bluuebunny/crossref_metadata_2025_split huggingface dataset:
Home mechanical ventilation for children with severe neurological impairment: Parents' perspectives on clinician counselling
Authors: Bogetz Jori F. , Munjapara Vasu , Henderson Carrie M. , Raisanen Jessica C. , Jabre Nicholas A. , Shipman Kelly J. , Wilfond Benjamin S. , Boss Renee D. 
Published: January 2022

AbstractAimTo retrospectively explore the perspectives of parents of children with severe neurological impairment (SNI), such as those with severe cerebral palsy, epilepsy syndromes, and structural brain differences, on clinician counseling regarding home mechanical ventilation (HMV).MethodInductive thematic analysis was performed on data from telephone interviews with parents who chose for and against HMV for their child with SNI at three academic children’s hospitals across the USA.ResultsTwenty‐six parents/legal guardians of 24 children were interviewed. Fourteen children had static encephalopathy, 11 received HMV, and 20 were alive at the time of parent interviews. Themes included how HMV related to the child’s prognosis, risk of death, and integration with goals of care. Although clinicians voiced uncertainty about how HMV would impact their child, parents felt this was coupled with prescriptive/intimidating examples about the child’s end of life and judgments about the child’s quality of life.InterpretationWhile prognositc uncertainty exists, this study suggests that parents of children with SNI seek clinician counseling about HMV that considers their goals of care and views on their child’s quality of life.
Clinical practice guidelines for management of hyperglycaemia in adults with diabetic kidney disease
Authors: Karalliedde Janaka , Winocour Peter , Chowdhury Tahseen A. , De Parijat , Frankel Andrew H. , Montero Rosa M. , Pokrajac Ana , Banerjee Debasish , Dasgupta Indranil , Fogarty Damian , Sharif Adnan , Wahba Mona , Mark Patrick B. , Zac‐Varghese Sagen , Patel Dipesh C. , Bain Stephen C. 
Published: January 2022

AbstractA significant percentage of people with diabetes develop chronic kidney disease and diabetes is also a leading cause of end‐stage kidney disease (ESKD). The term diabetic kidney disease (DKD) includes both diabetic nephropathy (DN) and diabetes mellitus and chronic kidney disease (DM CKD). DKD is associated with high morbidity and mortality, which are predominantly related to cardiovascular disease.Hyperglycaemia is a modifiable risk factor for cardiovascular complications and progression of DKD. Recent clinical trials of people with DKD have demonstrated improvement in clinical outcomes with sodium glucose co‐transporter‐2 (SGLT‐2) inhibitors. SGLT‐2 inhibitors have significantly reduced progression of DKD and onset of ESKD and these reno‐protective effects are independent of glucose lowering. At the time of this update Canagliflozin and Dapagliflozin have been approved for delaying the progression of DKD.The Association of British Clinical Diabetologists (ABCD) and UK Kidney Association (UKKA) Diabetic Kidney Disease Clinical Speciality Group have undertaken a literature review and critical appraisal of the available evidence to inform clinical practice guidelines for management of hyperglycaemia in adults with DKD. This 2021 guidance is for the variety of clinicians who treat people with DKD, including GPs and specialists in diabetes, cardiology and nephrology.
Imaging of equine septic discospondylitis using MRI, CT and post‐mortem radiographs
Authors: Geller Morgan , Slater Robert , Graham‐Williams Elizabeth , Wolf Tatiana , Spriet Mathieu , Berryhill Emily , Skipper Lauren , Aleman Monica 
Published: January 2022

SummaryThis report describes a case of septic discospondylitis in an 11‐year‐old American Miniature stallion. Key imaging features are described here and include Fast Spin Echo T2/STIR hyperintensity on MRI of the intervertebral disc space and surrounding soft tissues as well as vertebral endplate destruction. Spinal cord deformation was seen concurrently and is considered likely secondary to either associated inflammatory granulation tissue or disc herniation. These findings most likely explain the apparent cervical pain and spinal ataxia grade 2/5 due to cervical spinal cord disease in this case.
SLDCNet: Skin lesion detection and classification using full resolution convolutional network‐based deep learning CNN with transfer learning
Authors: Varma P. Bharat Siva , Paturu Siddartha , Mishra Suman , Rao B. Srinivasa , Kumar Pala Mahesh , Krishna Namani Vamshi 
Published: January 2022

