bluuebunny/crossref_metadata_2025_split huggingface dataset:
Drinking and acquisition of unrecorded alcohol across educational groups in Sweden
Authors: Norström Thor , Landberg Jonas , Trolldal Björn 
Published: May 2021

AbstractIntroductionIt is estimated that 18.5% of total alcohol consumption in Sweden in 2018 was unrecorded. However, little is known about the socio‐economic profile of consumers of unrecorded alcohol. The aim of this study was to elucidate this issue by analysing data from a unique Swedish national repeated cross‐sectional alcohol use survey.MethodsIndividual‐level information on alcohol consumption and socio‐economic status (SES) for the years 2013–2018 was retrieved from the Monitoring Project; a nationally representative monthly alcohol use survey. The analytical sample comprised 64 375 respondents aged 25–74 years. SES was measured by educational level. We used three educational groups: (i) low (<10 years); (ii) intermediate (10–12 years); and (iii) high (13+ years). We included indicators of the following sources of unrecorded alcohol consumption: travellers' import, smuggled alcohol, home production, internet and illicit home‐distilling. We estimated adjusted SES‐specific means of the various forms of unrecorded consumption. The means were adjusted for the effects of age, sex and region.ResultsThere were no significant educational differences in the total of unrecorded alcohol consumption; the same holds true for home‐production and internet. However, with respect to smuggled and home‐distilling, a statistically significant educational gradient was observed with the lowest educational group scoring approximately four times higher than the highest.Discussion and ConclusionsOur findings suggest that there are no differences across educational groups in the consumption of unrecorded alcohol as a whole. However, consumption of smuggled alcohol and illicitly distilled spirits is elevated in the low educational group.
Is disinvestment from alcohol and drug treatment services associated with treatment access, completions and related harm? An analysis of English expenditure and outcomes data
Authors: Roscoe Suzie , Pryce Robert , Buykx Penny , Gavens Lucy , Meier Petra S. 
Published: May 2021

AbstractIntroductionThe positive impact of substance use treatment is well‐evidenced but there has been substantial disinvestment from publicly funded treatment services in England since 2013/2014. This paper examines whether this disinvestment from adult alcohol and drug treatment provision was associated with changes in treatment and health outcomes, including: treatment access, successful completions from treatment, alcohol‐specific hospital admissions, alcohol‐specific mortality and drug‐related deaths.MethodsAnnual administrative data from 2013/2014 to 2018/2019 was matched at local government level and multi‐level time series analysis using linear mixed‐effect modelling conducted for 151 upper‐tier local authorities in England.ResultsBetween 2013/2014 and 2018/2019, £212.2 million was disinvested from alcohol and drug treatment services, representing a 27% decrease. Concurrently, 11% fewer people accessed, and 21% fewer successfully completed, treatment. On average, controlling for other potential explanatory factors, a £10 000 disinvestment from alcohol and drug treatment services was associated with reductions in all treatment outcomes, including 0.3 fewer adults in treatment (95% confidence interval 0.16–0.45) and 0.21 fewer adults successfully completing treatment (95% % confidence interval 0.12–0.29). A £10 000 disinvestment from alcohol treatment was not significantly associated with changes in alcohol‐specific hospital admissions or mortality, nor was disinvestment from drug treatment associated with the rate of drug‐related deaths.Discussion and ConclusionsLocal authority spending cuts to alcohol and drug treatment services in England were associated with fewer people accessing and successfully completing alcohol and drug treatment but were not associated with changes in related hospital admissions and deaths.
Metastatic Crohn’s disease: an underestimated entity
Authors: Ickrath Franziska , Stoevesandt Johanna , Schulmeyer Lena , Glatzel Caroline , Goebeler Matthias , Kerstan Andreas 
Published: May 2021

