bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endodontic treatment of a hypertaurodontic mandibular left second molar in a patient with many taurodonts combined with multiple pulp stones
Authors: Lim Adrian , Le Clerc Justine 
Published: August 2018

AbstractTaurodontism is a rare embryologic anomaly of teeth, defined by an apical displacement of the furcation of roots and enlarged pulp chambers. Taurodontism has been classified as hypo‐, meso‐ or hypertaurodontism according to the severity of the anomaly. The aim of this case report was to illustrate a clinical case with multiple bilateral taurodonts and to describe the endodontic management of the hypertaurodontic mandibular left second molar with a C‐shaped canal and extensive dental pulp calcifications. A healthy 20‐year‐old male patient was referred for the endodontic treatment of his lower left second molar. Cone beam computed tomography revealed a C‐shaped root canal configuration and several dental pulp calcifications in this tooth. The endodontic treatment was performed in two appointments under an operating dental microscope. A panoramic radiograph, made during the 18 months follow‐up appointment, revealed nine other taurodontic molars, most of them associated with dental pulp calcifications.
Classification and cyclic fatigue evaluation of new kinematics for endodontic instruments
Authors: Gambarini Gianluca , Piasecki Lucila , Miccoli Gabriele , Gaimari Gianfranco , Di Giorgio Roberto , Di Nardo Dario , Azim Adham A , Testarelli Luca 
Published: August 2018

AbstractThis study evaluated the effect of new motions of the motor TriAuto ZX2 on the cyclic fatigue of endodontic instruments. Vortex Blue 35.06 instruments were divided into four groups (n = 10) and tested for fatigue in a curved artificial canal (90° and 2 mm radius) using the following motions: continuous rotation (CR), Optimum Torque Reverse (OTR) set at 180° and the Optimum Glide Path (OGP), which was tested at 90° and 240°. The time to fracture (TTF) and the lengths of the fractured fragments were recorded. The mean TTF was significantly different among the groups (anova, P < 0.05): OGP 90° (213.39 ± 27.45), OTR 180° (121.24 ± 17.03), OGP 240° (45.24 ± 5.61) and CR (8.43 ± 1.27). Weibull analysis confirmed the shortest life expectancy for CR and the longest survival for OGP at 90°. The resistance to fatigue was affected by motions and pre‐set angles. The proprietary movements that are currently available for endodontic instruments were classified according to their kinematics.
Paediatric intensive care and neonatal intensive care airway management in the United Kingdom: the PIC‐NIC survey
Authors: Foy K. E. , Mew E. , Cook T. M. , Bower J. , Knight P. , Dean S. , Herneman K. , Marden B. , Kelly F. E. 
Published: August 2018

SummaryIn 2011, the Fourth National Audit Project (NAP4) reported high rates of airway complications in adult intensive care units (ICUs), including death or brain injury, and recommended preparation for airway difficulty, immediately available difficult airway equipment and routine use of waveform capnography monitoring. More than 80% of UK adult intensive care units have subsequently changed practice. Undetected oesophageal intubation has recently been listed as a ‘Never Event’ in UK practice, with capnography mandated. We investigated whether the NAP4 recommendations have been embedded into paediatric and neonatal intensive care practice by conducting a telephone survey of senior medical or nursing staff in UK paediatric intensive care units (PICUs) and neonatal intensive care units (NICUs). Response rates were 100% for paediatric intensive care units and 90% for neonatal intensive care units. A difficult airway policy existed in 67% of paediatric intensive care units and in 40% of neonatal intensive care units; a pre‐intubation checklist was used in 70% of paediatric intensive care units and in 42% of neonatal intensive care units; a difficult intubation trolley was present in 96% of paediatric intensive care units and in 50% of neonatal intensive care units; a videolaryngoscope was available in 55% of paediatric intensive care units and in 29% of neonatal intensive care units; capnography was ‘available’ in 100% of paediatric intensive care units and in 46% of neonatal intensive care units, and ‘always available’ in 100% of paediatric intensive care units and in 18% of neonatal intensive care units. Death or serious harm occurring secondary to complications of airway management in the last 5 years was reported in 19% of paediatric intensive care units and in 26% of neonatal intensive care units. We conclude that major gaps in optimal airway management provision exist in UK paediatric intensive care units and especially in UK neonatal intensive care units. Wider implementation of waveform capnography is necessary to ensure compliance with the new ‘Never Event’ and has the potential to improve airway management.
Comparison of injectate spread and nerve involvement between retrolaminar and erector spinae plane blocks in the thoracic region: a cadaveric study
Authors: Yang H.‐M. , Choi Y. J. , Kwon H.‐J. , O J. , Cho T. H. , Kim S. H. 
Published: August 2018

