bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alcohol and Cannabis Consumption Does Not Diminish Cure Rates in a Real-World Cohort of Chronic Hepatitis C Virus Infected Patients on Opioid Substitution Therapy—Data From the German Hepatitis C-Registry (DHC-R)
Authors: Christensen Stefan , Buggisch Peter , Mauss Stefan , Böker Klaus HW , Müller Tobias , Klinker Hartwig , Zimmermann Tim , Serfert Yvonne , Weber Bernd , Reimer Jens , Wedemeyer Heiner ,   German Hepatitis C-Registry
Published: March 2019

Background: The importance of alcohol and cannabis consumption for the effectiveness of treatment of chronic hepatitis C virus (HCV) infection with direct acting antivirals (DAAs) in people on opioid substitution therapy (OST) has not been investigated in detail. Methods: We investigated sustained virological response (SVR) rates and proportion of lost to follow-up (LTFU) between OST (n = 739) and non-OST patients (n = 7008) in the German Hepatitis C-Registry (Deutsches Hepatitis C-Register, DHC-R), which is a national multicenter prospective non-interventional real-world registry. Non-OST patients comprised patients with former/current drug use (non-OST/DU; n = 1500) and patients never consuming drugs (non-OST/NDU; n = 5508). Findings: SVR 12/24 rates (intention to treat [ITT]) in patients consuming no or less than 30 g/day (women) or 40 g/day (men) were significantly higher in non-OST/NDU (range 91%-92%) vs OST patients (range 83%-86%), mainly due to significantly higher LTFU rates in OST (range 11%-12%) compared with non-OST/NDU (range 2%-3%). In non-OST/NDU with high alcohol consumption of more than 30/40 g/day, SVR 12/24 rates (ITT) were lower (85%) but did not differ to OST (85%) with high alcohol consumption. No significant differences could be seen for SVR 12/24 in per-protocol (PP) analysis independent of alcohol consumption or amount of alcohol intake. Cannabis use did not significantly influence SVR 12/24 in ITT or PP or LTFU. Conclusions: High SVR rates could be achieved in both OST and non-OST patients irrespective of alcohol or cannabis consumption. However, LTFU is more likely in patients with current or former drug use than in patients without drug history and in patients with high alcohol consumption but occurred mainly after end of antiviral treatment (EOT), leaving a high chance for HCV elimination in these patients.
The influence of varying maxillary central incisor vertical dimension on perceived smile aesthetics
Authors: Lira dos Santos Elis Janaina , Dantas Alana Moura Xavier , Vilela Raíssa Marçal , de Lima Karina Jerônimo Rodrigues Santiago , Beltrão Rejane Targino Soares 
Published: March 2019

Objective: To evaluate patient perception of the smile focused on analysis of the upper incisors. Design: Cross-sectional study. Setting: Department of Clinical and Social Dentistry at Federal University of Paraíba, João Pessoa, Brazil. Participants: The sample consisted of 135 individuals (73 women and 62 men). Methods: Images with different characteristics associated with the incisal edges were shown at random and analysed using a Likert scale. Data were analysed using the Chi-square test or Fisher’s exact test with a statistically significant difference ( P < 0.05). Results: Smile I (difference of 1.5 mm in relation to the central incisor and lateral) was considered the most aesthetic, while Smile III (no difference in height between the central and lateral incisors) was the least aesthetic. A significant difference was found between perception of smile II (difference of 1 mm in relation to the central incisor and lateral) and age groups ( P < 0.005), with 31% (n = 13) of individuals aged 45–64 years considering smile II as not pleasant, 4.4% (n = 2) aged 15–24 years and 8.3% (n=4) aged 25–44 years and 4.4% (n = 2) aged 15–24 years considering the same. A significant difference was also found in relation to educational background of the assessor and smile perception, with smile III ( P = 0.0441) and smile IV ( P = 0.0053) considered the most aesthetic ( P = 0.0116). Conclusion: The smile considered most attractive among the sample was that with 1.5 mm steepness between the central and lateral incisors, while a flat smile arc was considered least attractive.
Predicted relationships between cognitive function, depressive symptoms, self-care adequacy, and health-related quality of life and major events among patients with heart failure
Authors: Kim JinShil , Hwang Seon Young , Heo Seongkum , Shin Mi-Seung , Kim Sun Hwa 
Published: March 2019