SummaryCutaneous metastatic Crohn’s disease (MCD) is a rare but challenging dermatologic manifestation of Crohn’s disease. It is histologically defined as the presence of non‐caseating granulomas at skin sites separated from and non‐contiguous to the gastrointestinal tract. Cutaneous metastatic Crohn’s disease should be distinguished from the much more frequent contiguous cutaneous manifestations of Crohn’s disease that present at perianal or, less common, peristomal sites with direct extension from the intestine to the adjacent skin. Versatile clinical presentation and the fact that occurrence can predate the initial diagnosis of Crohn’s disease may lead to misdiagnosis, delayed treatment and underreporting. As case numbers are small and randomized controlled studies on management are lacking, the therapeutic approach remains challenging and is often unsatisfactory. We here performed a systematic literature search identifying 264 published pediatric and adult cases of MCD and additionally report three of our own cases. Our review summarizes clinical characteristics, putative etiopathology, histologic findings, differential diagnoses and treatment options for MCD.
Analytical guidelines to increase the value of community science data: An example using eBird data to estimate species distributions
Authors: Johnston Alison , Hochachka Wesley M. , Strimas‐Mackey Matthew E. , Ruiz Gutierrez Viviana , Robinson Orin J. , Miller Eliot T. , Auer Tom , Kelling Steve T. , Fink Daniel 
Published: May 2021

AbstractAimEcological data collected by the general public are valuable for addressing a wide range of ecological research and conservation planning, and there has been a rapid increase in the scope and volume of data available. However, data from eBird or other large‐scale projects with volunteer observers typically present several challenges that can impede robust ecological inferences. These challenges include spatial bias, variation in effort and species reporting bias.InnovationWe use the example of estimating species distributions with data from eBird, a community science or citizen science (CS) project. We estimate two widely used metrics of species distributions: encounter rate and occupancy probability. For each metric, we critically assess the impact of data processing steps that either degrade or refine the data used in the analyses. CS data density varies widely across the globe, so we also test whether differences in model performance are robust to sample size.Main conclusionsModel performance improved when data processing and analytical methods addressed the challenges arising from CS data; however, the degree of improvement varied with species and data density. The largest gains we observed in model performance were achieved with 1) the use of complete checklists (where observers report all the species they detect and identify, allowing non‐detections to be inferred) and 2) the use of covariates describing variation in effort and detectability for each checklist. Occupancy models were more robust to a lack of complete checklists. Improvements in model performance with data refinement were more evident with larger sample sizes. In general, we found that the value of each refinement varied by situation and we encourage researchers to assess the benefits in other scenarios. These approaches will enable researchers to more effectively harness the vast ecological knowledge that exists within CS data for conservation and basic research.
Variability of echocardiographic measures of left ventricular diastolic function. The HUNT study
Authors: Letnes Jon Magne , Eriksen‐Volnes Torfinn , Nes Bjarne , Wisløff Ulrik , Salvesen Øyvind , Dalen Håvard 
Published: May 2021

AbstractObjectiveInvestigate variability related to image acquisition and reading process for echocardiographic measures of left ventricular (LV) diastolic function, and its influence on classification of LV diastolic dysfunction (LVDD).MethodsForty participants (19 women) mean age 62 (28–88) years underwent echocardiographic examinations twice by different echocardiographers and blinded analyses by four readers in a cross‐sectional design. Measurements included quantification of two‐ (2D) and three‐dimensional (3D) recordings of the left atrium (LA) (maximal) volume (LAVmax) and spectral Doppler blood flow and tissue velocities for assessment of LV diastolic function. Variability and reproducibility measures were calculated using variance component analyses and Kappa statistics.ResultsImage acquisition influenced variability more than image reading (mean 24% and 4% of variance, respectively), but variability from image reading was especially important for 2D LAVmax (16% of variance) compared to 4% for 3D LAVmax, which was reflected in better agreement for 3D measures. The variability of measures used in classification of LVDD had clinical significance, and agreement across the four raters in classification using current recommendations was only fair (Kappa 0.42), but the agreement improved when using 3D LAVmax (Kappa 0.58). Agreement and reliability measures were reported for all measures.ConclusionPerforming a new image acquisition influenced variability more than a introducing a new image reader, but there were differences across the different measures. LAVmax by 3D is superior to 2D with respect to lower variability. The variability of diastolic measures influences the reliability of LVDD classification, and this should be taken into account in the everyday clinic.
Outcomes in young adults with acute ischemic stroke undergoing endovascular thrombectomy: A real‐world multicenter experience
Authors: Yeo Leonard Leong‐Litt , Chen Vanessa Hui En , Leow Aloysius Sheng‐Ting , Meyer Lukas , Fiehler Jens , Tu Tian‐Ming , Tham Carol Huilian , Sia Ching‐Hui , Jamous Ala , Behme Daniel , Kastrup Andreas , Papanagiotou Panagiotis , Styczen Hanna , Forsting Michael , Lee Tsong‐Hai , Chu Chan‐Lin , Fischer Sebastian , Maus Volker , Abdullayev Nuran , Kabbasch Christoph , Mönch Sebastian , Maegerlein Christian , Arnberg Fabian , Andersson Tommy , Holmin Staffan , Teoh Hock‐Luen , Paliwal Prakash , Ahmad Aftab , Gopinathan Anil , Yang Cunli , Seet Raymond Chee‐Seong , Chan Bernard Poon‐Lap , Sharma Vijay K. , Tan Benjamin Yong‐Qiang 
Published: May 2021