SummaryAlthough different injection locations for retrolaminar and erector spinae plane blocks have been described, the two procedures have a similar anatomical basis. In this cadaveric study we compared anatomical spread of dye in the thoracic region following these two procedures. Following randomisation, 10 retrolaminar blocks and 10 erector spinae plane blocks were performed on the left or right sides of 10 unembalmed cadavers. For each block, 20 ml of dye solution was injected at the T5 level. The back regions were dissected and the involvement of the thoracic spinal nerve was also investigated. Twenty blocks were successfully completed. A consistent vertical spread, with deep staining between the posterior surface of the vertebral laminae and the overlaying transversospinalis muscle was observed in all retrolaminar blocks. Moreover, most retrolaminar blocks were predominantly associated with fascial spreading in the intrinsic back muscles. With an erector spinae plane block, dye spread in a more lateral pattern than with retrolaminar block, and fascial spreading in the back muscles was also observed. The number of stained thoracic spinal nerves was greater with erector spinae plane blocks than with retrolaminar blocks; median 2.0 and 3.5, respectively. Regardless of technique, the main route of dye spread was through the superior costotransverse ligament to the ipsilateral paravertebral space. Although erector spinae plane blocks were associated with a slightly larger number of stained thoracic spinal nerves than retrolaminar blocks, both techniques were consistently associated with posterior spread of dye and with limited spread to the paravertebral space.
A systematic review of clinicians' views and experiences of direct‐acting oral anticoagulants in the management of nonvalvular atrial fibrillation
Authors: Generalova Daria , Cunningham Scott , Leslie Stephen J. , Rushworth Gordon F. , McIver Laura , Stewart Derek 
Published: August 2018

AimsWhile a plethora of systematic reviews have provided evidence of efficacy, effectiveness and safety of direct‐acting oral anticoagulants (DOACs) in the management of nonvalvular atrial fibrillation, there has been little emphasis on clinicians' perspectives. This systematic review aimed to critically appraise, synthesize and present the available evidence of clinicians' views and experiences.MethodsStudies published in English from January 2006 to July 2017 reporting the views and/or experiences of doctors, nurses or pharmacists on any individual DOAC or as a pharmacological group were included. Studies were assessed for quality by two researchers, data extracted and findings synthesized using a narrative approach.ResultsFollowing exclusion of duplicates, 777 titles, 394 abstracts and 196 studies were screened. Ten studies were included in the review, nine of which were quantitative (cross‐sectional surveys) and one qualitative (semistructured interviews), with marked heterogeneity in outcomes reported. Studies were conducted exclusively in Europe and the USA. In those studies reporting clinician preference, DOACs were first choice over warfarin in naïve patients, based on perceptions of evidence of effectiveness equivalent or superior to warfarin and superior safety. Other advantageous factors were in those with an unstable International Normalized Ratio and likely to miss appointments. There were, however, concerns relating to management of over‐anticoagulation and experiences of observed bleeding rates.ConclusionThere is a limited evidence base of clinicians' perspectives of DOACs, necessitating further research, particularly given the trajectory of increased use worldwide.
Interaction of the originality of peers’ ideas and students’ openness to experience in predicting creativity in online collaborative groups
Authors: Pi Zhongling , Hong Jianzhong , Hu Weiping 
Published: August 2018

AbstractThere has been growing interest in the possibility that peers’ ideas can stimulate students’ creativity in group contexts. However, empirical research on this issue is limited. This study tested the hypothesis that peers’ ideas and students’ openness to experience would predict student creativity and attention to peers’ ideas. Undergraduate students (n = 60) completed creative tasks in an online collaborative group in which the ideas of “peers” were pre‐programmed. Mixed ANOVAs showed support for the hypothesis. Specifically, students with higher (but not lower) openness, when exposed to a high (but not low) rate of peers’ original ideas, paid greater attention to those ideas and were more creative. The implication for education is that teachers should encourage students to share more of their original ideas and to pay more attention to peers’ ideas in online collaborative groups.
Optimization of the 2014 Gleason grade grouping in a Canadian cohort of patients with localized prostate cancer
Authors: Wissing Michel , Brimo Fadi , Chevalier Simone , Scarlata Eleonora , McKercher Ginette , O'Flaherty Ana , Aprikian Saro , Thibodeau Valérie , Saad Fred , Carmel Michel , Lacombe Louis , Têtu Bernard , Ekindi‐Ndongo Nadia , Latour Mathieu , Trudel Dominique , Aprikian Armen 
Published: August 2018

