bluuebunny/crossref_metadata_2025_split huggingface dataset:
World Workshop of Oral Medicine VII: A systematic review of immunobiologic therapy for oral manifestations of pemphigoid and pemphigus
Authors: Mays Jacqueline W. , Carey Barbara P. , Posey Rachael , Gueiros Luiz Alcino , France Katherine , Setterfield Jane , Woo Sook Bin , Sollecito Thomas P. , Culton Donna , Payne Aimee S. , Greenberg Martin S. , De Rossi Scott 
Published: May 2019

AbstractObjectiveTo assess the evidence for treatment of oral involvement of pemphigus and pemphigoid with biologics.Study DesignThis systematic review used a comprehensive search strategy to identify literature describing oral involvement of pemphigus or pemphigoid treated with a biologic agent. The primary outcome measures were efficacy and safety of biologic therapy.ResultsInclusion criteria were met by 154 studies including over 1200 patients. Treatment of pemphigus with a total of 11 unique biologic agents and 3 unique combinations of agents is reported. Five randomized controlled trials (RCT) were included in the final analysis that investigated infliximab, IVIg, rituximab, and autologous platelet‐rich plasma therapy for pemphigus vulgaris. Three non‐RCT studies reported on successful rituximab or IVIg therapy for mucous membrane pemphigoid. Studies demonstrated considerable heterogeneity in agent, methods, and quality.ConclusionsEvidence clearly describing oral tissue response to biologic therapy is sparse. Two RCTs support use of rituximab, one supports use of IVIg, and one pilot study suggests intralesional injection of autologous platelet‐rich plasma aids healing of oral PV lesions. As oral lesions of pemphigus and pemphigoid can be refractory to systemic therapy, drug trials including biologic therapies should document details regarding response of the oral lesions to therapy.
Comparison between epidural and opioid analgesia for infants undergoing major abdominal surgery
Authors: Martin Lizabeth D. , Adams Trevor L. , Duling Laura C. , Grigg Eliot B. , Bosenberg Adrian , Onchiri Frankline , Jimenez Nathalia 
Published: May 2019

AbstractBackgroundEpidural analgesia is considered optimal for postoperative pain management after major abdominal surgery. The potential to decrease anesthetic and opioid exposure is particularly desirable for infants, given their vulnerability to respiratory depression and concern for anesthetic neurotoxicity. We reviewed our experience with infants undergoing major abdominal surgery to determine if epidural catheter use decreased anesthetic and opioid exposure and improved postoperative analgesia.MethodsThis retrospective cohort study included infants (<12 months) who underwent exploratory laparotomy, ureteral reimplantation, or bladder exstrophy repair between November 2011 and November 2014. Primary outcomes of anesthetic exposure (mean endtidal sevoflurane) and intraoperative opioid administration were compared between infants who received epidural catheters and those who did not. Secondary outcomes included postoperative pain and sedation scores and morphine equivalents administered 0‐24 and 24‐48 hours after surgery.ResultsOf 158 eligible infants, 82 were included and 47 received epidurals. Patients with epidurals underwent bladder exstrophy repair (N = 9), ureteral reimplantation (N = 8), and exploratory laparotomy (N = 30). Infants with epidurals received less intraoperative fentanyl (2.6 mcg/kg (0,4.5) vs 3.3 mcg/kg (2.4,5.8), P = 0.019) and morphine (6% (3/47) vs 26% (9/35), P = 0.014) in univariate analysis. After controlling for age and emergency surgery, differences in long‐acting opioid administration persisted, with significantly less morphine given in the epidural group (OR 0.181; 95% CI 0.035‐0.925; P = 0.040). Mean endtidal sevoflurane concentrations were similar between groups. There was no significant difference in postoperative median morphine equivalents.ConclusionPlacement of epidural catheters in infants undergoing major abdominal surgery is associated with decreased long‐acting opioid requirements intraoperatively. Epidural placement does not preclude opioid exposure however, as opioids may be administered for indications other than nociceptive pain in the difficult‐to‐assess postoperative infant. Further prospective studies are warranted to better quantify the effect of epidural analgesia on intraoperative anesthetic exposure in infants.
NGS‐based targeted resequencing identified rare subtypes of albinism: Providing accurate molecular diagnosis for Japanese patients with albinism
Authors: Okamura Ken , Hayashi Masahiro , Abe Yuko , Kono Michihiro , Nakajima Kimiko , Aoyama Yumi , Nishigori Chikako , Ishimoto Hiroshi , Ishimatsu Yuji , Nakajima Mika , Hozumi Yutaka , Suzuki Tamio 
Published: May 2019

