bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stratification of hepatocellular carcinoma risk through modified FIB‐4 index in chronic hepatitis B patients on entecavir therapy
Authors: Wang Hung‐Wei , Lai Hsueh‐Chou , Hu Tsung‐Hui , Su Wen‐Pang , Lu Sheng‐Nan , Lin Chia‐Hsin , Hung Chao‐Hung , Chuang Po‐Heng , Wang Jing‐Houng , Lee Mei‐Hsuan , Chen Chien‐Hung , Peng Cheng‐Yuan 
Published: July 2018

AbstractBackground and AimNoninvasive fibrosis indices can predict the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). Modified FIB‐4 (mFIB‐4) is a promising noninvasive index for predicting liver fibrosis. To investigate the predictive accuracy of several extant noninvasive fibrosis indices, including mFIB‐4, for HCC incidence in CHB patients receiving long‐term entecavir therapy.MethodsWe enrolled 1325 nucleos(t)ide analogue‐naïve CHB patients (noncirrhotic 844; cirrhotic 481) treated with entecavir. Baseline clinical features and fibrosis indices were collected and evaluated for predicting HCC risk through univariate and multivariate Cox regression analyses.ResultsOf the 1325 patients, 105 (7.9%) developed HCC during a median follow‐up period of 4.1 years. Age (hazard ratio [HR], 1.039; 95% confidence interval [CI], 1.020–1.059; P < 0.0001), diabetes mellitus (DM) (HR, 1.902; 95% CI, 1.185–3.052; P = 0.0077), and mFIB‐4 (HR, 4.619; 95% CI, 1.810–11.789; P = 0.0014) were independent predictors of HCC in all patients (mFIB‐4 ≥ 1.5 for the noncirrhotic cohort; DM and mFIB‐4 ≥ 2.0 for the cirrhotic cohort). A combination of mFIB‐4 and the DM status stratified the cumulative risk of HCC into three subgroups in all patients (high: mFIB‐4 ≥ 1.5/DM; intermediate: mFIB‐4 ≥ 1.5/non‐DM; and low: mFIB‐4 < 1.5, P < 0.0001) and in the cirrhotic cohort (high: mFIB‐4 ≥ 2.0/DM; intermediate: mFIB‐4 ≥ 2.0/non‐DM; and low: mFIB‐4 < 2.0, P = 0.0007). An mFIB‐4 cutoff value of 1.5 stratified the cumulative risk of HCC in the noncirrhotic cohort (P = 0.015).ConclusionsThe mFIB‐4 index alone or in combination with DM is the optimal noninvasive predictor of HCC risk in CHB patients receiving entecavir therapy.
Attitudes of health care professionals toward people with intellectual disability: a comparison with the general population
Authors: Morin D. , Valois P. , Crocker A. G. , Robitaille C. , Lopes T. 
Published: July 2018

AbstractBackgroundFew studies have examined attitudes that may promote the social inclusion of persons with an intellectual disability (ID) among health care providers (HCPs). Yet these attitudes could impact the accessibility and quality of services provided to this population, as well as the general attitudes of HCPs. The objectives of this study were to (1) examine HCPs' pro‐inclusion attitudes toward people with ID, (2) compare these to the general population's attitudes and (3) examine how HCPs' attitudes vary as a function of their socio‐demographic characteristics.MethodThe Attitudes Toward Intellectual Disability Questionnaire was administered to 367 HCPs and a representative sample of the Québec population (N = 1605).ResultsResults indicated that at least half of HCPs displayed positive attitudes, that is, attitudes that are compatible with notions of social inclusion and equal rights, toward individuals with ID. Positive attitudes were less frequently observed for the Interaction and the Sensitivity or tenderness factors measured by the Attitudes Toward Intellectual Disability Questionnaire. In comparison with the general population, HCPs exhibited more positive attitudes on the Knowledge of causes and Sensitivity or tenderness factors and less positive attitudes on the Interaction factor. HCPs who regarded themselves as more knowledgeable about ID and those who reported higher quality contacts or interactions with persons with ID expressed attitudes that were more favourable toward social inclusion.ConclusionsIn addition to providing general knowledge about ID and the specific health care needs of individuals with ID, training programmes should also promote interactions with this population. Further studies are needed to document HCPs' pro‐inclusion attitudes toward people with ID and to assess the impact of interventions on these attitudes.
“Heart disease never entered my head”: Women's understanding of coronary heart disease risk factors
Authors: Smith Rita , Frazer Kate , Hyde Abbey , O'Connor Laserina , Davidson Patricia 
Published: July 2018

