bluuebunny/crossref_metadata_2025_split huggingface dataset:
A 5‐year rotational grazing changes the botanical composition of sub‐alpine and alpine grasslands
Authors: Perotti Elisa , Probo Massimiliano , Pittarello Marco , Lonati Michele , Lombardi Giampiero 
Published: June 2018

AbstractAimThe implementation of Grazing Management Plans (GMP), a specific policy and management tool, aimed at enhancing farm productivity while preserving plant diversity, soil and landscape. The GMP are based on rotational grazing systems (RGS) with animal stocking rate adjusted to balance grassland carrying capacity. The aim was to test the 5‐year effects produced by GMP implementation on botanical composition, plant diversity and soil nutrient content on sub‐alpine and alpine pastures.LocationVal Troncea Natural Park, western Italian Alps.MethodsA total of 199 vegetation transects was carried out in summer 2011 and repeated in summer 2016. The botanical composition was recorded and plant diversity indices, i.e. species richness and Shannon diversity (H′ index), were computed. Mean soil nutrient content was indirectly estimated through computation of Landolt N indicator value (N index) for each transect. Pair‐sample statistical tests and PERMANOVA were perfomed at different levels: on the whole vegetation dataset, on vegetation communities (i.e. vegetation types and ecological groups) and considering functional pools of species.ResultsConsidering the whole vegetation dataset, species richness, H′ index and N index significantly increased from 2011 to 2016. Moreover, species richness significantly increased in almost all vegetation ecological groups, with the highest increase within the mesotrophic group. The H′ index significantly increased in eutrophic, pre‐forest and thermic groups, while the N index increased in all vegetation groups, except in the eutrophic and snow‐bed groups. A significant difference in botanical composition was detected within oligotrophic, mesotrophic and thermic groups. The number and cover of N‐poor high‐elevation species increased in all groups and this result might be related to effects produced by livestock, which promoted seed transport and increased connectivity amongst different communities. The meso‐eutrophic species number and cover significantly increased within thermic, mesotrophic and pre‐forest groups, suggesting greater use of such areas by livestock under RGS than under continuous grazing.ConclusionsThe implementation of RGS with stocking rate adjustments proved to be an effective and a sustainable management tool to enhance botanical composition and plant diversity of sub‐alpine and alpine grasslands over a 5‐year span.
Sample Size Determination for GEE Analyses of Stepped Wedge Cluster Randomized Trials
Authors: Li Fan , Turner Elizabeth L. , Preisser John S. 
Published: June 2018

Summary
In stepped wedge cluster randomized trials, intact clusters of individuals switch from control to intervention from a randomly assigned period onwards. Such trials are becoming increasingly popular in health services research. When a closed cohort is recruited from each cluster for longitudinal follow-up, proper sample size calculation should account for three distinct types of intraclass correlations: the within-period, the inter-period, and the within-individual correlations. Setting the latter two correlation parameters to be equal accommodates cross-sectional designs. We propose sample size procedures for continuous and binary responses within the framework of generalized estimating equations that employ a block exchangeable within-cluster correlation structure defined from the distinct correlation types. For continuous responses, we show that the intraclass correlations affect power only through two eigenvalues of the correlation matrix. We demonstrate that analytical power agrees well with simulated power for as few as eight clusters, when data are analyzed using bias-corrected estimating equations for the correlation parameters concurrently with a bias-corrected sandwich variance estimator.
Fertility managment in testicular cancer: the need to establish a standardized and evidence‐based patient‐centric pathway
Authors: Moody Jemma A. , Ahmed Kamran , Yap Tet , Minhas Suks , Shabbir Majid 
Published: June 2018

