bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Monitor Practice Program: implications for dentistry and dental education
Authors: Evans RW 
Published: January 2019

AbstractThe restorative model of care, known colloquially as drilling and filling, has been challenged on the basis of its inappropriateness. The Caries Management System protocol was developed as an evidence‐based strategy for non‐surgical treatment of caries lesions and the Monitor Practice Program was designed to test the hypothesis that use of the protocol would reduce risk of dental caries experience. After 7 years, patients attending intervention practices, compared with those attending control practices, needed: 30%–50% fewer restorative interventions; 55% fewer first time restorative interventions; 32% fewer repeat restorative interventions; and were only 23% as likely to be classified as high risk. The outcome was cost‐effective and patients attending intervention practices highly valued non‐invasive care, and intervention dentists derived professional satisfaction from non‐surgical caries management. The implications of the program are that the general public will likely embrace the benefits of non‐invasive caries management, as will many current and future dental practitioners. This calls for dental practice reform including: the establishment of a clinical discipline in cariology; cariology curriculum development; revised accreditation regulations for cariology programs in dental schools; advanced training in clinical cariology leading to a specialty; support from the dental profession; and public health advocacy.
Combining individual Chlamydia trachomatis IgG antibodies MOMP, TARP, CPAF, OMP2, and HSP60 for tubal factor infertility prediction
Authors: van Ess Eleanne F. , Eck-Hauer Anat , Land Jolande A. , Morré Servaas A. , Ouburg Sander 
Published: January 2019

ProblemTubal factor infertility (TFI) is a severe complication of genital Chlamydia trachomatis infections. In fertility workup, chlamydia antibody test (CAT) is used to predict TFI. The predictive value for TFI of most commonly used CAT is moderate.Method of studyA total of 183 infertile Dutch Caucasian women were included in this study. All underwent tubal patency testing (hysterosalpingography [HSG] or laparoscopy). Cases had TFI, and controls had no TFI (ie normal findings during HSG or laparoscopy). TFI was categorized based on severity (TFI 1‐TFI 4). This study investigated the predictive values of major outer membrane protein (MOMP), translocated actin‐recruiting phosphoprotein (TARP), chlamydial protease‐like activity factor (CPAF), heat shock protein‐60 (HSP60) and outer membrane protein 2 (OMP2) for TFI. A predictive algorithm is developed to detect TFI with a high certainty based on combinations of antibody titres. Serum was tested with the Mikrogen recomLine immunoblot and quantified with the recomScan. A greedy algorithm that explores all possible antibody combinations was developed.ResultsSignificant differences in the distributions of antigen titres between cases and controls were observed for CPAF (P = 0.0021), HSP60 (P = 0.0061), MOMP (P = 0.0497) and OMP2 (P = 0.0016). Single antibodies could not discriminate between TFI and controls by themselves. The greedy algorithm performs better in specificity, positive predictive value (PPV), accuracy and clinical utility index than the original Mikrogen algorithm. CPAF combined with HSP60 identified 18.2% of TFI cases with 100% certainty. Most of the TFI 4 cases were identified with cut‐offs of CPAF > 10.7 or OMP2 > 3.9.ConclusionThis proof‐of‐principle study shows that combinations of antibodies in serum are predictive for TFI. A commercially available test can be adapted to predict TFI with a 100% specificity.
Comparative outcomes in patients with ulcer‐ vs non‐ulcer‐related acute upper gastrointestinal bleeding in the United Kingdom: a nationwide cohort of 4474 patients
Authors: Sey Michael Sai Lai , Mohammed Seid B. , Brahmania Mayur , Singh Siddharth , Kahan Brennan C. , Jairath Vipul 
Published: January 2019