AbstractAlbinism, which is commonly inherited as an autosomal recessive trait, is characterized by a reduction or absence of melanin in the eyes, skin, and hair. To date, more than 20 causal genes for albinism have been identified; thus, the accurate diagnosis of albinism requires next‐generation sequencing (NGS). In this study, we analyzed 46 patients who tested negative for oculocutaneous albinism (OCA)1–4 and Hermansky‐Pudlak syndrome (HPS)1 based on conventional analysis, in addition to 28 new Japanese patients, using NGS‐based targeted resequencing. We identified a genetic background for albinism in 18 of the 46 patients (39%), who were previously tested negative according to the conventional analysis. In addition, we unveiled a genetic predisposition toward albinism in 23 of the 28 new patients (82%). We identified six patients with rare subtypes of albinism, including HPS3, HPS4, and HPS6, and found 12 novel pathological mutations in albinism‐related genes. Furthermore, most patients who were not diagnosed with albinism by the NGS analysis showed mild manifestations of albinism without apparent eye symptoms and harbored only one heterozygous mutation, occasionally in combination with skin‐color associated gene variants.
Affirmative Action: Well‐Being, Justice, and Qualifications
Authors: Segev Re’em 
Published: May 2019

AbstractA common concern regarding affirmative action is that it sanctions the selection of candidates whose qualifications are not the best overall and that this is inefficient or unjust or both. I argue that this concern is misguided, since there is no independent concern regarding qualifications with respect to the moral status of affirmative action. The only sense in which qualifications are not morally arbitrary—and the only sense in which there is a reason to select the most qualified candidate—is purely instrumental to the promotion of moral values whose fundamental concern is not qualifications.
An international survey of maximum surgical blood ordering schedule creation and compliance
Authors: Yazer Mark H. , Kutner Jose , McCabe Julie , O'Donghaile Diarmaid , Pendergrast Jacob , Treml Angela , Wendel Silvano , Yan Matthew , Ye Zhan , Yokoyama Ana Paula , Cohn Claudia S. ,   the Biomedical Excellence for Safer Transfusion (BEST) collaborative
Published: May 2019

Background and ObjectivesMaximal surgical blood order schedules (MSBOS) are prepared to assist surgeons and anaesthesiologists with pretransfusion test orders. The literature on the prevalence and usefulness of MSBOS in international settings is lacking. We developed a survey to understand the prevalence of MSBOS in hospitals and to analyse compliance with MSBOS recommendations.Method and MaterialsA survey tool was developed by the Biomedical Excellence for Safer Transfusions (BEST) collaborative. The survey link was distributed to BEST members who were encouraged to forward the link to colleagues. Survey respondents were asked to contribute data regarding their hospital's MSBOS and MSBOS compliance.ResultsThere were 174 completed surveys. Greater than half of respondents did not have an MSBOS. The total number of beds was significantly different (P = 0·04) in hospitals with (N = 81) or without (N = 93) an MSBOS. Less than a quarter of respondents felt that their MSBOS was being followed despite widespread access to the MSBOS. Over 60% of type and screen orders were MSBOS compliant; however, just 42% of cross‐match orders were compliant. There was a significant difference between the number of red‐blood‐cell units returned to the blood bank when comparing MSBOS compliant and MSBOS non‐compliant cross‐match orders (227 versus 788 units, respectively, P = 0·0026).ConclusionsAn MSBOS could be a useful tool to help with pretransfusion test orders; however, the majority of respondents lacked a MSBOS. In hospitals with a MSBOS, it was reported to be under‐utilized, which might contribute to the low compliance rates seen for cross‐match orders.
Suppressed baroreflex peripheral arc overwhelms augmented neural arc and incapacitates baroreflex function in rats with pulmonary arterial hypertension
Authors: Shinoda Masako , Saku Keita , Oga Yasuhiro , Tohyama Takeshi , Nishikawa Takuya , Abe Kohtaro , Yoshida Keimei , Kuwabara Yukimitsu , Fujii Kana , Ishikawa Tomohito , Kishi Takuya , Sunagawa Kenji , Tsutsui Hiroyuki 
Published: May 2019

New Findings
What is the central question of this study?
The impact of pulmonary arterial hypertension on open‐loop baroreflex function, which determines how powerfully and rapidly the baroreflex operates to regulate arterial pressure, remains poorly understood.