ObjectivesThe aim of the present paper was to determine the impact of testicular cancer (TC) and its treatments on fertility and to review the current management options for the infertile patient with TC, both before diagnosis and after treatment, with the aim of providing practical recommendations to update contemporary guidelines and standardize clinical practice.Patients and MethodsSearches were conducted for relevant articles on Pubmed and Google Scholar between 2000 and 2017, with additional articles sourced from reference lists of included publications.ResultsAt time of diagnosis, 6–24% of patients with TC were reported to be azoospermic and 50% oligozoospermic. Without conducting semen analysis at diagnosis, these patients cannot be identified and may be at further risk of subfertility. Gonadotoxic therapies cause an overall decrease in male fertility by 30% and there is currently no method to predict which patients will become azoospermic after treatment. Patients with larger, more invasive tumours, however, are at greater risk of infertility from local tumour effects, and are also more likely to undergo several different type of therapy, which has further detrimental effects on conception rates. Most treatment‐induced infertility recovers 2 years post‐treatment, but paternity can be delayed during a couple's peak reproductive years. Semen cryopreservation remains the procedure of choice in preserving fertility, but the service is underused, with only 24% of patients banking sperm. Microdissection testicular sperm extraction (microTESE) at the time of orchidectomy (onco‐microTESE) is a successful infertility treatment option for those found to be azoospermic or severely oligozoospermic at diagnosis, while microTESE may still retrieve sperm in azoospermic patients after chemotherapy.ConclusionThe underutilisation of semen analysis and sperm cryopreservation results in the failure to identify the azoospermic or severely oligozoospermic patient at diagnosis who may benefit from fertility‐preserving procedures, for example, onco‐microTESE at the time of orchidectomy. Fertility preservation and counselling needs to be broached earlier in the TC treatment pathway and made a greater priority. Given the advances in treatment, more patients with TC are surviving and looking to return to a normal life. Preserving their future fertility plays an important role in achieving this.
Penile blood pressure is useful to identify candidates for tadalafil treatment in patients with lower urinary tract symptoms
Authors: Koyama Juntaro , Kaiho Yasuhiro , Kawasaki Yoshihide , Sato Tomonori , Fukushi Taro , Kyan Atsushi , Arai Yoichi 
Published: June 2018

ObjectivesTo determine whether penile blood pressure (PBP) can be used to identify patients who can benefit from tadalafil treatment, the correlation between PBP at baseline and changes in lower urinary tract symptoms (LUTS) induced by tadalafil treatment was studied prospectively.Patients and MethodsPatients with BPH who were poor responders to α1‐blockers and took tadalafil instead of an α1‐blocker were registered between 2014 and 2016. The patients were divided into two groups (low‐ and high‐PBP groups) using the median baseline PBP of 110 mmHg as the threshold. The changes in the International Prostate Symptom Score (IPSS) between before and at 4 and 12 weeks after tadalafil treatment were compared between the low‐ and high‐PBP groups. Multivariate analysis was performed to identify parameters associated with IPSS improvement with tadalafil treatment.ResultsIn all, 51 patients were investigated. The IPSS in the low‐PBP group decreased immediately after the start of treatment, and there was significant improvement in the IPSS from baseline at 4 and 12 weeks after the start of treatment, whilst the IPSS in the high‐PBP group did not show significant changes. On multivariate analysis, PBP at baseline, anticholinergic drug use, and IPSS at baseline were significant predictors of a good IPSS response to tadalafil treatment.ConclusionsThis study demonstrated that PBP could reliably identify patients with BPH who could benefit from tadalafil treatment. Patients with low PBP could be better responders to tadalafil.
The microbiome in autoimmune diseases
Authors: De Luca F , Shoenfeld Y 
Published: June 2018

SummaryThe microbiome is represented by microorganisms which live in a symbiotic way with the mammalian. Microorganisms have the ability to influence different physiological aspects such as the immune system, metabolism and behaviour. In recent years, several studies have highlighted the role of the microbiome in the pathogenesis of autoimmune diseases. Notably, in systemic lupus erythematosus an alteration of the intestinal flora (lower Firmicutes/Bacteroidetes ratio) has been described. Conversely, changes to the gut commensal and periodontal disease have been proposed as important factors in the pathogenesis of rheumatoid arthritis. At the same time, other autoimmune diseases (i.e. systemic sclerosis, Sjögren’s syndrome and anti-phospholipid syndrome) also share modifications of the microbiome in the intestinal tract and oral flora. Herein, we describe the role of the microbiome in the maintenance homeostasis of the immune system and then the alterations of the microorganisms that occur in systemic autoimmune diseases. Finally, we will consider the use of probiotics and faecal transplantation as novel therapeutic targets.
Using natural language processing for identification of herpes zoster ophthalmicus cases to support population‐based study
Authors: Zheng Chengyi , Luo Yi , Mercado Cheryl , Sy Lina , Jacobsen Steven J , Ackerson Brad , Lewin Bruno , Tseng Hung Fu 
Published: June 2018