AbstractEndovascular thrombectomy (EVT) is the standard of care for anterior circulation acute ischemic stroke (AIS) with large vessel occlusion (LVO). Young patients with AIS‐LVO have distinctly different underlying stroke mechanisms and etiologies. Much is unknown about the safety and efficacy of EVT in this population of young AIS‐LVO patients.All consecutive AIS‐LVO patients aged 50 years and below were included in this multicenter cohort study. The primary outcome measured was functional recovery at 90 days, with modified Rankin Scale of 0–2 deemed as good functional outcome.A total of 275 AIS‐LVO patients that underwent EVT from 10 tertiary centers in Germany, Sweden, Singapore, and Taiwan were included. Successful reperfusion was achieved in 85.1% (234/275). Good functional outcomes were achieved in 66.0% (182/275). Arterial dissection was the most prevalent stroke etiology (42/195, 21.5%). National Institutes of Health Stroke Scale (NIHSS) score at presentation was inversely related to good functional outcomes (aOR: 0.92, 95% CI: 0.88–0.96 per point increase, p < 0.001). Successful reperfusion (aOR: 3.22, 95% CI: 1.44–7.21, p = 0.005), higher ASPECTS (aOR: 1.21, 95% CI: 1.01–1.44, p = 0.036), and bridging intravenous thrombolysis (aOR: 2.37, 95% CI: 1.29–4.34, p = 0.005) independently predicted good functional outcomes. Successful reperfusion was inversely associated with in‐hospital mortality (aOR: 0.14, 95% CI: 0.03–0.57, p = 0.006). History of hypertension strongly predicted in‐hospital mortality (aOR: 4.59, 95% CI: 1.10–19.13, p = 0.036).While differences in functional outcomes exist across varying stroke aetiologies, high rates of successful reperfusion and good outcomes are generally achieved in young AIS‐LVO patients undergoing EVT.
Diagnostic accuracy of the Dysphagia Trained Nurse Assessment tool in acute stroke
Authors: Benfield Jacqueline K. , Wilkinson Gwenllian , Everton Lisa F. , Bath Philip M. , England Timothy J. 
Published: May 2021

AbstractBackground and purposeComprehensive swallow screening assessments to identify dysphagia and make early eating and drinking recommendations can be used by trained nurses. This study aimed to validate the Dysphagia Trained Nurse Assessment (DTNAx) tool in acute stroke patients.MethodsParticipants with diagnosed stroke were prospectively and consecutively recruited from an acute stroke unit. Following a baseline DTNAx on admission, participants underwent a speech and language therapist (SLT) bedside assessment of swallowing (speech and language therapist assessment [SLTAx]), videofluoroscopy (VFS) and a further DTNAx by the same or a different nurse.ResultsForty‐seven participants were recruited, of whom 22 had dysphagia. Compared to SLTAx in the identification of dysphagia, DTNAx had a sensitivity of 96.9% (95% confidence interval [CI] 83.8–99.9) and specificity of 89.5% (95% CI 75.2–97.1). Compared to VFS in the identification of aspiration, DTNAx had a sensitivity of 77.8% (95% CI 40.0–97.2) and a specificity of 81.6% (95% CI 65.7–92.3). Over 81% of the diet and fluid recommendations made by the dysphagia trained nurses were in absolute agreement compared to SLTAx. Both DTNAx and SLTAx had low diagnostic accuracy compared to the VFS‐based definition of dysphagia.ConclusionsNurses trained in DTNAx showed good diagnostic accuracy in identifying dysphagia compared to SLTAx and in identifying aspiration compared to VFS. They made appropriate diet and fluid recommendations in line with SLTs in the early management of dysphagia.
Dentist‐administered cognitive behavioural therapy versus four habits/midazolam: An RCT study of dental anxiety treatment in primary dental care
Authors: Hauge Mariann Saanum , Stora Bent , Vassend Olav , Hoffart Asle , Willumsen Tiril 
Published: May 2021