What is the main finding and its importance?
The gain of the baroreflex total arc, indicating the baroreflex pressure‐stabilizing function, is markedly attenuated in rats with monocrotaline‐induced pulmonary arterial hypertension. This is caused by a rightward shift of the baroreflex neural arc and a downward shift of the peripheral arc. These findings contribute greatly to our understanding of arterial pressure regulation by the sympathetic nervous system in pulmonary arterial hypertension.

AbstractSympathoexcitation has been documented in patients with established pulmonary arterial hypertension (PAH). Although the arterial baroreflex is the main negative feedback regulator of sympathetic nerve activity (SNA), the way in which PAH impacts baroreflex function remains poorly understood. In this study, we conducted baroreflex open‐loop analysis in a rat model of PAH. Sprague–Dawley rats were injected with monocrotaline (MCT) s.c. to induce PAH (60 mg kg−1; n = 11) or saline as a control group (CTL; n = 8). At 3.5 weeks after MCT injection, bilateral carotid sinuses were isolated, and intrasinus pressure (CSP) was controlled while SNA at the coeliac ganglia and arterial pressure (AP) were recorded. To examine the static baroreflex function, CSP was increased stepwise while steady‐state AP (total arc) and SNA (neural arc) responses to CSP and the AP response to SNA (peripheral arc) were measured. Monocrotaline significantly decreased the static gain of the baroreflex total arc at the operating AP compared with CTL (−0.80 ± 0.31 versus −0.22 ± 0.22, P < 0.05). Given that MCT markedly increased plasma noradrenaline, an index of SNA, by approximately 3.6‐fold compared with CTL, calibrating SNA by plasma noradrenaline revealed that MCT shifted the neural arc to a higher SNA level and shifted the peripheral arc downwards. Monocrotaline also decreased the dynamic gain of the baroreflex total arc (−0.79 ± 0.16 versus −0.35 ± 0.17, P < 0.05), while the corner frequencies that reflect the speed of the baroreflex remained unchanged (0.06 ± 0.02 versus 0.08 ± 0.02 Hz, n.s.). In rats with MCT‐induced PAH, the suppressed baroreflex peripheral arc overwhelms the augmented neural arc and, in turn, attenuates the gain of the total arc, which determines the pressure‐stabilizing capacity of the baroreflex.
If You Make it Free, Will They Come? Using a Physical Activity Accessibility Model to Understand the Use of a Free Children’s Recreation Pass
Authors: Clark Andrew F. , Campbell Joannah , Tucker Patricia , Wilk Piotr , Gilliland Jason A. 
Published: May 2019

Background: Children’s sedentary lifestyles and low physical activity levels may be countered using population-level interventions. This study examines factors influencing the use of a free community-wide physical activity access pass for grade 5 students (G5AP). Methods: A natural experiment with longitudinal data collection. A sample of 881 children completed the 9-month follow-up survey self-reporting where they used the G5AP. Two analyses were conducted: Getis-Ord GI* geographic cluster analysis of the spatial distribution of users, and logistic regression examining the relationship between use and accessibility (informational, economic, and geographic) and mobility options, while accounting for intrapersonal and interpersonal factors. Results: Overall, 44.9% of children used the G5AP with clusters of high use in urban areas and low use in the suburbs. Other factors significantly related to G5AP included gender (girls), informational accessibility (active recruitment), economic accessibility (median household income), geographic accessibility (facilities within 1.6 km of home), and mobility options (access to Boys & Girls Club bus). Conclusions: This study found that a diverse population of children used the G5AP. To continue being successful, community-based physical activity interventions need to ensure that the intervention increases geographic, economic, and informational accessibility and provides mobility options that are available to the target population.
Common cold in Team Finland during 2018 Winter Olympic Games (PyeongChang): epidemiology, diagnosis including molecular point-of-care testing (POCT) and treatment
Authors: Valtonen Maarit , Waris Matti , Vuorinen Tytti , Eerola Erkki , Hakanen Antti J , Mjosund Katja , Grönroos Wilma , Heinonen Olli J , Ruuskanen Olli 
Published: May 2019