AbstractBackgroundSkin cancer is one of the life threating diseases in the world. So, millions of lives can be saved by early detection of skin cancer. In addition, automating the computer‐aided system of skin lesion detection and classification (SLDC) will assist the medical practitioners to ensure more efficacious treatment of skin lesion disease.Material and MethodIn this article, a hybrid preprocessing‐based transfer learning model for SLDC is proposed, which is named as SLDCNet. Initially, the hybrid Gaussian filter (HGF) with connected component label (CCL) based fast march inpainting procedure is used for hair removal and denoising of skin lesions. Next, full resolution convolutional networks (FrCN) based segmentation method is adapted for detecting the cancer region. Then, feature extraction is performed using deep residual learning and finally, transfer learning mechanism is applied for classification of eight skin lesions.ResultsThe extensive simulation results shows that proposed SLDCNet resulted in a classification accuracy of 99.92%, sensitivity of 99%, and specificity of 99.36%, respectively.ConclusionFrom the obtained results, it is proven that proposed SLDCNet provides better performance as compared to state‐of‐art SLDC approaches, and even the standard ISIC‐2019 public challenge.
Association of early bevacizumab interruption with efficacy of atezolizumab plus bevacizumab for advanced hepatocellular carcinoma: A landmark analysis
Authors: Hatanaka Takeshi , Hiraoka Atsushi , Tada Toshifumi , Hirooka Masashi , Kariyama Kazuya , Tani Joji , Atsukawa Masanori , Takaguchi Koichi , Itobayashi Ei , Fukunishi Shinya , Tsuji Kunihiko , Ishikawa Toru , Tajiri Kazuto , Ochi Hironori , Yasuda Satoshi , Toyoda Hidenori , Ogawa Chikara , Nishimura Takashi , Kakizaki Satoru , Shimada Noritomo , Kawata Kazuhito , Tanaka Takaaki , Ohama Hideko , Nouso Kazuhiro , Morishita Asahiro , Tsutsui Akemi , Nagano Takuya , Itokawa Norio , Okubo Tomomi , Arai Taeang , Imai Michitaka , Naganuma Atsushi , Koizumi Yohei , Nakamura Shinichiro , Joko Kouji , Iijima Hiroko , Hiasa Yoichi , Kumada Takashi ,   Real‐life Practice Experts for HCC (RELPEC) Study Group,   HCC 48 Group (hepatocellular carcinoma experts from 48 clinics in Japan)
Published: January 2022

AbstractAimThe present study focused on the association of early bevacizumab (Bev) interruption with the clinical outcome of atezolizumab plus bevacizumab.MethodsThis retrospective study included 239 patients with advanced hepatocellular carcinoma receiving atezolizumab/Bev from September 2020 to June 2021 at 16 different institutions in Japan. We conducted a 9‐week landmark analysis to investigate the association of Bev interruption due to adverse events with the therapeutic efficacy.ResultsThe median age was 73.0 (68.0–80.0) years old, with 195 (81.6%) men. The objective response rate was significantly higher in patients without Bev interruption than in those with it (34.5% vs. 17.3%, p = 0.038). The median progression‐free survival (PFS) was 6.5 months (95% confidence interval [CI] 4.5–9.7) and 9.0 months (95% CI 7.1–not applicable) in patients with and without Bev interruption, respectively, with statistical significance (p = 0.021). The 12‐month overall survival (OS) rates in patients with and without Bev interruption were 49.4% (CI 27.7%–67.9%) and 82.2% (95% CI 70.3%–89.6%), respectively, showing a significant difference (p = 0.004). The presence of Bev interruption was a significant factor associated with the PFS (p = 0.021) and OS (p = 0.008). A multivariate analysis showed that modified albumin–bilirubin 2b (p < 0.001) and later‐line treatment (p = 0.018) were unfavorable factors associated with Bev interruption. Liver injury, appetite loss, protein urea, and ascites or hepatic edema were more frequently found in patients with Bev interruption than in those without it.ConclusionsEarly Bev interruption was an unfavorable factor associated with the PFS and OS. Good liver function and treatment settings may be associated with maintaining Bev treatment.
Socio‐economic inequality in reported dental self‐care behaviour among Iranian households: A national pooled study
Authors: Kazemi‐Karyani Ali , Yahyavi Dizaj Jafar , Khoramrooz Maryam , Soltani Shahin , Soofi Moslem , Irandoust Kamran , Ramezani‐Doroh Vajihe 
Published: January 2022

