bluuebunny/crossref_metadata_2025_split huggingface dataset:
Potential distribution of riffle beetles (Coleoptera: Elmidae) in southern Brazil
Authors: Braun Bruna Marmitt , Gonçalves Alberto Senra , Pires Mateus Marques , Kotzian Carla Bender 
Published: December 2018

AbstractThe diversity and distribution of freshwater insects in South America is poorly known. Riffle beetles (Elmidae) are aquatic Coleoptera that are considered important indicators of environmental integrity. In Brazil, the country with the largest area and highest richness of Elmidae in the Neotropics, the diversity of the family remains incipient. The southern region of Brazil (state of Rio Grande do Sul) reportedly has a higher richness of stream insects than other regions. In this study, we used species distribution models (SDMs) to estimate the potential distribution of riffle beetle taxa in southern Brazil to identify areas with elevated diversity and suggest priority areas for further investigation towards conservation of Elmidae. As most records of Elmidae were represented by larvae, we predicted the potential distribution firstly of genera and secondly of species within the genus Macrelmis because they were available as adults and allowed identification to species level. These were modelled in relation to environmental factors such as climate, topography, hydrography and land cover. Our results suggested that montane regions and basins located within well‐preserved forested regions indicated the highest potential richness of Elmidae. In addition, the areas with higher predicted suitability for the occurrence of genera overlapped with the suitable areas for species of Macrelmis. This result suggests the existence of an elevated ecological similarity among most of the modelled taxa, and that projections for certain Elmidae genera can be useful proxies for estimations of the potential distribution of species in the region. The most important environmental factors related to the predicted distribution of Elmidae taxa were associated with climate (precipitation), landscape (forest cover) and topography. Unsurprisingly, freshwater ecoregions were also suggested as important drivers of Elmidae distribution. Our results indicate that conservation efforts for aquatic insects such as riffle beetles in Brazil should focus on watersheds located in montane and forested regions.
Methods of surgery for pelvic organ prolapse in a nationwide cohort (FINPOP 2015)
Authors: Mattsson Nina K. , Karjalainen Päivi , Tolppanen Anna‐Maija , Heikkinen Anna‐Mari , Jalkanen Jyrki , Härkki Päivi , Nieminen Kari 
Published: December 2018

AbstractIntroductionThe management of pelvic organ prolapse (POP) varies significantly between countries. The objective of this study was to describe the methods used for POP surgery in Finland and to identify the factors that affect clinicians’ choice to use either a native tissue repair (NTR) or a mesh repair method.Material and MethodsThis prospective cohort study included 3535 surgeries covering 83% of all POP operations performed in Finland in 2015. The operative details and patient characteristics, including the Pelvic Floor Distress Inventory (PFDI‐20), were compared between three selected surgical methods: NTR, transvaginal mesh (TVM) and abdominal mesh (AM). The predictive factors for the use of mesh augmentation were also studied with logistic regression analysis.ResultsThe most common method was NTR (n = 2855, 81%), followed by TVM (n = 429, 12%) and AM (n = 251, 7%). Approximately 92% of the patients who underwent primary prolapse surgery underwent NTR, and mesh surgery was used mainly for recurrent prolapse. The strongest predictor of mesh surgery was previous POP surgery for the same vaginal compartment (adjusted odds ratio [OR] = 56, 95% confidence interval [CI] = 38‐84 for TVM; adjusted OR = 22, 95% CI = 14‐34 for AM). Other predictive factors for mesh surgery were previous hysterectomy, healthcare district, severe bulge symptoms and advanced prolapse. TVM was associated with advanced anterior prolapse and older age. AM surgery was associated with advanced apical and/or posterior compartment prolapse. PFDI‐20 scores were the highest in the AM group (108 vs 103 in the TVM group and 98 in the NTR group, P = 0.012), which indicates more bothersome symptoms than in the other groups.ConclusionsThe Finnish practices follow international guidelines that advocate NTR as the principal surgical method for POP. Synthetic mesh augmentation was mainly used in patients with recurrent and advanced prolapse with severe symptoms. The variation in the rates of mesh augmentation for POP surgery in different hospitals implies a lack of sufficient evidence of the most suitable treatment method and indicates a need for national guidelines.
The effect of screening‐to‐labor interval on the sensitivity of late‐pregnancy culture in the prediction of group B streptococcus colonization at labor: A prospective multicenter cohort study
Authors: Virranniemi Minna , Raudaskoski Tytti , Haapsamo Mervi , Kauppila Jaana , Renko Marjo , Peltola Joanna , Risteli Leila , Laatio Liisa 
Published: December 2018

