bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endophytic fungal community of Dysphania ambrosioides from two heavy metal‐contaminated sites: evaluated by culture‐dependent and culture‐independent approaches
Authors: Parmar Shobhika , Li Qiaohong , Wu Ying , Li Xinya , Yan Jinping , Sharma Vijay K. , Wei Yunlin , Li Haiyan 
Published: September 2018

SummaryEndophytic fungal communities of Dysphania ambrosioides, a hyperaccumulator growing at two Pb‐Zn‐contaminated sites, were investigated through culture‐dependent and culture‐independent approaches. A total of 237 culturable endophytic fungi (EF) were isolated from 368 tissue (shoot and roots) segments, and the colonization rate (CR) ranged from 9.64% to 65.98%. The isolates were identified to 43 taxa based on morphological characteristics and rDNA ITS sequence analysis. Among them, 13 taxa (30.23%) were common in plant tissues from both sites; however, dominant EF were dissimilar. In culture‐dependent study, 1989 OTUs were obtained through Illumina Miseq sequencing, and dominant EF were almost same in plant tissues from both sites. However, some culturable EF were not observed in total endophytic communities. We suggest that combination of both culture‐dependent and culture‐independent methods will provide more chances for the precise estimation of endophytic fungal community than using either of them. The tissue had more influence on the culturable fungal community structure, whereas the location had more influence on the total fungal community structure (including culturable and unculturable). Both culture‐dependent and culture‐independent studies illustrated that endophytic fungal communities of D. ambrosioides varied across the sites, which suggested that HM concentration of the soil may have some influence on endophytic fungal diversity.
Long‐term outcomes in 1121 Australian prostate cancer patients treated with definitive radiotherapy
Authors: de Leon Jeremiah F , Kneebone Andrew , Gebski Val , Cross Shamira , Do Viet , Hayden Amy , Ngo Diana , Sidhom Mark , Turner Sandra 
Published: September 2018

AbstractIntroductionOptimal definitive treatment of prostate cancer is controversial, especially in high‐risk patients. We report the largest prospective cohort of Australian patients treated with radiotherapy for localised prostate cancer.MethodsOne thousand, one hundred and twenty‐one patients with prostate cancer were prospectively registered and treated to a dose of 70–74 Gy. Patients were classified as low, intermediate or high risk based on PSA, clinical staging and Gleason score. Intermediate‐risk patients were treated with 0–6 months of hormonal therapy (ADT) and high‐risk patients were offered neoadjuvant and adjuvant ADT. Overall survival (OS) and biochemical relapse‐free survival (bNED) were calculated using the Kaplan–Meier method.ResultsMedian follow‐up was 92 months. Eight‐year OS and bNED were 78.4% and 68.1% respectively in the entire cohort. OS for the low, intermediate and high‐risk groups was 84.5%, 78.4% and 68% respectively. For these risk groups, bNED was 80.3%, 65.7% and 53.7% respectively. In the intermediate and high‐risk group, OS and bNED decreased with increasing number of risk factors.ConclusionDefinitive radiotherapy is an effective treatment for prostate cancer, including in high‐risk cases.
Matrix metalloprotease 3 is associated with sarcopenia in rheumatoid arthritis ‐ results from the CHIKARA study
Authors: Tada Masahiro , Yamada Yutaro , Mandai Koji , Hidaka Noriaki 
Published: September 2018