AbstractBackgroundSetting out effective prevention strategies in dental diseases needs recognition related factors of the prevention behaviours and targeting the most disadvantaged groups in the term of dental hygiene. This study aimed to investigate socio‐economic inequality in the dental self‐care status (DSS) of Iranian households and decompose the measured inequality into its contributors.MethodIn this cross‐sectional study, pooled data were extracted from Households Income and Expenditure Surveys (HIESs) conducted in Iran from 2012 to 2017. The index of socio‐economic status (SES) for each household was constructed using principal components analysis (PCA). We used Wagstaff normalized concentration index as a measure of socio‐economic inequality in dental self‐care. Decomposition analysis was applied to determine the main factors contributed to the measured inequality.ResultsThe prevalence of dental self‐care in the whole population was 40.56%. The total concentration index was 0.271 (CI: 0.266, 0.275). The results of decomposition analysis for the measured inequality showed that SES, was the highest positive contributors (90.19%) followed by sex of household's head (12.15%), place of residence (11.79%) and education level of household‘s head (11.71%). Furthermore, the province of residence had the highest negative contribution (−11.37) to the inequality.ConclusionThe findings of this study showed that a huge portion of the observed inequality was explained by SES that might give us a policy recommendation: There is room for improving dental health and reducing inequality in dental self‐care by paying more attention to SES‐disadvantaged households.
Present status and future directions—Vital pulp treatment and pulp preservation strategies
Authors: Duncan Henry F. 
Published: January 2022

AbstractTherapeutic strategies focussed on the pulp preservation, are important when managing vital teeth with deep caries and an exposed pulp. These vital pulp treatments (VPTs); however, are not new, with indirect and direct pulp capping procedures being described as a therapy for carious teeth for over a century. As a result of unpredictable outcomes, the traditional indications for VPT particularly when the pulp was exposed were limited to the treatment of immature teeth with incomplete root formation. Over the last 20 years, the advent of regenerative endodontics and the promotion of biologically based therapies aimed at reducing intervention have reinvigorated VPT with new waves of basic science and clinical research indicating a role for VPT not only in mature cariously affected teeth, but also in teeth with signs and symptoms indicative of irreversible pulpitis. Driven by new materials such as hydraulic calcium silicate cements, a better understanding of pulpal immunity and biology as well and improved tissue handling, VPT has been at the forefront of treatment recommendations made by global Cariology and Endodontic organizations. Care must be exercised, however, as key gaps in scientific knowledge remain alongside severe limitations in educational dissemination amongst dentists. Although research has highlighted that carious injury to the dentine–pulp complex stimulates a wide range of responses and that the interaction between infection, inflammation and repair will eventually impact on the outcome of pulpitis, our ability to accurately and objectively diagnose the true inflammatory state of the pulp remains poor. An overreliance on symptoms leaves clinicians with subjective, crude diagnostic tools by which to inform treatment planning and decision‐making, which results in large variations in the treatments offered to patients. Not only is there an urgent need to develop preoperative and intraoperative diagnostic tools, but there is also a paucity of the high‐quality comparative evidence required to answer the most important questions and justify treatment options. The aim of this review was to consider the current status of VPT and to discuss the principle problems that are hindering clinical acceptance of these techniques. Potential solutions and opportunities are offered to suggest ways that VPT may become a more consistently prescribed evidenced‐based treatment in dental practice.
Advances in dermatology in sub‐Saharan Africa in the past 20 years from workshops to the birth of the African Society of Dermatology and Venereology
Authors: Verschoore Michèle , Dlova Ncoza 
Published: January 2022

AbstractBackgroundHighly pigmented African skin and hair have distinct characteristics because of their unique physiology and structure. Twenty years ago, despite an increasing number of dermatology specialists in some African countries, there remained a paucity of collaborative research and workshops on African hair and skin, and there was a need for an inclusive African society to represent dermatologists from all English and French‐speaking countries in sub‐Saharan Africa.MethodsWe documented significant research advances between 2000 and 2021 on African hair and skin physiology, as well as clinical dermatology, in sub‐Saharan Africa.ResultsThe main advances documented include the launch of annual African hair and skin workshops in 2004, the introduction of African research grants and the Africaderm web platform in 2013, and the registration of the African Society of Dermatology and Venereology (ASDV) in 2015, which led to the inaugural scientific meeting of ASDV in 2016.ConclusionThere have been significant research advances in African hair and skin over the past 20 years. As skin physiology and skin conditions are similar across sub‐Saharan Africa, scientific and clinical partnerships between companies, academia, and public health care sectors have played a key role in translating new scientific findings on African hair and skin to ensure knowledge is shared. This information has helped educate African specialists, health care workers, and consumers, with a particular focus on the preventable nature of certain dermatoses like skin bleaching‐related complications and traction alopecia.
Efficacy and safety of avanafil as compared with sildenafil in the treatment of erectile dysfunction: A randomized, double blind, multicenter clinical trial
Authors: Kumar Manish , Pathade Amey D , Gupta S VijayaBhaskara , Goyal Sanjay , Rath Debadarshi , Thakre Manish , Sanmukhani Jayesh , Mittal Ravindra 
Published: January 2022

