bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants of access of frail, community‐residing older adults to geriatricians in Ontario
Authors: Hogeveen Sophie , Hirdes John P. , Heckman George , Keller Heather 
Published: May 2023

AbstractObjectivesLittle is known about determinants of access to community‐based geriatricians. The Geriatric 5Ms™ describe geriatricians' core competencies and inform referrals to specialists for older adults with complex needs. We explored the association of the Geriatric 5Ms™ and other characteristics with outpatient access to geriatricians by home care (HC) clients.MethodsThis was a population‐based, retrospective cohort study of frail community‐dwelling HC clients (≥60 years) with complex needs (n = 196,444). Health assessment information was linked to health services data in Ontario, Canada, 2012–2015. Multivariable generalized estimating equations were used to identify characteristics associated with geriatrician contact (≥1 visit in 90 days post‐HC admission), including derived Geriatric 5Ms™ score, and predisposing, enabling, and need factors obtained from clinical assessments.ResultsOnly 5.2% of the cohort had outpatient geriatrician contact in Ontario, Canada. Derived Geriatric 5Ms™ score was associated with higher odds of contact, but the model had modest discriminatory power (c‐statistic = 0.67). In the broader multivariable model, based on empirically included factors and adjusted for regional differences, age, worsening of decision‐making, dementia, hallucinations, Parkinsonism, osteoporosis, and caregiver distress/institutionalization risk were associated with higher odds of geriatrician contact. Female sex, difficulties accessing home, impaired locomotion, recovery potential, hemiplegia/hemiparesis, and cancer, were associated with lower odds of contact. This model had good discriminatory power (c‐statistic = 0.77).ConclusionsFew frail, community‐dwelling older adults receiving HC had any outpatient geriatrician contact. While the derived Geriatric 5Ms™ score was associated with contact, a broader empirical model performed better than the Geriatric 5Ms™ in predicting contact with an outpatient geriatrician. Contact was mainly driven by conditions common in older adults, but evidence suggests that geriatricians are not evaluating the most medically complex and unstable older adults in the community. These findings suggest a need to re‐examine the referral process for geriatricians and the allocation of limited specialized resources.
Q‐switched ruby laser is safe and effective in treating primary gingival hyperpigmentation
Authors: Noyman Yehonatan , Kornowski Yoram , Slodownik Dan , Lapidoth Moshe , Levi Assi 
Published: May 2023

AbstractBackgroundPhysiologic gingival hyperpigmentation (PGH) is a benign condition that results from increased melanin production and is prevalent among darker skin individuals. Although the use of lasers for PGH has gained popularity in recent years, the lasers being used are mostly ablative, and act through a non‐selective tissue damage mechanism.AimsThe objective of this study was to evaluate the use of a non‐ablative 694‐nm Q‐switched ruby laser (QSRL) for the depigmentation of PGH.MethodsA retrospective single‐center study of patients diagnosed with PGH and treated with a QSRL Between March 2019 and November 2020.ResultsFour patients were treated with QSRL for 1–3 sessions, until complete depigmentation was achieved. The average follow‐up was 11 months (range 7–18 months) with no patient exhibiting re‐pigmentation. Adverse events included mild local tenderness and transient erosions in two patients.ConclusionThe 694‐nm QSRL is a novel and promising safe and effective method for treating PGH with the advantages of being a non‐ablative modality that minimizes tissue damage and optimizes the outcome.
Possible heterogeneity of initial pancreatic islet beta‐cell autoimmunity heralding type 1 diabetes
Authors: Lernmark Åke , Akolkar Beena , Hagopian William , Krischer Jeffrey , McIndoe Richard , Rewers Marian , Toppari Jorma , Vehik Kendra , Ziegler Anette‐G. ,   The TEDDY Study Group
Published: May 2023

