bluuebunny/crossref_metadata_2025_split huggingface dataset:
Robotic total mesorectal excision or transanal total mesorectal excision meta‐analysis
Authors: Chen Michelle Zhiyun , Tay Yeng Kwang , Warrier Satish K. , Heriot Alexander G. , Kong Joseph C. 
Published: September 2021

AbstractBackgroundsTotal mesorectal excision (TME) has been established as the standard for oncologic resection of rectal cancer, and has a direct impact on local recurrence and overall survival.ObjectivesOur meta‐analysis aims to evaluate the oncological outcomes of the newer techniques of TME – robotic TME versus Transanal TME (TaTME). Primary outcome measures included CRM positivity, R0 resection status, distal resection margins and lymph node yield. Secondary outcome measures were overall complication rates, anastomotic leak and wound infection rates, post‐operative ileus rates and mean operative time.MethodsA systematic literature search was performed to identify relevant studies through PubMEd and Embase from January 2000 to January 2021. Inclusion criteria included English language articles directly comparing TaTME and robotic TME.ResultsSeven hundred and fourteen studies were identified, and only six studies were included for this meta‐analysis. A total of 1065 participants, of which 632 (59.3%) underwent robotic TME, and 433 (40.7%) had TaTME. Robotic TME had a statistically significant higher lymph node yield (SMD ‐0.53, p = 0.020). There were no significant differences in the overall complication rates, wound infection and anastomotic leak rates, post‐operative ileus, mean operative time and CRM positivity.ConclusionThis is the first meta‐analysis assessing the outcomes of robotic TME versus TaTME, and only lymph node yield was statistically higher in robotic TME group. These techniques are potentially complementary rather than competing, and we believe that these two approaches can be adopted after appropriate training.
A review of the characteristics, mechanisms and clinical significance of habituation in foetuses and newborn infants
Authors: Sicard‐Cras Iona , Rioualen Stéphane , Pellae Elisabeth , Misery Laurent , Sizun Jacques , Roué Jean‐Michel 
Published: September 2021

AbstractHabituation has been a topic of interest since the early 20th century. We summarise the characteristics of habituation, the proposed habituation mechanisms, the associated cortical responses and the link between habituation and cognitive development. Behavioural and neuroimaging studies have highlighted the early sensory abilities of foetuses and newborn infants, with preterm newborn infants exhibiting decreased habituation and dishabituation capabilities that increase their environmental vulnerability. Habituation provides a foundation for the learning and cognition on which higher functions are constructed. It has been suggested that it is efficient for predicting cognitive developmental outcomes in term and preterm newborn infants.
Validation and public health modelling of risk prediction models for kidney cancer using the UK Biobank
Authors: Harrison Hannah , Pennells Lisa , Wood Angela , Rossi Sabrina H. , Stewart Grant D. , Griffin Simon J. , Usher‐Smith Juliet A. 
Published: September 2021

ObjectivesTo externally validate risk models for the detection of kidney cancer, as early detection of kidney cancer improves survival and stratifying the population using risk models could enable an individually tailored screening programme.MethodsWe validated the performance of 30 existing phenotypic models predicting the risk of kidney cancer in the UK Biobank cohort (n = 450 687). We compared the discrimination and calibration of models for men, women, and a mixed‐sex cohort. Population level data were used to estimate model performance in a screening scenario for a range of risk thresholds (6‐year risk: 0.1–1.0%).ResultsIn all, 10 models had reasonable discrimination (area under the receiver‐operating characteristic curve >0.60), although some had poor calibration. Modelling demonstrated similar performance of the best models over a range of thresholds. The models showed an improvement in ability to identify cases compared to age‐ and sex‐based screening. All the models performed less well in women than men.ConclusionsThe present study is the first comprehensive external validation of risk models for kidney cancer. The best‐performing models are better at identifying individuals at high risk of kidney cancer than age and sex alone; however, the benefits are relatively small. Feasibility studies are required to determine applicability to a screening programme.
Microvessel stenosis, enlarged perivascular spaces, and fibrinogen deposition are associated with ischemic periventricular white matter hyperintensities
Authors: Roseborough Austyn D. , Rasheed Berk , Jung Youngkyung , Nishimura Kevin , Pinsky William , Langdon Kristopher D. , Hammond Robert , Pasternak Stephen H. , Khan Ali R. , Whitehead Shawn N. 
Published: September 2021