AbstractAimPatients with rheumatoid arthritis (RA) show lower muscle mass and a higher prevalence of sarcopenia than healthy individuals. Correlations between sarcopenia and disease activity, physical function, laboratory data and body composition at baseline were investigated in a prospective, observational study (CHIKARA study) of RA patients.MethodsBody composition was measured using a bioelectrical impedance analyzer. Parameters were compared between sarcopenia and non‐sarcopenia groups, and correlations between sarcopenia and Disease Activity Score of 28 joints – erythrocyte sedimentation rate (DAS28‐ESR), modified health assessment questionnaire, treatment, and laboratory data, including matrix metalloproteinase 3 (MMP3), were investigated.ResultsThe participants were 100 patients with RA (women, 78%; mean age, 66.1 years). Mean disease duration was 5.5 years, DAS28‐ESR was 3.55 and the prevalence of sarcopenia was 28%. Median C‐reactive protein (CRP) and MMP3 were significantly higher in the sarcopenia group (0.21 mg/dL and 103.4 ng/mL) than in the non‐sarcopenia group (0.11 mg/dL and 70.3 ng/mL). Sarcopenia was negatively correlated with weight, body mass index (BMI), muscle mass, body fat mass, estimated bone mass and basal metabolic rate, and positively correlated with Steinbrocker stage, CRP and MMP3 on univariate analyses. BMI, body fat mass and MMP3 were independently associated with sarcopenia on multivariate logistic regression analysis. When MMP3 was ≥ 90.7 ng/mL, the odds ratio for sarcopenia was increased 3.1‐fold compared with < 90.7 ng/mL (P = 0.018).ConclusionThe prevalence of sarcopenia was 28% in patients with RA whose disease activity was mild. Low BMI, high fat mass and high MMP3 were independently associated with sarcopenia. MMP3 might be a useful marker for sarcopenia in patients with RA.
Long‐term patient reported outcomes of elbow, wrist and hand surgery for rheumatoid arthritis
Authors: Okura Chisa , Ishikawa Hajime , Abe Asami , Yonemoto Yukio , Okamura Koichi , Suto Takahito , Oyakawa Tomo , Miyagawa Yusuke , Otani Hiroshi , Ito Satoshi , Kobayashi Daisuke , Nakazono Kiyoshi , Murasawa Akira , Takagishi Kenji , Chikuda Hirotaka 
Published: September 2018

AbstractAimA retrospective questionnaire survey was conducted to investigate the long‐term outcomes of elbow, wrist and hand surgery for rheumatoid arthritis (RA).MethodsOne hundred and thirteen RA patients underwent primary elective elbow, wrist or hand surgery at our hospital between January 2002 and December 2003. To evaluate the outcomes at 10 years after surgery, the patient‐reported outcomes were assessed using an original questionnaire that inquired about the site of treatment; the modified Stanford Health Assessment Questionnaire (mHAQ) was also used.ResultsResponses were obtained from 67 patients (98 sites). In the 10 years after surgery, the Disease Activity Score of 28 joint – erythrocyte sedimentation rate (4) and the modified Health Assessment Questionnaire scores of the patients showed significant improvement. Nearly 85% of patients were satisfied with the outcome at the surgical site. The most frequent reason for perceived improvement was ‘pain relief’ (all surgical sites). An ‘improved appearance’ was frequently reported after finger surgery and ‘increased power’ was frequently reported after wrist and thumb surgeries. With regard to elbow surgery, 30% of the patients were satisfied with the increase in motion and power. In contrast, approximately 20% of patients complained of decreased power around the surgical site after elbow and thumb surgeries.ConclusionsOur original patient‐reported outcome assessment tool revealed that elbow, wrist and hand surgery provided long‐lasting benefits in RA patients. While the efficacy differed in some of the surgical sites, pain relief was the most favorable effect. Altered medical therapy may also have impacted the patient‐perceived outcomes of surgery at 10 years.
A multicentre observational study comparing patient reported outcomes to assess reliability of swollen and tender joint assessments and response to certolizumab treatment as compared to clinician assessments in rheumatoid arthritis
Authors: Inderjeeth Charles A. , Inderjeeth Adrisha J. , Raymond Warren D. 
Published: September 2018

AbstractAimsThe use of swollen (SJC) and tender joint counts (TJC) for rheumatoid arthritis (RA) disease activity and treatment effectiveness is well established. Patient‐reported outcomes (PRO) are important. However, it is unknown if patient scoring is as reliable as that of trained professionals.MethodsPRO including SJC and TJC were assessed at baseline, 6 and 12 weeks by patients and clinicians. Data were collected using ePRO (electronic) and pPRO (paper). The Least Squares Method (LSM), Pearson correlation (Rs) and weighted Kappa scores were used to assess inter‐rater reliability and agreement of responses between the patient, nurse and physician for changes in TJC and SJC from 0 to 12 weeks of treatment.ResultsThere was a total of 341 evaluable matched joint assessment in 52 patients with RA: 157 nurse, 106 patient and 78 physician. There were matched joint count pairs for 104 patient‐nurse, 72 physician‐nurse and 21 patient‐physician. Correlation (R) of TJC scores were as follows: patient‐nurse 0.83 (P < 0.001), physician‐nurse 0.85 (P < 0.001) and physician‐patient 0.59 (P = 0.005). The inter‐rater reliability (agreement) of the patient‐nurse pairs had a weighted Kappa of 0.59 (0.53, 0.68). Correlation (R) of SJC scores were as follows: patient‐nurse 0.69 (P < 0.001), physician‐nurse 0.66 (P < 0.001) and physician‐patient 0.42 (P = 0.058). The inter‐rater reliability (agreement) of the patient‐nurse pairs had a weighted Kappa of 0.48 (0.41, 0.55).ConclusionsThere is a moderate to high level of agreement between clinicians and patient TJC and SJC assessments that suggest it may be a useful option in assessing joints and response in RA. Further evaluation of RA activity tools such as Disease Activity Score of 28 joints, Crohn Disease Activity Index or Simple Disease Activity Index utilizing patient assessments may be worth exploring.
Can I take my normal painkillers doctor? Therapeutic management of pain following dermatological procedures
Authors: Nelson Sarah C , Nelson Toby G , Mortimer Neil J , Salmon Paul JM 
Published: September 2018

