bluuebunny/crossref_metadata_2025_split huggingface dataset:
A nationwide population‐based study of social demographic factors, associated diseases and mortality of keratoconus patients in Denmark from 1977 to 2015
Authors: Bak‐Nielsen Sashia , Ramlau‐Hansen Cecilia H. , Ivarsen Anders , Plana‐Ripoll Oleguer , Hjortdal Jesper 
Published: November 2018

AbstractPurposeTo study sociodemographic factors, associated diseases and survival of Danish keratoconus patients.MethodsAll patients diagnosed with keratoconus 1977–2015 (n = 2679) were matched to 10 persons who had not been diagnosed with keratoconus (n = 26 790). Conditional logistic regression assessed whether sociodemographic factors and specific systemic diseases were associated with the odds of keratoconus. Mortality was assessed with time‐to‐event analysis.ResultsAfter adjustment, non‐Europeans had more than threefold higher odds of keratoconus compared to Europeans (OR, 3.34; 96% CI 2.94–3.80). Single persons had 27% higher odds (OR, 1.27; 95% CI 1.13–1.43), and divorced persons had 18% lower odds (OR 0.82; 95% CI 0.68–0.97) of keratoconus compared with persons in a relationship. Persons living in cities with <500 and 500–4999 inhabitants had 40% (OR, 0.60; 95% CI 0.51–0.71) and 30% (OR, 0.70; 95% CI 0.61–0.81) lower odds of keratoconus, respectively, compared with those living in the capital (>1 000 000 inhabitants). Persons receiving government substitution had 68% higher odds of keratoconus (OR, 1.68; 95% CI 1.30–2.17) compared to self‐employed. Keratoconus patients had more than twofold higher odds of asthma (OR, 2.21; 95% CI 1.91–2.55), more than threefold higher odds of allergic rhinitis (OR, 3.44; 95% CI 2.75–4.30), more than sevenfold higher odds of atopic dermatitis (OR, 7.97; 95% CI, 6.21–10.21) and 69% higher odds of depression (OR, 1.69; 95% CI 1.18–2.43). Mortality rates were similar among keratoconus patients and controls (HR, 1.02; 95% CI 0.90–1.16).ConclusionDanish keratoconus patients differ from controls on several sociodemographic factors and have higher risk of allergic rhinitis, asthma, atopic dermatitis and depression. They do not have excess mortality compared to controls.
Changes of computed tomography‐based body composition after adrenalectomy in patients with endogenous hypercortisolism
Authors: Hong Namki , Lee Jooyeon , Ku Cheol Ryong , Han Kichang , Lee Cho Rok , Kang Sang Wook , Rhee Yumie 
Published: November 2018

SummaryContextData on longitudinal changes of computed tomography (CT)‐determined visceral fat area (VFA), skeletal muscle area (SMA) and skeletal muscle radiodensity (SMD) after adrenalectomy are limited in patients with hypercortisolism.ObjectiveTo examine the association of severity of cortisol excess and improvement of CT‐based muscle and fat parameters after adrenalectomy.DesignRetrospective observational cohort study.PatientsOne hundred thirty‐four patients with overt Cushing's syndrome (CS; n = 39), mild autonomous cortisol excess (MACE; n = 57), or nonfunctioning adrenal tumour (NFAT; n = 38) at a tertiary endocrinology institution between 2006 and 2017 were included.MeasurementsChanges in CT‐determined VFA, visceral‐to‐subcutaneous fat ratio (VSR), SMA, skeletal muscle index (SMI), and SMD measured at the third lumbar vertebra (L3).ResultsAt baseline, CS patients had higher VFA, lower SMA, SMI and SMD values, compared to NFAT or MACE patients. Compared to NFAT, significant decreases in VFA and increases in SMA, SMI and SMD was observed in CS 1 year after adrenalectomy. In MACE, adjusted mean changes of SMD but not VFA, SMA or SMI differ significantly compared to NFAT (+8.9% vs −3.4%, P = 0.032). In a multivariate linear regression model, the increase by 1 μg/dL of post‐dexamethasone serum cortisol at baseline was independently associated with greater reduction of VFA (−3.95%), VSR (−3.07%), and increase in SMD (+0.92%, P < 0.05 for all) after adrenalectomy.ConclusionsThe severity of cortisol excess was associated with greater improvement of L3 VFA, VSR and SMD 1 year after adrenalectomy. These CT‐based markers may allow more objective assessment of treatment benefit at earlier stage.
Primary vs myocutaneous flap closure of perineal defects following abdominoperineal resection for colorectal disease: a systematic review and meta‐analysis
Authors: Yang XY. , Wei MT. , Yang XT. , He YZ. , Hao Y. , Zhang XB. , Deng XB. , Wang ZQ. , Zhou ZQ. 
Published: November 2018

