bluuebunny/crossref_metadata_2025_split huggingface dataset:
Robotic lateral pelvic lymph node dissection after chemoradiation for rectal cancer: a Western perspective
Authors: Peacock O. , Limvorapitak T. , Bednarski B. K. , Kaur H. , Taggart M. W. , Dasari A. , Holliday E. B. , Minsky B. D. , You Y. N. , Chang G. J. 
Published: September 2020

AbstractAimThere are limited outcome data for lateral pelvic lymph node dissection (LPLND) following neoadjuvant chemoradiotherapy (nCRT), particularly in the West. Our aim was to evaluate the short‐term perioperative and oncological outcomes of robotic LPLND at a single cancer centre.MethodA retrospective analysis of a prospective database of consecutive patients undergoing robotic LPLND for rectal cancer between November 2012 and February 2020 was performed. The main outcomes were short‐term perioperative and oncological outcomes. Major morbidity was defined as Clavien–Dindo grade 3 or above.ResultsForty patients underwent robotic LPLND during the study period. The mean age was 54 years (SD ± 15 years) and 13 (31.0%) were female. The median body mass index was 28.6 kg/m2 (IQR 25.5–32.6 kg/m2). Neoadjuvant CRT was performed in all patients. Resection of the primary rectal cancer and concurrent LPLND occurred in 36 (90.0%) patients, whilst the remaining 4 (10.0%) patients had subsequent LPLND after prior rectal resection. The median operating time was 420 min (IQR 313–540 min), estimated blood loss was 150 ml (IQR 55–200 ml) and length of hospital stay was 4 days (IQR 3–6 days). The major morbidity rate was 10.0% (n = 4). The median lymph node harvest from the LPLND was 6 (IQR 3–9) and 13 (32.5%) patients had one or more positive LPLNs. The median follow‐up was 16 months (IQR 5–33 months), with 1 (2.5%) local central recurrence and 7 (17.5%) patients developing distant disease, resulting in 3 (7.5%) deaths.ConclusionRobotic LPLND for rectal cancer can be performed in Western patients to completely resect extra‐mesorectal LPLNs and is associated with acceptable perioperative morbidity.
How far have we come? A review of MPA network performance indicators in reaching qualitative elements of Aichi Target 11
Authors: Meehan Mairi C. , Ban Natalie C. , Devillers Rodolphe , Singh Gerald G. , Claudet Joachim 
Published: September 2020

AbstractEffective networks of marine protected areas (MPAs) are explicitly recognized and called for in international biodiversity conservation strategies such as the Aichi Targets. While various indicators have been proposed to assess effectiveness of individual MPAs, no comprehensive set of indicators exists for MPA networks, particularly for Aichi Target 11. The qualitative elements of this target recognize the value of social, economic, governance, and ecological factors in achieving effective biodiversity conservation. Here, we used a systematic literature review to identify indicators of MPA network effectiveness. We reviewed 64 publications, identifying 48 indicators that could be aligned with the qualitative elements. Results showed that assessments of MPA network effectiveness predominantly focused on effective management while neglecting equitable management and integration into the wider land and seascape. Indicators tended to focus on ecological characteristics, overlooking social, economic, and governance dimensions. Key challenges in addressing these gaps include identifying conflicting priorities and objectives in adjacent marine and land areas that interfere with cooperation and knowledge sharing, and ensuring diverse areas with distinct social and ecological contexts are considered. This study provides the first review of indicators for assessing MPA networks and adds to the literature assessing whether current and future targets can be met.
Clinical significance of esophagogastroduodenoscopy in patients with esophageal motility disorders
Authors: Matsubara Masaki , Manabe Noriaki , Ayaki Maki , Nakamura Jun , Murao Takahisa , Fujita Minoru , Kuinose Masahiko , Yamatsuji Tomoki , Naomoto Yoshio , Haruma Ken 
Published: September 2020