AbstractIntroductionThe aim of this study was to evaluate the effect of increasing screening‐to‐labor interval on the performance of group B streptococcus (GBS) screening by late‐pregnancy enriched culture compared with intrapartum real‐time polymerase chain reaction (RT‐PCR).Material and methodsGroup B streptococcus colonization was determined in 2624 women with singleton pregnancies by culture at 35‐37 weeks of gestation and at the beginning of labor by culture and RT‐PCR from recto‐vaginal swab samples.ResultsGroup B streptococcus colonization rates were 29.0% in late‐pregnancy culture, 29.7% in intrapartum culture and 28.2% in intrapartum PCR. Intrapartum culture was used as a reference, the late‐pregnancy culture had an overall sensitivity of 89.2% (95% CI 88.0%‐90.4%) and specificity of 96.5% (95% CI 95.8%‐97.2%), and intrapartum PCR had sensitivity of 91.5% (95% CI 90.4%‐92.6%) and specificity of 98.5% (95% CI 98.0%‐99.0%). However, up to 4 weeks after screening, the sensitivity of late‐pregnancy culture was equivalent to or higher than that of RT‐PCR. The RT‐PCR was invalid in 0.9% of the women. Between late‐pregnancy screening and labor, GBS colonization changed from negative to positive in 3.2% and from positive to negative in 2.5% of the women.ConclusionsThe late‐pregnancy enriched culture and intrapartum RT‐PCR have comparable sensitivities in the detection of GBS when culture screening is conducted no more than 4 weeks before labor. Late‐pregnancy culture sampling should be postponed to at least 37 weeks of gestation.
Safety and effectiveness of zero antimicrobial prophylaxis protocol for outpatient cystourethroscopy
Authors: Clennon Emily K. , Martinez Acevedo Ann , Sajadi Kamran P. 
Published: December 2018

ObjectivesTo examine compliance and clinical outcomes after implementation of a zero antimicrobial prophylaxis protocol for outpatient cystoscopy in an academic centre.Patients and MethodsMedical records of all patients who underwent diagnostic cystoscopy in the year preceding and year following protocol implementation were evaluated for urinary tract infection (UTI) diagnosis within 30 days of cystoscopy. Variables compared between groups included age, sex, smoking history, benign prostatic hyperplasia (BPH) diagnosis, diabetes mellitus, immunosuppression, catheter use (indwelling, suprapubic, or intermittent), and previous lower urinary tract reconstruction (augmentation cystoplasty or neobladder). UTI was defined using the National Surgical Quality Improvement Program definition. Rates were compared between groups, and statistical analyses were performed using chi‐squared and Fisher's exact tests and multivariable logistic regression, with significance defined as α < 0.05.ResultsIn total, 941 patients were included in the analysis (72% men), 513 before protocol initiation, and 427 after. Groups were similar with regard to demographic variables and potential risk factors for infection. After protocol implementation, there was a significant reduction in patients receiving procedural antimicrobial prophylaxis (30% vs 15%; P < 0.001). The incidence of UTI after cystoscopy was slightly higher in the post‐protocol group (2.9–3.7%), but the difference was not statistically significant (chi‐squared = 0.56, P = 0.45). The incidence of UTI did not significantly differ with procedural antibiotic prophylaxis or with other antibiotic use at time of cystoscopy. Five out of a total of 31 UTIs (16%) over the study period resulted in fever, and four (13%) resulted in urosepsis. The probability of neither complication differed significantly between pre‐ and post‐protocol groups. The only significant patient‐level predictor of post‐cystoscopy UTI was catheter use (odds ratio 1.48, 95% confidence interval 1.06–2.06).ConclusionProtocol implementation led to a significant decrease in procedural antimicrobial prophylaxis, indicating protocols may be effective tools in promoting antibiotic stewardship. UTI incidence did not change significantly under the protocol, and antibiotic prophylaxis did not decrease infection rate. Our results support catheter use as a risk factor for post‐cystoscopy infection, but other patient variables, including those present in the American Urological Association Best Practice statement, were not predictive. In total, this analysis suggests that decreasing antibiotic prophylaxis for cystourethroscopy is safe and can be effective in the outpatient setting.
Multicolour imaging for the detection of polypoidal choroidal vasculopathy and age‐related macular degeneration
Authors: Tan Colin S. , Ting Dominic S. , Lim Louis W. 
Published: December 2018