AbstractAimPerineal wound complications after abdominoperineal resection (APR) have become a major clinical challenge. Myocutaneous flap closure has been proposed in place of primary closure to improve wound healing. We conducted this comprehensive meta‐analysis to evaluate the current scientific evidence of primary closure vs myocutaneous flap closure of perineal defects following APR for colorectal disease.MethodsWe systematically searched the MEDLINE, Embase, PubMed, Web of Science and Cochrane Library databases to identify all relevant studies. After data extraction from the included studies, meta‐analysis was performed to compare perioperative outcomes of primary closure and myocutaneous flap closure.ResultsEighteen studies with a total of 17 913 patients (16 346 primary closure vs 1567 myocutaneous flap closure) were included. We found that primary closure was significantly associated with higher total perineal wound complications (P = 0.007), major perineal wound complications (P < 0.001) and perineal wound infection (P = 0.001). On the other hand, myocutaneous flap closure takes more operation time (P < 0.001) and increases the risk of perineal wound dehiscence (P = 0.01), deep surgical site infection (P < 0.001), enterocutaneous fistulas (P = 0.03) and return to the operating room (P = 0.0005). There were no significant differences between the two groups for other outcomes.ConclusionsThis is the first systematic review with meta‐analysis comparing primary closure with myocutaneous flap closure of perineal defects after APR for colorectal disease. Although taking more operation time and an increased risk of specific complications, the pooled results have validated the use of myocutaneous flaps for reducing total/major perineal wound complications. More investigations are needed to draw definitive conclusions on this dilemma.
Assessing surgical difficulty in locally advanced mid–low rectal cancer: the accuracy of two MRI‐based predictive scores
Authors: de'Angelis N. , Pigneur F. , Martínez‐Pérez A. , Vitali G. C. , Landi F. , Gómez‐Abril S. A. , Assalino M. , Espin E. , Ris F. , Luciani A. , Brunetti F. ,   the EuMaRCS Study Group
Published: November 2018

AbstractAimPredicting surgical difficulty is a critical factor in the management of locally advanced rectal cancer (LARC). This study evaluates the accuracy and external validity of a recently published morphometric score to predict surgical difficulty and additionally proposes a new score to identify preoperatively LARC patients with a high risk of having a difficult surgery.MethodsThis is a retrospective study based on the European MRI and Rectal Cancer Surgery (EuMaRCS) database, including patients with mid/low LARC who were treated with neoadjuvant chemoradiation therapy and laparoscopic total mesorectal excision (L‐TME) with primary anastomosis. For all patients, pretreatment and restaging MRI were available. Surgical difficulty was graded as high and low based upon a composite outcome, including operative (e.g. duration of surgery) and postoperative variables (e.g. hospital stay). Score accuracy was assessed by estimating sensitivity, specificity and area under the receiver operating characteristic curve (AROC).ResultsIn a total of 136 LARC patients, 17 (12.5%) were graded as high surgical difficulty. The previously published score (calculated on body mass index, intertuberous distance, mesorectal fat area, type of anastomosis) showed low predictive value (sensitivity 11.8%; specificity 92.4%; AROC 0.612). The new EuMaRCS score was developed using the following significant predictors of surgical difficulty: body mass index > 30, interspinous distance < 96.4 mm, ymrT stage ≥ T3b and male sex. It demonstrated high accuracy (AROC 0.802).ConclusionThe EuMaRCS score was found to be more sensitive and specific than the previous score in predicting surgical difficulty in LARC patients who are candidates for L‐TME. However, this score has yet to be externally validated.
Corpus callosum low‐frequency stimulation suppresses seizures in an acute rat model of focal cortical seizures
Authors: Couturier Nicholas H. , Durand Dominique M. 
Published: November 2018

