bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying and quantifying potentially problematic prescribing cascades in clinical practice: A mixed‐methods study
Authors: Mohammad Atiya K. , Hugtenburg Jacqueline G. , Vanhommerig Joost W. , van den Bemt Patricia M. L. A. , Denig Petra , Karapinar‐Carkıt Fatma 
Published: September 2024

AbstractBackgroundA prescribing cascade occurs when medication causes an adverse drug reaction (ADR) that leads to the prescription of additional medication. Prescribing cascades can cause excess medication burden, which is of particular concern in older adults. This study aims to identify and quantify potentially problematic prescribing cascades relevant for clinical practice.MethodsA mixed‐methods study was conducted. First, prescribing cascades were identified through literature search. An expert panel (n = 16) of pharmacists and physicians assessed whether these prescribing cascades were potentially problematic. Next, a cohort study quantified potentially problematic prescribing cascades in adults using Dutch community pharmacy data for the period 2015–2020. Additionally, the influence of multiple medications potentially causing the same ADR was evaluated. Prescription sequence symmetry analysis was used to calculate adjusted sequence ratios (aSRs), adjusting for temporal prescribing trends. An aSR >1.0 indicates the occurrence of a prescribing cascade. In a subgroup analysis, aSRs were calculated for older adults.ResultsSeventy‐six prescribing cascades were identified in literature and three were provided by experts. Of these, 66 (83.5%) were considered potentially problematic. A significant positive aSR for the medication sequence was found for 41 (62.1%) of these prescribing cascades. The highest aSR was found for amiodarone potentially causing hypothyroidism treated with thyroid hormones (4.63 [95% confidence interval 4.40–4.85]), based on 565 incident users. The biggest population (n = 34,645) was found for angiotensin converting enzyme‐inhibitors potentially causing urinary tract infections treated with antibiotics. Regarding four potential ADRs, the aSRs were higher for people using multiple medications that cause the same ADR as compared to people using only one of those medications. Among older adults the aSRs remained significant for 37 prescribing cascades.ConclusionAn overview was generated of potentially problematic prescribing cascades relevant for clinical practice. These results can support healthcare providers to intervene and reduce medication burden for older adults.
Memory problems in elderly people with traumatic brain injury
Authors: Monov Dimitar , Lilyanov Nikolay 
Published: September 2024

AbstractThe aim of this study is to assess the effectiveness of various therapy methods in elderly individuals with traumatic brain injury (TBI), taking into account the degree of memory loss and the severity of the injury. The study was conducted in 2022 in Moscow, Russia, and Sofia, Bulgaria, involving six clinics. A total of 200 elderly patients with TBI participated in the study, with a mean age of 72 years. Patients were categorized into groups based on the degree of memory loss and severity of the injury. Standardized tests, including the Mini‐Mental State Examination (MMSE), Clock Drawing Test, Digit Symbol Substitution Test, and Free, and Cued Selective Reminding Test, were used to assess cognitive functions. The Progressive Learning Test evaluated patients' ability to memorize and reproduce information over time. Groups receiving physical therapy and cognitive rehabilitation showed statistically significant improvement in cognitive functions compared to other therapy methods. Specifically, the mean score of the MMSE in these groups increased by 7 points (p < .001). Patients with more severe memory loss demonstrated more pronounced improvement in cognitive functions following the integrated therapy approach. The mean MMSE score increased by 10 points (p < .001), whereas in patients with milder memory loss, the growth was less significant (mean increase of 5 points, p < .05). Groups receiving physical therapy and cognitive rehabilitation consistently demonstrated significantly better results compared to speech therapy and psychological support throughout the study period.
Combination Therapy With CGF and Microneedling‐Assisted Compound Betamethasone for Resistant Alopecia Areata: A Pilot Study
Authors: Jia Lingling , Zhao Changjiang , Zhang Hongyi , Jiang Hua , Xiong Jiachao , Li Yufei 
Published: September 2024

