bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective diagnostic study on the use of narrow‐band imaging on suspicious lesions during colonoscopy examination
Authors: Yaacob Huzairi , Ikhwan Sani Mohamad , Hashim Mohd Nizam , Syed Abd Aziz Syed Hassan , Wan Zain Wan Zainira , Tuan Sharif Sharifah Emilia , Hayati Firdaus , Zakaria Andee Dzulkarnaen 
Published: February 2018

AbstractIntroductionColonoscopy is the gold standard to detect colorectal neoplasm. Narrow‐band imaging (NBI) has a good diagnostic accuracy to differentiate between neoplastic and non‐neoplastic colorectal lesions. This study explores the diagnostic validity of NBI colonoscopy as well as its associated factors related to neoplastic and non‐neoplastic colorectal lesions.MethodsThis study enrolled 100 patients in a single‐center tertiary teaching hospital. Patients presented for screening colonoscopy, and those with suspicious colorectal lesions were included in this study. During colonoscopy, the most suspicious lesion in each patient was analyzed using the NBI system based on Sano’s classification. Each lesion was biopsied for histopathological analysis, the gold standard. Endoscopic images were captured electronically. The sensitivity, specificity, and diagnostic accuracy of NBI colonoscopy were assessed. Other associated factors related to neoplastic and non‐neoplastic lesions were analyzed accordingly.ResultsThe sensitivity and specificity of the NBI were 88.2% and 71.9%, respectively. The area under the receiver–operator curve was 0.801, indicating that NBI has a good ability to differentiate between disease and non‐disease. There are significant associations between histopathological examination outcomes and both presenting symptoms, especially weight loss, and lesion site, even after other variables were controlled (P < 0.05).ConclusionThe NBI system in colonoscopy was capable of distinguishing neoplastic from non‐neoplastic colorectal lesions. It indicates an acceptable level of agreement with histopathology, the gold standard. However, the role of NBI in screening and surveillance in Malaysia still needs further evaluation and exploration.
Use of trimethoprim–sulfamethoxazole during pregnancy and risk of spontaneous abortion: a nested case control study
Authors: Muanda Flory T. , Sheehy Odile , Bérard Anick 
Published: February 2018

AimsData available on the fetal safety of trimethoprim–sulfamethoxazole (TMP‐SMX) exposure during pregnancy remains scarce and inconclusive. A previous study assessing the link between TMP‐SMX exposure during pregnancy and the risk of spontaneous abortion (SA) did not control for protopathic bias and indication bias.MethodsWe conducted a nested control study (n = 77 429 pregnancies including 7039 cases of SA and 70 390 controls) within the Quebec Pregnancy Cohort. For each case of SA, we selected 10 controls at the index date that were matched on gestational age and year of pregnancy. TMP‐SMX exposure was defined as either having filled at least one prescription between the first day of gestation (1DG) and the index date, or as having filled a prescription before pregnancy but with a duration overlapping the 1DG (102 pregnancies exposed to TMP‐SMX, including 25 cases of SA and 77 controls).ResultsAdjusting for potential confounders, TMP‐SMX exposure was associated with an increased risk of SA (AOR 2.94, 95% C 1.89–4.57, 25 exposed cases). Similar results were found after controlling for indication bias and protopathic bias.ConclusionGiven that this drug is widely use in HIV patients to prevent opportunistic infections and malaria, there is an urgent need to identify potential data sources in Africa for analysis of early pregnancy exposure to TMP‐SMX.
Life after institutional care: Implications for research and practice
Authors: Diraditsile Kabo , Nyadza Mbongeni 
Published: February 2018

