bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopy screening effect on stage distributions of esophageal cancer: A cluster randomized cohort study in China
Authors: Guan Chen‐Tao , Song Guo‐Hui , Li Bian‐Yun , Gong Yan‐Wei , Hao Chang‐Qing , Xue Li‐Yan , Chen Wan‐Qing , Wei Wen‐Qiang 
Published: April 2018

Efficacy of endoscopic screening for esophageal cancer is not sufficiently definitive and lacks randomized controlled trial evidence. The present study proved short‐term screening efficacy through describing and comparing disease stage distributions of intervention and control populations. Villages from Linzhou and Cixian were cluster randomly allocated to the intervention or to the control group and the target population of 52 729 and 43 068 individuals was 40‐69 years old, respectively, and the actual enrolled numbers were 18 316 and 21 178, respectively. TNM stage information and study‐defined stage information of esophageal cases from 2012 to 2016 were collected. Stage distributions were compared between the intervention and control groups in the total target population, as well as in the subgroup populations in terms of enrolment and before or after intervention. There were a total of 199 and 141 esophageal cancer cases in the intervention and control groups, respectively. For the target population, distributions of TNM stage were borderline significant between the two groups after intervention (P = .093). However, subgroup analysis of the enrolled population during the after‐intervention period had statistical significance for both TNM and study‐defined stage. Natural TNM stage distributions were approximately 32%, 41%, 24% and 3% for stages I to IV vs 71%, 19%, 7% and 3% in the intervention population. The natural study‐defined stage distributions from early, middle to advanced stages were approximately 18%, 49% and 33% vs 59%, 33% and 8%. Early‐stage esophageal cancer cases accounted for a higher proportion after endoscopy screening, and the efficacy in the target population depends on the intervention compliance.
Treatment choice, satisfaction and quality of life in patients with Graves’ disease
Authors: Conaglen Helen M. , Tamatea Jade A. U. , Conaglen John V. , Elston Marianne S. 
Published: April 2018

SummaryBackgroundThyrotoxicosis, most often caused by Graves’ disease (GD), when treated inadequately may result in premature mortality. There is little consensus as to which of the 3 treatment options available ‐ antithyroid drugs (ATD), radioactive iodine (RAI) and surgery, is better.Aims(i) To assess factors involved in treatment choice and treatment satisfaction in patients treated for Graves’ disease; (ii) To assess quality of life (QoL) following treatment of Graves’ disease.MethodParticipants were selected from a prospective study cohort assessing thyrotoxicosis incidence and severity. Of the 172 eligible patients with Graves’ disease, 123 treated patients participated (64% had received ATD only, 11% RAI and 25% total thyroidectomy, the latter 2 usually after a period of ATD), along with 18 untreated patients with newly diagnosed Graves’ disease (overall participation rate, 73%). Consented patients completed a questionnaire detailing factors involved in treatment choice, QoL and satisfaction with treatment.ResultsParticipants reported that the most important factors in choosing a treatment were the following: the effects on activities of daily living, concern about use of radioiodine, possibility of depression or anxiety, and doctor's recommendations. Satisfaction levels were high across all 3 treatment types. QoL 1‐year following treatment was higher than in untreated patients, and comparable with other international studies.ConclusionsPatient satisfaction with therapy and QoL does not differ by treatment type. Therefore, clinical and social factors, in combination with patient choice and resource availability, should determine which treatment modality patients with Graves’ disease should receive.
Professional foster families in the reunification process—Polish experience
Authors: Basiaga Jan P. , Róg Anna , Zięba‐Kołodziej Beata 
Published: April 2018