ABSTRACTBackgroundAlopecia areata (AA), an autoimmune disorder characterized by hair loss, can be particularly difficult to manage when patients do not respond to standard therapeutic approaches such as topical or injectable corticosteroids, contact immunotherapy, and systemic treatments. In instances where these conventional therapies prove ineffective, alternative or adjunctive treatments are sought. Concentrated growth factor (CGF) and microneedling (MN)‐assisted drug delivery are promising methods for the treatment of different dermatological diseases.ObjectiveThis study aimed to assess the practical benefits and the safety aspects of utilizing a dual treatment approach involving CGF and MN‐assisted compound betamethasone for patients suffering from resistant AA that are unresponsive to conventional medical interventions.Material and MethodsThis retrospective study was based on evaluations of seven patients with refractory AA treated with CGF and MN‐assisted compound betamethasone from July 2021 to December 2023. The efficacy of treatment was assessed by extents of hair regrowth percentages of involved areas.ResultsAmong the seven enrolled patients with refractory AA, a notable outcome was observed where one patient (14.3%) achieved a regrowth of hair by over 50%, while six patients (85.7%) exhibited complete recovery without any systemic or local adverse effects. Furthermore, the difference in SALT scores between baseline, and the final visit for all patients was found to be statistically significant, substantiating the therapeutic efficacy of the intervention employed.ConclusionThe present study demonstrated that the synergistic application of CGF in conjunction with MN‐assisted compound betamethasone may constitute a promising and well‐tolerated therapeutic modality for refractory AA, offering a potentially efficacious and safe treatment alternative.
The effect of intratesticular autologous platelet‐rich plasma injection on sperm retrieval rates and in vitro fertilization outcomes in couples with non‐obstructive azoospermia
Authors: Gudelci Tansu , Cakiroglu Yigit , Yuceturk Aysen , Batır Sevil , Karaosmanoglu Ozge , Korun Zeynep Ece Utkan , Tufek Ilter , Kural Ali Riza , Tiras Bulent 
Published: September 2024

AbstractAimTo assess the efficacy of intratesticular injection of autologous platelet‐rich plasma (PRP) in men with non‐obstructive azoospermia (NOA) and a history of failed microdissection‐testicular sperm extraction (mTESE) procedures.MethodsA prospective case series of a cohort study was conducted involving couples diagnosed with NOA. Patients with at least one failed mTESE procedure were included. Intratesticular PRP injection was performed using a standardized protocol. Follow‐up assessments included sperm analysis, hormonal evaluation, and in vitro fertilization (IVF) outcomes.ResultsData from 177 men with NOA were analyzed, with 135 patients meeting eligibility criteria. PRP treatment resulted in positive sperm retrieval rates of 27.5% in patients with one prior failed mTESE procedure and 16.4% in patients with two or more failed attempts. IVF outcomes showed fertilization rates of 86.4% and 100.0% in respective groups, with pregnancy rates of 36.8% and 22.2% per embryo transfer. Histopathological examination post‐mTESE revealed varied patterns, including Sertoli cell‐only syndrome and maturation arrest.ConclusionsIntratesticular PRP injection shows promise as a potential therapeutic approach for NOA patients with prior failed mTESE procedures, demonstrating improved sperm retrieval rates and favorable IVF outcomes. Further randomized controlled trials are warranted to validate these findings and refine the technique's efficacy in male infertility management to answer the question of whether PRP could significantly improve the second attempt retrieval rate.
Temporomandibular Joint Discectomy in Patients With Disc Displacement: Assessment of Osteoarthritis at 10‐ and 30‐Year Follow‐Up
Authors: Hol Caroline , Mork‐Knutsen Peer , Larheim Tore A. , Bjørnland Tore , Arvidsson Linda Z. 
Published: September 2024