Background: Cognitive decline, which often occurs in heart failure, is likely to decrease health-related quality of life and increase morbidity and mortality (major events), but it has been scantly addressed. Aims: To examine whether baseline cognitive domains of global cognition, memory and executive function predict baseline health-related quality of life and 15-month major events among patients with heart failure. Methods: This prospective study included 117 patients (mean age 65.5 ± 9.42 years; men 58.1%; New York Heart Association class III/IV 25.6%), who completed questionnaires, including neuropsychological testing for cognitive evaluation, depressive symptoms, self-care and health-related quality of life measures. Their 15-month major events were extracted from medical record reviews. Results: Approximately one-third of the sample had cognitive impairment. Forty-one patients (35.0%) experienced major events. Patients with major events had significantly worse memory (immediate recall memory 13.9 vs. 11.5, P=0.030; delayed recall memory 4.3 vs. 3.1, P=0.014) and reduced executive function (trail-making test A 28.1 vs. 38.0 seconds, P=0.031). After controlling for age, sex, heart failure severity and comorbidity, memory loss with depressive symptoms was associated with worse health-related quality of life, and odds ratios of experiencing major events increased only with reduced cognitive function in global cognition and executive function. Conclusion: Cognitive function is an important factor for health-related quality of life and major events, and memory loss – worsened health-related quality of life and poor executive function was more likely to increase the risk of major events. Future studies should consider both cognitive function and depressive symptoms when designing heart failure interventions to improve patient outcomes.
Leadership of professional learning communities in Singapore schools: The tight–loose balance
Authors: Ho Jeanne , Ong Monica , Tan Liang See 
Published: March 2019

Purpose This paper presents a study on how professional learning communities (PLC) are developed in an Asian setting, and the nature of leadership that helped to cultivate and sustain PLC in this setting. Research Method The study adopted a sequential mixed method, starting with a survey followed by qualitative case studies, involving focused group discussions (FGDs) and interviews. This paper focuses on findings derived from the qualitative data, triangulated with the survey data. Findings The study raises questions about common assumptions regarding PLC, and shares how Singapore’s unique cultural context mediates and filters Western notion of PLC and of leadership for PLC. The study suggests that leadership for PLC requires a centralised decentralisation approach, which provides clarity and alignment through strategic direction and supporting structures, while simultaneously enabling the distribution of leadership to teachers. The paper also explicates the tensions that arise due to the need to balance a tight–loose approach, and suggests how organisational and inquiry structures can both enable and constrain the distribution of leadership in a PLC. Implications Findings from the study has implications for policy makers and school leaders who are steering PLC initiatives.
Pan-European Economic Analysis to Identify Cost Savings for the Health Care Systems as a Result of Integrating Glucose Monitoring Based Telemedical Approaches Into Diabetes Management
Authors: Fritzen Katharina , Basinska Kornelia , Rubio-Almanza Matilde , Nicolucci Antonio , Kennon Brian , Vergès Bruno , Zakrzewska Katerina , Schnell Oliver 
Published: March 2019

Background: Self-monitoring of blood glucose supported by the diabetes-app OneTouch Reveal® has demonstrated to improve HbA1c. We aimed at analyzing costs savings related the integration of telemedical features into diabetes management. Methods: Data from a randomized controlled trial were used to assess the 10-year risk of patients for fatal myocardial infarction (MI). On the basis of this risk assessments—also related to a 5% or 10% reduction of hypoglycemic episodes—cost savings for the health care systems of five European countries—France, Germany, Italy, Spain, and the United Kingdom—were modeled. Results: HbA1c reduction of 0.92% in insulin-treated type 2 diabetes patients (T2DM) was associated with a 2.3% decreased 10-year risk for fatal MI. In combination with a 10% reduction of hypoglycemic events this risk reduction led to cost savings of €16.1 million (France), €57.8 million (Germany), €30.9 million (Italy), €23.8 million (Spain), and €5.8 million (UK), considering all insulin-treated T2DM patients in the respective countries. Conclusion: Improving metabolic control and thus risk for comorbidities like MI by combining the glucose meter with CRI with telemedical features has the potential to reduce costs for European health care systems.
Risk assessment in pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension
Authors: Humbert Marc , Farber Harrison W. , Ghofrani Hossein-Ardeschir , Benza Raymond L. , Busse Dennis , Meier Christian , Hoeper Marius M. 
Published: March 2019