AbstractWe researched the extent to which professional foster families fulfil their tasks to reintegrate families, what attitudes professional foster families assume towards the idea of reintegration, and to what extent and how professional foster families support a child separated from his or her family and parents in the process of reintegration.The research examined case studies of a sample of 58 professional foster families functioning as emergency shelter families in the Province of Silesia.The most Polish professional foster families assume a negative attitude towards reintegration. Moreover, some of the parents who participated in the research thought that most biological parents with difficulties should be deprived of their parental rights. The result of such attitudes is that foster parents make it difficult, in a variety of ways, for the biological parents to contact their child placed in foster care. Foster parents' full commitment to work related to restoring and maintaining emotional bonds between the children in foster care and their families is rarely noticeable. The foster families participating in the research were committed to an even lesser extent to the process of support for biological parents in developing their parental skills and attempts to have their child care rights restored.
Oesophageal causes of dysphagia localised only to the pharynx: Implications for the suspected head and neck cancer pathway
Authors: Nouraei S.A.R. , Murray I.A. , Heathcote K.J. , Dalton H.R. 
Published: April 2018

ObjectivesDysphagia is a presenting symptom of both pharyngeal and oesophageal cancers. The referral pathway choice is determined by whether it is thought to be oropharyngeal or oesophageal, and this is in turn influenced by whether dysphagia is perceived to be above or below the suprasternal notch. We studied the concordance between the presence of pharynx‐localised dysphagia (PLD) and the location of the underlying disease processes.DesignA subset analysis of the Dysphagia Hotline Cohort, collected between 2004 and 2015, of patients with PLD and a structural diagnosis.Main outcome measuresInformation about patient demography and presenting symptoms were recorded. The incisor‐to‐pathology distance, and the nature of the pathology, were recorded. Logistic regression analysis was used to identify independent predictors of malignancy.ResultsThe study included 177 patients. There were 92 males, and mean age at presentation was 74 years. The commonest benign pathologies were cricopharyngeal dysfunction with or without pharyngeal pouch (n = 67), peptic stricture (n = 44) and Schatzki's ring (n = 11). There were 49 cases of cancer, including one hypopharyngeal cancer, one cervical oesophageal cancer, 28 cancers of the upper/mid‐thoracic oesophagus, 15 cancers of the lower thoracic oesophagus and 4 cardio‐oesophageal cancers. In 105 (59%) patients, PLD was caused by oesophageal disease. Independent predictors of malignancy were weight‐change (loss >2.7 kg), a short history (<12 weeks) and presence of odynophagia. Nineteen (39%) of oesophageal cancers that presented with dysphagia that was localised only to the pharynx would have been beyond the reach of rigid oesophagoscopy.ConclusionsPharynx‐localised dysphagia is more likely to be a referred symptom of structural oesophageal disease, including cancer, than a primary symptom of structural pharyngeal disease. Absence of additional alarm symptoms such as a short history, weight‐loss, and odynophagia, do not adequately exclude the possibility of oesophageal cancer. When the differential diagnosis of PLD includes malignancy, cancer should be presumed to be arising from the oesophagus or the cardio‐oesophageal region until proven otherwise. This requires direct visualisation of the mucosal surfaces of the oesophagus and the cardio‐oesophageal region, using either transoral or transnasal flexible endoscopy, irrespective of whether the initial assessment occurs within head and neck or upper gastrointestinal suspected cancer pathways.
Prevalence of contact allergy to metals in the European general population with a focus on nickel and piercings: The EDEN Fragrance Study
Authors: Schuttelaar Marie L. A. , Ofenloch Robert F. , Bruze Magnus , Cazzaniga Simone , Elsner Peter , Gonçalo Margarida , Naldi Luigi , Svensson Åke , Diepgen Thomas L. 
Published: April 2018