ABSTRACTBackgroundFew ≥ 10‐year follow‐up studies of temporomandibular joint (TMJ) discectomy without replacement in patients with disc displacement (DD) analyse the relationship between the surgery and osteoarthritis (OA) exist.ObjectivesTo radiologically evaluate bony joint changes and OA development 10 and 30 years after TMJ discectomy as well as 30‐year clinical outcome.MethodsTwenty‐two discectomy patients at the University of Oslo, Norway, with records confirming initial TMJ diagnosis and attendance of 10‐year radiological follow‐up were evaluated and eligible for 30‐year follow‐up. Primary variables: discectomy and CT‐/CBCT‐diagnosed OA at follow‐ups. Secondary variables: perioperative TMJ diagnoses and remodelling at follow‐up. Unoperated TMJs (Unop‐TMJs) in unilaterally operated patients were controls. Statistical association and correlation analyses were performed for the 10‐year follow‐up (significance level p < 0.05).ResultsTwenty‐two patients attended the 10‐year follow‐up (mean follow‐up 11 years) with 27 operated TMJs (Op‐TMJs) and 17 Unop‐TMJs. OA perioperatively was associated with DD without reduction (p = 0.001) and additional disc abnormalities (p = 0.016). Although statistically non‐significant, the number of TMJs with OA had increased at 10‐year follow‐up (p = 0.114, Op‐TMJs: 14 to 20 joints; Unop‐TMJs: 2 to 5 joints). Remodelling was correlated with discectomy (p = 0.003) and to OA (p = 0.006). Nine patients attended the 30‐year follow‐up (mean follow‐up 32 years, 11 Op‐TMJs). All TMJs with OA at 30‐year follow‐up had OA at 10‐year follow‐up. Mean maximal interincisal opening was 39 mm. No DC‐TMD‐diagnosed arthralgia was found.ConclusionOsteoarthritis developed similarly between Op‐ and Unop‐TMJs. Only remodelling, not OA, was correlated to the surgery. The clinical results were still favourable at final follow‐up.
Correlation Between Swallowing and Cognitive Brain Networks in Older Adults via Functional MRI
Authors: Wang Jie , Zhang Mengqing , Wen Hongmei , Yang Cheng , Wei Xiaomei , Wang Yonghui , Dou Zulin 
Published: September 2024

ABSTRACTBackgroundClinical evidence supports that swallowing function is correlated with cognition, but the neurobiological mechanism associated with cognitive impairment and dysphagia remains unclear.ObjectivesTo compare the brain activation patterns of the swallowing and the cognitive tasks and explore neural associations between swallowing and cognitive function via task‐related functional magnetic resonance imaging (fMRI).MethodsA total of 13 healthy older adults (aged > 60 years) were recruited. Participants underwent the clinical dementia rating (CDR) test and the Montreal Cognitive Assessment (MoCA). A block‐designed task‐related fMRI study was conducted where each participant completed both swallowing and cognitive tasks within a single session. During the swallowing task, participants swallowed 2 mL of thickened water, while the Stroop Colour Word Test (SCWT) served as the cognitive task. First‐level analysis of swallowing time‐series images utilised the general linear model (GLM) with Statistical Parametric Mapping (SPM), applying a voxel threshold of p < 0.001 for significance. Common activations in brain regions during swallowing and cognitive tasks were extracted at the group level, with significance set at p < 0.05, corrected for multiple comparisons using the false discovery rate (FDR), with a minimum cluster size of 20 voxels. Correlation analysis between behavioural measurements and imaging signals was also conducted.ResultsSome regions were commonly activated in both task networks; these regions were the bilateral occipital lobe, cerebellum, lingual gyrus, fusiform, middle frontal gyrus, precentral and postcentral gyrus, right supramarginal and inferior parietal lobe. Most importantly, the average beta value of cognitive and swallowing tasks in these areas are both significantly negative related to the MoCA score. Furthermore, opposite signal changes were seen in the bilateral prefrontal lobes during the swallowing task, while positive activation in the bilateral prefrontal lobes was observed during the SCWT. Postcentral gyrus activation was more extensive than precentral gyrus activation in the swallowing task.ConclusionThe common activation of swallowing and cognitive tasks had multiple foci. The activity of cognitive and swallowing task in these areas is significantly negative correlated with the MoCA score. These findings may help to illustrate the association between dysphagia and cognitive impairment due to the common brain regions involved in cognition and swallowing and may provide a reference for further rehabilitation of dysphagia.Trial RegistrationClinical Trial: (Chinese Clinical Trial Registry): ChiCTR1900021795
Relationships Between Test Results for Oral Hypofunction, Subjective Frailty Symptoms and Oral Health‐Related Quality of Life of Japanese Dental Outpatients: A Multicentre, Cross‐Sectional Study
Authors: Morinaga Daisaku , Itoh Takatoshi , Soejima Yoshiki , Horikawa Tadashi , Nagai Shoji , Takeshita Fumitaka , Abe Naruyoshi , Kaku Toshio , Iijima Toshikazu , Soejima Daigo , Hara Toshihiro , Sato Ryuta , Murakami Mamoru , Sawase Takashi , Nishimura Masahiro 
Published: September 2024