AbstractAims and ObjectivesThis study investigated experiences of women with a primary diagnosis of ACS (NSTEMI & Unstable Angina). The study explored how women interpreted their risk for coronary heart disease (CHD) and how this influenced their treatment‐seeking decisions.BackgroundEfforts to reduce the incidence of cardiovascular disease, the number one killer of women, require aggressive risk factor modification, risk assessment and evidence‐based treatments. CHD is largely preventable; however, despite the availability of evidence on prevention and risk factor reduction, it appears that misunderstandings persist.DesignA naturalistic case study design guided this study.MethodsThirty women participated (n = 30); a within‐case analysis was followed by a cross‐case analysis. Data collection included participant diaries and face‐to‐face interviews. Data were analysed using modified analytic induction which allowed the emergence of theoretical insights.ResultsThis article provides insight into women's perception of risk for CHD, particularly in relation to smoking. The findings provide a platform for a wider discourse on women's interpretation of their risk for CHD and their treatment‐seeking decisions. The data reflect the ongoing misunderstanding that CHD affects men more than women.ConclusionsMore focus is needed on risk factor management and CHD symptom presentation in women. An emphasis on the chronic disease aspect of CHD may promote a timely focus on secondary prevention and the follow‐up needed through patient education and empowerment.Relevance to Clinical PracticeThis study demonstrates that primary and secondary prevention education initiatives are needed for CHD risk factor management and symptom interpretation. The implications of smoking on cardiovascular health need further dissemination. Efforts to support smoking cessation need to be strengthened and widely accessible. Primary care can have a key role to play in managing CHD risk and supporting women with positive risk factors.
Sexual dysfunctions and related variables with sexual function in patients who undergo dialysis for chronic renal failure
Authors: Keskin Gülseren , Babacan Gümüş Aysun , Taşdemir Yiğitoğlu Gülay 
Published: July 2018

Aims and objectivesTo evaluate personality characteristics and psychological symptoms believed to have an effect on the sexual functions and performances of patients undergoing dialysis treatment.BackgroundChronic renal failure is a life‐threatening condition which can often have a poor prognosis. The loss of vital kidney function and other complications can affect almost all age groups.DesignA quantitative descriptive study.MethodsThe study sample included 225 patients selected randomly from patients who have undergone dialysis treatment for at least 3 months at a dialysis centre in a university hospital. In this study, the Golombok Rust Inventory of Sexual Satisfaction (GRISS), the Eysenck Personality Inventory (EPI) and the Brief Symptom Inventory (BSI) were used.ResultsIn the correlation test, made to investigate the relation between the patients’ sexual satisfaction and their personalities, a significant positive relation was found between the communication subscale of the GRISS and the Lie dimension of the EPI, and a significant negative relation was found between the Communication subscale of the GRISS and the Lie dimension of the EPI, and between the Vaginismus and Orgasm subscales of the GRISS and the Extroversion dimension of the EPI.ConclusionResults showed that sexual problems, in the areas of nonsensuality, anorgasmia, avoidance and communication, are associated with extroversion and psychological symptoms.Relevance to clinical practiceSexual health and the psychological well‐being of patients with renal failure is an important issue that should be considered in nursing practice. Nurses should take the psychological problems of patients and their relations with partners into account and consider these problems in a holistic manner within the framework of nursing practice. They would then be able to play an effective role in intervening at an early stage and would be better equipped to help and control the psychological and sexual problems that some patients may experience.
“Operating in the dark”: Nurses’ attempts to help patients and families manage the transition from oncology to comfort care
Authors: Canzona Mollie Rose , Love Deborah , Barrett Rolland , Henley Joanne , Bridges Sara , Koontz Adam , Nelson Sharon , Daya Serena 
Published: July 2018

