

Abstract
Background
Cold agglutinin disease can cause the agglutination of red blood cells and hemolytic anemia due to cold temperature. Herein, we report a case of progressive hemolytic anemia due to cold agglutinin disease during fluid resuscitation and in the absence of exposure to cold.

Case presentation
A 71-year-old Japanese man was admitted to the emergency department with signs of hypotension and disturbed consciousness. He was diagnosed with diabetic ketoacidosis, and treatment with fluid resuscitation and insulin infusion was initiated. Laboratory test results obtained the following day indicated hemolytic anemia. On day 5 after admission, red blood cell agglutination was detected, and the patient was diagnosed with cold agglutinin disease.

Conclusions
Cold agglutinin disease should be considered in the differential diagnosis of progressive hemolytic anemia during fluid resuscitation, even if the solution is at room temperature.
Clozapine-induced stuttering in the absence of known risk factors: a case report
Authors: Jaguga Florence 
Published: April 2021

Abstract
Background
Stuttering is a rare side effect of clozapine. It has been shown to occur in the presence of one or more factors such as abnormal electrophysiological findings and seizures, extrapyramidal symptoms, brain pathology, and a family history of stuttering. Few case reports have documented the occurrence of clozapine-induced stuttering in the absence of these risk factors.

Case presentation
A 29-year-old African male on clozapine for treatment-resistant schizophrenia presented with stuttering at a dosage of 400 mg/day that resolved with dose reduction. Electroencephalogram findings were normal, and there was no clinical evidence of seizures. The patient had no prior history or family history of stuttering, had a normal neurological examination, and showed no signs of extrapyramidal symptoms.

Conclusion
Clinicians ought to be aware of stuttering as a side effect of clozapine, even in the absence of known risk factors. Further research should investigate the pathophysiology of clozapine-induced stuttering.
Innate immune response in bovine neutrophils stimulated with Mycoplasma bovis
Authors: Gondaira Satoshi , Nishi Koji , Fujiki Jumpei , Iwano Hidetomo , Watanabe Reina , Eguchi Ayako , Hirano Yuki , Higuchi Hidetoshi , Nagahata Hajime 
Published: April 2021

AbstractMycoplasma bovis(M. bovis) is a significant worldwide pathogen of cattle. Neutrophils have an important role in the innate immune response during infection withM. bovis. However, even though neutrophils accumulate inM. bovisinfection, the interaction ofM. bovisand neutrophils has not been fully elucidated. We attempted to elucidate the innate immune response of neutrophils stimulated withM. bovisand evaluate the transcriptome and functional analysis of bovine neutrophils stimulated withM. bovis. Proinflammatory cytokines, such as inducible nitric oxide (iNOS), which was the most increased gene in transcriptome analysis, were increased in quantitative polymerase chain reaction analysis of bovine neutrophils stimulated with live or heat-killedM. bovis. Nitric oxide and intracellular reactive oxygen species production of neutrophils stimulated withM. boviswas significantly increased. Neutrophils stimulated withM. bovisshowed an increased ratio of nonapoptotic cell death compared to unstimulated controls. We demonstrated that neutrophil extracellular traps (NETs) formation was not recognized in neutrophils stimulated with liveM. bovis. However, heat-killedM. bovisinduced NETs formation. We also showed the interaction withM. bovisand bovine neutrophils regarding proinflammatory cytokine gene expression and functional expression related to NETs formation. Live and killedM. bovisinduced innate immune responses in neutrophils and had the potential to induce NETs formation, but liveM. bovisescaped NETs.
Opportunities for successful de-escalation of proton pump inhibitors at a federally qualified health center
Authors: Ayoub Joelle , McGregor Jessina C. , Castner Rebecca M. , Singh Harleen 
Published: April 2021

Abstract
Background
A Proton Pump Inhibitor (PPI) de-escalation initiative was piloted at a Family Medicine Federally Qualified Health Center (FQHC) after a needs assessment showed that PPIs were prescribed inappropriately. The objective was to evaluate implementation of a PPI de-escalation program for an urban, underinsured patient population at a (FQHC).

Methods
Patients receiving PPI with an upcoming appointment with their primary care provider (PCP) were evaluated by a pharmacist for the appropriateness of therapy. The pharmacist administered a questionnaire to patients to assess PPI usage patterns and then evaluated for appropriate PPI therapy which included diagnoses, risk factors for gastrointestinal bleed, symptom control, and duration of PPI therapy. For consenting patients, de-escalation was implemented per pharmacist protocol.

Results
A total of 36 patients were evaluated for appropriate PPI use, among those, 21 (58%) were eligible for de-escalation, and 19 agreed to de-escalation. Fifteen patients (15/19) had successful PPI de-escalation after 4 weeks without discomfort or symptoms which disrupted daily activities.