ABSTRACTBackgroundOral hypofunction is the stage before oral dysfunction. The subjective symptoms of poor oral function and the decline in oral health‐related quality of life (OHRQoL) that occur in the oral hypofunction stage can be missed.ObjectiveThis multicentre cross‐sectional study was performed to examine the relationships between the test results for oral hypofunction, subjective frailty symptoms and OHRQoL of outpatients in dental clinics.MethodsThe basic characteristics and oral function test results of 637 dental clinic outpatients were evaluated. The subjective symptoms of physical and oral frailty were investigated using a questionnaire. OHRQoL was assessed using the Japanese short version of the Oral Health Impact Profile (OHIP‐JP16) and OHRQoL dimension score.ResultsThe overall prevalence of oral hypofunction was 37.8%, with no significant difference between men and women. No significant differences in the presence or absence of subjective symptoms of frailty and a high OHIP score were observed based on sex. However, the prevalence of oral hypofunction was significantly different among the age groups and increased with age. The subjective symptoms of frailty score, OHIP score and OHRQoL dimension score were significantly higher in patients with versus without oral hypofunction. Age, number of underlying diseases, total score for subjective symptoms of frailty, total score for OHIP and OHRQoL dimension score were significantly associated with oral hypofunction.ConclusionOral hypofunction may affect the subjective symptoms of frailty and OHRQoL in older adults.
Critical Appraisal of Clinical Trials Evaluating Physical Therapy Treatments for Temporomandibular Disorders: A Scoping Review
Authors: Ballesteros‐Frutos Jorge , Fernandez‐Matias Ruben , Gallardo‐Zamora Pablo , Pecos‐Martín Daniel 
Published: September 2024

ABSTRACTBackgroundPhysical therapy seems the most promising treatment for temporomandibular disorders (TMD), although their effectiveness is controversial in general, due to high heterogeneity regarding study designs, applied treatments and outcomes measures.ObjectivesThe aim of this scoping review is to analyse the methodological characteristics of clinical trials evaluating physical therapy treatments in subjects with TMD.MethodsA systematic search was conducted in Medline/PubMed, SPORTDiscus, Scopus, Web of Science, SciELO, Cochrane, ScienceDirect and EMBASE databases on 31 October 2023. Clinical trials evaluating physical therapy interventions in patients older than 18 years with TMD, published in English or Spanish languages. Data regarding content reporting of study designs, sample characteristics, interventions and outcome measures was extracted. Descriptive summary statistics were reported.ResultsThe search retrieved 15 322 records, and 136 were included. There were 107 randomised clinical trials, 5 non‐randomised controlled trials and 24 non‐controlled trials. Most studies had moderate to high risk of bias, small sample sizes (median, 44 subjects) and short follow‐up periods (1–3 months). The most common diagnostic criteria used was the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) (48.9%). The most reported experimental interventions were manual therapy (40.4%), exercise (30.2%) and electrotherapy modalities (27.2%), and the most common outcome measure domains were pain (83.8%), range of movement (61.8%), disability (45.6%) and mechanosensitivity (29.4%). There was poor content reporting of experimental interventions.ConclusionsCurrent literature of clinical trials of physical therapy interventions for TMD has moderate to high risk of bias, poor content reporting, small sample size and short‐term follow‐ups which limit internal and external validity, as well as applicability into clinical practice.
Effect of finishing and polishing techniques on the fit accuracy and dimensions of conventional and CAD‐CAM removable partial denture frameworks
Authors: Altoman Majed S. , Soltanzadeh Pooya , Suprono Montry S. , Gadah Thrya S. , Kattadiyil Mathew T. 
Published: September 2024