AbstractThis study sought to investigate the lived experiences of care leavers from institutional care facility in Botswana. The study objectives were to explore the challenges faced by children after leaving the institutional care and to identify services that can be offered to them in preparation for life in a society in general. The study adopted a cross‐sectional qualitative research approach, and data were collected through in‐depth interviews that were qualitatively analysed. Thirty participants was sampled, and there were divided into 2 sections comprising care leavers and key informants who were part of the institutional care staff. They were selected using purposive and snowball sampling methods. The findings confirm that institutional care has both positive and negative effects on care leavers in the sense that it provides children with educational opportunities, family, and strong interrelation skills. Furthermore, the study findings show that during children's stay in the institutional care, they are sometimes neglected by housemothers that affect their transition into mainstream society. Moreover, the study findings reveal that care leavers encounter many challenges ranging from finance management to unemployment, discrimination from the society, and poverty. Lastly, future research, policy direction, and implications are discussed.
Efficacy of traction‐assisted colorectal endoscopic submucosal dissection using a clip‐and‐thread technique: A prospective randomized study
Authors: Yamasaki Yasushi , Takeuchi Yoji , Uedo Noriya , Kanesaka Takashi , Kato Minoru , Hamada Kenta , Tonai Yusuke , Matsuura Noriko , Akasaka Tomofumi , Hanaoka Noboru , Higashino Koji , Ishihara Ryu , Okada Hiroyuki , Iishi Hiroyasu 
Published: February 2018

Background and AimColorectal endoscopic submucosal dissection (ESD) remains challenging because of technical difficulties, long procedure time, and high risk of adverse events. To facilitate colorectal ESD, we developed traction‐assisted colorectal ESD using a clip and thread (TAC‐ESD) and conducted a randomized controlled trial to evaluate its efficacy.MethodsPatients with superficial colorectal neoplasms (SCN) ≥20 mm were enrolled and randomly assigned to the conventional‐ESD group or to the TAC‐ESD group. SCN ≤50 mm were treated by two intermediates, and SCN >50 mm were treated by two experts. Primary endpoint was procedure time. Secondary endpoints were TAC‐ESD success rate (sustained application of the clip and thread until the end of the procedure), self‐completion rate by the intermediates, and adverse events.ResultsAltogether, 42 SCN were analyzed in each ESD group (conventional and TAC). Procedure time (median [range]) for the TAC‐ESD group was significantly shorter than that for the conventional‐ESD group (40 [11–86] min vs 70 [30–180] min, respectively; P < 0.0001). Success rate of TAC‐ESD was 95% (40/42). The intermediates’ self‐completion rate was significantly higher for the TAC‐ESD group than for the conventional‐ESD group (100% [39/39] vs 90% [36/40], respectively; P = 0.04). Adverse events included one intraoperative perforation in the conventional‐ESD group and one delayed perforation in the TAC‐ESD group.ConclusionTraction‐assisted colorectal endoscopic submucosal dissection reduced the procedure time and increased the self‐completion rate by the intermediates (UMIN000018612).
Kidney function monitoring and nonvitamin K oral anticoagulant dosage in atrial fibrillation
Authors: Andreu Cayuelas Jose Manuel , Caro Martínez Cesar , Flores Blanco Pedro Jose , Elvira Ruiz Gines , Albendin Iglesias Helena , Cerezo Manchado Juan Jose , Bailen Lorenzo Jose Luis , Januzzi James L. , García Alberola Arcadio , Manzano‐Fernández Sergio 
Published: February 2018