ObjectiveTo compare the efficacy and safety of avanafil as compared with sildenafil in the management of patients with erectile dysfunction.MethodsIt was a prospective, randomized, double‐blind, two‐arm, active‐controlled, parallel, multicenter, non‐inferiority clinical study carried out in patients with erectile dysfunction for at least 3 months and International Index of Erectile Function – Erectile Function domain score of <26 at enrolment.ResultsA total of 220 patients were randomized to receive either avanafil tablets 100 mg or sildenafil tablets 50 mg in 1:1 ratio. After 4 weeks of treatment, 40.0% of patients in the avanafil group and 45.6% of patients in the sildenafil group required dose escalation to a high dose (avanafil 200 mg/sildenafil 100 mg). The difference in the mean change of International Index of Erectile Function – Erectile Function score from baseline in the two groups increased from week 4 (1.1, 95% confidence interval −0.2 to 2.5) to week 8 (1.4, 95% confidence interval 0.1–2.7) and week 12 (2.1, 95% confidence interval 0.8–3.5), showing non‐inferiority at week 4, and superiority at week 8 and week 12. Avanafil showed a faster onset of action as shown by a significantly better response to modified Sexual Encounter Profile 1 in the avanafil group (84.8%) as compared with that in the sildenafil group (28.2%; P < 0.001). Both avanafil and sildenafil were well tolerated by all the patients in the study; the most common adverse event reported during the study was headache in both the groups.ConclusionAvanafil is superior to sildenafil in improving the International Index of Erectile Function – Erectile Function domain score at the end of 12 weeks of treatment with the added advantage of faster onset of action.
Multi‐centre prospective randomised controlled clinical trial to evaluate a bioactive split thickness skin allograft vs standard of care in the treatment of diabetic foot ulcers
Authors: Armstrong David G. , Galiano Robert D. , Orgill Dennis P. , Glat Paul M. , Carter Marissa J. , Di Domenico Lawrence A. , Reyzelman Alexander M. , Zelen Charles M. 
Published: January 2022

AbstractDiabetic foot ulcers (DFUs) pose a significant risk for infection and limb loss. Advanced wound therapies including human skin allografts have shown promise in resolving these challenging wounds. The primary objective of this randomised, prospective study was to compare the response of 100 subjects with non‐healing DFUs of which 50 were treated with a cryopreserved bioactive split thickness skin allograft (BSA) (TheraSkin; Misonix,Inc., Farmingdale, NY) compared with 50 subjects treated with standard of care (SOC, collagen alginate dressing) at 12 weeks. Both groups received standardised care that included glucose monitoring, weekly debridement's as appropriate, and an offloading device. The primary endpoint was proportion of full‐thickness wounds healed at 12 weeks, with secondary endpoints including differences in percent area reduction (PAR) at 12 weeks, changes in Semmes‐Weinstein monofilament score, VAS pain, and w‐QoL. The result illustrated in the intent‐to‐treat analysis at 12 weeks showed that 76% (38/50) of the BSA‐treated DFUs healed compared with 36% (18/50) treated with SOC alone (adjusted P = .00056). Mean PAR at 12 weeks was 77.8% in the BSA group compared with 49.6% in the SOC group (adjusted P = .0019). In conclusion, adding BSA to SOC appeared to significantly improve wound healing with a lower incidence of adverse events related to treatment compared with SOC alone.
The association between estimated glomerular filtration rate and prognosis in patients with diabetic foot osteomyelitis
Authors: Zhang Jinghang , Chen Dong , Li Xuemei , Ding Min , Xu Jun , Wang Meijun , Chang Bai 
Published: January 2022