AbstractImportanceDiagnosis codes are inadequate for accurately identifying herpes zoster (HZ) ophthalmicus (HZO). There is significant lack of population‐based studies on HZO due to the high expense of manual review of medical records.BackgroundTo assess whether HZO can be identified from the clinical notes using natural language processing (NLP). To investigate the epidemiology of HZO among HZ population based on the developed approach.DesignA retrospective cohort analysis.ParticipantsA total of 49 914 southern California residents aged over 18 years, who had a new diagnosis of HZ.MethodsAn NLP‐based algorithm was developed and validated with the manually curated validation data set (n = 461). The algorithm was applied on over 1 million clinical notes associated with the study population. HZO versus non‐HZO cases were compared by age, sex, race and co‐morbidities.Main Outcome MeasuresWe measured the accuracy of NLP algorithm.ResultsNLP algorithm achieved 95.6% sensitivity and 99.3% specificity. Compared to the diagnosis codes, NLP identified significant more HZO cases among HZ population (13.9% vs. 1.7%). Compared to the non‐HZO group, the HZO group was older, had more males, had more Whites and had more outpatient visits.Conclusions and RelevanceWe developed and validated an automatic method to identify HZO cases with high accuracy. As one of the largest studies on HZO, our finding emphasizes the importance of preventing HZ in the elderly population. This method can be a valuable tool to support population‐based studies and clinical care of HZO in the era of big data.
The effect of single tooth implant restorations on the survival, morbidity, pulpal, and periapical health of adjacent teeth: A chart review
Authors: Duqum Ibrahim , Barker Sarah , Marshall Elizabeth , Wang Rujin , Preisser John S. , Khan Asma 
Published: June 2018

AbstractPurposeTo determine whether the placement and restoration of a single tooth posterior implant affects the survival, morbidity, pulpal, and periapical health of adjacent natural teeth.Materials and MethodsA retrospective chart review identified patients who received single posterior tooth implants between August 2004 and July 2015 at the UNC SOD and met the study inclusion criteria. Preoperative and postoperative records were reviewed; survival and changes in coronal, pulpal, and periapical status of teeth adjacent to the implant and contralateral tooth were recorded. Dichotomous survival, restoration, and retreatment outcomes were analyzed using conditional logistic regression with patient as strata and implant versus control as the predictor. Exact odds ratio estimates and the 95% confidence intervals were obtained for the relationship of implant versus control side and outcomes.ResultsFive hundred and fifty‐five sites with follow‐up time averaging 5 years ± 30.8 months were reviewed. Teeth adjacent to implants had 1.75 (95% CI: 1.17, 2.64) times the odds of restorative retreatments as compared to controls (P = .005). On the implant side, 48 adjacent teeth (4.5%) were more heavily restored at follow up, while 84 (7.9%) experienced retreatment with comparable number of surfaces restored. On the contralateral side, 54 adjacent teeth (5.0%) were more heavily restored, and 56 (5.2%) experienced comparable levels of retreatment. In addition, 17 (1.7%) implant adjacent teeth required root canal treatment, compared to 12 (1.2%) on the contralateral side; 1 implant adjacent tooth required root canal retreatment. Forty‐two teeth (3.8%) adjacent to implants were lost, compared to 35 (3.2%) adjacent to natural teeth.ConclusionsThe incidence for restorative retreatment was significantly higher on teeth adjacent to implant restorations as compared to the contralateral controls. There were no significant differences in the survival, morbidity, pulpal, or periapical health of teeth adjacent to single tooth implants compared to those adjacent to the contralateral natural tooth.
A clinical and radiological long‐term follow‐up study of narrow diameter implants in the aesthetic area
Authors: Trbakovic Amela , Bongenhielm Ulf , Thor Andreas 
Published: June 2018