ObjectivesTo evaluate the five‐tier Gleason grade group (GG) scoring of prostate cancers adopted by the International Society of Urology Pathology (ISUP) in 2014, and to propose modifications to optimize its performance.Patients and MethodsData were obtained from PROCURE, a prospective cohort of patients with localized prostate cancer undergoing radical prostatectomy in Québec, 2006–2013. Surgical specimens were evaluated by genitourinary pathologists using 2014 ISUP criteria. Treatment failure was defined as biochemical recurrence and/or initiation of secondary, non‐adjuvant therapy. Analyses were conducted using Kaplan–Meier methods, log‐rank tests, Cox proportional hazards models and Harrell's concordance indices.ResultsA total of 1 917 patients were included, with a median follow‐up of 69 months. The 5‐year treatment failure rates were 9.6%, 23.5%, 43.1%, 52.6% and 84.3% in GG1–5, respectively (P < 0.001 when comparing GG2 with GG3). Treatment failure rates for patients in GG2 and GG3 with tertiary Gleason 5 pattern were higher than patients in the same group without a tertiary pattern (P < 0.001), but were similar to rates for patients in GGs 3 or 4 without a tertiary pattern (P > 0.3). Primary Gleason pattern (4/5) predicted treatment failure in GG5 (5‐year failure rates 82.3% vs 97.1%, respectively; P = 0.001). The five‐tier GG system had greater accuracy as a prognostic indicator compared with the four‐tier system (Harrell's concordance index 0.716 vs 0.676). When upgrading patients in GG2/3 with tertiary Gleason 5 pattern to patients in GG3/4, and separating patients in GG5 by primary Gleason pattern, the Harrell's concordance index increased to 0.730.ConclusionThe five‐tier GG system increased accuracy for predicting treatment failure compared with the previous grading systems, but can be further improved.
Bladder emptying method is the primary determinant of urinary tract infections in patients with spinal cord injury: results from a prospective rehabilitation cohort study
Authors: Anderson Collene E. , Chamberlain Jonviea D. , Jordan Xavier , Kessler Thomas M. , Luca Eugenia , Möhr Sandra , Pannek Jürgen , Schubert Martin , Brinkhof Martin W. G. ,   the SwiSCI Study Group
Published: August 2018

ObjectiveTo understand the occurrence of and risk factors for urinary tract infections (UTIs) in patients with spinal cord injury (SCI) undergoing specialized SCI rehabilitation in Switzerland.Patients and MethodsThis study used data collected from 369 patients, who participated in a nationwide rehabilitation cohort for SCI in Switzerland between 2013 and 2017. Information on UTIs as well as their potential determinants, including demographics, lesion characteristics, and time‐updated data on functional independence and bladder management, was used. Multivariable regression methods were applied to perform a time‐updated evaluation of determinants of UTI risk.ResultsThe crude incidence rate (IR) of UTIs was 0.55 UTIs per 100 person‐days (95% confidence interval [CI] 0.49–0.62), the cumulative IR was 43%, and the median length of stay was 122 days. The bladder emptying method at discharge was largely determined by 28 days after admission. Among those using indwelling or assisted intermittent catheterization (IC), the likelihood of self‐IC at discharge was positively related to the level of self‐care independence, negatively related to age at injury, and lower in women than men. Catheter users consistently had higher adjusted IRs for UTI than spontaneous voiders. The IR ratios were: indwelling catheter: 5.97 (95% CI 2.63–13.57); assisted IC: 6.05 (95% CI 2.63–13.94); self‐IC: 5.16 (95% CI 2.31–11.52); test for differences across catheter groups: P = 0.82. Lesion severity and previous UTI had additional but smaller effect sizes.ConclusionsBladder emptying method was identified as the main risk factor for UTI in patients with SCI. As spontaneous voiders had the lowest UTI rate, further research is warranted to reduce voiding dysfunction, for instance using neuromodulation procedures.
Current management of radiation cystitis: a review and practical guide to clinical management
Authors: Pascoe Claire , Duncan Catriona , Lamb Benjamin W. , Davis Niall F. , Lynch Thomas H. , Murphy Declan G. , Lawrentschuk Nathan 
Published: August 2018