AbstractThe etiology of type 1 diabetes (T1D) foreshadows the pancreatic islet beta‐cell autoimmune pathogenesis that heralds the clinical onset of T1D. Standardized and harmonized tests of autoantibodies against insulin (IAA), glutamic acid decarboxylase (GADA), islet antigen‐2 (IA‐2A), and ZnT8 transporter (ZnT8A) allowed children to be followed from birth until the appearance of a first islet autoantibody. In the Environmental Determinants of Diabetes in the Young (TEDDY) study, a multicenter (Finland, Germany, Sweden, and the United States) observational study, children were identified at birth for the T1D high‐risk HLA haploid genotypes DQ2/DQ8, DQ2/DQ2, DQ8/DQ8, and DQ4/DQ8. The TEDDY study was preceded by smaller studies in Finland, Germany, Colorado, Washington, and Sweden. The aims were to follow children at increased genetic risk to identify environmental factors that trigger the first‐appearing autoantibody (etiology) and progress to T1D (pathogenesis). The larger TEDDY study found that the incidence rate of the first‐appearing autoantibody was split into two patterns. IAA first peaked already during the first year of life and tapered off by 3–4 years of age. GADA first appeared by 2–3 years of age to reach a plateau by about 4 years. Prior to the first‐appearing autoantibody, genetic variants were either common or unique to either pattern. A split was also observed in whole blood transcriptomics, metabolomics, dietary factors, and exposures such as gestational life events and early infections associated with prolonged shedding of virus. An innate immune reaction prior to the adaptive response cannot be excluded. Clarifying the mechanisms by which autoimmunity is triggered to either insulin or GAD65 is key to uncovering the etiology of autoimmune T1D.
Utility and limitations of patient‐adjusted D‐dimer cut‐off levels for diagnosis of venous thromboembolism—A systematic review and meta‐analysis
Authors: Gerber Joël L. , Messmer Anna S. , Krebs Tobias , Müller Martin , Hofer Debora M. , Pfortmueller Carmen A. 
Published: May 2023

AbstractPurposeTo systematically assess test performance of patient‐adapted D‐dimer cut‐offs for the diagnosis of venous thromboembolism (VTE).MethodsSystematic review and analysis of articles published in PubMed, Embase, ClinicalTrials.gov, and Cochrane Library databases. Investigations assessing patient‐adjusted D‐dimer thresholds for the exclusion of VTE were included. A hierarchical summary receiver operating characteristic model was used to assess diagnostic accuracy. Risk of bias was assessed by Quality Assessment of Diagnostic Accuracy Studies 2 score.ResultsA total of 68 studies involving 141,880 patients met the inclusion criteria. The standard cut‐off revealed a sensitivity of 0.99 (95% confidence interval [CI] 0.98–0.99) and specificity of 0.23 (95% CI 0.16–0.31). Sensitivity was comparable to the standard cut‐off for age‐adjustment (0.97 [95% CI 0.96–0.98]) and YEARS algorithm (0.98 [95% CI 0.91–1.00]) but lower for pretest probability (PTP)‐adjusted (0.95 [95% CI 0.89–0.98) and COVID‐19‐adapted thresholds (0.93 [95% CI 0.82–0.98]). Specificity was significantly higher across all adjustment strategies (age: 0.43 [95% CI 0.36–0.50]; PTP: 0.63 [95% CI 0.51–0.73]; YEARS algorithm: 0.65 [95% CI 0.39–0.84]; and COVID‐19: 0.51 [95% CI 0.40–0.63]). The YEARS algorithm provided the best negative likelihood ratio (0.03 [95% CI 0.01–0.15]), followed by age‐adjusted (both 0.07 [95% CI 0.05–0.09]), PTP (0.08 [95% CI 0.04–0.17), and COVID‐19‐adjusted thresholds (0.13 [95% CI 0.05–0.32]).ConclusionsThis study indicates that adjustment of D‐dimer thresholds to patient‐specific factors is safe and embodies considerable potential for reduction of imaging. However, robustness, safety, and efficiency vary considerably among different adjustment strategies with a high degree of heterogeneity.
Quality care close to home: Objectives and early outcomes of a second paediatric heart transplant service in Australia
Authors: Basu Shreerupa , Irving Claire , Roberts Philip , Orr Yishay , Reilly Catherine , Casey Charlene , Griffiths Amelia , Oake Diane , McElduff Michelle , Macdonald Peter , Nair Priya , Jansz Paul , Festa Marino 
Published: May 2023