BackgroundStudies on sensitization to metals in the general population are scarce.ObjectivesTo determine the prevalence of sensitization to metals in the general population, and factors associated with nickel sensitization.MethodsIn 5 European countries (The Netherlands, Germany, Italy, Portugal and Sweden), a random sample (N = 3119) from the general population (aged 18‐74 years) was patch tested and interviewed by use of a questionnaire on exposure to metals, piercing, and jewellery.ResultsOverall, the age‐standardized prevalences of sensitization to nickel, cobalt and chromium were, respectively, 14.5%, 2.1%, and 0.8%. The highest prevalence of nickel sensitization was seen in Portugal (18.5%) and the lowest (8.3%) in Sweden. The prevalence of cobalt sensitization varied between 3.8% (The Netherlands) and 0.9% (Italy), and the prevalence of chromium sensitization varied between 1.3% (Portugal) and 0.2% (Sweden). Significant associations were observed between nickel allergy and female sex (odds ratio [OR] 5.19; 95% confidence interval [95%CI]: 3.99‐6.74), past piercing use (OR 3.86; 95%CI: 2.85‐5.24), and currently having ≥3 piercings (OR 5.58; 95%CI: 4.02‐7.76).ConclusionsThe prevalence of sensitization to metals in the European general population was high, mostly because of nickel. The lowest prevalence of contact allergy to nickel and chromium observed in Sweden supports the effectiveness of long‐standing regulation.
Potential of Krebs von den Lungen‐6 as a predictor of relapse in interstitial pneumonia with anti‐aminoacyl tRNA synthetase antibodies‐positive dermatomyositis
Authors: Isoda Kentaro , Kotani Takuya , Takeuchi Tohru , Konma Junichi , Ishida Takaaki , Hata Kenichiro , Otani Kenichiro , Fujiwara Hiroshi , Shoda Takeshi , Makino Shigeki , Arawaka Shigeki 
Published: April 2018

AbstractObjectiveTo identify a predictor of relapse in interstitial pneumonia (IP) in patients with anti‐aminoacyl tRNA synthetase antibodies‐positive dermatomyositis (ARS‐DMIP).MethodsThis retrospective cohort study comprised 27 ARS‐DMIP patients. We compared clinical and laboratory findings between the relapse and non‐relapse groups during 2 years after treatment initiation to find predictors of relapse in IP. Candidate predictors were further assessed by analysing the relationship with the relapse of IP.ResultsOne patient with ARS‐DMIP died. About 7 (26.9%) of the remaining 26 patients with ARS‐DMIP had a relapse of IP. We found that the levels of serum Krebs von den Lungen‐6 (KL‐6) in the relapse group were significantly higher than those in the non‐relapse group at the time points before treatment (P = .046) and after treatments, including 6 (P = .004), 12 (P = .013), 18 (P = .003) and 24 months (P < .001). The KL‐6 values that maximised the area under the ROC curve were 2347 U/mL before treatment, 622 U/mL after 6 months and 468 U/mL after 12 months. The relapse rates after 104 weeks were significantly higher in patients with KL‐6 levels ≥2400 U/mL before treatment (P = .014), ≥600 ng/mL after 6 months (P < .005) and ≥470 U/mL after 12 months (P = .010).ConclusionThese findings suggest that the levels of KL‐6 before and after treatment in ARS‐DMIP may represent the disease activity of IP, and they may be useful as the predictor of relapse in IP in patients with ARS‐DMIP.
Genetics of gallstone disease
Authors: Rebholz Charlotte , Krawczyk Marcin , Lammert Frank 
Published: April 2018

AbstractBackgroundGallstone disease (GD) belongs to the most frequent disorders in gastroenterology and causes high costs in our health‐care systems. Gallstones are uncommon in children but frequent in adults, in particular in women, and are triggered by exogenous risk factors. Here, we summarize the current knowledge concerning the contribution of inherited predisposition to gallstone risk.DesignIn this review, we present the current data and recent research on the genetics of gallstone disease.ResultsSeveral GD‐predisposing gene variants have been reported, with most prominent effects being conferred by a common variant (p.D19H) of the hepatic and intestinal cholesterol transporter ABCG5/G8. A smaller group of patients might develop gallstones primarily due low phosphatidylcholine concentrations in bile as a result of loss‐of‐function mutations of the ABCB4 transporter (low phospholipid‐associated cholelithiasis syndrome). Regardless of the origin, the risk factors for gallstones lead to the supersaturation of bile with insoluble compounds, in particular cholesterol. As result, cholesterol stones develop and present the most frequent type of gallstones. Laparoscopic cholecystectomy with low morbidity and mortality is currently the most common and effective method for the therapy of symptomatic gallbladder stones.ConclusionsGallstone disease represents a multifactorial condition and previous studies have identified the major genetic contributors to gallstone formation. The increasing knowledge about the pathomechanisms of hepatobiliary metabolism and GD as well as the identification of additional risk factors might help to overcome the current invasive therapy by specific lifestyle intervention and precise molecular treatment.
Psychosocial impact, perceived stress and learning effect in undergraduate dental students during transition from pre‐clinical to clinical education
Authors: Frese C. , Wolff D. , Saure D. , Staehle H. J. , Schulte A. 
Published: April 2018