BackgroundCurrent pulmonary hypertension treatment guidelines recommend use of a risk stratification model encompassing a range of parameters, allowing patients to be categorised as low, intermediate or high risk. Three abbreviated versions of this risk stratification model were previously evaluated in patients with pulmonary arterial hypertension (PAH) in the French, Swedish and COMPERA registries. Our objective was to investigate the three abbreviated risk stratification methods for patients with mostly prevalent PAH and chronic thromboembolic pulmonary hypertension (CTEPH), in patients from the PATENT-1/2 and CHEST-1/2 studies of riociguat.MethodsRisk was assessed at baseline and at follow-up in PATENT-1 and CHEST-1. Survival and clinical worsening-free survival were assessed in patients in each risk group/strata.ResultsWith all three methods, riociguat improved risk group/strata in patients with PAH after 12 weeks. The French non-invasive and Swedish/COMPERA methods discriminated prognosis for survival and clinical worsening-free survival at both baseline and follow-up. Furthermore, patients achieving one or more low-risk criteria or a low-risk stratum at follow-up had a significantly reduced risk of death and clinical worsening compared with patients achieving no low-risk criteria or an intermediate-risk stratum. Similar results were obtained in patients with inoperable or persistent/recurrent CTEPH.ConclusionsThis analysis confirms and extends the results of the registry analyses, supporting the value of goal-oriented treatment in PAH. Further assessment of these methods in patients with CTEPH is warranted.
Comparing Paclitaxel Plus Fluorouracil Versus Cisplatin Plus Fluorouracil in Chemoradiotherapy for Locally Advanced Esophageal Squamous Cell Cancer: A Randomized, Multicenter, Phase III Clinical Trial
Authors: Chen Yun , Ye Jinjun , Zhu Zhengfei , Zhao Weixin , Zhou Jialiang , Wu Chaoyang , Tang Huarong , Fan Min , Li Ling , Lin Qin , Xia Yi , Li Yunhai , Li Jiancheng , Jia Huixun , Lu Saiquan , Zhang Zhen , Zhao Kuaile 
Published: March 2019

PURPOSE This trial aimed to assess the efficacy and safety of the paclitaxel plus fluorouracil regimen versus the cisplatin plus fluorouracil regimen in definitive concurrent chemoradiotherapy (dCRT) in patients with locally advanced esophageal squamous cell carcinoma (ESCC). PATIENTS AND METHODS Patients with locally advanced ESCC were enrolled and randomly assigned to either the paclitaxel plus fluorouracil group or the cisplatin plus fluorouracil group. The patients in the paclitaxel plus fluorouracil group were treated with paclitaxel and fluorouracil one cycle per week in dCRT for five cycles followed by paclitaxel and fluorouracil one cycle per month in consolidation chemotherapy for two cycles. The patients in the cisplatin/5-fluorouracil group were treated with cisplatin and fluorouracil one cycle per month in dCRT for two cycles followed by two cycles in consolidation chemotherapy. The radiotherapy dose was 61.2 Gy delivered in 34 fractions. The primary end point was 3-year overall survival (OS). RESULTS Four hundred thirty-six patients with ESCC in six centers were recruited at a 1:1 ratio between April 2012 and July 2015. The median follow-up of the surviving patients was 48.7 months (interquartile range, 42.6-60.9). The 3-year OS was 55.4% in the paclitaxel plus fluorouracil group and 51.8% in the cisplatin plus fluorouracil group (hazard ratio, 0.905 [95% CI, 0.698 to 1.172]; P = .448). The 3-year progression-free survival was also not significantly different between the paclitaxel plus fluorouracil group and the cisplatin plus fluorouracil group (43.7% v 45.5%, respectively; hazard ratio, 0.973 [95% CI, 0.762 to 1.243]; P = .828). Compared with the cisplatin plus fluorouracil group, the paclitaxel plus fluorouracil group had significantly lower incidences of acute grade 3 or higher anemia, thrombocytopenia, anorexia, nausea, vomiting, and fatigue ( P < .05), but higher incidences of acute grade 3 or higher leukopenia, radiation dermatitis, and radiation pneumonitis ( P < .05). CONCLUSION The paclitaxel plus fluorouracil regimen did not significantly prolong the OS compared with the standard cisplatin plus fluorouracil regimen in dCRT in patients with locally advanced ESCC.
Counseling and Management of the Risks of Living With Epilepsy
Authors: Noe Katherine 
Published: March 2019