ObjectivesThe first aim of this study was to elucidate the detection rate of esophagogastroduodenoscopy (EGD) in patients complaining of dysphagia with esophageal motility disorders; the second was to clarify the useful parameters of EGD associated with esophageal motility disorders.MethodsParticipants included 380 patients who underwent EGD before high‐resolution manometry (HRM) for dysphagia. EGD findings were investigated according to the following five parameters: resistance when passing through the esophagogastric junction (EGJ), residue in the esophageal lumen, esophageal dilation, and spastic and nonocclusive contractions. HRM diagnoses were based on the Chicago classification (v3.0).ResultsThe percentage of abnormal EGD findings was 64.4% among patients with esophageal motility disorders, and the results differed for each esophageal motility disorder. The rate of abnormal EGD for both EGJ outflow obstruction and major disorders of peristalsis was significantly higher than that for manometrically normal subjects. On multivariate analysis, resistance when passing through EGJ, residue in the esophageal lumen, spastic and nonocclusive contraction were significantly associated with esophageal motility disorders. The sensitivity, specificity, positive predictive value, and negative predictive value of these parameters for detection of esophageal motility disorders were 75.1%, 86.6%, 84.8% and 77.8%, respectively.ConclusionEsophagogastric junction outflow obstruction and major disorders of peristalsis can be screened with EGD. Among several endoscopic parameters, resistance when passing through EGJ, residue in the esophageal lumen, spastic and nonocclusive contraction are considered significantly useful indicators.
How culture may nurture institutional trust: Insights from Bangladesh and Nepal
Authors: Jamil Ishtiaq , Baniamin Hasan Muhammad 
Published: September 2020

AbstractMotivationMost studies of the normative roots of political trust argue that they stem from policy performance rather than from cultural orientation. That sits at odds with the observation that institutional trust—that is, citizens’ confidence in public agencies—is high in Bangladesh and Nepal despite poor policy performance.PurposeThe article assesses the influence of policy performance and cultural orientation of citizens in Bangladesh and Nepal on institutional trust.Approach and MethodsThe article draws on country representative surveys (Governance and Trust Survey 2) in Bangladesh and Nepal carried out in 2014–15. It identifies cultural preferences and specifically authoritarian cultural orientation (ACO)—characterized by deference to authority, unquestioning obedience, and reliance on authorities—and compares this to institutional trust.FindingsHigh authoritarian cultural orientation (ACO) can lead citizens to trust public institutions. People’s submissiveness to the country’s authorities can obstruct critical thinking and even create positive impressions of the authorities, which in turn generates institutional trust. Institutions that are more visible and exert more authority may attract greater trust among citizens who exhibit ACO.Policy ImplicationsWhen assessing citizens’ perceptions of policy performance, their cultural orientations must be considered. Trust in public agencies cannot be treated as proxy for their policy performance.
Whole‐body muscle magnetic resonance imaging in patients with muscle symptoms: incidental findings and outcomes
Authors: Claeys K. G. , Goosens V. 
Published: September 2020

AbstractBackground and purposeWhole‐body muscle magnetic resonance imaging (MRI) has become widely used for diagnostic workup in patients with muscle diseases. The prevalence of incidental findings in diagnostic whole‐body muscle MRI is unknown. Here, the prevalence and outcomes of incidentalomas in whole‐body muscle MRI in a large cohort of patients with muscle symptoms were studied.MethodsTwo hundred and six patients who consulted at our neuromuscular clinic with muscle weakness and/or myalgia and/or increased serum creatine kinase and in whom a whole‐body muscle MRI was performed between January 2016 and March 2020 were included.ResultsWhole‐body muscle MRI revealed at least one incidentaloma in 132 patients (64.1%), with mean age at MRI examination 50.4 years (19–74 years). Most of the incidental findings were benign. However, diagnostic examinations were indicated in 16.3% of the incidentalomas, treatment was needed in 4.7% and, in retrospect, symptoms related to the incidental findings were identified in 14.3%. Three malignant (glioblastoma multiforme, renal cell carcinoma and hepato‐splenomegaly related to a lymphoma) and one precancerous (low‐grade appendiceal mucinous neoplasm) incidental findings were identified. In one patient an abdominal aortic aneurysm was detected and in another a large cerebral arteriovenous malformation. In 1.2% of the incidentalomas, i.e. periventricular white matter lesions (LAMA2 mutations) and fibrous dysplasia (ANO5 mutations), an indirect link with the muscle disease could be established.ConclusionsIt is concluded that incidental findings in diagnostic whole‐body muscle MRI in patients with muscle symptoms occur frequently. Most of them are benign, but in some timely detecting the incidentaloma leads to early treatment and can thus impact prognosis.
The unexploited potential of listening to deep‐sea fish
Authors: Bolgan Marta , Parmentier Eric 
Published: September 2020