ObjectivesThe common cold is the main cause of medical time loss in elite sport. Rapid diagnosis has been a challenge that may be amenable to molecular point-of-care testing (POCT).MethodsWe performed a prospective observational study of the common cold in Team Finland during the 2018 Winter Olympic Games. There were 44 elite athletes and 68 staff members. The chief physician recorded the symptoms of the common cold daily on a standardised form. Two nasal swabs were taken at the onset of symptoms. One swab was analysed within 45 min using a molecular POCT for respiratory syncytial virus and influenza A and B viruses. After the Games, the other swab was tested for 16 possible causative respiratory viruses using PCR in laboratory-based testing.Results20 out of 44 (45%) athletes and 22 out of 68 (32%) staff members experienced symptoms of the common cold during a median stay of 21 days. Eleven (26%) samples tested virus-positive using POCT. All subjects with influenza (n=6) and 32 close contacts were treated with oseltamivir. The aetiology of the common cold was finally detected in 75% of the athletes and 68 % of the staff members. Seven virus clusters were identified. They were caused by coronaviruses 229E, NL63 and OC43, influenza B virus, respiratory syncytial virus A, rhinovirus and human metapneumovirus. The virus infections spread readily within the team, most commonly within the same sport discipline.ConclusionsThe cold was indeed a common illness in Team Finland during the Winter Olympic Games. POCT proved to be clinically valuable, especially for influenza. The aetiology of the common cold was identified in most cases.
MethylatedSEPTIN9plasma test for colorectal cancer detection may be applicable to Lynch syndrome
Authors: Hitchins Megan P , Vogelaar Ingrid P , Brennan Kevin , Haraldsdottir Sigurdis , Zhou Nianmin , Martin Brock , Alvarez Rocio , Yuan Xiaopu , Kim Sungjin , Guindi Maha , Hendifar Andrew E , Kalady Matthew F , DeVecchio Jennifer , Church James M , de la Chapelle Albert , Hampel Heather , Pearlman Rachel , Christensen Maria , Snyder Carrie , Lanspa Stephen J , Haile Robert W , Lynch Henry T 
Published: May 2019

ObjectiveThe plasma-based methylatedSEPTIN9(mSEPT9) is a colorectal cancer (CRC) screening test for adults aged 50–75 years who are at average risk for CRC and have refused colonoscopy or faecal-based screening tests. The applicability of mSEPT9 for high-risk persons with Lynch syndrome (LS), the most common hereditary CRC condition, has not been assessed. This study sought preliminary evidence for the utility of mSEPT9 for CRC detection in LS.DesignFirstly, SEPT9 methylation was measured in LS-associated CRC, advanced adenoma, and subject-matched normal colorectal mucosa tissues by pyrosequencing. Secondly, to detect mSEPT9 as circulating tumor DNA, the plasma-based mSEPT9 test was retrospectively evaluated in LS subjects using the Epi proColon 2.0 CE assay adapted for 1mL plasma using the “1/1 algorithm”. LS case groups included 20 peri-surgical cases with acolonoscopy-based diagnosis of CRC (stages I-IV), 13 post-surgical metastatic CRC, and 17 pre-diagnosis cases. The control group comprised 31 cancer-free LS subjects.ResultsDifferential hypermethylation was found in 97.3% (36/37) of primary CRC and 90.0% (18/20) of advanced adenomas, showing LS-associated neoplasia frequently produce the mSEPT9 biomarker. Sensitivity of plasma mSEPT9 to detect CRC was 70.0% (95% CI, 48%-88%)in cases with a colonoscopy-based CRC diagnosis and 92.3% (95% CI, 64%-100%) inpost-surgical metastatic cases. In pre-diagnosis cases, plasma mSEPT9 was detected within two months prior to colonoscopy-based CRC diagnosis in 3/5 cases. Specificity in controls was 100% (95% CI 89%-100%).ConclusionThese preliminary findings suggest mSEPT9 may demonstrate similar diagnostic performance characteristics in LS as in the average-risk population, warranting a well-powered prospective case–control study.
“He is suitable for her, of course he is our relative”: a qualitative exploration of the drivers and implications of child marriage in Gezira State, Sudan
Authors: Dean Laura , Obasi Angela , El Sony Asma , Fadul Selma , El Hassan Hanaa , Thomson Rachael , Tolhurst Rachel 
Published: May 2019