AbstractAims and objectivesTo investigate challenges nurses face when providing care for oncology patients transitioning from curative to palliative care and to identify educational and support opportunities for nurses.BackgroundCommunicating with oncology patients/families transitioning from curative treatments to care focused on comfort can be problematic for a variety of reasons. Research suggests discrepancies exist between physicians’ and patients’ perceptions of probable length of life. These disconnects can deepen suffering. Oncology and palliative care nurses are well positioned to facilitate this transition. However, they receive little formal instruction regarding these complex scenarios beyond what occurs through on‐the‐job training.MethodsTwenty‐eight nurses working in oncology (n = 14) and palliative care (n = 14) settings participated. The constant comparative method was used to analyse the data.ResultsFour themes emerged that characterise oncology and palliative care nurses’ experiences: (a) coping with interprofessional communication errors during the transition, (b) responding to patient/family reactions to miscommunication about the goals of care, (c) navigating emotional connection to patients, and (d) adapting to sociocultural factors that influence information exchange.ConclusionsThis study supports previous research regarding challenges related to patient reactions, family relationships and emotional burden during end‐of‐life care. However, it adds to the literature by a providing a more in‐depth explication of interprofessional and patient–physician communication barriers that negatively impact care.Relevance to clinical practiceMisunderstandings between patients, physicians and nurses have the potential to distress complicate nurses’ efforts to support patients and families. Nurses reported a problematic power dynamic that impedes their ability to facilitate communication between patient and physician or to offer insights that could enhance patient care. Medical education and continuing education initiatives are needed to build understanding across professional roles and specialties and to improve comfort discussing worsening prognosis and end‐of‐life issues.
Effects of oral administration of different dosages of carvacrol essential oils on intestinal barrier function in broilers
Authors: Liu ShuDong , Song MinHo , Yun Won , Lee JiHwan , Lee ChangHee , Kwak WooGi , Han NamSoo , Kim HyeunBum , Cho JinHo 
Published: July 2018

AbstractEssential oils are widely used in the pharmaceutical, food and cosmetic industries, and many plant essential oils have shown that they have positive effects on broilers nutrition. This experiment was conducted to study the effects of orally administered different dosages of carvacrol essential oils on intestinal barrier function in broiler chickens. A total of eighty 28‐day‐old (1.28 ± 0.15 kg) ROSS 308 broilers were randomly allocated to four groups of 20 replicates each, with one chicken per replicate per cage, and all were fed with the same diet. Four experimental groups were orally administered 0, 200, 300 or 400 μl carvacrol essential oils at 18:00 hr every day during the 2‐week experimental period. As a result of which, the gene expression of the occludin, claudin‐1, claudin‐5, ZO‐1 and ZO‐2 in intestinal mucosa of small intestine (p < 0.05) and the goblet cell content in small intestine epithelium (p < 0.05) were significantly increased; test subjects with 300 or 400 μl carvacrol essential oils reduced the microbial counts of Salmonella spp. and Escherichia coli in the intestines (p < 0.05); Essential oils administration also significantly increased activity of the sucrase (p < 0.05) and lactase (p < 0.05) in intestinal mucosa. In conclusion, the carvacrol essential oils have positive effects on growth performance and intestinal barriers function of broilers; those effects may be related to the dosage, as administration of 300 or 400 μl was more effective than that of 200 μl.
An early Oligocene fossil acorn, associated leaves and pollen of the ring‐cupped oaks (Quercus subg. Cyclobalanopsis) from Maoming Basin, South China
Authors: Liu Xiao‐Yan , Xu Sheng‐Lan , Han Meng , Jin Jian‐Hua 
Published: July 2018