AbstractCovering more than 65% of the Earth surface, the deep sea (200–11,000 m depth) is the largest biotope on Earth, yet it remains largely unexplored. The biology of its communities is still poorly understood, and many species are still to be discovered. Despite this, deep‐sea fish are already threatened by our exploitation and their conservation is hampered by a severe scarcity of data. Studies focusing on fish acoustic communication are receiving growing attention in coastal areas as they provide useful information to different fields, ranging from behaviour, ecology, wild population monitoring, biodiversity assessment, fisheries and aquaculture management. Modern non‐invasive techniques such as passive acoustic monitoring (PAM) can provide high‐resolution, long‐term and large spatial scale information on populations and ecosystem dynamics in otherwise not accessible environments. Although acoustic communication of deep‐sea fish is still poorly documented, many deep‐sea species are likely to emit sounds as they possess the required anatomical structures. Here we suggest that monitoring deep‐sea fish vocal communication might help to better understand their diversity, ecology and dynamics. Emerging technologies based on PAM have the potential to provide a holistic view of the importance of acoustic communication for deep‐sea fish and, ultimately, to inform us about essential aspects for their management and protection.
Clinical utility of sample preheat treatment in a modified Nijmegen‐Bethesda assay (mNBA) for inhibitor monitoring in congenital and acquired haemophilia A: A single‐centre four‐year experience
Authors: Gandhi Tejas , Lawler Pura , Foxton Eleanor , Chowdary Pratima , Riddell Anne 
Published: September 2020

AbstractIntroductionLaboratory monitoring for factor VIII inhibitors ideally requires samples with the lowest possible factor VIII (FVIII) level, potentially challenging in patients with congenital haemophilia A (CHA) receiving regular prophylaxis and acquired haemophilia A (AHA) patients with endogenous FVIII. Inactivation of FVIII by preheating (preheat treatment, PHT) of patient plasma has been suggested to facilitate monitoring.AimTo evaluate the clinical utility of PHT prior to inhibitor analysis by modified Nijmegen‐Bethesda assay (mNBA) in patients with CHA and AHA.MethodsInhibitor screening by mNBA under standard conditions and with PHT at 56°C for 30, 60 and 90 minutes was evaluated. FVIII inhibitor results between 2007 and 2010 without PHT (720 results from 222 CHA and AHA patients), and between 2011 and 2014 post‐PHT (1102 results from 302 patients) were available for analysis.ResultsOf total 1822 results available, 61% were from severe HA patients, 22% from mild and moderate HA and 16% from AHA. Pre‐PHT, 74% of samples were analysed by the mNBA, and the remaining 26% were not tested as FVIII levels were >20 IU/dL as per local protocol. Postintroduction of PHT (90 and 60 minutes), 96% of samples received were analysed for an inhibitor. Post‐PHT in patients with AHA (n = 26), 69% of samples tested with factor VIII levels >20 IU/dL were found to have detectable inhibitor.ConclusionFVIII inhibitor testing using PHT at 56°C for 60 minutes facilitates inhibitor surveillance of CHA on prophylaxis. Potentially, 30 minutes at 56°C might be equally efficacious. In AHA receiving immunosuppression, monitoring of inhibitor titre after initial factor VIII response might enable personalized immunosuppression.
Management of haemophilia patients in the COVID‐19 pandemic: Experience in Wuhan and Tianjin, two differently affected cities in China
Authors: Zhang Ai , Liu Wei , Poon Man‐Chiu , Liu Aiguo , Luo Xiaoping , Chen Lingling , Hu Qun , Yang Renchi 
Published: September 2020

