bluuebunny/crossref_metadata_2025_split huggingface dataset:
The modified R.E.N.A.L. nephrometry score comprising longitudinal tumor localization is better for predicting intraoperative collecting system entry during robot‐assisted partial nephrectomy
Authors: Kobayashi Keita , Ban Yoshimasa , Hiroyoshi Toshiya , Isoyama Naohito , Shiraishi Koji 
Published: January 2024

AbstractIntroductionDuring robot‐assisted partial nephrectomy (RAPN) for small renal tumors, intraoperative collecting system entry (CSE) is a factor that defines the surgical complexity (prolonged inhibition time), complications (postoperative urinary leakage), and requirements for intraoperative ureteral catheter insertion.MethodsFrom October 2018 to March 2023, 113 consecutive patients who underwent RAPN for clinical T1‐stage renal tumors were included in this single‐center retrospective validation study. Patient and tumor characteristics associated with intraoperative CSE were analyzed to validate the modified R.E.N.A.L. nephrometry score (RNS).ResultsIntraoperative CSE was observed in 54 patients (48%). During the univariate analysis, upper pole tumor location, tumor size, renal sinus invasion, and urinary tract proximity were significant predictors of intraoperative CSE. Subsequent multivariate analysis identified upper pole tumor location (upper vs. lower: odds ratio [OR], 5.36; p = .014) and nearness of the tumor to the collecting system or sinus (>4 but <7 mm vs. ≥7 mm: OR, 4.17; p = .04; ≤4 mm vs. ≥7 mm: OR, 32.71; p < .001) as independent predictors of intraoperative CSE.ConclusionThe modified RNS, which includes longitudinal tumor localization as a variable instead of polar line‐based tumor location, may be a better risk classification tool than the conventional RNS (area under the receiver‐operating characteristic curve: 0.816 vs. 0.754) for determining the need for intraoperative ureteral catheter insertion and predicting intraoperative CSE and surgical complexity.
The key components of a clinical psychology formulation: A consensus study
Authors: Thrower Naomi E. , Bucci Sandra , Morris Lydia , Berry Katherine 
Published: January 2024

AbstractObjectivePsychological formulation is a key competency for clinical psychologists. However, there is a lack of consensus regarding the key components and processes of formulation that are hypothesized to contribute to poor reliability of formulations. The aim of this study was to develop consensus on the essential components of a formulation to inform training for clinical psychologists and best practice guidelines.MethodsA Delphi methodology was used. Items were generated from the literature and discussed and refined with a panel of experts (n = 10). In round one, 110 clinical psychologists in the United Kingdom rated the importance of components of formulation via an online questionnaire. Criteria for consensus were applied and statements were rerated in round two if consensus was not achieved.ResultsConsensus was achieved on 30 items, with 18 statements regarding components of a formulation and 12 statements regarding formulation process. Items that clinicians agreed upon emphasized the importance of integrating sociocultural, biological, strengths and personal meaning alongside well‐established theoretical frameworks. Consensus was not reached on 20 items, including whether a formulation should be parsimonious or adhere to a model.ConclusionOur findings provide mixed evidence regarding consensus on the key components of formulation. There was an agreement that formulation should be client‐led and incorporate strengths and sociocultural factors. Further research should explore client perspectives on the key components of formulation and how these compare to the clinicians' perspectives.
Image intensifier‐guided transperineal prostate biopsy for patients without a rectum: novel technique
Authors: McNicholas Daniel P. , Parr Nigel J. 
Published: January 2024