AbstractPeriventricular white matter hyperintensities (pvWMH) are neuroimaging abnormalities surrounding the lateral ventricles that are apparent on magnetic resonance imaging (MRI). They are associated with age, neurodegenerative disease, and cerebrovascular risk factors. While pvWMH ultimately represent a loss of white matter structural integrity, the pathological causes are heterogeneous in nature, and currently, cannot be distinguished using neuroimaging alone. pvWMH could occur because of a combination of small vessel disease (SVD), ependymal loss, blood–brain barrier dysfunction, and microgliosis. In this study we aimed to characterize microvascular stenosis, fibrinogen extravasation, and microgliosis within pvWMH with and without imaging evidence of periventricular infarction. Using postmortem neuroimaging of human brains (n = 20), we identified pvWMH with and without periventricular infarcts (PVI). We performed histological analysis of microvessel stenosis, perivascular spaces, microgliosis, and immunohistochemistry against fibrinogen as a measure of serum protein extravasation. Herein, we report distinctions between pvWMH with and without periventricular infarcts based on associations with microvessel stenosis, enlarged perivascular spaces, and fibrinogen IHC. Microvessel stenosis was significantly associated with PVI and with cellular deposition of fibrinogen in the white matter. The presence of fibrinogen was associated with PVI and increased number of microglia. These findings suggest that neuroimaging‐based detection of infarction within pvWMH may help distinguish more severe lesions, associated with underlying microvascular disease and BBB dysfunction, from milder pvWMH that are a highly frequent finding on MRI.
Tumor eradicated by combination of imiquimod and OX40 agonist for in situ vaccination
Authors: Chu Yanhong , Li Rutian , Qian Lingyu , Liu Fangcen , Xu Ruihan , Meng Fanyan , Ke Yaohua , Shao Jie , Yu Lixia , Liu Qin , Liu Baorui 
Published: September 2021

AbstractVarious cancer vaccines have been developed to generate and amplify antigen‐specific T cell responses against malignancy. Among them, in situ vaccination is one of the most practical types as it can trigger immune responses without previous antigen identification. Here we reported a novel in situ vaccine by intratumoral injection of imiquimod and OX40 agonist. In mice bearing hepatic carcinoma, both the injected tumor and the noninjected tumor in the distant lesion of the same mice were suppressed after vaccination. Further studies found that this in situ vaccine triggered systemic tumor‐specific responses, with one‐fold increase of effector memory T cells properties and stronger toxicity of lymphocytes in spleen. Besides, we found that imiquimod upregulated the expression of OX40 on CD4+ T cells and thus enhanced the effectiveness of OX40 agonist. Five immune‐positive‐related pathways were activated after vaccination. This in situ vaccine caused little harm to normal organs and provided long‐term protection against the same syngeneic tumor rechallenge. Due to its effectiveness, feasibility and safety, this strategy could potentially be applied to various types of late‐stage solid tumors and worthy of further clinical research.
Contact allergy in a paediatric population observed in a tertiary referral centre in Belgium
Authors: Noë Esther , Huygens Sara , Morren Marie‐Anne , Garmyn Marjan , Goossens An , Gilissen Liesbeth 
Published: September 2021