SummaryObjectiveLow‐frequency fiber‐tract stimulation has been shown to be effective in treating mesial temporal lobe epilepsies through activation of the hippocampal commissure in rodents and human patients. The corpus callosum is a major pathway connecting the two hemispheres of the brain; however, few experiments have documented corpus callosum stimulation. The objective is to determine the efficacy of corpus callosum stimulation at low frequencies to suppress cortical seizures.Methods4‐Aminopyridine was injected in the primary motor cortex of 24 rats under anesthesia. Recording electrodes were placed in the contralateral motor cortex and hippocampus. Three pairs of stimulating electrodes were inserted into the corpus callosum along its longitudinal axis. Local field potentials were recorded 1 hour before, during, and after stimulation to determine the effect of stimulation on seizure duration. Stimulation was delivered from each pair of electrodes independently in separate experiments. Furthermore, electrical stimulation was applied to the region of the corpus callosum with the highest degree of innervation of the seizure focus to compare the efficacy of different stimulation frequencies (1‐30 Hz) on seizure suppression.ResultsCorpus callosum stimulation was effective at suppressing seizures at 10 Hz by 76% (P < 0.05, n = 5) and at 20 Hz by 95% (P < 0.0001, n = 14). Stimulation at frequencies of 1 and 30 Hz did not have a significant effect on reducing the total time spent seizing (P > 0.9999, n = 5). Furthermore, stimulation was only effective at suppressing seizures when the pair of electrodes was placed within the section of corpus callosum containing fibers innervating the seizure focus. Secondarily generalized seizures in the hippocampus were eliminated when seizures in the cortical focus were suppressed.SignificanceLow‐frequency fiber‐tract stimulation of the corpus callosum suppresses both cortical and cortically induced hippocampal seizures in an acute model of focal cortical seizures. The stimulation paradigm is selective, as it is only effective when targeted to specific regions of the corpus callosum that project maximally to cortical regions generating the seizure activity. Selective placement of stimulation electrodes along the corpus callosum could be used as a patient‐specific treatment for cortical epilepsies.
Health‐related quality of life in paediatric haemophilia B patients treated with rIX‐FP
Authors: von Mackensen Sylvia , Shah Jinesh , Seifert Wilfried , Kenet Gili 
Published: November 2018

IntroductionFrequent infusions and bleeds can impact on the health‐related quality of life (HRQoL) of paediatric haemophilia B patients. rIX‐FP (IDELVION®) is a fusion protein linking recombinant factor IX with recombinant albumin, and is associated with low bleeding rates with a weekly regimen, which could improve HRQoL.AimsTo measure the effect of rIX‐FP prophylaxis on the HRQoL of paediatric patients and treatment satisfaction in their caregivers using the Haemo‐QoL and Hemo‐SATP questionnaires, respectively.MethodsAt baseline and end‐of‐study (EOS), patients 4‐11 years old participating in the PROLONG‐9FP program answered the Haemo‐QoL questionnaire and gave information on their socio‐demographic data and physical activity. Caregivers completed the Hemo‐SatP. Minimal important differences (MID) (|Cohen's d| > 0.5) between baseline and EOS and the number of responders (patients with meaningful subject‐level improvements over time) at EOS were calculated.ResultsTwenty patients (age group I: 4‐7 years old [n = 12]; age group II: 8‐12 years old [n = 8]) completed the Haemo‐QoL questionnaire at baseline. MIDs were found in age group I representing improvement for “physical health” (d = −0.547) domain; 60% of patients were responders for “physical health.” In age group II, MIDs were seen in most domains; 71.4% patients were responders in “total score.” In caregivers, improvements were seen for most domains of the Hemo‐SatP with a small effect size. Fewer patients missed school when treated with rIX‐FP and 94.1% patients maintained their physical activity level.ConclusionProphylaxis with rIX‐FP led to substantial improvements in HRQoL in paediatric patients and treatment satisfaction in caregivers.
Sports participation and physical activity in patients with von Willebrand disease
Authors: Atiq Ferdows , Mauser‐Bunschoten Eveline P. , Eikenboom Jeroen , van Galen Karin P. M. , Meijer Karina , de Meris Joke , Cnossen Marjon H. , Beckers Erick A. M. , Laros‐van Gorkom Britta A. P. , Nieuwenhuizen Laurens , van der Bom Johanna G. , Fijnvandraat Karin , Leebeek Frank W. G. ,   the WiN study group
Published: November 2018