IntroductionIt is challenging to perform prostate biopsy in men with suspicion of prostate malignancy without a rectum to facilitate prostate biopsy. Nevertheless, such patients are presenting at an earlier stage, due to increased PSA testing in association with improved MRI imaging. We describe a novel technique for prostate biopsy in two such cases.TechniqueThe patient is under General Anaesthesia and in lithotomy position. The patient is catheterised and a measured volume of contrast is inserted to the catheter balloon. By using anatomical surface landmarks, placing traction on the catheter to bring the balloon to the level of the bladder neck and using fluoroscopy, the distance to the apical prostate was estimated. This facilitates image intensifier guided trans‐perineal prostate biopsy.OutcomesA 67‐year‐old patient, with a history of panproctocolectomy for ulcerative colitis, presented with increasing PSA and a suspicious prostate on MP‐MRI. The prostate couldn’t be visualised on transperineal ultrasound and the patient was offered transperineal biopsy using image intensifier guidance. Several biopsy cores were taken and prostate cancer was diagnosed. The second patient was a 68‐year‐old who presented similarly, but with a history of panproctocolectomy for Crohn's disease. Using the above technique, biopsies were taken with low‐risk prostate cancer diagnosed. Subsequently, due to rising PSA levels, a repeat set of prostate biopsies was taken 13 months later in an identical manner, upstaging his disease. There were no post‐operative complications after any of the procedures.ConclusionWe review the literature and discuss several techniques available to sample the prostate in this patient cohort. We conclude that we have identified a safe and effective technique, which utilises commonly available equipment, to biopsy the prostate in the post proctectomy patient.
What do we know about sex education of people with intellectual disabilities? An umbrella review
Authors: Pérez‐Curiel Patricia , Vicente Eva , Morán Mª Lucía , Gómez Laura E. 
Published: January 2024

AbstractBackgroundSpecial attention is required when considering any educational intervention aimed at its promotion and development. Our objective is to conduct an umbrella review of systematic reviews that gather evidence from relationships and sex education programmes tailored for individuals with intellectual disabilities.MethodsThe protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐analyses Protocol. Systematic reviews were identified through a search in Web of Science, SCOPUS and PsychINFO, using the descriptors: ‘intellectual disab*’ AND ‘sex*’AND ‘systematic’.FindingsThe results of the nine reviews included in the meta‐review yield relevant outcomes related to 50 sex education interventions carried out with people with intellectual disabilities. This provided the opportunity to delve into the characteristics of these interventions to ascertain the accomplishments achieved to date.ConclusionsThe findings serve as foundation to propose and promote new research on this important area of life, addressing the inequalities identified concerning the sexuality and affective‐sexual education of people with intellectual disabilities. It offers valuable information for the educational, social and healthcare fields, facilitating the design of more effective and rights‐respecting initiatives.
Triggers, clinical manifestations and assessment of paediatric fixed drug eruptions: A systematic review of the literature
Authors: Mathieu Audrey , de Grandmont Mathilde , Fernandes Carolina Lucena , Kechichian Elio 
Published: January 2024

AbstractFixed drug eruption (FDE) is a cutaneous drug reaction characterised by recurrent skin lesions occurring at the same site after each exposure to a causative agent. There is currently limited evidence in the paediatric population. The objective of this systematic review is to investigate the clinical features, causative agents and management of paediatric FDE. A systematic search of the English and French literature on paediatric FDE was conducted using the Medline and Embase databases. After full‐text article review, 92 articles were included, representing a total of 233 patients. Antibiotics were the most frequent triggering agents, mainly sulfonamides (65.0% of antibiotics). Systemic symptoms were rare, and most patients only received supportive therapy. One hundred and six patients (106) performed a test to confirm the causative agent. Of these, 72.6% had oral provocation tests (OPTs) and 28.3% had patch tests. The patient's age, presence of bullous lesions and mucosal lesions were similar between tested and untested patients. It did not seem to influence the decision to perform OPTs. Paediatric FDE is a non‐severe skin drug reaction. Antibiotics were the most reported triggering agents. Drug testing, including oral provocation test, was safely performed in the paediatric population.
Liver, renal, genitourinary and diabetic ketoacidosis risks among new users of empagliflozin versus dipeptidyl peptidase‐4 inhibitors in patients with type 2 diabetes: Post‐authorization safety study based on multinational cohorts
Authors: Rebordosa Cristina , Thomsen Reimar W. , Tave Arlene K. , Madsen Morten , Beachler Daniel C. , Martinez David , Garcia‐Esteban Raquel , Plana Estel , Tormos Anita , Farsani Soulmaz Fazeli , Perez‐Gutthann Susana , Pladevall‐Vila Manel 
Published: January 2024