AimWe describe the experience of a new paediatric heart transplant (HT) centre in Australia. New South Wales offers quaternary paediatric cardiac services including comprehensive care pre‐ and post‐HT; however, perioperative HT care has previously occurred at the national paediatric centre or in adult centres. Internationally, perioperative HT care is highly protocol‐driven and a majority of HT occurs in low volume centres. Establishing a low volume paediatric HT centre in New South Wales offers potential for quality HT care close to home.MethodsRetrospective review of programme data for the first 12 months was undertaken. Patient selection was audited against the programme's intended initiation criteria. Longitudinal patient data on outcomes and complications were obtained from patient medical records.ResultsThe programme's initial phase offered HT to children with non‐congenital heart disease and no requirement for durable mechanical circulatory support. Eight patients met criteria for HT referral. Three underwent interstate transfer to the national paediatric centre. Five children (13–15 years, weight 36–85 kg) underwent HT in the new programme. Individual predicted 90‐day mortality was 1.3–11.6%, with increased risk for recipients transplanted from veno‐arterial extracorporeal membrane oxygenation (VA‐ECMO) and with restrictive/hypertrophic cardiomyopathies. Survival at 90 days and for duration of follow‐up is 100%. Observed programme benefits include mitigation of family dislocation and improved continuity of care within a family‐centred programme.ConclusionAudit of the first 12 months' activity of a second paediatric HT centre in Australia demonstrates adherence to proposed patient selection criteria and excellent 90‐day patient outcomes. The programme demonstrates feasibility of care close to home, providing continuity for all patients including those requiring increased rehabilitation and psychosocial support post‐transplantation.
Ulva: An emerging green seaweed model for systems biology
Authors: Blomme Jonas , Wichard Thomas , Jacobs Thomas B. , De Clerck Olivier 
Published: May 2023

AbstractGreen seaweeds exhibit a wide range of morphologies and occupy various ecological niches, spanning from freshwater to marine and terrestrial habitats. These organisms, which predominantly belong to the class Ulvophyceae, showcase a remarkable instance of parallel evolution toward complex multicellularity and macroscopic thalli in the Viridiplantae lineage. Within the green seaweeds, several Ulva species (“sea lettuce”) are model organisms for studying carbon assimilation, interactions with bacteria, life cycle progression, and morphogenesis. Ulva species are also notorious for their fast growth and capacity to dominate nutrient‐rich, anthropogenically disturbed coastal ecosystems during “green tide” blooms. From an economic perspective, Ulva has garnered increasing attention as a promising feedstock for the production of food, feed, and biobased products, also as a means of removing excess nutrients from the environment. We propose that Ulva is poised to further develop as a model in green seaweed research. In this perspective, we focus explicitly on Ulva mutabilis/compressa as a model species and highlight the molecular data and tools that are currently available or in development. We discuss several areas that will benefit from future research or where exciting new developments have been reported in other Ulva species.
Association between defect morphology and healing of intrabony defects treated with minimally invasive non‐surgical therapy: A pilot exploratory analysis of two cohorts
Authors: Nibali Luigi , Mehta Jaimini , Al‐Shemeri Dhare , Anoixiadou Styliani , Parashis Andreas , Vouros Ioannis 
Published: May 2023

AbstractObjectiveThe aim of this study was to explore the associations between defect morphology (defined by clinical and radiographic parameters) and the healing of periodontal intrabony defects treated with minimally invasive non‐surgical therapy (MINST).Background DataMINST has shown to result in favorable clinical and radiographic improvements in intrabony defects. However, it is not clear which types of intrabony defects are most suitable for this treatment.MethodsClinical and radiographic analyses were carried out in a total of 71 intrabony defects treated with MINST belonging to two previously published studies. Baseline defect characteristics were analyzed and related to clinical and radiographic outcomes at 12 months post‐MINST with or without adjunctive enamel matrix derivative.ResultsNo associations were detected between defect depth, angle and predicted number of walls and clinical and radiographic healing 12 months post‐MINST.ConclusionsNo evidence emerged for associations between defect characteristics and healing following MINST. These data seem to suggest that factors other than defect morphology may influence treatment response to MINST.
The impact of rural structural and community health factors on postmastectomy complications among south central Appalachian breast cancer patients
Authors: Tasman Jordan , Roberson Patricia N. E. , Clegg Devin , Boukovalas Stefanos , Lloyd Jillian 
Published: May 2023