AbstractThe study aimed to test the effectiveness of cognitive behavioural therapy (CBT) administered by a general dental practitioner (GDP) in a general dental practice. In a two‐arm parallel randomised controlled trial, the experimental group received a short dentist‐administered CBT‐intervention (D‐CBT). A best‐practice control group (FHM) received dental treatment during sedation with midazolam combined with an evidence‐based communication model (The Four Habits Model). Ninety‐six patients with self‐reported dental anxiety were allocated to the treatment arms at a 1:1 ratio. Modified Dental Anxiety Scale (MDAS) scores spanned from 12 to 25, and 82 patients (85%) had a score of 19 or more, indicating severe dental anxiety. In both treatment arms, scores on MDAS and Index of Dental Anxiety and Fear (IDAF‐4C) decreased significantly, but no differences were found between treatment arms. Mean reductions were: MDAS scores: −6.6 (SD = 0.5); IDAF‐4C scores: −1.0 (SD = 1.1). In conclusion, local GDPs in general dental practices with proper competence have the ability for early detection of dental anxiety and, with the use of a manual‐based D‐CBT or FHM treatment, GDPs could offer efficient first‐line treatment suitable for dental anxiety of varying severities.
Depth‐based barotrauma severity, reflex impairment and stress response in two species of ice‐angled fish
Authors: Althoff Andrew L. , Suski Cory D. , Louison Michael J. 
Published: May 2021

AbstractBarotrauma is a frequent event in fish captured from depth, and anglers often attempt to remedy this problem by venting fish. Barotrauma has been frequently assessed in fish during the warm water season, but no work has been done during winter ice angling, and the need and/or effectiveness of venting for ice‐angled fish has not been quantified. To answer these questions, bluegill Lepomis macrochirus Rafinesque and black crappie Pomoxis nigromaculatus (Lesueur) were angled through the ice, barotrauma assessed, and the effect of venting on reflex responsiveness and blood glucose levels after 1 or 2.5 h of holding were determined. Greater capture depths resulted in more severe barotrauma, with bluegill experiencing symptoms at shallower depths than black crappie. Bluegill reflex action mortality predictor (RAMP) scores improved more than black crappie scores following venting. These results suggest barotrauma impacts fish in winter fisheries in a similar fashion to fish in warmer conditions, with species‐specific differences in their susceptibility to barotrauma and their response to venting.
Asymmetric density‐dependent competition and predation between larval salamanders
Authors: Anderson Thomas L. , Burkhart Jacob J. , Davenport Jon M. 
Published: May 2021

Abstract

Body size differences among consumers often lead to asymmetric interactions, with larger individuals typically being stronger competitors and/or predators on small individuals. These types of interaction are particularly exemplified in freshwater pond communities, where substantial size variation exists both within and among species of top consumers. We investigated whether density dependence can modify the outcome of size‐structured interactions between larval stages of two pond‐breeding salamanders, Ambystoma annulatum and Ambystoma opacum. Size structure exists in populations of these species due to variation in the timing of breeding, which we hypothesised would amplify predation rates and competitive asymmetries from the early‐arriving species (A. annulatum) on the later‐arriving species (A. opacum).

We manipulated the relative densities of both A. annulatum and A. opacum in outdoor mesocosms. We maintained the experiment through metamorphosis, and analysed size at metamorphosis, larval period length and survival of each species.

Ambystoma annulatum imparted a strong density‐dependent effect on A. opacum through a combination of predation and competition. Survival of A. opacum was negatively related to the density of A. annulatum. For the A. opacum that survived, body size was reduced and larval period lengthened at higher A. annulatum densities, indicative of interspecific competition that was partly explained by resource pre‐emption. In contrast, A. annulatum was only affected by intraspecific density‐dependent competition.