AbstractAimTo estimate risks of diabetic ketoacidosis (DKA), acute liver injury (ALI), acute kidney injury (AKI), chronic kidney disease (CKD), severe complications of urinary tract infection (UTI) and genital infection (GI) among patients with type 2 diabetes initiating empagliflozin versus those initiating a dipeptidyl peptidase‐4 (DPP‐4) inhibitor.Materials and MethodsIn this large multinational, observational, new‐user cohort study in UK, Danish and US healthcare data sources, patients initiated empagliflozin or a DPP‐4 inhibitor between August 2014 and August 2019, were aged ≥18 years, and had ≥12 months' continuous health plan enrolment. Incidence rates by exposure and incidence rate ratios, adjusted for propensity‐score deciles, were calculated.ResultsIn total, 64 599 empagliflozin initiators and 203 315 DPP‐4 inhibitor initiators were included. There was an increased risk [pooled adjusted incidence rate ratios (95% confidence interval)] of DKA [2.19 (1.74‐2.76)] and decreased risks of ALI [0.77 (0.50‐1.19) in patients without predisposing conditions of liver disease; 0.70 (0.56‐0.88) in all patients] and AKI [0.54 (0.41‐0.73)]. In the UK data, there was an increased risk of GI [males: 4.04 (3.46‐4.71); females: 3.24 (2.81‐3.74)] and decreased risks of CKD [0.53 (0.43‐0.65)] and severe complications of UTI [0.51 (0.37‐0.72)]. The results were generally consistent in subgroup and sensitivity analyses.ConclusionsCompared with DDP‐4 inhibitor use, empagliflozin use was associated with increased risks of DKA and GI and decreased risks of ALI, AKI, CKD and severe complications of UTI. These associations are consistent with previous studies and known class effects of sodium‐glucose cotransporter 2 inhibitors, including renoprotective effects and beneficial effects on alanine aminotransferase levels.
Two years with GIOIA ‘Effects of gliflozins and gliptins on markers of cardiovascular damage in type 2 diabetes’: A prospective, multicentre, quasi‐experimental study on sodium‐glucose cotransporter 2 and dipeptidyl peptidase‐4 inhibitors in diabetes clinical practice
Authors: Longo Miriam , Caruso Paola , Scappaticcio Lorenzo , Maiorino Maria Ida , Bellastella Giuseppe , Capuano Annalisa , Esposito Katherine , Giugliano Dario 
Published: January 2024

AbstractAimTo assess and compare the metabolic and vascular effectiveness of sodium‐glucose cotransporter 2 inhibitors (SGLT‐2i) and dipeptidyl peptidase‐4 inhibitors (DPP‐4i) in the clinical practice of patients with type 2 diabetes in Italy.Materials and MethodsGIOIA is a 2‐year prospective, multicentre, quasi‐experimental study that enrolled patients with type 2 diabetes initiating SGLT‐2i or DPP‐4i for inadequate glycaemic control [glycated haemoglobin (HbA1c) >7%] between March 2018 and March 2021. The primary endpoints were changes in markers of organ damage [carotid intima‐media thickness (CIMT), albuminuria, myocardial function] and HbA1c from baseline to year 2.ResultsIn total, 1150 patients were enrolled in the study (SGLT‐2i n = 580, DPP‐4i n = 570). Patients initiated on SGLT‐2i were younger (about 6 years) and heavier (about 11 kg), had higher HbA1c level (1% more), more albuminuria and cardiovascular events (16% more) than patients initiated on DPP‐4i. CIMT and echocardiographic parameters were not significantly different. Propensity score matching yielded two groups, each consisting of 155 patients with diabetes with similar baseline characteristics. Despite a significant similar reduction in HbA1c levels in both groups (−0.8%), more patients on SGLT‐2i had regression of CIMT and albuminuria (22% and 10%, respectively, p < .001 vs. DPP‐4i); more patients on DPP‐4i had progression of CIMT and albuminuria (23% and 28%, respectively, p < .001 vs. SGLT‐2i). Left ventricular ejection fraction improved slightly (3%, p = .043) on SGLT‐2i only.ConclusionsIn a real‐world setting, both SGLT‐2i and DPP‐4i improve glycaemic control persisting after 2 years of treatment, with a robust effect on both CIMT and albuminuria regression for SGLT‐2i as compared with DPP‐4i in the propensity score matching.
Knowledge of emergency dental management among a localized sample of athletic trainers
Authors: Wenger K. , Williamson A. , McNally M. , Dutta E. 
Published: January 2024