AbstractDermatological procedures performed purely under local anaesthesia can provide excellent intraoperative analgesia. However, post‐procedure patients can have significant pain. Consequences of pain include patient distress, poor compliance with dressings and subsequent delayed wound healing as well as the potential fear and avoidance of further procedures. Anecdotally the same postoperative analgesia regime is given to all dermatology patients. There is a general fear by dermatologists of nonsteroidal anti‐inflammatory drugs (NSAIDs) due to perceived risk of postoperative bleeding and of tramadol due to its sedative effects. Understanding of pharmacology within the patient population and their comorbidities is necessary in choosing the appropriate analgesic regime. We reviewed the most commonly used analgesics, giving a summary of the important pharmacology and evidence of their use in the literature in order to allow clinicians to give individual approach to managing post‐procedure analgesia.
Perioperative cardiovascular complications following urogynecological operations
Authors: Larsen Michael Due , Guldberg Rikke , Lose Gunnar 
Published: September 2018

AbstractIntroductionThe risk of perioperative cardiovascular complications following operations for urinary incontinence and pelvic organ prolapse (POP) must be taken into consideration during surgical planning. The literature on the cardiovascular risk following urinary incontinence and POP operations shows conflicting results. Our aims were to provide an estimate of the mortality and the risk of cardiovascular complications following urinary incontinence and POP operations considering women’s preoperative cardiovascular comorbidity.Material and methodsThis nationwide register‐based study includes a total of 13 992 operations for urinary incontinence and 35 765 for POP from 2007 to 2017. The risk was estimated as an incidence/rate ratio for women with and without former cardiovascular comorbidity adjusted for relevant confounders by using a case‐crossover study design.ResultsA total of 7677 patients were at high risk, with a cardiovascular comorbidity prior to the operation, and 42 076 patients were at low risk, with no cardiovascular comorbidity. Overall, 11 patients died within 30 days following an operation, of whom five were in the high‐risk group and six in the low‐risk group. Of the women at high risk, 0.59% had cardiovascular complications from 0 to 6 days following an operation, corresponding to an incidence/rate ratio of 3.64 (95% CI; 2.67‐4.97), compared with women at low risk where no complications were registered in the first week.ConclusionsWe found an increased risk of cardiovascular complications following urogynecological operations in women with preoperative cardiovascular comorbidity, and no increased risk in women without prior cardiovascular comorbidity. In general, the risk of cardiovascular complications was lower than that found in previous studies.
Design Effect of Metallic (Durable) and Polymeric (Resorbable) Stents on Blood Flow and Platelet Activation
Authors: Marom Gil , Eswaran Senthil K. , Rapoza Richard J. , Hossainy Syed F. A. , Slepian Marvin J. , Bluestein Danny 
Published: September 2018