AbstractThe ring‐cupped oaks (Quercus subg. Cyclobalanopsis) characterized by united and concentric ring‐cupped acorns, are mainly distributed in broad‐leaved evergreen forests in tropical and subtropical regions of East and Southeast Asia. Their geological history has been traced from the middle Eocene to Pleistocene. Most reports of the subgenus have been on the basis of leaves, whereas the acorns or cupules, more valuable evidence for the inter‐ and intrageneric classifications, have been relatively poorly documented. Here, we describe a new species, Quercus shangcunensis sp. nov., based on a ring‐cupped fossil acorn and pollen on the acorn, as well as Quercus sp. associated leaves, recovered from the early Oligocene Shangcun Formation of Maoming Basin, Guangdong Province, South China. The morphological and anatomical structures of these fossils confirm their attribution to the subg. Cyclobalanopsis. Quercus shangcunensis sp. nov. represents the world's first Oligocene fossil acorn and the earliest fossil acorn in China for the subgenus, indicating that the subg. Cyclobalanopsis arrived in the low latitude area of South China at least by the early Oligocene. Our fossil provides evidence that the subgenus was present in one of its modern distribution centers in the Oligocene, suggesting that the modern distribution patterns of the subg. Cyclobalanopsis most likely originated during or prior to the Oligocene.
Water associated with residential areas and tourist resorts is the key predictor of Asian tiger mosquito presence on a Mediterranean island
Authors: Sanz‐Aguilar A. , Rosselló R. , Bengoa M. , Ruiz‐Pérez M. , González‐Calleja M. , Barceló C. , Borrás D. , Paredes‐Esquivel C. , Miranda M. A. , Tavecchia G. 
Published: July 2018

AbstractThe Asian tiger mosquito, Aedes albopictus (Diptera: Culicidae), is a highly invasive species and a vector of several viruses of serious concern to public health. Investigating the habitat selection of this species at small to medium scales is essential to the planning of effective prevention and control campaigns. The present group considered detailed data for this species' presence/absence collected at 228 sites on Mallorca Island (Spain) in autumn 2015, 3 years after the first detection of the species on the island. Site occupancy models accounting for false negative detections and imperfect monitoring were used to evaluate the relationships between mosquito presence and habitat variables. In the study area, mosquito presence was negatively associated with altitude, probably as a result of greater human presence at low altitudes near the coast. Moreover, the presence of Ae. albopictus was positively associated with swimming pools as a result of associated gardens, plants and sources of fresh water. These two variables were combined to predict the presence of the species across the entire island.
Recurrence of native kidney disease after kidney transplantation
Authors: Yamamoto Izumi , Yamakawa Takafumi , Katsuma Ai , Kawabe Mayuko , Katsumata Haruki , Hamada Aki Mafune , Nakada Yasuyuki , Kobayashi Akimitsu , Yamamoto Hiroyasu , Yokoo Takashi 
Published: July 2018

ABSTRACTThe extent of recurrence of original kidney disease after kidney transplantation has been underestimated for several reasons. First, the duration of observation varies among studies. Second, the criteria used to schedule protocol and episode biopsies differ among institutions. And third, diagnostic modalities used for early detection of recurrent original kidney disease also vary. Thus, rates of graft loss attributable to a recurrence of original kidney disease vary among institutions and are often underestimated. However, the recurrence of original disease is often thought to be less important than chronic rejection followed by loss of a functioning allograft. It is important to note that recent data have shown that in patients with certain limited primary kidney diseases (e.g., membranous proliferative glomerulonephritis [MPGN], IgA nephritis [IgAN], focal segmental glomerulonephritis [FSGS], and membranous nephropathy [MN]), the predominant (60%) cause of graft loss is the recurrence of original kidney disease. In addition, the rate of 5‐year graft survival in patients with recurrent original kidney disease averages 45%. Thus, research must address the recurrence of original kidney disease. Here we focus on this recurrence and discuss diagnoses, preventive strategies, treatments, and future research directions.
On the extraordinary winter flood episode over the North Atlantic Basin in 1936
Authors: Ballesteros‐Cánovas Juan Antonio , Stoffel Markus , Benito Gerardo , Rohrer Mario , Barriopedro David , García‐Herrera Ricardo , Beniston Martin , Brönnimann Stefan 
Published: July 2018