AbstractBackground/AimsAthletic trainers are often the point person when sports‐related traumatic dental injuries (TDIs) occur. The aim of this study was to assess knowledge levels of the management of TDIs among athletic trainers in the Midwest United States, as well as evaluate variables that may influence knowledge levels.Material and MethodsA survey was sent to athletic trainers licensed in Minnesota, Nebraska, and Iowa. The survey included 28 multiple‐choice and fill in the blank questions split into three sections. The three sections included background, emergency management of TDIs, and opinion questions.ResultsOf the participants, 100% recalled receiving medical first aid training. However, only 71% recalled receiving formal training on emergency management of dental injuries. Although 75% were confident in managing a dental injury, over 63% of participants scored less than 70% in the knowledge score section. Majority of the participants (98.4%) reported that they believe training on the management of TDIs is important. Athletic trainers working with contact sports were more likely to have experienced managing TDIs more recently than those working in noncontact sports.ConclusionsThis study shows the gaps in knowledge among athletic trainers pertaining to management of TDIs and emphasizes the importance of sports community having adequate education on emergency management of such dental injuries.
Short‐latency afferent inhibition is reduced in people with multiple sclerosis during fatiguing muscle contractions
Authors: Brotherton Emily J. , Sabapathy Surendran , Dempsey Lisa M. , Kavanagh Justin J. 
Published: January 2024

AbstractUnderstanding how inhibitory pathways influence motor cortical activity during fatiguing contractions may provide valuable insight into mechanisms associated with multiple sclerosis (MS) muscle activation. Short‐latency afferent inhibition (SAI) reflects inhibitory interactions between the somatosensory cortex and the motor cortex, and although SAI is typically reduced with MS, it is unknown how SAI is regulated during exercise‐induced fatigue. The current study examined how SAI modulates motor evoked potentials (MEPs) during fatiguing contractions. Fourteen people with relapsing–remitting MS (39 ± 6 years, nine female) and 10 healthy individuals (36 ± 6 years, six female) participated. SAI was induced by stimulation of the median nerve that was paired with TMS over the motor representation of the abductor pollicis brevis. A contraction protocol was employed that depressed force generating capacity using a sustained 3‐min 15% MVC, immediately followed by a low‐intensity (15% MVC) intermittent contraction protocol so that MEP and SAI could be measured during the rest phases of each duty cycle. Similar force, electromyography and MEP responses were observed between groups. However, the MS group had significantly reduced SAI during the contraction protocol compared to the healthy control group (p < .001). Despite the MS group reporting greater scores on the Fatigue Severity Scale and Modified Fatigue Impact Scale, these scales did not correlate with inhibitory measures. As there were no between‐group differences in SSEPs, MS‐related SAI differences during the fatiguing contractions were most likely associated with disease‐related changes in central integration.
Risk factors for severe hearing loss in Susac syndrome: A national cohort study
Authors: Peyre Marion , Mageau Arthur , Henry Feugeas Marie‐Cécile , Doan Serge , Halimi Caroline , Klein Isabelle , Goulenok Tiphaine , François Chrystelle , Chauveheid Marie‐Paule , Papo Thomas , Sacré Karim ,   the French Susac Study Group
Published: January 2024

AbstractBackgroundNonreversible hearing loss (HL) is the main sequelae of Susac syndrome (SuS). We aimed to identify risk factors for HL in SuS.MethodsThe CARESS study is a prospective national cohort study that started in December 2011, including all consecutive patients with SuS referred to the French reference center. The CARESS study was designed with a follow‐up including fundoscopy, audiometry, and brain magnetic resonance imaging at 1, 3, 6, and 12 months after diagnosis and then annually for 5 years. The primary outcome was the occurrence at last follow‐up of severe HL defined as the loss of 70 dB in at least one ear on audiometry or the need for hearing aids.ResultsThirty‐six patients (female 66.7%, median age 37.5 [range 24.5–42.5] years) included in the clinical study were analyzed for the primary outcome. Thirty‐three patients (91.7%) had cochleovestibular involvement at SuS diagnosis including HL >20 dB in at least one ear in 25 cases. At diagnosis, 32 (88.9%), 11 (30.6%), and 7 (19.4%) patients had received steroids, intravenous immunoglobulin, and/or immunosuppressive (IS) drugs, respectively. After a median follow‐up of 51.8 [range 29.2–77.6] months, 19 patients (52.8%) experienced severe HL that occurred a median of 13 [range 1.5–29.5] months after diagnosis. Multivariable analysis showed that the odds of severe HL were lower in patients who received IS drugs at diagnosis (OR 0.15, 95% CI 0.01–1.07, p = 0.058).ConclusionsSevere HL in SuS is associated with the absence of IS drugs given at diagnosis. Our findings support the systematic use of IS drugs in SuS.
The future of gender research in small‐scale fisheries: Priorities and pathways for advancing gender equity
Authors: Rice Emma D. , Gondwe Edith , Bennett Abigail E. , Okanga Patrick Asango , Osho‐Abdulgafar Nimah F. , Fakoya Kafayat , Oloko Ayodele , Harper Sarah , Kawaye Patrick Chimseu , Chuku Ernest O. , Smith Hillary 
Published: January 2024