ABSTRACT

PURPOSE OF REVIEW
For patients living with epilepsy, quality of life is determined not only by seizure control but by mood, antiepileptic drug adverse effects, relationships, and access to education, employment, and transportation. This article reviews some of the most commonly encountered concerns associated with epilepsy, including mood disorders, driving, injuries, mortality, bone health, genetic burden, and impact on relationships.

RECENT FINDINGS
People with epilepsy are at increased risk for anxiety, depression, and suicide. Depression is underrecognized in patients with epilepsy, but effective validated screening tools are available for use. Mortality rates for people with epilepsy are 2 times higher than those of the general population, but much of this is attributable to underlying conditions rather than seizures. Sudden unexpected death in epilepsy (SUDEP) occurs in an estimated 1:1000 adults with epilepsy per year, and the risk can be reduced by improved observation and seizure control. An increased risk of injury, including fractures, is also present in patients with epilepsy. Reduced bone health leading to increased fracture risk is an important negative consequence of long-term use of antiepileptic medication. Seizures while driving can also cause accidents and injury. Despite the importance of driving for people with epilepsy, physicians are underperforming in providing counsel about driving.

SUMMARY
Optimal care of the patient with epilepsy includes addressing risks to emotional health, physical health including fractures and SUDEP, social health, and an independent lifestyle. Identification of and treatments to reduce these risks can do more to improve quality of life than a narrow clinical focus on seizure control alone.
Treatment of Women With Epilepsy
Authors: Sazgar Mona 
Published: March 2019

ABSTRACTPURPOSE OF REVIEWThis article provides the latest information to guide practitioners in counseling and treating women with epilepsy.RECENT FINDINGSThere is an increasing body of literature on the multidirectional effects of sex hormones on seizure frequency and severity and of seizures altering areas of the brain involved in neuroendocrine function. Ongoing pregnancy outcome data from pregnancy registries and meta-analysis of observational studies have provided key information on the safety of using antiseizure medications during pregnancy and the risk to the fetus.SUMMARYIn treating and counseling women with epilepsy from puberty to menopause, it is important to understand the complex interactions of sex hormones, seizures, and antiseizure medications on reproductive health and pregnancy outcomes.
Blood Flow–restricted Exercise Does Not Induce a Cross-Transfer of Effect: A Randomized Controlled Trial
Authors: AMPOMAH KWASI , AMANO SHINICHI , WAGES NATHAN P. , VOLZ LAUREN , CLIFT RACHEL , LUDIN ARIMI FITRI MAT , NAKAZAWA MASATO , LAW TIMOTHY D. , MANINI TODD M. , THOMAS JAMES S. , RUSS DAVID W. , CLARK BRIAN C. 
Published: March 2019

ABSTRACT

Purpose
The goal of this trial was to determine whether low-load blood flow–restricted (BFR) exercise of appendicular muscles induces a cross-transfer of effect to the trunk extensor (TE) muscles, such that low-load TE exercise would enhance TE size and function to a greater extent than standard low-load exercise in people with recurrent low back pain (LBP). We also investigated the direct effects of BFR exercise in the appendicular muscles.

Methods
Thirty-two adults with recurrent, nonspecific LBP were randomized into two groups: Appendicular BFR exercise (BFR exercise) or control exercise (CON exercise). All participants trained (two times per week) for 10 wk, with a 12-wk follow-up. Participants performed three sets of leg extension (LE), plantar flexion (PF), and elbow flexion (EF) exercises followed by low-load TE exercise without BFR. Outcome measures included magnetic resonance imaging–derived muscle size (quadriceps and TE), strength (LE, PF, EF, and TE), and endurance (LE and TE).

Results
There was no evidence for a cross-transfer of effect to the TE. There was also no statistically significant enhancement of limb skeletal muscle size or function of BFR relative to CON exercise at any time point; though, moderate effect sizes for BFR exercise were observed for enhanced muscle size and strength in the leg extensors.