IntroductionChild marriage is a fundamental development challenge for women and girls, with significant negative health and social outcomes. Sudan has a high rate of child marriage, with 34% of women aged 20–24 married before their 18th birthday. Since limited preventive interventions exist, we aimed to inform the evidence base to strengthen strategic action, using mixed qualitative methods to enhance study credibility. This study is the first to conduct a rigorous qualitative examination of the drivers of child marriage from the perspective of key stakeholders involved in marriage decision making within Sudan, and makes a significant contribution towards global knowledge by developing an evidence-based conceptual framework.MethodsInitially, we completed 14 focus group discussions separated by gender with mothers, fathers, and girls married as adolescents, and 23 key informant interviews. We then used a critical incident case study approach to explore 11 ‘cases’ of child marriage (46 interviews).ResultsFindings indicate that gendered social norms and values, underpinned by religious beliefs and educational accessibility, interconnect to shape marriage decisions. In thiscontext, many child marriages aretriggeredby an intrakinship proposal and further enabled by the relative lack of autonomy and influence of girls and women in marriage decision-makingprocesses.DiscussionInterconnected drivers demand context-specific holistic and multisectoral approaches, which should include simultaneous strategies to expand access to education, health services and livelihood opportunities, and evoke legal change, and participatory social and attitudinal processes that include the engagement of religious leaders and men.
Intraoperative physiological ranges associated with improved outcomes after major spine surgery: an observational study
Authors: Li Gang , Lin Liang , Xiao Jifang , Rosenbaum Stanley , Bickler Philip , Meng Lingzhong 
Published: May 2019

ObjectiveThere is inadequate information about the values of many intraoperative physiological measurements that are associated with improved outcomes after surgery. The purpose of this observational study is to investigate the optimal physiological ranges during major spine surgery.SettingA teaching hospital in the USA.ParticipantsA convenience sample of 102 patients receiving major posterior spine surgery with multilevel spinal fusion in a prone position.MethodsPhysiological variables, including but not limited to mean arterial pressure (MAP) and cerebral and somatic tissue oxygen saturation (SctO2/SstO2), were recorded. The results of these measurements were associated with length of hospital stay and composite complication data and were analysed based on thresholds (ie, a cut-off value for optimal and suboptimal physiology) and the area under the curve (AUC) values. The AUC values were measured as the area enclosed by the actual tracing and the threshold. The outcomes were dichotomised into above-average and below-average (ie, improved) categories.ResultsAnalyses based on thresholds identified the following variables associated with above-average outcomes: MAP <60 mm Hg, temperature <35°C, heart rate >90 beats per minute (bpm), SctO2<60% and SstO2>80%. Analyses based on AUC values identified the following as associated with above-average outcomes: MAP <70 and >100 mm Hg, temperature <36°C, heart rate >90 bpm, tidal volume (based on ideal body weight)<6 mL/kg, tidal volume (based on actual body weight) >10 mL/kg and peak airway pressure <15 cmH2O.ConclusionThe following physiological ranges are associated with improved outcomes (ie, shorter hospitalisation and fewer complications) during major spine surgery: MAP of 70–100 mm Hg, temperature ≥36°C, heart rate <90 bpm, tidal volume based on ideal body weight >6 mL/kg, SctO2>60% and SstO2<80%.
Indications and outcomes of vitrectomy surgery in a series of 1000 black African eyes
Authors: Okonkwo Ogugua Ndubuisi , Lewis Karinya , Hassan Adekunle Olubola , Gyasi Micheal Ekuoba , Oluyadi Banji , Ogunro Adunola , Oderinlo Olufemi , Ulaikere Mildred 
Published: May 2019

ObjectiveTo determine the common indications for, and outcomes of pars plana vitrectomy surgery among black Africans in a low-resource setting.Methods and AnalysisA retrospective, non-comparative case review was undertaken. Data from 1000 consecutive eyes of 1000 patients in a single centre who underwent pars plana vitrectomy surgery between May 2005 and July 2013 were used for the study. Demographic data, primary indication for surgery, ocular status and outcomes were assessed.ResultsRhegmatogenous retinal detachment was the most common primary indication occurring in 61.8% of eyes. Diabetic vitrectomy, trauma and proliferative sickle cell retinopathy were also common indications occurring in 10.1%, 6.1% and 4.5% of eyes, respectively. At presentation, 33% of patients with retinal detachment had some form of proliferative vitreoretinopathy, and half of those had the more advanced grades C and D. Patients presented on an average of 13.5 months after onset of symptoms. As a result, visual outcomes were less than other reported studies.ConclusionRetinal detachment was the most common indication for vitrectomy, but even these cases presented late with an advanced presentation. This study highlights the need for affordable and accessible vitreoretinal services in Sub-Saharan Africa and increased awareness of general eye health, along with strategies to reduce trauma and identify early those at risk of chronic eye diseases, such as diabetic retinopathy and sickle cell retinopathy.