AbstractBackgroundContact allergy is increasingly recognized as being important in children with eczema.ObjectivesTo retrospectively analyse the patch test results in children over the past 10 years, aiming to (1) evaluate demographic characteristics and lesion locations, (2) describe frequencies of positive patch test reactions, and (3) investigate the relationship with atopic dermatitis (AD).MethodsA total of 329 children were patch tested between January 2010 and December 2019 with the European (children) baseline series and/or other series, and the personal product(s) used.ResultsA total of 119 (36%) children presented with at least one positive reaction. Children with AD had a higher prevalence of positive reactions compared with the non‐AD group (P = .002), but without statistically significant difference regarding sensitization to more than one hapten (P = .39). The face (20.2%), hands (19.3%), feet (16.8%), arms (12.6%), and body folds (10.9%) were the most common sites of primary localizations. The most frequent contact allergens were nickel sulfate and linalool hydroperoxide (both 16%), limonene hydroperoxide (13.5%), and para‐phenylenediamine (10.9%). No statistically significant difference for nickel sulfate was found between the AD and non‐AD group (P = .20).ConclusionsContact allergy in children with eczema was frequently observed in our tertiary referral centre in Belgium as well, confirming the need for patch testing.
The role of social identity in improving access to water, sanitation and hygiene (WASH) and health services: Evidence from Nepal
Authors: Balasubramanya Soumya , Stifel David , Alvi Muzna , Ringler Claudia 
Published: September 2021

SummaryMotivationCOVID‐19 has revived focus on improving equitable access to water, sanitation and hygiene (WASH) and health services in developing countries. Most public programming tends to rely on economic indicators to identify and target vulnerable groups. Can expanded targeting criteria that include social status help to improve not only targeting, but also equity in access to WASH and health services?PurposeThis article assesses the role of social identity in mediating access to WASH and health services, controlling for economic disadvantages such as household wealth, income sources, and assets.Methods and approachWe use regression analysis applied to the 2016 Nepal Demographic and Health Survey (DHS) to estimate the relationships between social identity and access to WASH and health services, controlling for wealth (using wealth index quantiles) and remittances (using indicator variables for domestic and international remittances).FindingsWe find that differences in access are mediated in large part by caste, and religious and ethnic identity, especially in rural areas, suggesting that the supply of such services is lower for historically disadvantaged communities. In addition, communities with least access are not necessarily the most economically disadvantaged, indicating that relying solely on traditional economic indicators to target programmes and interventions may not be sufficient to improve equity in access to public health services.Policy implicationsThe results make a case for broadening indicators beyond the economic criteria for improving targeting of public funds for more inclusive development.
The effects of CO2 laser and topical agent combination therapy for onychomycosis: A meta‐analysis
Authors: Han Yang , Wang Yi , Zhang Xin‐rui , Chen Juan , Li Xiao‐dong 
Published: September 2021

AbstractThe routine options for onychomycosis are oral, topical, and device‐based therapies which are often limited in terms of efficacy and unsatisfactory side effects. Topical agents such as luliconazole, tioconazole, terbinafine, and tazarotene can be more effective when combined with laser therapies. Our aim was to compare the efficacy and satisfaction rates of CO2 laser therapy with topical agents in patients with onychomycosis. PubMed, the Cochrane Library, Embase, and Ovid databases were searched to identify randomized controlled trials (RCTs) evaluating the effects of combined therapies. Selected study data were analyzed for differences expressed as odds ratio (OR) and relative ratio (RR) with 95% confidence intervals (CI) for dichotomous outcomes. Efficacy and satisfaction outcomes were assessed using quantitative methods. Our investigations showed that combined CO2 laser and topical treatments significantly increased efficacy 5.38‐fold when compared with topical agents alone (OR 5.38; 95% CI; 3.20–9.04; p < 0.00001), with low heterogeneity observed among studies (I2 = 38%). Mycological clearance comparison rates were also improved by combined treatments. The higher satisfaction of the combined group was assessed by pooled effect (OR 4.56; 95% CI; 2.78–7.49; p < 0.00001). Our evidence suggests combined therapy may exert positive effects and satisfactory safety for patients with moderate to severe onychomycosis, however, optimal combination options and appropriate dosages require more comprehensive RCTs.
Left atrial intramural hematoma: The role of echocardiography
Authors: Greco Cosimo Angelo , Albanese Miriam , Pisanò Ennio Carmine , Garzya Massimiliano , Donateo Mario , Nicolardi Salvatore , Scotto di Quacquaro Antonio , Mangia Federica , De Razza Luigi , Casali Giovanni , Zaccaria Salvatore 
Published: September 2021