Conclusions
This pharmacist led initiative in collaboration with PCPs resulted in successful de-escalation of PPIs in an underserved primary care setting.
On a simple, data-aided analytic description of the morphology of equatorial F-region zonal plasma drifts
Authors: Shidler Samuel A. , Rodrigues Fabiano S. 
Published: April 2021

AbstractWe present results of an effort to evaluate the ability of an analytic model to describe the behavior of the equatorial zonal plasma drifts given inputs provided by readily available climatological models of thermospheric and ionospheric parameters. In a data-model fusion approach, we used vertical drift measurements to drive the model and zonal drift measurements to evaluate its output. Drift measurements were made by the Jicamarca incoherent scatter radar, and model results were evaluated for different seasons and two distinct solar flux conditions. We focused, in particular, on model results for different versions of the Horizontal Wind Model (HWM 97, 07, and 14). We found that, despite its simplicity, the analytic model can reproduce fairly well most of the features in the observed zonal plasma drifts, including the vertical shear associated with the evening plasma vortex. During daytime hours the model predicts similar results for the zonal drifts independently of the HWM used to drive the model. More importantly, the modeled daytime drifts match exceptionally well the behavior and magnitude of the observed drifts for all seasons and solar flux conditions considered. The nighttime results drive the overall performance of the analytic model, and we found that a single HWM cannot provide the best results for all seasons and solar flux conditions. We also examined the main sources of zonal drift variability. Most of the morphology is controlled by the zonal wind dynamo term of the analytic model, but with non-negligible contribution from the vertical drift term. Finally, we examined the contribution from the E- and F-region to the zonal wind dynamo. The morphology of the zonal drifts in the region of observation (240–560 km altitude) is controlled mostly by the F-region winds, but with significant contributions from the daytime E-region particularly during December solstice and low solar flux conditions.
Clinical performance of narrow-diameter titanium–zirconium implants in immediately loaded fixed full-arch prostheses: a 2-year clinical study
Authors: Coskunses Fatih Mehmet , Tak Önjen 
Published: April 2021

Abstract
Objectives
The aim of this study was to evaluate the outcomes of immediate fixed full-arch prostheses supported by axial or tilted narrow-diameter Ti-Zr implants (3.3 mm) (Roxolid®, Institut Straumann® AG, Basel, Switzerland) (NDIs) in combination with standard-diameter implants up to 2 years’ follow-up.

Materials and methods
The study was conducted at Kocaeli University Faculty of Dentistry from 2016 to 2018. 37 jaws of 28 patients with an average age of 52 years were rehabilitated with fixed full-arch prostheses supported by 179 implants. Cumulative survival rate (CSR), implant success, marginal bone loss (MBL), and prosthetic survival rate as well as complications were analyzed.

Results
Total CSR of 99.4% and 98.5% for all and narrow implants respectively have been observed at 2 years’ follow-up. No prosthesis failures were observed, yielding a cumulative prosthetic survival rate of 100%. The NDIs achieved 0.63 mm MBL at 1 year and 1.02 mm at 2 years. The mean MBL at 1 year was 0.51 mm (mandible 0.63 mm/maxilla 0.41 mm) and 0.73 mm (mandible 0.90 mm/maxilla 0.43 mm) at 2 years. Both implant angulation and loading protocol did not influence the MBL.

Conclusions
The combination of narrow-diameter implants with standard-diameter implants in immediate fixed full-arch rehabilitation has a good prognosis to become a new standard of care for severely atrophic jaws.

Clinical relevance
The use of narrow-diameter implants in fixed full-arch rehabilitations in atrophic ridges would be a successful and predictable treatment approach.
A custom virtual reality training solution for ophthalmologic surgical clinical trials
Authors: Heimann Felix , Barteselli Giulio , Brand André , Dingeldey Andreas , Godard Laszlo , Hochstetter Hendrik , Schneider Michael , Rothkegel Alexander , Wagner Clemens , Horvath Joshua , Ranade Shrirang 
Published: April 2021

AbstractWe present a summary of the development and clinical use of two custom designed high-fidelity virtual-reality simulator training platforms. This simulator development program began in 2016 to support the phase III clinical trial Archway (ClinicalTrials.gov identifier, NCT03677934) intended to evaluate the Port Delivery System (PDS) developed by Genentech Inc. and has also been used to support additional clinical trials. The two simulators address two specific ophthalmic surgical procedures required for the successful use of PDS and provide state-of-the-art physical simulation models and graphics. The simulators incorporate customized active haptic feedback input devices that approximate different hand pieces including a custom hand piece specifically designed for PDS implantation. We further describe the specific challenges of the procedure and the development of corresponding training strategies realized within the simulation platform.
Comprehensive power swing detection by current signal modeling and prediction using the GMDH method
Authors: Hosseini Seyed Amir , Taheri Behrooz , Abyaneh Hossein Askarian , Razavi Farzad 
Published: April 2021

AbstractPower swing is an undesirable variation in power flow. This can be caused by large disturbances in demand load, switching, disconnection or reclosing lines. This phenomenon may enter the zones of distance relays and cause relay malfunction leading to the disconnection of healthy lines and undermining network reliability. Accordingly, this paper presents a new power swing detection method based on the prediction of current signal with a GMDH (Group Method of Data Handling) artificial neural network. The main advantage of the proposed method over its counterparts is the immunity to noise effect in signals. In addition, the proposed method can detect stable, unstable, and multi-mode power swings and is capable of distinguishing them from the variety of permanent faults occurring simultaneously. The method is tested for different types of power swings and simultaneous faults using DIgSILENT and MATLAB, and compared with some latest power swing detection methods. The results demonstrate the superiority of the proposed method in terms of response time, the ability to detect power swings of different varieties, and the ability to detect different faults that may occur simultaneously with power swings.