IntroductionPatients with bleeding disorders may experience limitations in sports participation and physical activity. Several studies on sports participation have been performed in haemophilia patients, but studies in patients with von Willebrand disease (VWD) are lacking.AimWe assessed the sports participation and physical activity of a large cohort of VWD patients.MethodsPatients were included from the “WiN study.” All patients completed a questionnaire on sports participation, physical activity, quality of life and bleeding symptoms (Tosetto bleeding score).ResultsFrom the 798 included patients, 474 had type 1, 301 type 2 and 23 type 3 VWD. The mean age was 39 ± 20 (standard deviation) years. Five hundred and fifty‐two patients (69.3%) participated in various types of sports. Type 3 VWD patients more often did not participate in sports due to fear of bleeding and physical impairment, respectively, OR = 13.24 (95% CI: 2.45‐71.53) and OR = 5.90 (95% CI: 1.77‐19.72). Patients who did not participate in sports due to physical impairment had a higher bleeding score item for joint bleeds 1.0 (±1.6) vs 0.5 (± 1.1) (P = 0.036). Patients with type 3 VWD and patients with a higher bleeding score frequently had severe limitations during daily activities, respectively, OR = 9.84 (95% CI: 2.83‐34.24) and OR = 1.08 (95% CI: 1.04‐1.12).ConclusionThe majority of VWD patients participated in sports. Patients with type 3 VWD, a history of joint bleeds and a more severe bleeding phenotype frequently experienced limitations in sports participation and physical activities during daily life.
The traditional care culture and the Western nursing culture in Cameroon
Authors: Chance Emmanuel Aoudi , Ågotnes Gudmund , Petersen Karin Anna 
Published: November 2018

AbstractAimThis study explored the relationship between the traditional care culture and the Western nursing culture.BackgroundCameroonians are highly dependent on seeking medical aid from traditional healers and medicines, despite the emergence of contemporary health practices that are provided by Western nursing care.MethodsThis study was conducted based on Bourdieu's praxeological approach using observational and descriptional research, and interviews.ResultsWhile the traditional care culture and the Western nursing culture practices coexist, there are also conflicts and challenges. The people of Cameroon prefer the availability of both health care forms because they are provided with options in terms of the care they are offered and can afford.ConclusionTraditional care culture practices can be combined with the contemporary practices of Western nursing care. Both health care forms have advantages, and when integrated, they can contribute to providing more effective health care practices that can improve health care services in Cameroon.
Transnationalization of a Recruitment Regime: Skilled Migration to Japan
Authors: Conrad Harald , Meyer‐Ohle Hendrik 
Published: November 2018

AbstractJapan, facing a demographic decline and challenges by companies and universities to internationalize, has opened its doors to skilled migration. Focussing initially on a two‐step student migration model, Japanese companies are now recruiting young graduates from overseas universities, mainly in Asia. We argue that, with the help of brokers, the domestic recruitment regime (a set of particular employment practices) has been transnationalized. Based on interviews with stakeholders and discussing international recruitment fairs as the site of engagement, we present first evidence that the activities of brokers have the potential to change attitudes towards employability among overseas universities and their students. We also find that this development compromises the original diversity objectives of Japanese employers and point to a lack of rules of engagement for brokers operating across national borders.
Serum urate levels and therapy in adults treated with long‐term dialysis: a retrospective cross‐sectional study
Authors: Yeo Estella , Palmer Suetonia C. , Chapman Peter T. , Frampton Christopher , Stamp Lisa K. 
Published: November 2018

AbstractBackgroundThe management of gout in chronic kidney disease and end‐stage renal disease is challenging and remains controversial. There are limited data on the use of urate‐lowering therapy in people receiving dialysis.AimTo estimate the point prevalence of gout, gout treatment and achievement of target serum urate (SU) among adults treated with long‐term dialysis.MethodsThree secular cohorts of adults receiving dialysis for at least 90 days on 1 February 2017, 1 January 2016 and 1 January 2015 were identified. Medical records were reviewed for SU concentrations. Results were compared between haemodialysis (HD) and peritoneal dialysis (PD), and participants prescribed and not prescribed urate‐lowering therapy. The percentage reduction in SU 24‐ and 48‐h post‐HD was estimated based on data from a previous study. SU concentrations were then used to estimate the percentage time the SU was <0.36 mmol/L using linear interpolation.ResultsOf 216 dialysis patients, 61 (point prevalence 28.2%, 95% confidence interval 22.35–34.8%) had a diagnosis of gout. The mean (SD) age among those with gout was 61 years (14.4), 46 (75.4%) were men and 18 (31.1%) identified as Māori or Pacific Island. Forty‐two (68.9%) were prescribed allopurinol (mean (SD) dose 116.0 ± 66.9 mg/day). 46% had a predialysis SU ≤0.36 mmol/L on less than 25% of occasions and 23% were below target on 76–100% of occasions. SU was below target 41% of time, with no statistically significant difference in those on HD or PD (P = 0.39), and those prescribed or not prescribed allopurinol (P = 0.55).ConclusionsGout is experienced by approximately one in four adults treated with dialysis and two‐thirds are prescribed allopurinol. A minority have SU at a target sufficient to prevent gout despite allopurinol and HD. A treat to target SU should be considered in those with SU above target.
Inhibiting the urokinase‐type plasminogen activator receptor system recovers STZ‐induced diabetic nephropathy
Authors: Dal Monte Massimo , Cammalleri Maurizio , Pecci Valeria , Carmosino Monica , Procino Giuseppe , Pini Alessandro , De Rosa Mario , Pavone Vincenzo , Svelto Maria , Bagnoli Paola 
Published: November 2018