AbstractBackgroundClinical practice guidelines recommend regular kidney function monitoring in atrial fibrillation patients on nonvitamin K oral anticoagulants (NOAC); however, information regarding compliance with these recommendations in daily life conditions is scarce. We sought to determine the compliance with kidney function monitoring recommendations in nonvalvular atrial fibrillation (NVAF) patients starting NOAC and its implication on the appropriateness of NOAC dosage.Material and methodsThis study involves the retrospective analysis of a multicentre registry including consecutive NVAF patients who started NOAC (n = 692). Drug dosage changes and serum creatinine determinations were recorded during 1‐year follow‐up. European Heart Rhythm Association criteria were used to define the appropriateness of kidney function monitoring as well as adequate NOAC dosage.ResultsDuring the follow‐up (334 ± 89 days), the compliance with kidney function monitoring recommendations was 61% (n = 425). After multivariate adjustment, age (OR × year: 0.92 (CI 95%: 0.89‐0.95) P < .001), creatinine clearance (OR × mL/min: 1.02 (CI 95%: 1.01‐1.03) P < .001) and adequate NOAC dosage at baseline (OR: 1.54 (CI 95%: 1.06‐2.23), P = .024) were independent predictors of appropriate kidney function monitoring. Compliance with kidney function monitoring recommendations was independently associated with change to appropriate NOAC dose after 1 year (OR: 2.80 (CI 95%: 1.01‐7.80), P = .049).ConclusionsNoncompliance with kidney function monitoring recommendations is common in NVAF patients starting NOAC, especially in elderly patients with kidney dysfunction. Compliance with kidney function monitoring recommendations was associated with adequate NOAC dosage at 1‐year follow‐up. Further studies are warranted to evaluate the implication of kidney function monitoring on prognosis.
Relation of quality of anticoagulation control with different management systems among patients with atrial fibrillation: Data from FANTASIIA Registry
Authors: Roldán Rabadán Inmaculada , Esteve‐Pastor María Asunción , Anguita‐Sánchez Manuel , Muñiz Javier , Camacho Siles José , Quesada María Angustias , Ruiz Ortiz Martín , Marín Francisco , Martínez Sellés Manuel , Bertomeu Vicente , Lip Gregory Y.H. , Cequier Fillat Angel , Badimón Lina ,   the FANTASIIA Study Investigators
Published: February 2018

AbstractBackgroundAnticoagulation control in patients with atrial fibrillation (AF) has a multidisciplinary approach although is usually managed by general practitioners (GP) or haematologists. The aim of our study was to assess the quality of anticoagulation control with vitamin K antagonists (VKAs) in relation to the responsible specialist in a “real‐world” AF population.MethodsWe consecutively enrolled VKA anticoagulated patients included in the FANTASIIA Registry from 2013 to 2015. We analysed demographical, clinical characteristics and the quality of anticoagulation control according to the specialist responsible (ie GPs or haematologists).ResultsData on 1584 patients were included (42.5% females, mean age 74.0 ± 9.4 years): 977 (61.7%) patients were controlled by GPs and 607 (38.3%) by haematologists. Patients managed by GPs had higher previous heart disease (53.2% vs 43.3%, P < .001), heart failure (32.9% vs 26.5%, P < .008) and dilated cardiomyopathy (15.2% vs 8.7%, P < .001) with better renal function (69.3 ± 24.7 vs 63.1 ± 21.4 mL/min, P < .001) compared to patients managed by haematologists. There was no difference between groups in the type of AF, CHA2DS2‐VASc or HAS‐BLED scores, but patients with electrical cardioversion were more prevalent in GP group. The overall mean time in therapeutic range (TTR) assessed by Rosendaal method was 61.5 ± 24.9%; 52.6% of patients had TTR<65% and 60% of patients had TTR<70%. TTR was significantly lower in patients controlled by haematologists than by GPs (63 ± 24.4 vs 59.2 ± 25.6, P < .005).ConclusionsAbout 60% of AF patients anticoagulated with VKAs had poor anticoagulation control (ie TTR<70%), and their management was only slightly better than when it is managed by general practitioners.
Impact of Mon2 monocyte‐platelet aggregates on human coronary artery disease
Authors: Brown Richard A. , Lip Gregory Y. H. , Varma Chetan , Shantsila Eduard 
Published: February 2018