SummaryBackgroundOutcomes after Nonvariceal upper gastrointestinal bleeding (NVUGIB) have historically focused on ulcer‐related causes. Little is known regarding non‐ulcer bleeding, the most common cause of NVUGIB.AimTo compare outcomes between ulcer‐ and non‐ulcer‐related NVUGIB and explore whether these could be explained by differences in baseline characteristics, bleeding severity or processes of care.MethodsAnalysis of 4474 patients with NVUGIB from 212 United Kingdom hospitals as part of a nationwide audit. Logistic regression models were used to adjust for baseline characteristics, bleeding severity and processes of care.Results1682 patients had ulcer‐related and 2792 patients had non‐ulcer‐related bleeding. Those with ulcer‐related bleeding were older (median age 73 vs 69, P < 0.001), less likely to have been taking a PPI (18% vs 32%, P < 0.001), more likely to have been taking aspirin (40% vs 27%, P < 0.001) and present with shock (43% vs 32%, P < 0.001). Furthermore, those with ulcer‐related bleeding were more likely to receive blood transfusion (66% vs 39%, P < 0.001), PPI infusion (27% vs 5%, P < 0.001) and endoscopic therapy (37% vs 8%, P < 0.001). Overall, ulcer‐related bleeding had higher odds of in‐hospital mortality (OR: 1.54; 95% CI: 1.21‐1.96, P < 0.0001), rebleeding (OR: 2.08; 95% CI: 1.73‐2.51, P < 0.0001) and need for surgical/radiologic intervention (OR: 2.64; 95% CI: 1.85‐3.77, P < 0.0001). The associations disappeared after adjustment for bleeding severity, whereas adjustment for patient characteristics or process of care factors had no impact.ConclusionPatients with ulcer‐related NVUGIB bleeding have worse outcomes than those with non‐ulcer‐related NVUGIB bleeding, which is due to more severe bleeding.
The willingness of patients with gastroparesis to take risks with medications
Authors: Navas Christopher M. , Crowell Michael D. , Lacy Brian E. 
Published: January 2019

SummaryBackgroundGastroparesis has a significant negative impact on patients’ quality of life. Only one medication is approved for gastroparesis and it is associated with a significant risk of side effects.AimTo assess the willingness of patients to take risks associated with medications to treat gastroparesis symptoms.MethodsWe developed a questionnaire to assess medication risk‐taking behaviour in patients identified as having documented gastroparesis (consistent symptoms, normal upper endoscopy, delayed gastric emptying). The survey assessed demographics, symptoms, medication use, anxiety, depression and impulsivity. A standard reference gamble evaluated respondents’ willingness to take medication risks.ResultsTwo hundred seven questionnaires were mailed to patients, 103 questionnaires were completed. Seventy‐six percent were female; the mean age was 48 years; average duration of gastroparesis symptoms was 10 years. Self‐reported symptom severity was severe in 52% and moderate in 32%. Gastroparesis patients reported that they would accept a median 13.4% risk of sudden death to cure their symptoms using a hypothetical medication. Self‐reported gastroparesis symptom severity and Gastroparesis Cardinal Symptom Index scores correlated significantly with increased willingness to take risks associated with medications to treat gastroparesis, while anxiety was negatively associated.ConclusionsGastroparesis patients are willing to accept markedly high risks with a hypothetical medication to cure their symptoms. Patients with severe gastroparesis symptoms and higher Gastroparesis Cardinal Symptom Index scores were more willing to take these risks. This study, the first to quantify gastroparesis patients’ willingness to accept medication associated risks, should help clinicians through the complex maze of gastroparesis therapies and their associated risks and benefits.
Systematic review with meta‐analysis: review of donor features, procedures and outcomes in 168 clinical studies of faecal microbiota transplantation
Authors: Lai Cheuk Yin , Sung Joanne , Cheng Felix , Tang Whitney , Wong Sunny H. , Chan Paul K.S. , Kamm Michael A. , Sung Joseph J.Y. , Kaplan Gilaad , Chan Francis K.L. , Ng Siew C. 
Published: January 2019