AbstractWe aimed to explore the association between estimated glomerular filtration rate (eGFR) and prognosis in patients with diabetic foot osteomyelitis (DFO). Three hundred twenty‐one DFO inpatients were enrolled and classified into four groups according to the eGFRs as follows: normal (≥90), mildly reduced (60‐89), moderately reduced (30‐59) and severely reduced (<30). These patients were followed‐up for 6 months to observe the outcomes, including ulcer healing and amputation. The associations between eGFR and the outcomes were analysed by univariate and multivariate logistic regression models. Compared with patients with normal eGFR, patients with severely reduced eGFR group had higher risk of healing failure (OR = 4.72, 95% CI: 1.44‐15.48), total amputation (OR = 4.50, 95% CI: 1.18‐17.13) and minor amputation (OR = 4.05, 95% CI: (1.04‐15.87). Severely reduced eGFR in patients with DFO was an independent predictor for amputation and healing failure.
Therapeutic effect of laparoscopic sleeve gastrectomy on obstructive sleep apnea and relationship of type 2 diabetes in Japanese patients with severe obesity
Authors: Yanari Shingo , Sasaki Akira , Umemura Akira , Ishigaki Yasushi , Nikai Haruka , Nishijima Tsuguo , Sakurai Shigeru 
Published: January 2022

AbstractAims/IntroductionObstructive sleep apnea (OSA) is among the most important obesity‐related diseases, and offers the potential for accelerated the early onset and progression of type 2 diabetes. The aim of the present study was to clarify the therapeutic effect of laparoscopic sleeve gastrectomy on OSA in severely obese Japanese patients, and to find correlations between OSA improvements and β‐cell function (BCF).Materials and MethodsBetween September 2013 and December 2019, 61 patients who underwent laparoscopic sleeve gastrectomy were enrolled. The apnea–hypopnea index (AHI) was used to diagnose OSA. The tongue area, uvula area and other parameters were measured using cone‐beam computed tomography. Regarding BCF parameters, the homeostasis model assessment of β‐cell function, insulinogenic, Matsuda and disposition indexes were used to evaluate the improvement in BCF. Improvement of OSA was defined as AHI <15.ResultsThe improvement rate of OSA was 51.8% (29/56). The change in AHI was significantly correlated with the excess weight loss percentage (ρ = 0.501), changes in tongue area (ρ = 0.350) and uvula area (ρ = 0.341). Multivariate analysis showed that preoperative AHI and postoperative hemoglobin A1c were independent prognostic factors of OSA non‐improvement. The homeostasis model assessment of β‐cell function (P < 0.001), the insulinogenic index (P < 0.001) and the disposition index (P = 0.019) of patients with AHI of <15 were significantly higher than those in patients with AHI of ≥15.ConclusionsLaparoscopic sleeve gastrectomy is a promising procedure for severely obese patients with OSA. BCF recovery was found to be significantly higher in patients with OSA improvement.
Paediatric mycosis fungoides – characteristics, management and outcomes with particular focus on the folliculotropic variant
Authors: Reiter O. , Amitay‐Laish I. , Oren‐Shabtai M. , Feinmesser M. , Ben‐Amitai D. , Hodak E. 
Published: January 2022

AbstractBackgroundThe literature on paediatric mycosis fungoides (MF) and especially its folliculotropic variant (FMF) is sparse.ObjectivesTo describe the clinical manifestations, treatments, outcomes and long‐term course of paediatric MF, including FMF.MethodsA retrospective analysis was conducted of all consecutive MF patients diagnosed at ≤18 years attending two medical centres in 1995–2015.ResultsThe cohort included 71 patients, all but two of whom had early‐stage disease: hypopigmented (55%), folliculotropic (42%) and classical MF (39%), alone or in combination. The head and neck area were involved in 43% of patients with early‐stage FMF compared to 12% of the non‐FMF group (P = 0.004). There was no difference in the involvement of other body areas between the groups. Pruritus, although mild, was more often recorded among patients with early‐stage FMF compared to non‐FMF (58% vs. 29%, respectively, P = 0.02). Complete response (CR) was achieved in 60 of the 69 patients with early‐stage MF (87%) after an average of 1.8 treatment modalities. NBUVB was the most administered treatment to non‐FMF patients with CR rates of 63% vs. 29% of FMF patients (P = 0.04). Systemic/bath PUVA and UVA+NBUVB were the most administered treatments to FMF patients with CR rates of 60% vs. 81% for non‐FMF patients (P = 0.17). During a mean follow‐up of 9.2 years (range 1–24), stage progression was observed in four (6%) of the patients with early‐stage disease, two of whom (all FMF) to advanced stage.ConclusionsPaediatric MF presents as an early‐stage disease with over‐representation of hypopigmented and FMF variants. NBUVB and UVA‐based therapies yield good response rates in non‐FMF and FMF patients, respectively. Disease course is indolent, and even on relatively long follow‐up, it has a very low progression rate from early to advanced‐stage disease, occurring in patients with FMF. We propose a treatment algorithm for paediatric MF.