IntroductionHaemorrhage is a frequent complication of radiation cystitis leading to emergency presentations in patients with prior pelvic radiation therapy. Standard initial patient management strategies involve resuscitation, bladder washout with clot evacuation and continuous bladder irrigation. Beyond this, definitive surgical treatment is associated with significant morbidity and mortality. Alternative less invasive management options for non‐emergent haemorrhagic cystitis include systemic medical therapies, hyperbaric oxygen (HBO), intravesical therapies and laser ablation. However, evidence to support and compare treatment for haemorrhagic radiation cystitis is limited.MethodsHerein, a literature search pertaining to the current management of haemorrhagic cystitis was conducted.ResultsIn total, 23 studies were included in this review with 2 studies reviewing systemic therapy, 7 studies evaluating HBO therapy, 10 studies investigating a variety of intravesical therapies and the remaining 4 were relating to ablative therapies. Across these studies, the patient groups were heterogenous with small numbers and variable follow up periods.ConclusionWith evaluation of existing literature, this narrative review also provides a stepwise clinical algorithm to aid the urologist in treating patients presenting with complications associated with radiation cystitis.
An analysis of the frequency of Y‐chromosome microdeletions and the determination of a threshold sperm concentration for genetic testing in infertile men
Authors: Johnson Mark , Raheem Amr , De Luca Francesco , Hallerstrom Marcus , Zainal Yasmeen , Poselay Sameer , Mohammadi Baharak , Moubasher Amr , Johnson Thomas Frederick , Muneer Asif , Sangster Philippa , Ralph David J. 
Published: August 2018

ObjectiveTo describe the prevalence of Y‐chromosome microdeletions in a multi‐ethnic urban population in London, UK. To also determine predictive factors and a clinical threshold for genetic testing in men with Y chromosome microdeletions.Patients and MethodsA retrospective cohort study of 1473 men that were referred to a tertiary Andrology centre with male factor infertility between July 2004 and December 2016. All had a genetic evaluation, hormonal profile and 2 abnormal semen analyses. Those with abnormal examination findings also had targeted imaging performed.ResultsThe prevalence of microdeletions was 4% (n = 58) in this study. These microdeletions were partitioned into the following regions: Azoospermia factors (AZF); AZFc (75%), AZFb+c (13.8%), AZFb (6.9%), AZFa (1.7%), and partial AZFa (1.7%). A high follicle‐stimulating hormone level (P < 0.001) and a low sperm concentration (P < 0.05) were both found to be significant predictors for the identification of a microdeletion. Testosterone level, luteinising hormone level and testicular volume did not predict the presence of a microdeletion. None of the men with an AZF microdeletion had a sperm concentration of >0.5 million/mL. Lowering the sperm concentration threshold to this level retained the high sensitivity (100%) and increased the specificity (31%). This would produce significant cost savings when compared to the European Academy of Andrology/European Molecular Genetics Quality Network and European Association of Urology guidelines. The surgical sperm retrieval (SSR) rate after microdissection testicular sperm extraction was 33.2% in men with AZFc microdeletion.ConclusionsThe prevalence of Y‐chromosome microdeletions in infertile men appears to vary between populations and countries. A low sperm concentration was a predictive factor (P < 0.05) for identifying microdeletions in infertile males. A threshold for genetic testing of 0.5 million/mL would increase the specificity and lower the relative cost without adversely affecting the sensitivity. The rate of SSR was lower than that previously described in the literature.
Phenotypic severity scoring system and categorisation for prune belly syndrome: application to a pilot cohort of 50 living patients
Authors: Wong Daniel G. , Arevalo Michelle K. , Passoni Niccolo Maria , Iqbal Nida S. , Jascur Thomas , Kern Adam J. , Sanchez Emma J. , Satyanarayan Arthi , Gattineni Jyothsna , Baker Linda A. 
Published: August 2018