SummaryBackgroundFaecal microbiota transplantation (FMT) is effective for Clostridium difficile infections (CDI) refractory to standard treatment and is being studied in other diseases.AimTo evaluate donor characteristics, procedures and clinical outcomes of FMT.MethodsWe systematically reviewed FMT studies published up to 29 August 2018 using MEDLINE (R) and EMBASE and identified clinical studies with FMT donor information. We reported data on donor characteristics, screening criteria, administration, clinical outcomes and adverse events.ResultsAmong 5267 reports, 239 full‐text articles were screened and 168 articles were included. FMT was performed commonly for CDI (n = 108) and inflammatory bowel disease (IBD) (n = 31). We reported characteristics of 1513 donors [58% male; mean age, 34.3 years; mean body mass index, 21.6]. Donors in Asia were younger than the West (mean age 30.7 vs 32.9, P = 0.00075). Less than 50% of studies screened donors for transmittable pathogens. Final cure rate for CDI was 95.6% (95% confidence interval [CI], 93.9%‐97.1%) and final remission rates for ulcerative colitis (UC) and Crohn's disease (CD) were 39.6% (95% CI, 25.4%‐54.6%) and 47.5% (95% CI, 29.4%‐65.8%), respectively. Cure rates in CDI and final remission rates for CD and UC were comparable across all routes of FMT administration. Overall adverse event incidence was <1%, mostly GI‐related. Adverse event rates did not differ significantly between routes of FMT administration or indication.ConclusionsIn a systematic review assessing donor characteristics and FMT efficacy, we observed heterogeneity in donor selection, application and outcomes of FMT. These data can facilitate standardisation of FMT protocols for various diseases.
Patterning emergent marsh vegetation assemblages in coastal Louisiana,USA, with unsupervised artificial neural networks
Authors: Snedden Gregg A. 
Published: January 2019

AbstractQuestionsAre self‐organizing maps (SOMs) useful for patterning coastal wetland vegetation communities? DoSOMs provide robust alternatives to traditional classification methods, particularly when underlying species response functions are unknown or difficult to approximate, or when a need exists to continuously classify new samples obtained under ongoing long‐term ecosystem monitoring programs as they become available?LocationCoastal Louisiana,USA.MethodsASOMwas trained from in‐situ observations of 559 vegetation species relative cover data from 2,526 samples collected over 8 years at 343 locations across coastal Louisiana. Hierarchical cluster analysis was applied to theSOMoutput to delineate vegetation community types, and indicator species analysis was conducted. Salinity and flood duration were compared across the delineated community types.ResultsTheSOMpatterned the 2,526 training samples into 260 output neurons, which were further clustered into eleven community types. Clear gradients in salinity and flood duration existed among the community types, and geographic zonation of the communities was evident across the landscape. At some locations assemblages were temporally stable; at other locations, they varied considerably. Samples not used in training the network were effectively projected onto theSOMand assigned to one of the delineated community types.ConclusionsTheSOMwas effective in delineating plant communities in the region that were qualitatively similar to those obtained in previous investigations. Being robust to skewed distributions and the presence of outliers,SOMs provide an alternative to traditional distribution‐based statistical approaches. Their ability to efficiently classify new data into existing community types makes their use an ideal approach to classifying samples obtained from ongoing, long‐term ecological monitoring programs.
Open‐label study to evaluate trifluridine/tipiracil safety, tolerability and pharmacokinetics in patients with advanced solid tumours and hepatic impairment
Authors: Saif Muhammad Wasif , Rosen Lee , Rudek Michelle A. , Sun Weijing , Shepard Dale R. , Becerra Carlos , Yamashita Fumiaki , Bebeau Paul , Winkler Robert 
Published: January 2019

AimsTrifluridine/tipiracil (FTD/TPI) prolongs survival in refractory metastatic colorectal cancer, but limited data exist on its use in patients with hepatic impairment. This Phase I, open‐label, nonrandomized study investigated the safety, tolerability and pharmacokinetics of FTD/TPI in patients with advanced solid tumours (except breast cancer) and varying degrees of hepatic impairment, to provide dosing recommendations.MethodsPatients aged ≥18 years with advanced solid tumours and normal hepatic function, or mild, moderate or severe hepatic impairment according to National Cancer Institute criteria, were planned to be enrolled. Patients received FTD/TPI 35 mg/m2 orally twice daily on days 1–5 and 8–12 of each 28‐day cycle.ResultsTwenty‐four patients were enrolled to the normal hepatic function (n = 8) and mild (n = 10) and moderate (n = 6) hepatic impairment cohorts. Overall, 12 patients (50.0%) had at least 1 adverse event leading to study discontinuation. In the moderate hepatic impairment cohort, 5 of 6 patients experienced grade ≥ 3 elevation in bilirubin. No patients with severe hepatic impairment were enrolled. FTD area under the curve at steady state decreased by 18% and 22% in the mild and moderate cohorts, respectively; however, no clear change was observed in TPI area under the curve.ConclusionsFTD/TPI can be safely administered in patients with normal hepatic function and mild hepatic impairment, with no initial dose adjustment. FTD/TPI is not recommended for use in patients with moderate hepatic impairment because of findings of grade 3 or 4 increased blood bilirubin. Therefore, FTD/TPI is not recommended for patients with moderate or severe hepatic impairment.
Faculty members’ perceptions of online program community and their efforts to sustain it
Authors: Bolliger Doris U. , Shepherd Craig E. , Bryant H. Victoria 
Published: January 2019