AbstractIn this study, we analyze the linkage between atmosphere and ocean modes and winter flood variability over the 20th century based on long‐term flow‐discharge series, historical archives, and tree‐ring records of past floods in the North Atlantic Basin (NAB). The most extreme winter floods occurred in 1936 and had strong impacts on either side of the Atlantic. We hypothesize that the joint effects of sea surface temperatures (SSTs) over the Atlantic and Pacific Oceans and the Arctic Oscillation (AO), which is closely related to the North Atlantic Oscillation, play a significant role when describing flood variability in North America and Europe since 1900. Statistical modeling supports the assumption that the response of flood anomalies over the NAB to AO phases is subsidiary of SST phases. Besides, we shed light on the extraordinarily winter flood of 1936 that was characterized by very high SSTs over both the Atlantic and Pacific (>98th percentile) and very low, negative values of AO (<1st percentile). This outstanding winter flood episode was most likely characterized by stratospheric polar vortex anomalies, which can usually be linked to an increased probability of storms in western and southwestern Europe and increased snowfall events in eastern North America. By assessing the flood anomalies over the NAB as a coupled AO and SST function, one could further the understanding of such large‐scale events and presumably improve anticipation of future extreme flood occurrences.
Garnet‐controlled very low velocities in the lower mantle transition zone at sites of mantle upwelling
Authors: Nagel Thorsten J. , Duesterhoeft Erik , Schiffer Christian 
Published: July 2018

AbstractDeep mantle plumes and associated increased geotherms are expected to cause an upward deflection of the lower–upper mantle boundary and an overall thinning of the mantle transition zone between about 410 and 660 km depth. We use subsequent forward modelling of mineral assemblages, seismic velocities, and receiver functions to explain the common paucity of such observations in receiver function data. In the lower mantle transition zone, large horizontal differences in seismic velocities may result from temperature‐dependent assemblage variations. At this depth, primitive mantle compositions are dominated by majoritic garnet at high temperatures. Associated seismic velocities are expected to be much lower than for ringwoodite‐rich assemblages at undisturbed thermal conditions. Neglecting this ultralow‐velocity zone at upwelling sites can cause a miscalculation of the lower–upper mantle boundary on the order of 20 km.
Recurrent membranous nephropathy and acute cellular rejection in a patient treated with direct anti‐HCV therapy (ledipasvir/sofosbuvir)
Authors: Murakami Naoka , Ding Yanli , Cohen David J. , Chandraker Anil K. , Rennke Helmut G. 
Published: July 2018

AbstractDirect‐acting antiviral agents (DAAs) are very effective therapy for chronic hepatitis C infection, and have revolutionized the treatment of hepatitis C in kidney allograft recipients. Although well tolerated in general, rare renal complications have been reported. We describe a case of recurrent membranous nephropathy and acute cellular rejection in a kidney allograft recipient after DAA (ledipasvir/sofosbuvir) therapy, whose allograft function had been stable for more than 30 years. The patient was presented with nephrotic range proteinuria with stable creatinine. The kidney allograft biopsy revealed recurrent membranous nephropathy with fine granular deposits of IgG1/IgG4 codominance and positive phospholipase A2 receptor (PLA2R) staining. The patient was treated with pulse steroid and rituximab, leading to a decrease in proteinuria. As DAAs are more frequently used, physicians should be aware of immune‐related renal complications.
Knowledge and attitudes of Australian general practitioners towards medicinal cannabis: a cross-sectional survey
Authors: Karanges Emily A , Suraev Anastasia , Elias Natalie , Manocha Ramesh , McGregor Iain S 
Published: July 2018

ObjectivesTo examine the knowledge and attitudes of Australian general practitioners (GP) towards medicinal cannabis, including patient demand, GP perceptions of therapeutic effects and potential harms, perceived knowledge and willingness to prescribe.Design, setting and participantsA cross-sectional survey completed by 640 GPs (response rate=37%) attending multiple-topic educational seminars in five major Australian cities between August and November 2017.Main outcome measuresNumber of patients enquiring about medicinal cannabis, perceived knowledge of GPs, conditions where GPs perceived it to be beneficial, willingness to prescribe, preferred models of access, perceived adverse effects and safety relative to other prescription drugs.ResultsThe majority of GPs (61.5%) reported one or more patient enquiries about medicinal cannabis in the last three months. Most felt that their own knowledge was inadequate and only 28.8% felt comfortable discussing medicinal cannabis with patients. Over half (56.5%) supported availability on prescription, with the preferred access model involving trained GPs prescribing independently of specialists. Support for use of medicinal cannabis was condition-specific, with strong support for use in cancer pain, palliative care and epilepsy, and much lower support for use in depression and anxiety.ConclusionsThe majority of GPs are supportive or neutral with regards to medicinal cannabis use. Our results highlight the need for improved training of GPs around medicinal cannabis, and the discrepancy between GP-preferred models of access and the current specialist-led models.