AbstractPurposeTo study long‐term function of narrow diameter implants (NDI:s) and if reduced implant‐tooth distance negatively impacts adjacent teeth.Materials and MethodsA clinical and radiological follow‐up of NDI:s replacing maxillary laterals and mandibular incisors was performed. Subjects that received 3.0‐3.3 mm‐diameter single implants from 3 units in Uppsala and Västerås, Sweden, between 2002 and 2011 were offered to participate in this retrospective study.ResultsTwenty‐seven patients (30 implants) underwent clinical and CBCT examination, mean follow‐up time was 63.3 months. On average, the implant‐tooth distance was 1.6 mm at the cervical region and 17 implants were placed 1 mm or less to the adjacent root. Additionally, 2 patients (3 implants) underwent clinical examination (I). Twenty‐seven patients (36 implants) declined the examination but agreed to an interview (II). At the time of the follow‐up, all implants had good function, and implant survival of group I and II together was 97.2%. In both groups, the 2 main patient concerns were discoloration and regression of the buccal gingiva.ConclusionSurvival of implants is in accordance to standard diameter studies and although most implants were placed very close to the adjacent teeth, no pathologies could be linked to this except aesthetic concerns.
Predictors of complications and mortality following left colectomy with primary stapled anastomosis for cancer: results of a multicentric study with 1111 patients
Authors: Pellino G. , Frasson M. , García‐Granero A. , Granero‐Castro P. , Ramos Rodríguez J. L. , Flor‐Lorente B. , Bargallo Berzosa J. , Alonso Hernández N. , Labrador Vallverdú F. J. , Parra Baños P. A. , Ais Conde G. , Garcia‐Granero E. ,   The ANACO Study Group
Published: June 2018

AbstractAimReports detailing the morbidity–mortality after left colectomy are sparse and do not allow definitive conclusions to be drawn. We aimed to identify risk factors for anastomotic leakage, perioperative mortality and complications following left colectomy for colonic malignancies.MethodWe undertook aSTROBE‐compliant analysis of left colectomies included in a national prospective online database. Forty‐two variables were analysed as potential independent risk factors for anastomotic leakage, postoperative morbidity and mortality. Variables were selected using the ‘least absolute shrinkage and selection operator’ (LASSO) method.ResultsWe analysed 1111 patients. Eight per cent of patients had a leakage and in 80% of them reoperation or surgical drainage was needed. A quarter of patients (24.9%) experienced at least one minor complication. Perioperative mortality was 2%, leakage being responsible for 47.6% of deaths. Obesity (OR2.8, 95%CI1.00–7.05,P = 0.04) and total parenteral nutrition (TPN) (OR3.7, 95%CI1.58–8.51,P = 0.002) were associated with increased risk of leakage, whereas female patients had a lower risk (OR0.36, 95%CI0.18–0.67,P = 0.002). Corticosteroids (P = 0.03) and oral anticoagulants (P = 0.01) doubled the risk of complications, which was lower with hyperlipidaemia (OR0.3,P = 0.02). Patients onTPNhad more complications (OR4.02, 95%CI2.03–8.07,P = 0.04) and higher mortality (OR8.7, 95%CI1.8–40.9,P = 0.006). Liver disease and advanced age impaired survival, corticosteroids being the strongest predictor of mortality (OR21.5,P = 0.001).ConclusionRequirement forTPNwas associated with more leaks, complications and mortality. Leakage was presumably responsible for almost half of deaths. Hyperlipidaemia and female gender were associated with lower rates of complications. These findings warrant a better understanding of metabolic status on perioperative outcome after left colectomy.
Genotypes associated with tacrolimus pharmacokinetics impact clinical outcomes in lung transplant recipients
Authors: Calabrese Daniel R. , Florez Rebecca , Dewey Katherine , Hui Christine , Torgerson Dara , Chong Tiffany , Faust Hilary , Rajalingam Raja , Hays Steven R. , Golden Jeffrey A. , Kukreja Jasleen , Singer Jonathan P. , Greenland John R. 
Published: June 2018