AbstractThis study investigated faculty members’ perceptions of program community and what they do to support it in online graduate programs. Researchers developed and administered an online survey to ascertain perceptions of program community among education and engineering faculty members at United States, land‐grant, research‐extensive universities. Three hundred forty‐four faculty members responded. Most participants thought that fostering community beyond courses was important. Faculty members used a variety of strategies to accomplish this task, including social media, synchronous communication and advising, face‐to‐face socials and orientations, and cohort models. Yet, many also relied on classroom strategies. Several participants indicated that they and their students lacked the time, resources or interest to pursue program community and that geographical distance and university reward policies complicated its establishment. Differences via discipline, gender and years of online teaching experience were also reported.
Brain‐derived and circulating vesicle profiles indicate neurovascular unit dysfunction in early Alzheimer’s disease
Authors: Gallart‐Palau Xavier , Serra Aida , Hase Yoshiki , Tan Chee Fan , Chen Christopher P. , Kalaria Raj N. , Sze Siu Kwan 
Published: January 2019

AbstractVascular factors that reduce blood flow to the brain are involved in apparition and progression of dementia. We hypothesized that cerebral hypoperfusion (CH) might alter the molecular compositions of brain intercellular communication mechanisms while affecting the neurovascular unit in preclinical and clinical human dementias. To test that hypothesis, mice were subjected to bilateral common carotid stenosis (BCAS) and the molecular compositions of brain‐derived and circulating extracellular vesicles (EVs) were assessed. Murine brain vesicle profiles were then analyzed in parallel with brain EVs from post‐mortem subjects affected by preclinical Alzheimer’s Disease (AD) and mixed dementias. Brain EVs were identified with molecular mediators of hypoxia responses, neuroprotection and neurotoxicity in BCAS mice, patterns also partially resembled by subjects with preclinical AD and mixed dementias. Together these findings indicate that brain EVs represent a promising source of therapeutic targets and circulating markers of neurovascular insult in idiopathic dementias. Furthermore, the results obtained generate novel and compelling hypotheses about the molecular involvement of the vascular component in the etiology of human dementias.
Misallocation and aggregate productivity across time and space
Authors: Restuccia Diego 
Published: January 2019

AbstractProductivity is at the core of the large differences in income per capita across countries. What accounts for international productivity differences? I discuss cross‐country differences in the allocation of inputs across heterogeneous production units—misallocation—as a potential factor in accounting for aggregate productivity. Policies and institutions generating misallocation are prevalent in poor and developing countries and may also be responsible for differences in the selection of operating producers and technology used, contributing substantially to aggregate productivity differences across countries.
Modelling spatial biodiversity in the world’s largest mangrove ecosystem—The Bangladesh Sundarbans: A baseline for conservation
Authors: Sarker Swapan Kumar , Reeve Richard , Paul Nirmal K. , Matthiopoulos Jason 
Published: January 2019