AbstractObjectiveTo identify lessons learned from haemophilia care experience in Wuhan (COVID‐19 outbreak epicenter in China) and Tianjin (with relatively low COVID‐19 incidence) in the pandemic.MethodsWe compared the challenges in haemophilia management attributed to local COVID‐19 containment policies, healthcare resource availability, clotting factors supply, daily living restrictions and coping strategies employed.ResultsWuhan was in lockdown with strict traffic controls, enforced quarantine and overwhelmed resources. Tianjin was in relatively relaxed countermeasures to COVID‐19. In Wuhan, haemophilia treatment (for bleeding, prophylaxis, multidisciplinary team care, immune tolerance induction) and patient education were severely affected, while the challenges in Tianjin were less. In both cities, patients’ fear for COVID‐19 infection also affected their management. Coping strategy in Wuhan included channelling of clotting factors supply from hospitals to nine pharmacies; timely transfers of in‐need patients to healthcare facilities by a volunteer service network jointly coordinated by the government, hospitals and the community. Although factor concentrate supply in each city was adequate, patients still worried whether there would be enough supply to last through the pandemics. Consequently, many downgraded their treatment regimens resulting in increased bleeding episodes. In both cities, telemedicine was promoted for patient care and education.ConclusionsThe COVID‐19 pandemic had varying adverse impacts on haemophilia care depending on the local infection incidence. Our experience suggests that haemophilia management strategies in the pandemic need to be established according to the local virus containment/mitigation policies, daily living restrictions and resource availability.
Primary prophylaxis was associated with lower arthropathy in Colombian men with haemophilia B: A longitudinal analysis (2015‐2019)
Authors: Hernández Vargas Juliana Alexandra , Linares Adriana , Solano María Helena , Valbuena Ana María , Acuña Lizbeth 
Published: September 2020

AbstractIntroductionThe risk of chronic haemophilic arthropathy (CHA) is related to severity. Evidence suggests that primary prophylaxis (PPr) could reduce CHA incidence and its impact on quality of life.AimTo evaluate the association between PPr and CHA in Colombian males with haemophilia B (HB) during 2015 to 2019.MethodsA panel‐time analysis was performed with data provided by the National Health System to update a nationwide open cohort of people with congenital coagulopathies. The association was evaluated in a logistic random‐effect regression model (LRERM), adjusted by age at diagnosis, prophylaxis dose and frequency, severity, haemarthrosis and high‐titre inhibitors.ResultsDuring 2015‐2019, a total of 362 men with HB and treated with either, primary, secondary or tertiary prophylaxis were identified. At baseline, CHA prevalence in the cohort was 36.84% (n = 133), median age was 19.0 years (IQR: 10.0‐27.0), and median age at diagnosis was 1.0 year (IQR: 0.0‐4.0). PPr was prescribed in 37.85% (n = 137), and median dose (IU/Kg/dose) was almost the same for primary vs. secondary/tertiary prophylaxis. Patients in PPr had a lower frequency of severe HB, CHA, haemarthrosis, infectious complications and high‐titre inhibitors than those in secondary or tertiary prophylaxis (STPr). In the LRERM, PPr was associated with a significant reduction of 89.70% in the odds of CHA (aOR = 0.103, IC 95%: 0.040, 0.270; P < .001), compared with STPr.ConclusionsPPr decreased the odds of CHA by 89.70% in males with HB in Colombia. Our findings are consistent with previous studies and support the strategy to prescribe PPr to our patients.
Investigation of microbial profile, levels of endotoxin and lipoteichoic acid in teeth with symptomatic irreversible pulpitis: a clinical study
Authors: Arruda‐Vasconcelos R. , Louzada L. M. , Feres M. , Tomson P. L. , Cooper P. R. , Gomes B. P. F. A. 
Published: September 2020