Our results suggest that density‐dependent effects reinforce asymmetric interactions among larval salamanders. However, the intensity of the asymmetric interactions is mediated by the arrival time and size of conspecifics. Specifically, earlier‐arriving species can negatively affect the later‐arriving species via size‐mediated predation and competition.

The interactive effects of density dependence and arrival time of community members are probably a common mechanism generating size variability in ecological communities. Yet, most studies only evaluate one mechanism or the other. By interweaving these two processes, our work displays the importance of understanding context‐dependence in species interactions.
Verrucous carcinoma of the oesophagus is a genetically distinct subtype of oesophageal squamous cell carcinoma
Authors: Isidro Raymond A , Dong Fei , Hornick Jason L , Wee Jon O , Agoston Agoston , Patil Deepa T. , Deshpande Vikram , Zhao Lei 
Published: May 2021

AimsOesophageal verrucous carcinoma (VSCC) is a rare and morphologically distinct type of oesophageal squamous cell carcinoma (SCC). Diagnosing VSCC on biopsy material is challenging, given the lack of significant atypia and the presence of keratinising epithelium and exophytic growth. The molecular pathogenesis of VSCC remains unclear. The aim of this study was to characterise the genomic landscape of VSCC in comparison to conventional oesophageal SCC.Methods and resultsThree cases of VSCC from the Brigham and Women’s Hospital pathology archive were identified. Formalin‐fixed, paraffin‐embedded (FFPE) tumour tissue was used for p16 immunohistochemistry (IHC), high‐risk human papillomavirus (HPV) in‐situ mRNA hybridisation (ISH) and DNA isolation. Tumour DNA was sequenced using a targeted massively parallel sequencing assay enriched for cancer‐associated genes. Three additional cases of VSCC were identified by image review of The Cancer Genome Atlas (TCGA) oesophageal SCC cohort. VSCC cases were negative for p16 IHC and high‐risk HPV ISH. TP53 mutations (P < 0.001) and copy number variants (CNVs) for CDKN2A (P < 0.001), CDKN2B (P < 0.01) and CCND1 (P < 0.01) were absent in VSCC and significantly less frequent in comparison to conventional SCC. Five VSCC cases featured SMARCA4 missense mutations or in‐frame deletions compared to only four of 88 conventional SCC cases (P < 0.001). VSCC featured driver mutations in PIK3CA, HRAS and GNAS. Recurrent CNVs were rare in VSCC.ConclusionsVSCC is not only morphologically but also genetically distinct from conventional oesophageal SCC, featuring frequent SMARCA4 mutations and infrequent TP53 mutations or CDKN2A/B CNVs. Molecular findings may aid in establishing the challenging diagnosis of VSCC.
Evaluation of plasma and urinary levels of vascular endothelial growth factor and matrix metalloproteinase‐9 in patients with infantile hemangioma
Authors: Rotter Anita , Lima Xinaida T. , Oliveira Zilda N. P. 
Published: May 2021

AbstractBackgroundThe pathogenesis of infantile hemangioma (IH) is not fully understood. It has been suggested that angiogenic factors increase in the proliferative stage, decreasing subsequently in the regression phase.ObjectivesTo evaluate vascular endothelial growth factor (VEGF) and matrix metalloproteinase 9 (MMP‐9) levels, according to infantile hemangioma (IH) growth stages and size, and to compare these levels in patients with IH and control subjects.MethodsThis cross‐sectional study included 68 patients with IH and 25 control subjects. Plasma and urinary MMP‐9 and VEGF levels were evaluated during proliferative and regression phases. These levels were correlated with tumor size measured by ultrasonography. Nonparametric tests were performed.ResultsAmong 68 patients with IH, 55 (81%) were female. Age ranged from 1 to 40 months (median 7.0 months). There was no difference in plasma and urinary levels of VEGF and MMP‐9 between patients and control subjects. There were no significant differences in these levels between IH patients younger or older than 12 months of age, as a cutoff between proliferative and involution phases. No significant correlation was observed between tumor size and levels of the markers (R < 0.20 and P > 0.05 for all comparisons).ConclusionIn our large sample, levels of VEGF and MMP‐9 did not reflect the characteristic increased angiogenesis in patients with IH when compared to healthy subjects. In addition, these markers were not increased in the proliferative stage of the IH and did not correlate with tumor size.