AbstractThe urokinase‐type plasminogen activator (uPA) receptor (uPAR) participates to the mechanisms causing renal damage in response to hyperglycaemia. The main function of uPAR in podocytes (as well as soluble uPAR ‐(s)uPAR‐ from circulation) is to regulate podocyte function through αvβ3 integrin/Rac‐1. We addressed the question of whether blocking the uPAR pathway with the small peptide UPARANT, which inhibits uPAR binding to the formyl peptide receptors (FPRs) can improve kidney lesions in a rat model of streptozotocin (STZ)‐induced diabetes. The concentration of systemically administered UPARANT was measured in the plasma, in kidney and liver extracts and UPARANT effects on dysregulated uPAR pathway, αvβ3 integrin/Rac‐1 activity, renal fibrosis and kidney morphology were determined. UPARANT was found to revert STZ‐induced up‐regulation of uPA levels and activity, while uPAR on podocytes and (s)uPAR were unaffected. In glomeruli, UPARANT inhibited FPR2 expression suggesting that the drug may act downstream uPAR, and recovered the increased activity of the αvβ3 integrin/Rac‐1 pathway indicating a major role of uPAR in regulating podocyte function. At the functional level, UPARANT was shown to ameliorate: (a) the standard renal parameters, (b) the vascular permeability, (c) the renal inflammation, (d) the renal fibrosis including dysregulated plasminogen‐plasmin system, extracellular matrix accumulation and glomerular fibrotic areas and (e) morphological alterations of the glomerulus including diseased filtration barrier. These results provide the first demonstration that blocking the uPAR pathway can improve diabetic kidney lesion in the STZ model, thus suggesting the uPA/uPAR system as a promising target for the development of novel uPAR‐targeting approaches.
Substance use screening and brief intervention: Evaluation of patient and implementation differences between primary care and emergency department settings
Authors: O'Grady Megan A. , Kapoor Sandeep , Kwon Nancy , Morley Jeanne , Auerbach Mark , Neighbors Charles J. , Conigliaro Joseph , Morgenstern Jon 
Published: November 2018

AbstractRationale, aims, and objectivesThere are well‐documented barriers that have limited widespread, sustained adoption of screening and brief intervention for risky substance use in health care settings. In order to better inform implementation efforts, this study evaluates whether patient characteristics, screening results, and implementation success indicators differed between two clinical setting types: primary care and emergency.MethodsPatients presenting to an emergency or primary care setting were screened for risky substance use (n = 41 567). Patients with a positive screen were further assessed for psychosocial, health, and substance use problems (n = 1604). Differences in patient characteristics between primary care and emergency settings were examined using chi‐square and t tests. Multilevel logistic regression was used to examine whether setting type predicted screening results. Site‐level indicators of implementation success were calculated (percentage prescreens completed, percentage full screens completed, and percentage refused services) for all patient visits (n = 78 656).ResultsAs compared with primary care patients, emergency patients had more severe substance use patterns and screening scores, were more likely to use a variety of illicit drugs, and reported more psychosocial issues. In logistic regression models, setting type did not predict whether patients screened positive; however, it did predict screening into a higher vs lower risk category such that emergency patients were more likely to be in a higher risk category. Emergency settings had lower indicators of implementation success (eg, 14% lower prescreen completion rate) as compared with primary care settings on some implementation measures.ConclusionsThis evaluation found important differences in patient characteristics and screening and implementation results between primary care and emergency settings. Health care organizations and administrators implementing screening and brief intervention should attend to setting differences that could affect implementation and clinical care.