AbstractBackgroundMonocyte‐platelet aggregates (MPAs) form when Mon1, Mon2 or Mon3 monocyte subsets adhere to platelets. They are pathophysiologically linked to coronary artery disease (CAD). However, their individual roles in the occurrence of diffuse CAD remain unknown.Materials and methodsPeripheral blood from 50 patients with diffuse CAD, 40 patients with focal CAD and 50 age‐matched patients with normal coronary arteries was analysed by flow cytometry to quantify MPAs associated with individual monocyte subsets. Cutaneous forearm microcirculation was assessed using laser Doppler flowmetry at rest and after iontophoresis of acetylcholine (endothelium‐dependent vasodilation) and sodium nitroprusside (endothelium‐independent vasodilation) at 100 μA for 60 seconds. Patients with CAD had repeat assessment at 6 and 12 months.ResultsBaseline counts of MPAs with Mon2 subset (CD14++CD16+CC2+ monocytes) were significantly higher in patients with diffuse CAD compared to focal CAD (P = .001) and patients without CAD (P = .006). On multivariate regression, MPAs with Mon2 independently predicted diffuse CAD (odds ratio 1.10, 95% confidence interval 1.02‐1.19, P = .01) and correlated negatively with endothelium‐dependent microvascular vasodilation (r = −.37, P = .008), an association which persisted after adjustment for covariates. Longitudinal observation confirmed the persistence of an inverse relationship between MPAs with Mon2 and endothelium‐dependent microvascular function.ConclusionMonocyte‐platelet aggregates with Mon2 are increased in patients with diffuse CAD and therefore could represent an important contributor to accelerated coronary atherosclerotic progression by a mechanism involving microvascular endothelial dysfunction.
Functional components of public expenditure, fiscal consolidations, and economic activity
Authors: Castro Vítor 
Published: February 2018

AbstractThis paper analyses how the functional components of public expenditure and spending‐driven consolidations affect the economic growth, unemployment, and income inequality. A dynamic panel data least squares dummy variable estimator estimator is employed over a sample of 15 European Union countries during the period 1990–2012. The empirical results show that real GDP growth decreases when fiscal austerity measures are implemented, especially if they are spending‐driven. Cuts in public expenditure undermine economic growth, namely if they slash spending on public order, recreation, and education. Spending cuts on education, in particular, affect the investment in human capital, harming not only growth but also economic, social, and human development. The unemployment rate also proved to be significantly boosted when austerity measures restrict spending on education, whereas income inequality rises when social protection expenditures are cut.
A canker disease of apple caused by Cytospora parasitica recorded in China
Authors: Ma R. , Liu Y.‐M. , Yin Y.‐X. , Tian C.‐M. 
Published: February 2018

SummaryA stem canker disease of apple that differs from previously reported canker diseases has been recorded in Xinjiang Uygur Autonomous Region in China. Eight Cytospora strains obtained from diseased apple trees and inoculated onto healthy apple tree branches resulted in the development of the same disease symptoms. This pathogen formed conceptacles, which were multilocular pycnidia with common walls and a single ostiole. Comprehensive analysis of three DNA sequence regions (internal transcribed spacer, large ribosomal subunit and transcription elongation factor) and morphological and cultural characteristics revealed that these strains were most similar to the fungus Cytospora parasitica. This is the first report of C. parasitica causing canker disease of apple in China.
Effect of individual structured and qualified feedback on improving clinical performance of dental students in clinical courses‐randomised controlled study
Authors: Schüler I. M. , Heinrich‐Weltzien R. , Eiselt M. 
Published: February 2018

AbstractAimAnalysis of the effect of individual structured and qualified feedback (FB) on practical skills development of dental students during clinical courses.MethodsFifty‐three final‐year dental students at Jena University Hospital participated in this prospective randomised controlled interventional study. Two calibrated assessors evaluated 128 pre‐ and post‐assessments of 4 different dental treatment steps performed by dental students during the integrated clinical course in restorative dentistry and prosthodontics and the clinical course paediatric dentistry. The assessment included direct observation, graded and non‐grading evaluation and was documented with a specific FB assessment tool. Dental students in the intervention group (IG) received an elaborated, structured and qualified FB after the pre‐assessment that focussed on individual strengths and weaknesses, providing specific suggestions for improvement and establishing a personal learning goal. Participants were randomly allocated to the IG and the control group (CG).ResultsIn both groups, dental students significantly enhanced their performance, but the difference was higher in the IG than in the CG. Large effect sizes (ES) were observed in all observed items, but FB had largest effect size in improving technical skills (ES = 1.6), followed by management (ES = 1.3) and communication skills (ES = 0.8). Factors with the highest influence on FB in enhancing dental students' clinical performance were their insight into their own mistakes or omissions, the observed dental treatment step and the duration of FB.ConclusionIndividual structured and qualified FB is an effective method to enhance dental students' professional performances and to individually guide the learning process.
Tools for managing hydrologic alteration on a regional scale: Estimating changes in flow characteristics at ungauged sites
Authors: Sengupta Ashmita , Adams Stephen K. , Bledsoe Brian P. , Stein Eric D. , McCune Kenneth S. , Mazor Raphael D. 
Published: February 2018

Abstract

Hydrologic alteration is a predominant stressor for biological resources in streams. This stress is further aggravated by competing human and ecological demands for limited water resources. Understanding flow–ecology relationships and establishing relevant and implementable flow targets are essential to protect biological communities.