AbstractBioresorbable vascular scaffolds (BVS) provide transient vessel support for occluded coronary arteries while resorbing over time, potentially allowing vessel restoration approximating the native, healthy state. Clinical trials indicate that the Absorb BVS (Abbott Vascular, Santa Clara, CA) performance was similar to that of the Xience metallic drug‐eluting stent (DES), with low long‐term complications rates. However, when under‐deployed in very small vessels (diameter < 2.25 mm), the thrombosis rate of BVS was higher, possibly due to the effect of strut thickness on the hemodynamics (157 μm BVS vs. 81 μm DES). This study aims to determine the influence of BVS design in vessels of varying diameter on the potential platelet activation. Sixteen computational fluid dynamics models of vessels of varying diameter (1.8–3.0 mm), strut thickness (81–157 μm), and BVS/DES designs were compared. Platelet stress accumulation (SA), a metric for the activation potential, was calculated along platelet flow trajectories and their probability distribution was compared. The models were consistent with clinical observations, indicating that devices deployed in very small vessels exhibited increased probability for platelet activity as compared to the same devices deployed in nominal sized vessels. Deployment, although with residual stenosis, increased probability for higher SA than in similar diameter straight vessels. Reducing BVS struts thickness while maintaining their pattern improved performance closer to that of DES. Our findings highlight the importance of appropriate vessel sizing and deployment technique for BVS, and may help designing future BVS with thinner struts, ultimately improving performance in very small vessels.
Statistics in ophthalmology revisited: the (effect) size matters
Authors: Grzybowski Andrzej , Mianowany Mariusz 
Published: September 2018

AbstractThe association of biomedical sciences with mathematics is inextricable and undeniable. It should be considered that gaining confidence or strong belief within the framework of a scientific experiment – in the ‘compulsory’ marriage with statistics – does not mean total and undisturbed certainty. The null hypothesis significance testing (NHST) has been the kernel of statistical data analysis for a long period. Medicine is making use of it in a very wide range. The main problem in NHST arises out of a dichotomic perception of reality. Scientific reasoning was biased in the aftermath of the uncritical, almost dogmatic, trust in a level of statistical significance, namely a p‐value, defined as ‘the dictating paradigm of p‐value’. The level of statistical significance (p‐value) is not completely plausible and objective; it cannot be equated with the nature of a phenomenon or population characteristics. The p‐value refers directly to a formulated hypothesis only, that is the probability of observing a given outcome under the condition posited by a specific null hypothesis and given a specific model of the distribution of outcomes under the null hypothesis. Experts claim that unjustified conclusions and guidelines have become the bane of many scientific journals. Investigators should be able to interpret study results in a broad context and look at them critically. Statistics indeed is a leaven to further scientific discussion, not its conclusion. It is not easy to abandon the p‐value. Lots of researchers recommended an ecumenical approach to the statistical analysis of research data, for example analyses of the same results using a variety of statistical procedures. Many of them express the view that a threshold level of statistical significance should be lower than p < 0.05. To enhance the plausibility and true scientific value of research works, investigators should also take into consideration the effect size along with its confidence limits. The effect size is a kind of added value and should be determined a priori. Account must be taken of their origin, conditioning (medical knowledge), as well as specific implications in clinical practice. The effect size makes possible to compare results of various research works. It is argued that to the rescue for modern science can come research works that bear the stamp of reproducibility, for example studies conducted in several independent centres, based on coherent and meticulous methodology, or data from various centres typed in one spotless big database and submitted to rigorous and deliberate multilevel statistical analyses.
Retinal vein occlusion and obstructive sleep apnea: a series of 114 patients
Authors: Agard Emilie , El Chehab Hussam , Vie Anne‐Laure , Voirin Nicolas , Coste Olivier , Dot Corinne 
Published: September 2018

AbstractPurposeEvaluate the prevalence of obstructive sleep apnea (OSA) in patients with retinal vein occlusion (RVO).MethodsA prospective and controlled study including 114 patients from January to September 2016, who were divided into two groups: 69 patients with RVO (RVO+) and 45 controls (RVO−), matched for age, sex and disease. All the patients completed a simple questionnaire and the Epworth Sleepiness Scale and underwent a RUSleeping® (portable monitoring device and then continuously monitored the subject's respiration to detect respiratory events). In addition, all patients with RVO were administered OSA screening with a polysomnography (PSG) during an overnight stay in the hospital, which was analysed by a single sleep apnea specialist.ResultsSleep apnea was suspected in 73.9% in the RVO group and 63% in the control group based on the simple questionnaire; 22% in the RVO group and 4.3% in the control group according to the Epworth Sleepiness Scale; 82.6% in the RVO group and 55.6% in the control group (p = 0.005) according to RUSleeping®. Multivariate logistic regression analysis (based on RUsleeping®) confirmed that RVO was associated with OSA (adjusted odds ratio, 5.65, [1.60–19.92], p = 0.007). All patients in the RVO group were confirmed by PSG, and finally, 91.5% were diagnosed with moderate‐to‐severe OSA. Among the RVO+ patients, the mean apnea–hypopnoea index (AHI) was 42.2 events per hour (7.7–96.5). OSA was moderate in 22% patients and severe in 69.5% patients. There was no significant relationship between RVO severity and the PSG data variables.ConclusionThe systematic screening of OSA with the gold standard PSG found a high prevalence of OSA in patients with RVO. The OSA is probably a risk factor associated with RVO. Polysomnography remains the gold standard method; nevertheless, the RUsleeping® RTS portable monitoring device can assess the presence and severity of sleep apnea with a low failure rate and a single use, prior to PSG, which is less available in clinical practice. Further studies with larger samples are needed to clarify the association.
Contralateral eye comparison of the long‐term visual quality and stability between implantable collamer lens and laser refractive surgery for myopia
Authors: Chen Xun , Guo Lin , Han Tian , Wu Liangcheng , Wang Xiaoying , Zhou Xingtao 
Published: September 2018