AbstractLeft atrial intramural hematoma (LAIH) is an uncommon entity for which a timely diagnosis is critical for decision making. Cardiac surgical or catheter‐based procedures are potential causing factors. Though cardiac computerized tomography and magnetic resonance are highly accurate diagnostic modalities, their role is limited by the lack of widespread availability. The present clinical case illustrates the diagnostic features of LAIH that can be obtained using echocardiography at the bedside in critically ill patients. We report a case of LAIH, that followed a catheter ablation procedure and was complicated by cardiac and cerebral ischemia. Cardiac surgical management was required.
Comparison of three protocols for the management of re‐fracture of teeth with uncomplicated crown fractures
Authors: Tewari Nitesh , Tamchos Rigzen , Chaurasia Bikash , Rahul Morankar , Mathur Vijay Prakash , Goel Shubhi , Bansal Kalpana 
Published: September 2021

AbstractBackgroundCrown fractures restored by fragment reattachment are liable to re‐fracture, which may cause fragment dislodgement. There is a paucity of literature regarding management of fragment reattachment cases following a further fracture. Hence the aim of the present in‐vitro study was to evaluate and compare the efficacy of three different management protocols for such scenarios.MethodologyEighty maxillary bovine incisors without structural deformity and with similar dimensions were fractured as per the standard protocol. They were subjected to drying for 24 hours and the fragments were rehydrated by placing them in a humidification chamber for 15 minutes. They were then reattached by using flowable light‐cured composite resin. The teeth (n=20) were fractured again by fixing them in a mechanical frame and using a mallet. They were randomly allocated to three experimental groups. (Group I mechanical abrasion and fragment reattachment, Group II mechanical abrasion, humidification and reattachment, Group III mechanical abrasion and composite restoration, and Group IV positive control with no re‐fracture). The samples were thermocycled and the force required to fracture was tested by using a universal testing machine (Instron‐3360, USA). This was done by applying a tangential load with a speed of 1 mm/min to the teeth with a 500‐kg load cell. Statistical analysis of the results was performed using ANOVA and the independent t‐test.ResultsThe highest force required to fracture was reported in Group IV (333.26 ± 66.69N) while the lowest was in Group II (254.86 ± 105.23N). The forces in Group I and Group II were 258.36 ± 65.78N and 298.02 ± 97.94N, respectively (p=0.016, F=3.68). The independent t‐test between the groups revealed a significant difference between Group I and Group IV (p= 0.001) and Group II and Group IV (p=0.009).ConclusionThe force required to fracture was significantly lower in the groups involving attachment of the re‐fractured fragments. Among the experimental groups, the group with composite restoration required the highest force to fracture.
Infraposition or infraocclusion– Is it time to rename?
Authors: Doğramacı Esma , Rossi‐Fedele Giampiero 
Published: September 2021

AbstractDental infraposition and dental infraocclusion, hereinafter referred to as infraposition and infraocclusion respectively, are terms that are often used interchangeably. This can be noted in the International Association of Dental Traumatology guidelines for the management of traumatic dental injuries, where infraocclusion is listed as an injury‐specific outcome following avulsion of permanent teeth. Infraposition and infraocclusion are terms that have been used in the dental literature to describe teeth that interfere with the normal eruption and development of the permanent dentition. While teeth described in this manner share certain clinical characteristics that give rise to these terms being used interchangeably within the dental traumatology field, this may not necessarily be correct and may be confusing. The aim of this short communication is to start a discussion in the dental trauma community regarding the need for a more adequate term, particularly in relation to replanted teeth.
The EU's role in income redistribution and insurance: Support, norm‐setter or provider? A review of justice‐based arguments
Authors: Vandenbroucke Frank 
Published: September 2021