AbstractIntroductionThis study aimed to develop a suitable instrument for a comprehensive quantitative and qualitative assessment of perceived psychosocial impact, levels of stress and learning effect in undergraduate dental students during the transition from pre‐clinical to clinical education. These findings might improve curricular structures and didactic organisation during this period.Materials and methodsAt the beginning of their first clinical year, undergraduate dental students were asked to complete an anonymous forty‐item questionnaire. Two hundred and seventy‐six undergraduate dental students were willing to participate and completed the questionnaire and participated during the years 2011‐2016.ResultsThe response rate was between 45% and 96%. Correlational analysis (Spearman‐Rho) in the field of psychosocial impact showed the dental teacher to be the most important multiplier of students' feelings. If the students feel that their teacher acts cooperatively, positive items increase and negative items decrease significantly (P < .0001). Also, students who report high levels of stress are affected significantly in their psychosocial interaction (P < .0001). Wilcoxon test yielded highest levels of stress in endodontology during the first weeks (P < .0001). During the same period, the greatest learning increment was seen for diagnostics and caries excavation.ConclusionIn conclusion, teaching of undergraduate dental students during the transition period from pre‐clinical to clinical education can be positively influenced by a supportive learning environment and by specific chronological modifications in the curriculum. Students should start their clinical training with diagnostics, preventive dentistry and initial periodontal treatment. Due to high levels of perceived stress, endodontology should be introduced later in the clinical curriculum.
Postictal suppression and seizure durations: A patient‐specific, long‐term iEEG analysis
Authors: Payne Daniel E. , Karoly Philippa J. , Freestone Dean R. , Boston Ray , D'Souza Wendyl , Nurse Ewan , Kuhlmann Levin , Cook Mark J. , Grayden David B. 
Published: April 2018

SummaryObjectiveWe report on patient‐specific durations of postictal periods in long‐term intracranial electroencephalography (iEEG) recordings. The objective was to investigate the relationship between seizure duration and postictal suppression duration.MethodsLong‐term recording iEEG from 9 patients (>50 seizures recorded) were analyzed. In total, 2310 seizures were recorded during a total of 13.8 years of recording. Postictal suppression duration was calculated as the duration after seizure termination until total signal energy returned to background levels. The relationship between seizure duration and postictal suppression duration was quantified using the correlation coefficient (r). The effects of populations of seizures within patients, on correlations, were also considered. Populations of seizures within patients were distinguished by seizure duration thresholds and k‐means clustering along the dimensions of seizure duration and postictal suppression duration. The effects of bursts of seizures were also considered by defining populations based on interseizure interval (ISI).ResultsSeizure duration accounted for 40% of postictal suppression duration variance, aggregated across all patients and seizures. Seizure duration accounted for more than 25% of the variance in postictal suppression duration in 2 patients and accounted for less than 25% in the remaining 7. In 3 patients, heat maps showed multiple distinct postictal patterns indicating multiple populations of seizures. When accounting for these populations, seizure duration accounted for less than 25% of the variance in postictal duration in all populations. Variance in postictal suppression duration accounted for less than 10% of ISI variance in all patients.SignificanceWe have previously demonstrated that some patients have multiple seizure populations distinguishable by seizure duration. This article shows that different seizure populations have distinct and consistent postictal behaviors. The existence of multiple populations in some patients has implications for seizure management and forecasting, whereas the distinct postictal behaviors may have implications for sudden unexpected death in epilepsy (SUDEP) prediction and prevention.
Nearly 200 years of sustained selection have not overcome the leaf area–stem size relationship in the poinsettia
Authors: Trejo Laura , Rosell Julieta A. , Olson Mark E. 
Published: April 2018