AbstractPurposeTo investigate the long‐term visual quality and stability of implantable collamer lens (ICL) and laser refractive surgery (LRS) for myopia.MethodsThis study comprised 52 eyes of 26 high‐myopia anisometropia patients who were suitable for surgical treatment. In each patient, the higher‐myopia eye was implanted with ICL and the lower‐myopia eye was treated with LRS. The patients were followed for 3 years. During that time period, uncorrected (UDVA) and corrected distance visual acuity (CDVA), refraction, wavefront aberration and visual quality were evaluated.ResultsThe spherical equivalent refractive error changed from −14.11 ± 3.39 D preoperatively to −1.27 ± 1.05 D 3 years after ICL implantation and from −8.75 ± 2.76 D to −1.12 ± 1.30 D after LRS. The changes in refractive error from 1 month to 3 years were −0.52 and −0.77 D for the ICL and LRS groups, respectively. The safety indices (postoperative CDVA/preoperative CDVA) were 1.84 ± 1.00 and 1.32 ± 0.40, and the efficacy indices (postoperative UDVA/preoperative CDVA) were 1.40 ± 1.10 and 1.11 ± 0.44, respectively. The postoperative coma, spherical and total higher‐order aberrations in the ICL group were lower than those in the LRS group.ConclusionBoth ICL implantation and LRS are safe and effective procedures for myopia with suitable indications, but ICL implantation is more stable. Fewer induced aberrations are gained after ICL implantation.
The impact of extent of internal limiting membrane peeling on anatomical outcomes of macular hole surgery: results of a 54‐week randomized clinical trial
Authors: Yao Yuou , Qu Jinfeng , Dong Chongya , Li Xiaoxin , Liang Jianhong , Yin Hong , Huang Lvzhen , Li Yan , Liu Peipei , Pan Chungting , Ding Xue , Song Dan , Sadda Srinivas R. , Zhao Mingwei 
Published: September 2018

AbstractPurposeTo compare the anatomical outcomes of different extents of internal limiting membrane (ILM) peeling in idiopathic macular hole surgery.MethodsProspective, parallel‐group, randomized clinical trial. A total of 121 eyes of 121 patients with idiopathic macular hole underwent pars plana vitrectomy, and peeling of the ILM with a diameter of two disk diameters (DD) or 4DD based on randomization. The main outcome was the proportion of eyes with complete hole closure at 12 months. The second outcome was the hole closure grading stratified by macular hole closure index (MHCI) at each visit.ResultsAt 12 months, there was no significant difference in anatomical outcomes with complete closure achieved in 52 (82.5%) of 63 eyes in the 2DD group and 53 (91.4%) of 58 eyes in the 4DD group (p = 0.15). For subjects with MHCI ≤0.5 (n = 24), complete closure rate was significantly lower in the 2DD group compared to the 4DD group (p = 0.012; 18.2% versus 75.9%, respectively). Average BCVA was lower in 2DD group than 4DD group (p = 0.014). By contrast, when MHCI was >0.5, the complete closure rate between the two groups showed no significant difference: 96.2% (50 patients) versus 95.6% (43 patients), respectively (p = 0.185).ConclusionIn patients with idiopathic full‐thickness macular hole and MHCI ≤0.5, a larger ILM peel of 4DD tends to achieve better anatomical outcomes than a more limited 2DD peel.