AbstractPurposeThe study examined how structural and community health factors, including primary care physicians (PCP), food insecurity, diabetes, and mortality rate per county, are linked to the number and severity of postmastectomy complications among south central Appalachian breast cancer patients depending on rural status.MethodsData was obtained through a retrospective review of 473 breast cancer patients that underwent a mastectomy from 2017 to 2021. Patient's ZIP Code was used to determine their rural–urban community area code and their county of residence for census data. We conducted a zero inflated Poisson regression.FindingsResults demonstrated that patients in small rural/isolated areas with low (B = −4.10, SE = 1.93, OR = 0.02, p = 0.03) to average (B = −2.67, SE = 1.32, OR = 0.07, p = 0.04) food insecurity and average (B = −2.67, SE = 1.32, OR = 0.07, p = 0.04) to high (B = −10.62, SE = 4.71, OR = 0.00, p = 0.02) PCP have significantly fewer postmastectomy complications compared to their urban counterparts. Additionally, patients residing in small rural/isolated areas with high (B = 4.47, SE = 0.49, d = 0.42, p < 0.001) diabetes and low mortality (B = 5.70, SE = 0.58, d = 0.45, p < 0.001) rates have significantly more severe postmastectomy complications.ConclusionThese findings demonstrate that patients who reside in small/rural isolated areas may experience fewer and less severe postmastectomy when there is certain optimal structural and community health factors present compared to their urban counterparts. Oncologic care teams could utilize this information in routine consult for risk assessment and mitigation. Future research should further examine additional risks for postmastectomy complications.
Emerging Hyalomma lusitanicum: From identification to vectorial role and integrated control
Authors: Valcárcel Félix , Elhachimi L. , Vilá M. , Tomassone L. , Sánchez M. , Selles S. M. A. , Kouidri M. , González M. G. , Martín‐Hernández R. , Valcárcel Á. , Fernández N. , Tercero J. M. , Sanchis J. , Bellido‐Blasco J. , González‐Coloma A. , Olmeda A. S. 
Published: May 2023

AbstractIn the Mediterranean basin, the tick species Hyalomma lusitanicum Koch stands out among other species of the Hyalomma genus due to its wide distribution, and there is great concern about its potential role as a vector and/or reservoir and its continuous expansion to new areas because of climate warming and human and other animal movements. This review aims to consolidate all the information on H. lusitanicum, including taxonomy and evolution, morphological and molecular identification, life cycle, sampling methods, rearing under laboratory conditions, ecology, hosts, geographical distribution, seasonality, vector role and control methods. The availability of adequate data is extremely relevant to the development of appropriate control strategies in areas where this tick is currently distributed as well as in new areas where it could become established in the near future.
A Retrospective, Long‐term Follow‐up of the Clinical Outcomes and Cost‐effectiveness of Single‐anesthetic Multiple Total Joint Procedures in Hemophilic Arthropathy
Authors: Peng Hui‐ming , Jiang Chao , Zheng Zhi‐bo , Chen Xin , Feng Bin , Zhai Ji‐liang , Bian Yan‐yan , Weng Xi‐sheng 
Published: May 2023