AbstractImportanceMulticolour is a new imaging technology and its sensitivity for detecting polypoidal choroidal vasculopathy (PCV) and age‐related macular degeneration (AMD) has not been well described.BackgroundTo evaluate the accuracy of multicolour imaging compared to colour fundus photography (CFP) in differentiating AMD and PCV from normal eyes, and in detecting PCV.DesignProspective cohort study at a tertiary referral centre.ParticipantsFifty consecutive patients with PCV or AMD.MethodsStandardized multimodal imaging, including CFP, multicolour imaging, and fluorescein and indocyanine green angiography, were graded by a Central Reading Center using standardized grading protocols.Main Outcomes and MeasuresSensitivity, specificity, positive and negative predictive values (PPV and NPV).ResultsOf 100 eyes, 44 had PCV, 33 had AMD, and 23 were normal. Multicolour imaging had higher specificity (73.9% vs 52.2%) and NPV (94% vs 85.7%) compared to CFP for detecting all types of AMD. For the detection of PCV, multicolour had higher sensitivity (86.4% vs 59.1%) and NPV (89.3% vs 74.3%). Polypoidal lesions were detected in 39 of 44 eyes (88.6%) using multicolour imaging, while the branching vascular network (BVN) was detected in 16 of 44 eyes (36.4%). Using BVN as a parameter, infrared imaging specificity and PPV for detecting PCV were 96.6% and 88.9%, respectively.Conclusions and RelevanceMulticolour imaging is superior to standard CFP in differentiating AMD and PCV from normal eyes, and in detecting features of PCV. Specific features seen on multicolour imaging can alert ophthalmologists to the likely presence of these diseases so that additional definitive investigations can be performed.
Four‐year results of a minimally invasive transscleral glaucoma gel stent implantation in a prospective multi‐centre study
Authors: Lenzhofer Markus , Kersten‐Gomez Inga , Sheybani Arsham , Gulamhusein Husayn , Strohmaier Clemens , Hohensinn Melchior , Burkhard Dick H , Hitzl Wolfgang , Eisenkopf Lisa , Sedarous Fady , Ahmed Iqbal I. , Reitsamer Herbert A. 
Published: December 2018

AbstractImportanceThe transscleral XEN Glaucoma Gel Microstent (XEN‐GGM, Allergan Plc., Parsippany, New Jersey) is implanted by a minimally invasive ab interno technique.BackgroundThe present study aims to assess the long‐term clinical outcomes in patients after XEN‐GGM implantation.DesignThis prospective, non‐randomized, multi‐centred study was conducted in three countries (Austria, Canada and Germany).ParticipantsSixty‐four consecutive eyes of 64 patients with open angle glaucoma received the XEN‐GGM (63 μm) without Mitomycin C. Thirty‐five (55%) were solo procedures, and 29 (45%) were combined with cataract surgery.MethodsVisits were planned at baseline, 6 months, 1, 2, 3 and 4 years postoperatively.Main Outcome MeasuresThe main outcome measures were mean intraocular pressure (IOP), mean number of IOP lowering medication. Secondary outcome parameters were: visual acuity, visual fields and complete surgical failure (defined as presence of a secondary IOP lowering procedure or loss of light perception) at 4 years, postoperatively.ResultsMean best‐medicated baseline IOP was 22.5 ± 4.2 mmHg and decreased significantly to 13.4 ± 3.1 mmHg 4 years postoperatively (−40%, n = 34, P < 0.001). Mean number of IOP lowering medication decreased significantly from 2.4 ± 1.3 preoperatively to 1.2 ± 1.3 (−50%, n = 34, P < 0.001) postoperatively. Visual field mean deviation showed no significant change between preoperative and postoperative examinations. Complete surgical failure rate per year was 10%.Conclusions and RelevanceThe XEN‐GGM resulted in lower IOP and a reduction in medications from baseline over 4 years of follow‐up. There was no detectable decrease in visual fields over the study. The surgical failure rate is comparable to other filtration surgeries.
A randomized controlled trial on the efficiency of free‐handed, pilot‐drill guided and fully guided implant surgery in partially edentulous patients
Authors: Younes Faris , Eghbali Aryan , De Bruyckere Thomas , Cleymaet Roberto , Cosyn Jan 
Published: December 2018