AbstractAimMangrove forests are among the most threatened and rapidly vanishing, but poorly understood ecosystems. We aim to uncover the variables driving mangrove biodiversity and produce baseline biodiversity maps for the Sundarbans world heritage site—the Earth's largest contiguous mangrove ecosystem.LocationThe Bangladesh Sundarbans, South Asia.MethodsWe collected species abundance, environmental and disturbance data from 110 permanent sample plots (PSPs) covering the entire Bangladesh Sundarbans (6,017 km2). We applied generalized additive models to determine the key variables shaping the spatial distributions of mangrove diversity and community composition. Biodiversity maps were constructed using covariate‐driven habitat models, and their predictive performances were compared with covariate‐free (i.e., direct interpolation) approaches to see whether the inclusion of habitat variables bolster spatial predictions of biodiversity or whether we can rely on direct interpolation approaches when environmental data are not available.ResultsHistorical forest exploitation, disease, siltation and soil alkalinity were the key stressors causing loss of alpha and gamma diversity in mangrove communities. Both alpha and gamma diversity increased along the downstream‐to‐upstream and riverbank‐to‐forest interior gradients. Mangrove communities subjected to intensive past tree harvesting, disease outbreaks and siltation were more homogeneous in species composition (beta diversity). In contrast, heterogeneity in species composition increased along decreasing salinity and downstream‐to‐upstream gradients. We find that the surviving biodiversity hotspots (comprising many globally endangered tree species) are located outside the established protected area network and hence open to human exploitation. We therefore suggest bringing them immediately under protected area management.Main conclusionsWe provide the first habitat‐based modelling and mapping of alpha, beta and gamma diversity in threatened mangrove communities. In general, habitat‐based models showed better predictive ability than the covariate‐free approach. Nevertheless, the small margin of differences between the approaches demonstrates the utility of direct interpolation approaches when environmental data are unavailable.
Predicting clinical progression in multiple sclerosis after 6 and 12 years
Authors: Dekker I. , Eijlers A. J. C. , Popescu V. , Balk L. J. , Vrenken H. , Wattjes M. P. , Uitdehaag B. M. J. , Killestein J. , Geurts J. J. G. , Barkhof F. , Schoonheim M. M. 
Published: January 2019

Background and purposeTo predict disability and cognition in multiple sclerosis (MS) after 6 and 12 years, using early clinical and imaging measures.MethodsA total of 115 patients with MS were selected and followed up after 2 and 6 years, with 79 patients also being followed up after 12 years. Disability was measured using the Expanded Disability Status Scale (EDSS); cognition was measured only at follow‐up using neuropsychological testing. Predictors of interest included EDSS score, baseline brain and lesion volumes and their changes over 2 years, baseline age, clinical phenotype, sex and educational level.ResultsHigher 6‐year EDSS score was predicted by early EDSS score and whole‐brain volume changes and baseline diagnosis of primary progressive MS (adjusted R2 = 0.56). Predictors for 12‐year EDSS score included larger EDSS score changes and higher T1‐hypointense lesion volumes (adjusted R2 = 0.38). Year 6 cognition was predicted by primary progressive MS phenotype, lower educational level, male sex and early whole‐brain atrophy (adjusted R2 = 0.26); year 12 predictors included male sex, lower educational level and higher baseline T1‐hypointense lesion volumes (adjusted R2 = 0.14).ConclusionsPatients with early signs of neurodegeneration and a progressive disease onset were more prone to develop both disability progression and cognitive dysfunction. Male sex and lower educational level only affected cognitive dysfunction, which remains difficult to predict and probably needs more advanced imaging measures.
Leptospirosis: An important infectious disease in North American horses
Authors: Divers T. J. , Chang Y.‐F. , Irby N. L. , Smith J. L. , Carter C. N. 
Published: January 2019

SummaryNorth American horses are commonly exposed to Leptospira organisms. Leptospira Bratislava is the most common infecting serovar but this serovar has not been confirmed to cause clinical disease in North American horses. Leptospira Pomona type kennewicki is responsible for most of the clinical diseases (leptospirosis) in North American horses. Leptospirosis is most commonly associated with diseases of the placenta and fetus, the kidneys and the eyes in horses. In‐utero infections in pregnant mares may result in abortion, neonatal illness or birth of an antibody positive healthy foal. Acute renal failure in younger horses and recurrent uveitis in adult horses are other well documented clinical syndromes of leptospirosis. Abortions, neonatal disease and acute renal failure are caused by a subacute infection, while horses with Leptospira associated recurrent uveitis develop ocular disease months or years after the initial Leptospira infection. Diagnosis of Leptospirosis is made by a combination of antigen or antibody testing methods. Mares that abort following Leptospira infection have no additional clinical signs at the time of abortion but may shed the offending Leptospira spp. in the urine for several weeks. Antibiotic treatments are sometimes used in hopes of decreasing Leptospira shedding in infected horses or prophylactically in exposed pregnant mares but documentation of efficacy is lacking. Horses with Leptospira ‐ associated acute renal failure can be successfully treated with antibiotics and supportive care. Recurrent uveitis is commonly associated with leptospirosis in North American horses and although horses may have chronic intraocular infection triggering an immune disease, systemic antimicrobial therapy has not been effective in eliminating the organism from the eye. An equine approved Leptospira Pomona type kennewicki vaccine is now available in North America.