ObjectiveAlthough total joint replacement (TJR) procedures are efficacious, perioperative high‐dose factors replacement therapy (FRT) to avoid catastrophic bleeding represents a significant hurdle, particularly for patients with multiple joint affection. Double simultaneous bilateral TJRs were reported as safe and cost‐effective. However, little is known about multiple TJRs. The feasibility and effects remain debatable. Surgeons need to weigh the high cost of FRT against safety. Accordingly, we aimed to evaluate the clinical outcomes and cost‐effectiveness of single‐anesthetic multiple‐joint procedures of lower limbs in end‐stage hemophilic arthropathy.MethodsOur retrospective cohort study retrieved data from an inpatient database of patients with hemophilia who underwent total knee arthroplasty (TKA), total hip arthroplasty (THA), and/or ankle arthrodesis from January 2000 to April 2016. Complications, hospital stays, transfusion, doses of clotting factor, medical costs, range of motion (ROM), Harris hip scores (HHSs) and Hospital for special surgery knee scores (HSSs) were recorded. A P value < 0.05 was considered significant.ResultsA total number of 81 patients were included in this study, among which 89 TKAs and 52 THAs were performed. Compared to the single TJR group, the simultaneous multiple TJR group showed a significantly higher rate of blood transfusions (P < 0.05). But no significant differences were found in the length of hospital stays, factor consumption, hospitalization costs excluding prosthesis expenses, and total complication rates. Finally, similar postoperative ROM, HHS, and HSS were witnessed in two groups (P value > 0.05).ConclusionOur data indicated that simultaneous multiple TJRs are a safe and cost‐effective choice for treating hemophilic patients with multiple HA‐affected lower limb joints.
Physiotherapy management of nociplastic pain: A Delphi study of Italian specialists
Authors: Baroni Andrea , Margelli Michele , Saoncella Anna , Toigo Ilenia , Antonellini Giulia , Straudi Sofia 
Published: May 2023

AbstractBackground and PurposeNociplastic pain due to central sensitization (CS) is common in people suffering from chronic pain, but no clinical practice guideline is available in rehabilitative settings for patients' management. The aim of this study is to achieve expert consensus on physiotherapy competencies in the management of people with nociplastic pain and suspected CS mechanisms.MethodsA web‐based Delphi process was employed. Experts in the rehabilitation field were recruited following pre‐defined eligibility criteria. Following completion of three Delphi rounds, the final list of competencies was generated.ResultsIn all, 23 participants were recruited. They all completed Round 1 (23/23, 100%), twenty Round 2 and Round 3 (20/23, 87%). Following Round 1, seven areas were identified by the panel as crucial for CS physiotherapy management; 19 competencies out of 40 reached the consensus between experts, and nine additional competencies were added to Round 2 following literary review. Round 2 identified the agreement for all the 29 competencies. During Round 3, all the experts confirmed the final list generated through the consensus process.DiscussionAn agreement between experts was found for the final list of competencies that a physiotherapist should implement every time it approaches people with suspected CS mechanisms. Further research is needed to support the clinical utility of our findings and their applicability in daily practice.
Identification of stable restorer lines developed through inter‐sub‐specific hybridization in rice (Oryza sativa) using multi‐trait stability index
Authors: Sruthi Kanneboina , Eswari Kancherla Basaveswari , Damodhar Raju Chennamadhavuni , Sheshu Madhav Maganti , Dhandapani Appavoo , Senguttuvel Ponnuvel , Bala Satya Sree Muthireddy , Sri Krishna Latha Katuru , Beulah Pasumarthi , Nagaraju Pagidipala , Manasa Yekula , Koteswararao Potla , Sadath Ali Mohammad , Divya Balakrishnan , Revathi Ponnusamy , Kemparaju Kaliyur Balachandra , Jyothi Badri , Sundaram Raman Meenakshi , Hari Prasad Arremsetty Subramanyam 
Published: May 2023

AbstractInter‐sub‐specific hybridization between indica and tropical japonica rice germplasm is the most efficient approach for broadening the genetic base of hybrid rice parental lines and enhancing the heterotic potential of hybrids in a tropical country like India. In the present study, 106 indica/tropical–japonica derived lines were developed through inter‐sub‐specific hybridization and screened using functional markers with respect to the major fertility restorer genes, Rf3 and Rf4, and the wide compatibility gene, S5n. The fertility restoration ability of newly developed restorers was validated through test cross nursery performance. The functional markers were observed to accurately predict the trait of fertility restoration. From the present study, the decreasing order of efficiency of different gene combinations on fertility restoration ability are as follows: Rf4/S5n > Rf4/Rf3/S5n > Rf4 > Rf4/Rf3 > Rf3/S5n > Rf3. Based on multi‐trait stability index (MTSI) analysis, the four newly identified restorers, that is, RP6388‐90, RP6382‐49, RP6375‐81 and RP6368‐38, were selected as the top best performing genotypes with high stability for multiple traits, and these genotypes will be useful for the development of superior rice hybrids in India.