AbstractOrganismal parts often covary in their proportions, a phenomenon known as allometry. One way of exploring the causes of widespread allometric patterns is with artificial selection, to test whether or not it is possible to move populations into “empty” allometric space not occupied by the wild type. Domesticated organisms have been subject to many generations of selection, making them ideal model systems. We used the domesticated Christmas poinsettiaEuphorbia pulcherrimain combination with wild populations to examine the origin of the proportionality between leaf area and stem size, which scales predictably across nearly all plants. In accordance with the stated aims of breeders to produce more compact plants, we predicted that domesticated poinsettias would have greater leaf area for a given stem volume than the tall, lanky wild ancestors. Our data rejected this prediction, showing instead that domesticates have leaf area–stem volume relationships identical to the wild ancestors. Presumably the metabolic dependence between stems and leaves makes the leaf area–stem volume relationship difficult to overcome. The relative fixity of this relationship leads to predictable covariation in other traits: The fuller outlines of domestic poinsettias involve significantly shorter internodes, and given a constant leaf area–stem volume relationship, smaller individual leaf areas. At the same time, domestic poinsettias are subject to selection favoring breakage resistance, which is achieved via thicker stems for a given length rather than stiffer stem tissue resistance to bending. Our results show that domesticated poinsettias differ from wild plants in a suite of traits including leaf size, internode distances, and stem length–diameter relations, but despite over 200 years of selection favoring rounded outlines, there has been no change in the total leaf area–stem volume relationship, helping to predict which changes are likely achievable and which will not be under continued artificial selection and in the wild.
Habitat disruption and the identification and management of functional trait changes
Authors: Kelley Jennifer L , Grierson Pauline F , Collin Shaun P , Davies Peter M 
Published: April 2018

AbstractAquatic ecosystems are facing escalating threats from urbanization, habitat loss and projected impacts of climate change, which both individually and in combination have the potential to fundamentally alter ecosystem functioning. While it is well established that habitat disturbances can affect the composition and diversity of aquatic communities, only recently have studies considered whether such impacts result in changes in species’ functional traits. We consider how functional traits of freshwater and marine fishes respond to environmental change, and how shifts in the expression of these traits can impact community dynamics and key ecological processes, including trophic interactions and nutrient transfer. We find that a multitude of functional traits, including behavioural and sensory traits, is sensitive to habitat disturbances. We demonstrate how these trait changes can be used to reveal hidden “ecological diversity” as well as serving as early indicators of environmental perturbation. We conclude that management strategies that consider the fundamental biological responses of fishes to habitat disturbance will be particularly effective in determining causal relationships within the ecological network. While detailed information on trait function is often lacking, even some general understanding of trait function and importance will facilitate targeted and efficient ecosystem management. We urge fisheries biologists and aquatic ecosystem managers to consider the role of functional traits in facilitating effective habitat restoration and management.
Do Business Borrowers Benefit from Bank Bailouts?: The Effects of TARP on Loan Contract Terms
Authors: Berger Allen N. , Makaew Tanakorn , Roman Raluca A. 
Published: April 2018

AbstractWe investigate benefits to business borrowers from bank bailouts, specifically the Troubled Asset Relief Program (TARP). Applying difference‐in‐difference methodology to loan‐level data, we find more favorable borrower contract terms in five dimensions, spread, amount, maturity, collateral, and covenants, suggesting increased credit supply at the intensive margin by bailed‐out banks. Findings are robust to dealing with endogeneity and other issues. Riskier borrowers benefit more, consistent with moral hazard exploitation. Small and unlisted borrowers benefit less, suggesting fewer benefits for financially constrained firms. Benefits accrue to both relationship and nonrelationship borrowers. Results contribute to the research and policy debates on bank bailouts.