Estimating degree of ecologically relevant hydrologic alteration depends on the availability of long‐term flow data at sites with biological information. However, measured flow data are seldom available at sufficient density to support large‐scale analyses of the biological effects of hydrologic alterations. The ability to accurately simulate flows and estimate flow metrics at many ungauged locations across a broad geographical area remains a fundamental challenge.

We address this challenge by applying a novel technique to simulate flow regimes at any stream reach of interest by first developing an ensemble of regionally calibrated and validated hydrological models, and then using a selection tool to match the “best‐fit” model to ungauged stream reaches. An ensemble of 26 HEC‐HMS rainfall–runoff models were calibrated to represent the range of catchment conditions in the southern California region.

We developed current and historical flow regimes and a suite of flow metrics at 572 ungauged sites in southern California with bioassessment monitoring data. The flow metrics represent hydrograph characteristics of magnitude, timing, frequency, duration and variability. The flow metrics were estimated under three precipitation conditions—dry, wet and average. In addition, we estimated aggregated flow metrics for (dry + wet + average) condition. Hydrologic alteration was estimated as the deviation between the modelled current and historical flow metrics.

Approximately 79% of the region shows some degree of hydrologic alteration, and approximately 40% of the sites are estimated to be severely altered. Magnitude metrics tend to increase in response to urban and agricultural land uses, whereas the timing and duration metrics are mostly unchanged.

This mechanistic modelling approach demonstrates the feasibility of estimating flow alterations for ungauged catchments with relative ease of transferability over a broad geographical region. The continuous granular flow data allow for computation and consideration of metrics that may be applicable to a variety of ecological endpoints and consideration of a range of management trade‐offs.
Plant geographical range size and climate stability in China: Growth form matters
Authors: Xu Wubing , Svenning Jens‐Christian , Chen Guoke , Chen Bin , Huang Jihong , Ma Keping 
Published: February 2018

AbstractAimGeographical variation of range size is thought to be linked to climate seasonality and Quaternary glacial–interglacial oscillations. In addition, the importance of long‐term climate stability is expected to be modulated by species' migration abilities. For plants, growth forms integrate traits that affect migration ability. Hence, we assess the relative importance of short‐ and long‐term climate stability for range size patterns in plants and whether long‐term stability is more important for more poorly migrating growth forms.LocationChina.Time periodLast 21 ka.Major taxa studiedVascular plants.MethodsA dataset including > 30,000 vascular plants was used to quantify geographical patterns of range size across China for all species and for eight growth forms separately. Spatial and non‐spatial regressions with information‐theoretical multi‐model selection were performed to estimate the explanatory importance of climate seasonality and climate‐change velocity from the Last Glacial Maximum to the present. The proportion of endemism for each growth form was also calculated.ResultsLarge geographical range sizes were generally observed in regions with strong climate seasonality and high climate‐change velocity. The association between range size and velocity was stronger for perennial herbs and shrubs than for ferns, annual herbs, climbers and trees and stronger for small than for large trees; that is, more important for the growth forms with lower migration capacities. In line with this interpretation, growth forms strongly influenced by velocity also tend to have high proportions of endemism, which is also consistent with a relatively low ability to migrate.Main conclusionsRange size patterns of vascular plants in China are shaped by both climate seasonality and long‐term climate stability, even though the region had a relatively mild influence from the Pleistocene glaciations, with a stronger influence of palaeoclimate stability on more poorly migrating groups. The differential influences of palaeoclimate stability across growth forms suggest that it needs further attention in research and management and that different growth forms are likely to respond in different ways to future climate changes.