AbstractObjectivesTo compare the effectiveness of free‐handed (FH), pilot‐drill guided (PG) and fully guided (FG) implant surgery by means of the apical global deviation (AGD) in relation to the additional financial cost and time spent.Materials and methodsThirty‐three partially edentulous patients in need of ≥2 implants in the posterior maxilla were randomly allocated to one of the following treatment groups: FH, PG and FG. Eleven patients (mean age 57; eight females; altogether 26 implants) were treated by FH surgery, 11 (mean age 53; seven females; altogether 24 implants) by PG surgery and 10 (mean age 60; six females; altogether 21 implants) by FG surgery. The accuracy in implant positioning was assessed by comparing the actual implant position to its planned position with the AGD as the main measure of effectiveness. Cost analysis included data on time investment (pre‐ and per‐operative) and operational cost. The efficiency of PG and FG surgery was assessed by means of the incremental cost‐effectiveness ratio (ICER), defined as the extra investment that is needed per unit reduction in AGD when compared to FH surgery.ResultsFG surgery was most effective (mean AGD: 0.97 mm) and FH surgery was least effective (mean AGD: 2.11 mm) in terms of surgical accuracy. As a result, 5/26 implants had to be restored with a cement‐retained restoration following FH surgery, although screw‐retention was planned for all implants in every group. The total time investment did not differ significantly between the 3 groups (p = 0.811). A significant additional cost per implant was found for PG and FG as compared to FH surgery pointing to 8.29% (€176.54) and 10.45% (€222.52), respectively (p < 0.001). The ICER revealed an additional cost of €5.48 and €4.12 per per cent reduction in AGD for PG and FG surgery, respectively.ConclusionThe extra operational cost for guided implant surgery is acceptable and clinically justified since cementation can be avoided. FG surgery is the most efficient surgical approach, even though the absolute operational cost is higher when compared to PG and FH surgery.
Differential impact of age on survival in head and neck cancer according to classic Cox regression and decision tree analysis
Authors: Yang Ching‐Chieh , Su Yu‐Chieh , Lin Yu‐Wei , Huang Chung‐I , Lee Ching‐Chih 
Published: December 2018

ObjectivesTo assess the impact of age on the survival of patients with head and neck squamous cell carcinoma (HNSCC) using different statistical methods.DesignA retrospective population‐based study.SettingSurveillance, Epidemiology, and End Results database.Subjects and methodsA total of 28 639 patients with newly diagnosed HNSCC were enrolled between 1 January 2007 and 31 December 2013. The effect of age on 5‐year disease‐specific survival was calculated using a Kaplan‐Meier method and compared using log‐rank tests. A Cox proportional hazards model was used for a multivariate analysis. A classification and regression tree (CART) analysis that partitioned patients with significantly different Kaplan‐Meier curves was introduced to identify the important cancer‐related parameters influencing survival.ResultsUni‐ and multivariate analyses indicated that patients who were older than 60 years had poorer 5‐year disease‐specific survival regardless of tumour subsite and tumor‐node‐metastasis (TNM) stage. However, the CART analysis determined that age played only a minor role in survival after comparing with other prognosticators. The relative importance of age using the Gini index was as follows: 3.21% for oral cancer, 8.32% for oropharyngeal cancer, 2.56% for hypopharyngeal cancer and 16.51% for laryngeal cancer.ConclusionsDifferent to traditional statistical methods, the CART analysis which was used to identify homogeneous populations revealed that the impact of age varied for different patient groups according to the presence or absence of other prognosticators. This important information could help to guide our clinical decisions and future researches.
Disparity in access to kidney allograft offers among transplant candidates with human immunodeficiency virus
Authors: Cohen Jordana B. , Locke Jayme E. , Shelton Brittany , Reed Rhiannon D. , Mustian Margaux , MacLennan Paul , Forde Kimberly A. , Reese Peter P. , Sawinski Deirdre 
Published: December 2018