ObjectiveTo design a novel system of scoring prune belly syndrome (PBS) phenotypic severity at any presenting age and apply it to a large pilot cohort.Patients and MethodsFrom 2000 to 2017, patients with PBS were recruited to our prospective PBS study and medical records were cross‐sectionally analysed, generating individualised RUBACE scores. We designed the pragmatic RUBACE‐scoring system based on six sub‐scores (R: renal, U: ureter, B: bladder/outlet, A: abdominal wall, C: cryptorchidism, E: extra‐genitourinary, generating the acronym RUBACE), yielding a potential summed score of 0–31. The ‘E’ score was used to segregate syndromic PBS and PBS‐plus variants. The cohort was scored per classic Woodard criteria and RUBACE scores compared to Woodard category.ResultsIn all, 48 males and two females had a mean (range) RUBACE score of 13.8 (8–25) at a mean age of 7.3 years. Segregated by phenotypic categories, there were 39 isolated PBS (76%), six syndromic PBS (12%) and five PBS‐plus (10%) cases. The mean RUBACE scores for Woodard categories 1, 2, and 3 were 20.5 (eight patients), 13.8 (25), and 10.6 (17), respectively (P < 0.001).ConclusionsRUBACE is a practical, organ/system level, phenotyping tool designed to grade PBS severity and categorise patients into isolated PBS, syndromic PBS, and PBS‐plus groups. This standardised system will facilitate genotype–phenotype correlations and future prospective multicentre studies assessing medical and surgical treatment outcomes.
FOXM1 overexpression is associated with adverse outcome and predicts response to intravesical instillation therapy in stage pT1 non‐muscle‐invasive bladder cancer
Authors: Breyer Johannes , Wirtz Ralph M. , Erben Philipp , Rinaldetti Sebastien , Worst Thomas S. , Stoehr Robert , Eckstein Markus , Sikic Danijel , Denzinger Stefan , Burger Maximilian , Hartmann Arndt , Otto Wolfgang 
Published: August 2018

ObjectiveTo investigate the role of forkhead box protein M1 (FOXM1) mRNA expression and its prognostic value in stage pT1 non‐muscle‐invasive bladder cancer (NMIBC).Patients and MethodsClinical data and formalin‐fixed paraffin‐embedded tissues from transurethral resection of the bladder from patients with stage pT1 NMIBC, treated with an organ‐preserving approach, were analysed retrospectively. Total RNA was isolated using commercial RNA extraction kits, and mRNA expression of FOXM1, MKI67, KRT20 and KRT5 was measured by single‐step quantitative RT‐PCR using RNA‐specific TaqMan Assays. Statistical analysis was performed using Spearman's Rho, Wilcoxon or Kruskal–Wallis tests, Kaplan–Meier estimates of recurrence‐free (RFS), progression‐free (PFS) and cancer‐specific survival (CSS) and Cox regression analysis.ResultsData from 296 patients (79.4% men, median age 72 years) were available for the final evaluation. Spearman correlation analysis showed that mRNA expression of FOXM1 was significantly correlated with MKI67 (ρ: 0.6530, P < 0.001) and with the luminal subtype, reflected by the positive correlation with KRT20 (ρ: 0.2113, P < 0.001). Furthermore, there was also a strong correlation of FOXM1 expression with adverse clinical and pathological variables, such as concomitant carcinoma in situ (P = 0.05), multifocal tumours (P = 0.005) and World Health Organization 1973 grade 3 disease (P < 0.001). Kaplan–Meier analysis showed overexpression of FOMX1 to be associated with worse PFS (P = 0.028) and worse CSS (P = 0.015). FOXM1 overexpression was also shown to be a predictive risk factor for CSS (hazard ratio 1.61 [1.13–2.34], L‐R chi‐squared: 7.19, P = 0.007). FOXM1 overexpression identified a subgroup of patients within the luminal subtype with worse RFS (P = 0.017), PFS (P < 0.001) and CSS (P = 0.015). Patients with low FOXM1 expression had better outcomes, irrespective of instillation therapy, whereas patients with high FOXM1 expression benefitted from intravesical chemotherapy with mitomycin C.ConclusionHigh FOXM1 expression was associated with adverse clinical and pathological features and worse outcomes, and predicted response to intravesical instillation therapy in patients with stage pT1 NMIBC.
PGK1 as an immune target in Kawasaki disease
Authors: Cui J , Zhou Y , Hu H , Zhao L , Du Z , Du H 
Published: August 2018

SummaryKawasaki disease (KD) is an immune-mediated vasculitis with symptoms that mimic febrile illness; the immune origin has been suggested but never proved. First, cell chip technology was used to screen immune targets cells. With the indirect immunofluorescence assay we found that the HeLa cell chip could be recognized by KD patient serum samples. The target cell proteome was extracted as antigens, and antigen recognition reaction was performed using the patients’ serum as antibodies and the detected target protein was detected and identified as phosphoglycerate kinase 1 (PGK1). Then PGK1 was produced and tested with enzyme-linked immunosorbent assay (ELISA), Western blotting, immunoprecipitation and competitive inhibition immunofluorescence assay. Immunoglobulin (Ig)G against PGK1 was detected in 46% (23 of 50) sera of KD patients, 13% (five of 38) sera in febrile non-KD patients (FC) and 2·6% (one of 38) sera in healthy donors. As an immune target, PGK1 not only helps understanding of the pathogenesis, it also has potential value in facilitating the laboratory diagnosis of KD.