AbstractIncome redistribution and insurance are core functions of welfare states. What role should the EU play in this domain? I examine the purchase of normative theorizing on social justice on this question, focusing on the contrast between three models of EU involvement: the EU as Support, which implies the sharing of resources through intergovernmental transfers; the EU as Provider, which implies EU cross‐border transfers towards individual citizens; the EU as Norm‐setter, which implies that the EU formulates normative policy ideals. I review different accounts of justice for the EU and how they bear on the choice between these models of EU involvement. Conceptions of “background justice” have some purchase in a debate on the EU's role, but that purchase is limited. They need to be complemented by shared conceptions of domestic justice and a degree of moral cosmopolitanism. I argue that a “European Social Union” should be a Support and Norm‐setter in the realm of insurance and redistribution. Through the establishment of interstate insurance, it would be a true “insurance union.” It would engage in interstate redistribution, but there are no compelling reasons of justice for it to become a direct Provider of insurance or redistribution towards individual citizens.
Trophic downgrading decreases species asynchrony and community stability regardless of climate warming
Authors: Rezende Felipe , Antiqueira Pablo A. P. , Petchey Owen L. , Velho Luiz Felipe M. , Rodrigues Luzia C. , Romero Gustavo Q. 
Published: September 2021

AbstractTheory and some evidence suggest that biodiversity promotes stability. However, evidence of how trophic interactions and environmental changes modulate this relationship in multitrophic communities is lacking. Given the current scenario of biodiversity loss and climate changes, where top predators are disproportionately more affected, filling these knowledge gaps is crucial. We simulated climate warming and top predator loss in natural microcosms to investigate their direct and indirect effects on temporal stability of microbial communities and the role of underlying stabilising mechanisms. Community stability was insensitive to warming, but indirectly decreased due to top predator loss via increased mesopredator abundance and consequent reduction of species asynchrony and species stability. The magnitude of destabilising effects differed among trophic levels, being disproportionally higher at lower trophic levels (e.g. producers). Our study unravels major patterns and causal mechanisms by which trophic downgrading destabilises large food webs, regardless of climate warming scenarios.
A national study of epilepsy‐related deaths in Scotland: Trends, mechanisms, and avoidable deaths
Authors: Mbizvo Gashirai K. , Schnier Christian , Simpson Colin R. , Chin Richard F. M. , Duncan Susan E. 
Published: September 2021

AbstractObjectiveThis study was undertaken to investigate the trends and mechanisms of epilepsy‐related deaths in Scotland, highlighting the proportion that were potentially avoidable.MethodsThis was a retrospective observational data‐linkage study of administrative data from 2009–2016. We linked nationwide data encompassing mortality records, hospital admissions, outpatient attendance, antiepileptic drug (AED) prescriptions, and regional primary care attendances. Adults (aged ≥16 years) suffering epilepsy‐related death were identified for study using International Classification of Diseases, 10th Revision coding combined with AED prescriptions. We reported epilepsy‐related mortality rate (MR), age‐specific mortality ratios, multiple cause‐of‐death frequencies, and the proportion of potentially avoidable deaths (identified as those with an underlying cause listed as avoidable by the Office for National Statistics).ResultsA total of 1921 epilepsy‐related deaths were identified across Scotland; 1185 (62%) decedents were hospitalized for seizures in the years leading up to death, yet only 518 (27%) were seen in a neurology clinic during the same period. MR remained unchanged over time, ranging from 5.9 to 8.7 per 100 000 Scottish population (95% confidence interval [CI] = −.05 to .66 per 100 000 for annual change in MR). Mortality ratios were significantly increased in young adults aged 16–54 years (2.3, 95% CI = 1.8–2.8), peaking at age 16–24 years (5.3, 95% CI = 1.8–8.8). Sudden unexpected death in epilepsy (SUDEP) constituted 30% of the 553 young adult epilepsy‐related deaths, with several other non‐SUDEP fatal mechanisms identified including aspiration pneumonia, cardiac arrest, AED or narcotic poisoning, drowning, and alcohol dependence. Seventy‐six percent of young adult epilepsy‐related deaths were potentially avoidable.SignificanceEpilepsy‐related deaths are a major public health problem in Scotland, given that they are not reducing, people are dying young, and many deaths are potentially avoidable. SUDEP is only one of several important mechanisms by which epilepsy‐related deaths are occurring in young adults. Services may need to be re‐evaluated to improve specialist referral following seizure‐related hospital admissions.