Conclusions
Low-load BFR exercise of the appendicular muscles did not result in a cross-transfer of effect to the TE musculature. There was also no significant benefit of low-load BFR exercise on the appendicular muscle size and function, suggesting no benefit from low-load BFR exercise in adults with recurrent, nonspecific LBP.
Physiological Evaluation for Endurance Exercise Prescription in Sickle Cell Disease
Authors: MESSONNIER LAURENT A. , GELLEN BARNABAS , LACROIX ROXANE , PEYROT SANDRINE , RUPP THOMAS , MIRA JOSÉ , PEYRARD ARTHUR , BERKENOU JUGURTHA , GALACTÉROS FRÉDÉRIC , BARTOLUCCI PABLO , FÉASSON LÉONARD 
Published: March 2019

ABSTRACT

Purpose
Although strenuous exercise may expose sickle cell disease (SCD) patients to risks of vaso-occlusive crisis, evidence suggests that regular endurance exercise may be beneficial. This study aimed to test (i) the safety and usefulness of a submaximal incremental exercise in evaluating physical ability of SCD patients and identify a marker for the management of endurance exercise and (ii) the feasibility of endurance exercise sessions in SCD patients.

Methods
Twenty adults with SCD (12 men and 8 women) performed a submaximal incremental exercise used to determine the first lactate threshold (LT1) and stopped as soon as blood lactate concentration ([lactate]b) reached ≥4 mmol·L−1. Fifteen of those patients (8 men and 7 women) also performed three 30-min endurance exercise sessions at ~2.5 mmol·L−1 of [lactate]b on separate occasions.

Results
LT1 occurred at 47 ± 3 and 33 ± 3 W for men and women, respectively, demonstrating the extreme deconditioning and, thus, low physical ability of adult SCD patients. During endurance exercise, peripheral oxygen saturation and [lactate]b most often remained stable and within acceptable ranges.

Conclusions
The proposed strategy of submaximal incremental exercise allowed safe determination of LT1, an important parameter of patients’ physical ability. The study also demonstrated the feasibility and safety of individually tailored endurance exercises at ~2.5 mmol·L−1 of [lactate]b. These latter results suggest that endurance training programs may be considered for adult SCD patients and that the method proposed here may be helpful in that regard.
Selection and regeneration of purple sweet potato calli against drought stress simulated by polyethylene glycol
Authors: Sunaryo Widi , Darnaningsih Darnaningsih , Nurhasanah Nurhasanah 
Published: March 2019

Background: Water shortage due to natural and/or technical drought stress, widespread throughout Sumatra, Java, Sulawesi and Kalimantan islands, significantly reduces crop production. The development of varieties tolerant to drought stress is important since it is more effective rather than improving irrigation infrastructure to increase the sweet potato productivity. Methods: Selection and regeneration experiments assessing purple sweet potato callus tolerance of drought stress, simulated by polyethylene glycol (PEG), were conducted to generate new variant plants tolerant of drought stress. Sterile explants (leaf and petiole) generated from previous in vitro culture were inoculated to the Murishage and Skoog (MS) medium containing plant growth regulator combination as treatments to induce calli. The calli were then transferred to half-MS medium containing 0, 5, 10, 15 and 20% PEG as selection agent for drought tolerance. The surviving calli were regenerated in the MS medium containing 0, 0.5, 1 or 1.5 mg l-1 6-benzylaminopurine (BAP). The callus formation, growth and survivability during in vitro culture were measured. Results: Calli were successfully formed in almost all media containing 2,4-Dichlorophenoxyacetic acid (2,4-D ) with the concentration of 1, 2, 3 and 4 mg l-1 and BAP (concentration: 0.5 and 1 mg l-1), but the medium of MS + 2 mg l-1 2,4-D + 0.5 mg l-1 BAP resulted in the highest number of induced calli per treatment (mean=11.36), with the percentage of responsive explants standing at around 96%. The higher the concentration of PEG, the lower the number of surviving calli. At 20% PEG, only 54.42% calli survived. There were five plants successfully regenerated from the survived calli at 20% PEG, using MS medium containing 1.5 mg l-1 BAP. Conclusions: The experiment has successfully produced putative drought-tolerant plants by callus screening using PEG as drought-tolerance-selecting agent in purple sweet potato.