AbstractAimTo investigate the microbial profile, and levels of endotoxin (LPS) and lipoteichoic acid (LTA), in infected dentine (ID) and root canals (RC) at different phases of root canal treatment in teeth with symptomatic irreversible pulpitis.MethodologyTen volunteers were included, and samples were collected from infected dentine (ID) and the root canal lumen (RC) using sterile excavators and paper points, respectively. RC samples were taken before (S1) and after (S2) chemo‐mechanical canal preparation (CMP), and after intracanal medication (ICM; S3). Checkerboard DNA‐DNA hybridization was used for microbial analysis. The levels of LPS and LTA were evaluated using the limulus amebocyte lysate assay and ELISA, respectively. Shapiro–Wilk’s test was used to verify data normality. Friedman’s test was used to evaluate statistical differences using checkerboard DNA‐DNA hybridization in the ID and RC at the different phases of the RC treatment. Post hoc Dunn’s multiple comparison test was used to verify significant differences recorded at the different time‐points. The levels of LPS and LTA were analysed statistically by using repeated measures anova and Tukey’s post hoc test to evaluate differences in both sites. The significance level was set at 5% (P < 0.05).ResultsA total of 40 DNA probes were used for microbial investigation of ID and RC samples using checkerboard DNA‐DNA hybridization. The levels and complexity of bacteria were similar in the ID and initial RC samples. The levels of LPS and LTA in ID were significantly higher than the initial RC samples (S1; P < 0.05). Canal preparation was effective in significantly decreasing the levels of bacteria, LPS and LTA (P < 0.05). ICM did not provide additional reduction in the levels of bacteria and LPS (P > 0.05). However, a significant reduction in the levels of LTA was observed after ICM (P < 0.05).ConclusionThe microbial profile of infected dentine and root canals of teeth with irreversible pulpitis was complex, harbouring different species including Gram‐positive and Gram‐negative, cocci and bacilli, and facultative and strict anaerobes. Root canal preparation was effective in reducing the levels of bacteria, LPS and LTA from the root canals of teeth with pulpitis.
Interferon regulatory factor 4 deficiency in CD8+ T cells abrogates terminal effector differentiation and promotes transplant acceptance
Authors: Zou Dawei , Fu Jinfei , Guo Zhiyong , Chen Wenhao 
Published: September 2020

SummaryAllogeneic CD8+ cytotoxic T cells play an essential role in rejecting transplanted allografts, but how their effector function is regulated on a transcriptional level remains unclear. Herein, we investigate the role of interferon regulatory factor 4 (IRF4) in controlling CD8+ T‐cell function in response to transplant. B6.Rag1−/− mice were adoptively transferred with CD8+ T cells isolated from either Irf4fl/flCd4‐Cre (T‐cell‐specific Irf4‐deficient) or Irf4fl/fl control mice, followed by BALB/c skin transplantation. Recipients that received Irf4‐deficient CD8+ T cells permanently accepted the skin allografts, whereas recipients that received control CD8+ T cells acutely rejected the transplanted skins. Mechanistically, compared with the transferred control CD8+ T cells in B6.Rag1−/− recipients, the transferred Irf4‐deficient CD8+ T cells lost the capacity to differentiate into CD127−KLRG1+ terminal effector cells, barely produced effector cytokines and cytotoxic molecules (e.g. IL‐2, IFN‐γ, TNF‐α, granzyme A and granzyme B), and displayed defect in proliferative capacity, evident by their decreased Ki67 expression and lower frequencies. Moreover, the transferred Irf4‐deficient CD8+ T cells displayed low expression of transcription factors ID2 and T‐bet that govern the terminal effector T‐cell programmes, and high expression of transcription factor TCF1 that maintains the naïve‐memory T‐cell programmes. Hence, IRF4 deficiency in CD8+ T cells abrogates their terminal effector differentiation and promotes transplant acceptance. These findings suggest that targeting IRF4 expression represents an attractive and promising therapeutic approach for inducing transplant acceptance.
Psychiatric Euthanasia and the Ontology of Mental Disorder
Authors: Maung Hane Htut 
Published: September 2020

AbstractIn the Netherlands and Belgium, it is lawful for voluntary euthanasia to be offered on the grounds of psychiatric suffering. A recent case that has sparked much debate is that of Aurelia Brouwers, who was helped to die in the Netherlands on account of her suffering from borderline personality disorder. It is sometimes claimed that whether or not a mentally ill person’s wish to die is valid hinges on whether or not that wish is a symptom of the person’s mental disorder. This article addresses the philosophical problems raised by this claim, with a specific focus on the diagnosis of borderline personality disorder. After considering descriptivist and causal conceptualizations of mental disorder, I argue that the current approach to borderline personality disorder in psychiatry precludes the possibility of dissociating the wish to die from the disorder. I then examine the implications of this analysis for the question of whether or not the request for voluntary euthanasia in the case of borderline personality disorder can be considered valid. Ultimately, I conclude that the inability to dissociate the wish to die from the disorder does not invalidate the wish in the case of borderline personality disorder.