AbstractPurposeThe purpose of this study was to compare the effects of finishing and polishing techniques on the fit accuracy, metal loss, and surface roughness of conventional versus CAD‐CAM removable partial denture (RPD) frameworks.Materials and MethodsA 3D‐printed maxillary Kennedy class III modification I model served as the master cast. Forty impressions (20 conventional and 20 digital) were divided into four groups: lost‐wax technique (Group I: LWT), CAD‐printed (Group II: CAD‐RP), CAD‐printed from a stone cast (Group III: CAD‐RPS), and lost‐wax technique from resin‐printed models (Group IV: LWTR). Various finishing and polishing techniques were applied, followed by digital scanning for fit accuracy assessment using surface matching software. Metal thickness loss and surface roughness were evaluated pre‐ and post‐finishing and polishing. The Kruskal‐Wallis test followed by the Scheffe post‐hoc test were conducted to evaluate the fit accuracy between groups (α = 0.05).ResultsColor mapping revealed significant differences (p < 0.001) between conventionally casted RPD frameworks and 3D‐printed groups post‐finishing and polishing. The most significant gap was observed with the guide plates from printed RPD frameworks. The D‐Lyte technique resulted in less metal loss compared to the conventional finishing and polishing technique (p < 0.001).ConclusionWithin the limitations of this study, conventionally processed RPD groups exhibited better overall fit accuracy post‐finishing and polishing. Both conventional cast and 3D‐printed RPD frameworks showed clinically acceptable fit accuracy. The D‐Lyte technique presented less metal loss and smoother surfaces compared to other groups, suggesting it as a viable alternative.
Secondary prophylaxis and specialist review compliance in paediatric patients with acute rheumatic fever and rheumatic heart disease in a Western Australian metropolitan setting
Authors: Tarca Adrian , Melvin Jennifer , MacDonald Bradley , Jeyaseelan Ahilan , Ramsay James , Shipton Stephen , Vine Julie , Yim Deane 
Published: September 2024

AimRheumatic heart disease (RHD), a consequence of acute rheumatic fever (ARF), continues to cause significant morbidity and mortality in susceptible young people. Secondary antibiotic prophylaxis is an effective strategy to prevent ARF recurrence and RHD progression. However, the proportion of patients receiving the recommended minimum benzathine penicillin injections (>80%) remains low. This retrospective cohort study reviews the utility of the Hospital in the Home nursing service in providing secondary prophylaxis for outpatients in a metropolitan state capital.MethodsFifty‐eight patients with ARF/RHD receiving secondary prophylaxis through the Hospital in the Home service between 1 July 2012 and 30 June 2020 were included. Compliance of secondary prophylaxis, specialist review and echocardiogram frequency were compared against the recommendations from the Australian RHD guidelines.ResultsForty‐six (79%) patients received >80% of recommended doses, with 36% (n = 21) receiving 100% and a further 29% (n = 17) achieving compliance of 90%–99%. We found that 35% of patients attended all specialist reviews (including echocardiography) at the recommended frequency, with 75% of those not attending all reviews, missing only one or two appointments. Compliance was greater in those with more severe disease. In the 12 (21%) patients who did not meet the >80% target, compliance ranged between 33% and 79% (mean 64.5%) and all had priority 3 disease.ConclusionCommunity‐based administration of secondary prophylaxis through a registry‐based system is an effective strategy of improving compliance within a metropolitan area and should be utilised in a culturally safe and collaborative manner to increase uptake.
Seeking simplicity, navigating complexity: How veterinarians select an antimicrobial drug, dose, and duration for companion animals
Authors: Scarborough Ri O. , Bailey Kirsten E. , Sri Anna Ellen , Browning Glenn Francis , Hardefeldt Laura Y. 
Published: September 2024

AbstractBackgroundMinimizing harm from antimicrobials requires use of the narrowest spectrum drug, at an effective dose for the minimum effective duration. Many prescribers are not currently following these guidelines. To address suboptimal antimicrobial use, the underlying reasons must be understood.ObjectivesTo identify factors influencing choices of antimicrobial drug, dose, and duration for companion animals.SubjectsTwenty‐two veterinarians treating companion animals in Australia. Diversity of participants was deliberately sought.MethodsSemistructured interviews were conducted online. Two case studies were discussed, and then a range of broader questions was posed. Transcripts were analyzed thematically, using an inductive approach.ResultsFew participants chose guideline‐concordant management for the case studies. Prescribing choices were influenced by a complex array of factors associated with the clinical case, pet owner, drug, veterinarian, veterinary colleagues, and external factors. Key factors driving broad‐spectrum antimicrobial use included a sense of safety, habit, ease of administering the drug (especially in cats), pharmaceutical marketing, and the self‐perpetuating dispensary cycle. Many participants were concerned about antimicrobial resistance, but insufficiently informed about how to minimize this risk. Several participants believed that longer duration of treatment and ensuring patients finish a predetermined course would decrease the risk of antimicrobial resistance and improve clinical outcomes.Conclusions and Clinical ImportanceVeterinarians are engaged with the concept of antimicrobial stewardship, but face numerous practical barriers and require more information. In particular, improved education is needed on enhancing patient safety by minimizing both spectrum of activity and duration of treatment, and dispelling myths about “finishing the course.”