AbstractThis paper presents an agenda for the future of gender research in small‐scale fisheries (SSF). Building on expert insight from scholars who gathered during the 4th World Small‐Scale Fisheries Congress Africa (4WSFC) with a synthesis of existing literature, we identify six topics that warrant future investigation in SSF, along with methodological considerations for addressing them. Research priorities include identifying pathways towards (1) equitable participation in governance and decision‐making, (2) valuing all actors' contributions to aquatic food systems, (3) increasing access to financial services, (4) inclusive infrastructural development, (5) livelihood diversification and (6) reducing occupational health hazards. Several important methodological considerations include (i) using multiple methodologies, (ii) applying participatory methods, (iii) collecting gender‐disaggregated data, (iv) integrating gender into a food systems approach in fisheries, (v) engaging an intersectional approach and (vi) operationalising equity.
Desire discrepancy in long‐term relationships: A qualitative study with diverse couples
Authors: Arenella Katherine , Girard Abby , Connor Jennifer 
Published: January 2024

AbstractSexual desire discrepancy is one of the most common, and potentially distressing, aspects of couples' sexual health. There are gaps in the literature exploring desire discrepancy specifically in distressed couples, as well as in queer (sexual and/or gender minority) couples. This study sought to gather qualitative data regarding long‐term couples' experiences with distressing desire discrepancy. Semi‐structured interviews were conducted with both heterosexual and queer partners of varying gender identities (n = 26) to fill these research gaps. Interviews included couple interviews, as well as individual interviews with partners. Data analysis was conducted with thematic analysis, which yielded four primary themes across the course of relationships: Sexual and relationship satisfaction; Changes in sexual frequency, desire, and behavior; Changes in barriers to sex; and Coping with desire discrepancy. Findings can inform clinical interventions focused on desire discrepancy, as well as future research investigating couple's sexual health.
Insights into malignant mitral valve degenerative disease from a sudden cardiac death cohort highlighting significant measurement differences from normal
Authors: Westaby Joseph , Bicalho Luciana , Zullo Emelia , Sheppard Mary N 
Published: January 2024

AimsMitral valve prolapse (MVP) is an accepted cause of sudden cardiac death (SCD) in most autopsy series. Diagnosis at autopsy relies upon subjective assessment with no established objective pathological criteria. This study set out to establish objective measurements to help pathologists dealing with SCD.MethodsWe diagnosed 120 (1.5%) cases of MVP in 8108 cases of SCD. We measured the mitral annulus, anterior and posterior leaflets, rough zone and mitral annular disjunction (MAD) in 27 MVP cases and compared them to 54 age‐ and sex‐matched normal mitral valves.ResultsAge of death was 39 ± 16 years, with 59 females and 61 males. History of mild MV disease was present in 19 (16%). Eleven (9%) died associated with exertion. Left ventricular hypertrophy was present in nine (15%) females and 10 (16%) males. Both MV leaflets showed thickening and ballooning in all individuals. MVP showed highly significantly increased annular circumference, elongation and thickening of both leaflets as well as increased MAD (all P < 0.001). Left ventricular fibrosis was present in 108 (90%), with interstitial fibrosis in the posterolateral wall and papillary muscle in 88 (81%) and coexisting replacement fibrosis in 40 (37%).ConclusionThis is the largest MVP associated with SCD series highlighting a young cohort with equal representation of males and females. There is involvement of both leaflets with significant annular dilatation, elongation and thickening of both leaflets with MAD. Left ventricular fibrosis explains arrhythmia. Our quantitative measurements should serve as a reference for pathologists assessing post‐mortem hearts for MVP.