AbstractBackgroundDespite a survival benefit from transplantation and acceptable outcomes, patients with human immunodeficiency virus (HIV+) face barriers to kidney transplantation. Little is known about the acceptance or decline of organ offers on their behalf because waitlist registry data do not include HIV serostatus.MethodsWe performed a retrospective cohort study using match run data from the Organ Procurement and Transplantation Network, including every kidney offer from May 1, 2007, to July 3, 2013. HIV and hepatitis C virus (HCV) serostatus were obtained by merging the match run with clinical data from a large dialysis provider. We used Cox proportional hazards modeling to evaluate differences in time to the first organ offer and to transplantation. A total of 35 646 uninfected, 2213 HCV+, 418 HIV+, and 71 HIV+/HCV+ candidates received organ offers during the study period.ResultsCompared to uninfected candidates, HIV+ candidates had a significantly lower likelihood of receiving a first offer (adjusted hazard ratio [aHR] 0.88, 95% confidence interval [CI] 0.79‐0.99) and undergoing transplantation (aHR 0.82, 95% CI: 0.68‐0.98) after receiving a first offer; HCV+ candidates had a similar likelihood of receiving a first offer (aHR 0.98, 95% CI: 0.92‐1.03) and greater likelihood of transplantation after receiving a first offer (aHR 1.23, 95% CI: 1.12‐1.36).ConclusionsHIV+ candidates had a significantly longer wait until their first organ offer and to transplantation. Efforts to increase their access to transplantation are needed.
Incidence and variables associated with 30‐day mortality after lung transplantation
Authors: Banga Amit , Mohanka Manish , Mullins Jessica , Bollineni Srinivas , Kaza Vaidehi , Huffman Lynn , Peltz Matthias , Bajona Pietro , Wait Michael , Torres Fernando 
Published: December 2018

AbstractBackgroundWith the introduction of the lung allocation score (LAS), sicker patients are prioritized for lung transplantation (LT). There is a lack of data regarding variables independently associated with 30‐day mortality after LT.MethodsWe queried the UNOS database for adult patients undergoing LT between 1989 and 2014. Patients with dual organ or previous transplantation and those with missing survival data were excluded. Mortality during the first 30 days after LT was the primary outcome variable.ResultsThe yearly trends indicate a statistically significant reduction in the 30‐day mortality during the study period (P < 0.001, overall mortality: 5.5%) which has continued in the post‐LAS era (P = 0. 014, overall mortality: 3.6%). Among patients with 30‐day mortality, “primary non‐function” (n = 118, 72.8%) was reported as the most common etiology. Transplant indication of vascular diseases, history of non‐transplant cardiac or lung surgery, mean pulmonary pressures >35 mm Hg, disabled functional status, ECMO support, high LAS, ischemic time >6 hours, and blunt injury as the mechanism of donor death are independently associated with 30‐day mortality.ConclusionThe incidence of early mortality after LT continues to decline in the post‐LAS era. Apart from the mechanism of donor death and ischemic time, early mortality appears to be primarily driven by the recipient characteristics.
Factors associated with disordered eating behaviours in adolescents with Type 1 diabetes
Authors: Cecilia‐Costa R. , Volkening L. K. , Laffel L. M. 
Published: December 2018

AimsTo assess the occurrence of disordered eating behaviours in teenagers with Type 1 diabetes and to compare characteristics according to level of disordered eating behaviours.MethodsIn this cross‐sectional study, we collected adolescents’ demographic and diabetes management data by parent–youth interview and chart review. Teenagers completed psychosocial surveys, including the Diabetes Eating Problem Survey‐Revised (DEPS‐R), a diabetes‐specific measure of disordered eating behaviours. We categorized teenagers according to level of disordered eating behaviours: low, DEPS‐R score <10; moderate, DEPS‐R score 10–19; and high, DEPS‐R score ≥20.ResultsThe 178 teenagers (48% girls) were aged 14.9±1.3 years, with diabetes duration of 7.4±3.7 years. Most (59%) had low, 26% had moderate, and 15% had high levels of disordered eating behaviours. Several biomedical and psychosocial characteristics differed by level of disordered eating behaviours. There were more girls in the moderate (62%) and high (65%) than in the low level of disordered eating behaviours group (37%; P=0.003) and more obese teenagers in the moderate (13%) and high (27%) groups than in the low group (4%; P=0.0003). Frequency of daily blood glucose monitoring decreased (P=0.0006) and HbA1c level increased (P=0.01) with greater level of disordered eating behaviours. A greater level of disordered eating behaviours was also associated with poorer treatment adherence, more negative affect regarding blood glucose monitoring, poorer quality of life, and more depressive symptoms (all P<0.0001), along with more diabetes‐specific family conflict (P=0.01).ConclusionsIdentifying teenagers with Type 1 diabetes who have moderate and high levels of disordered eating behaviours may prevent progression to eating disorders and substantial morbidity by directing support and intervention efforts to those in need.