AbstractMost lung transplantation immunosuppression regimens include tacrolimus. Single nucleotide polymorphisms (SNPs) in genes important to tacrolimus bioavailability and clearance (ABCB1, CYP3A4, and CYP3A5) are associated with differences in tacrolimus pharmacokinetics. We hypothesized that polymorphisms in these genes would impact immunosuppression‐related outcomes. We categorized ABCB1, CYP3A4, and CYP3A5 SNPs for 321 lung allograft recipients. Genotype effects on time to therapeutic tacrolimus level, interactions with antifungal medications, concentration to dose (C0/D), acute kidney injury, and rejection were assessed using linear models adjusted for subject characteristics and repeat measures. Compared with CYP3A poor metabolizers (PM), time to therapeutic tacrolimus trough was increased by 5.1 ± 1.6 days for CYP3A extensive metabolizers (EM, P < 0.001). In the post‐operative period, CYP3A intermediate metabolizers spent 1.2 ± 0.5 days less (P = 0.01) and EM spent 2.1 ± 0.5 days less (P < 0.001) in goal tacrolimus range than CYP3A PM. Azole antifungals interacted with CYP3A genotype in predicting C0/D (P < 0.001). Increased acute kidney injury rates were observed in subjects with high ABCB1 function (OR 3.0, 95% CI 1.1‐8.6, P = 0.01). Lower rates of acute cellular rejection were observed in subjects with low ABCB1 function (OR 0.36, 95% CI 0.07‐0.94, P = 0.02). Recipient genotyping may help inform tacrolimus dosing decisions and risk of adverse clinical outcomes.
Genital basal cell carcinoma, a different pathogenesis from sun‐exposed basal cell carcinoma? A case‐control study of 30 cases
Authors: Wang Yen‐Jen , Tang Tzu‐Yin , Wang Jen‐Yu , Huang Yen‐Kai , Wu Yu‐Hung 
Published: June 2018

BackgroundGenital basal cell carcinoma (BCC) accounts for <1% of all BCCs. We aimed to elucidate the pathogenesis of genital BCC.MethodsWe retrospectively evaluated cases of pathologically diagnosed genital BCC between 1990 and 2016 in an Asian tertiary referral center. The control group was composed of consecutive cases, from 2016, of BCCs occurring in sun‐exposed areas. Presence of human papillomavirus (HPV) was evaluated by polymerase chain reaction (PCR). Immunohistochemical p16 and p53 staining was performed and analyzed.ResultsWe found 33 genital BCCs (33/1837, 1.8%) over 26 years. The mean follow‐up duration was 30.0 ± 33.2 months. Genital BCCs had a larger size (14.05 vs 8.92 mm, P = 0.014), more common presence of ulcers (61.3% vs 32.0%, P = 0.035), shorter epidermal p53 clone (0.33 vs 1.20 mm, P = 0.007), and high p53 expression levels. Most cases (29/30, 96.7%) showed negative or faint spotty p16 staining. Patient age, tumor depth, presence of pigment, or histology subtype did not differ significantly. Thirty genital BCCs were negative for HPV.ConclusionsHPV infection is mostly likely not involved in genital BCC pathogenesis. A greater level of p53 expression in genital BCCs implicates pathways other than ultraviolet (UV)‐specific p53 mutations in their pathogenesis.
Mouthguard sheet temperature after heating
Authors: Mizuhashi Fumi , Koide Kaoru 
Published: June 2018

AbstractBackground/AimMouthguard sheet materials such as ethylene vinyl acetate and polyolefin have been used commonly. However, the change of the sheet temperature during heating of the polyolefin has not been determined. The aim of this study was to examine the change of the sheet temperature during heating and to examine the vacuum‐formed mouthguard characteristics for the sheet materials.Materials and methodsThe mouthguard materials used were 4.0‐mm sheets of ethylene vinyl acetate and polyolefin. The sheet temperature of the two materials was measured when the center of the sheet was displaced by 10, 15, and 20 mm from the baseline after heating. Sheet temperature differences by sheet materials were analyzed by two‐way analysis of variance. The sheets were vacuum‐formed when the heating temperatures reached 100°C using ethylene vinyl acetate sheet and polyolefin sheet. Mouthguard thickness and fit was measured at the central incisor and the first molar. Differences in the thickness and fit between the sheet materials were analyzed by two‐way analysis of variance.ResultsThe sheet temperature of ethylene vinyl acetate sheets became higher as the hanging distance became larger (P < 0.05), but that of polyolefin sheets was not different. The thicknesses of the vacuum‐formed mouthguard at the central incisor and the first molar were greater in the mouthguards formed by ethylene vinyl acetate sheets than that with polyolefin sheets (P < 0.01 or P < 0.05). The fit of the mouthguard was not different between mouthguards formed by ethylene vinyl acetate sheets and that formed by polyolefin sheets.ConclusionsThe change of mouthguard sheet temperature during heating was different between ethylene vinyl acetate and polyolefin sheets. The ethylene vinyl acetate sheets maintained the vacuum‐formed mouthguard thickness in comparison with the polyolefin sheets with a better fit.