bluuebunny/crossref_metadata_2025_split huggingface dataset:
Loss of plasticity in life‐history strategy associated with secondary invasion into stressful environments in invasive narrowleaf plantain (Plantago lanceolata L.)
Authors: Wan Justin S. H. , Fazlioglu Fatih , Bonser Stephen P. 
Published: March 2018

AbstractAdaptation to changing environments is a fundamental process occurring throughout a species’ range, particularly under novel and stressful conditions at the range‐edges of invasive species. However, the evolutionary consequences associated with adaptation are still poorly understood. Secondary invasion into stressful areas may incur fitness costs that could limit range expansion. In addition, developmental plasticity is predicted to be lost under strong selection in stressful habitats. We assessed populations across a range transect of an invasive plant (Plantago lanceolata L.) for a loss of developmental plasticity and for adaptation costs, where there was prior expansion inland into stressful and novel areas from relatively benign areas closer to the coast. In the glasshouse, we grew plants from seed originating from two secondary invasion locations (near‐edge and edge), and from the range centre location representing the area of primary invasion. Plants were exposed to high or low nutrient treatment, and novel copper stress and control (no copper) treatment to assess adaptation costs associated with secondary invasion. In addition, we compared the costs in near‐edge and edge plants. Developmental plasticity in life‐history traits was lost for secondary invasion plants compared to plants from the range centre. Plants from secondary invasion locations expressed a slower life‐history under both nutrient treatments. In contrast, range‐centre plants were able to switch to a faster life‐history under high nutrient treatment. Our copper treatment had only slight effects on plants, where they expressed intermediate specific leaf area (SLA) under copper treatment. Near‐edge plants had the lowest plant size and reproduction. The loss of plasticity associated with secondary invasion may have implications on evolution in range‐edge populations. Phenotypic plasticity may have initially mediated ecological adaptation to stressful habitats; however, adaptation to stressful conditions can also have the consequence of inhibiting further range expansion in invasive species.
The prevalence of second canals in the mesiobuccal root of maxillary molars: A cone beam computed tomography study
Authors: Fernandes Nelson Alexander , Herbst Dirk , Postma Thomas Corne , Bunn Belinda Kathleen 
Published: March 2018

AbstractThe aim of this study was to determine the prevalence of MB2 canals in permanent maxillary molars utilising CBCT; in patients attending a university hospital. A total of 200 patient scans, (100 female and 100 male patients), were enrolled in the study. In total, 800 teeth were analysed, and teeth with additional canals in their MB roots (MB2) were identified. First maxillary molar teeth exhibited the highest prevalence of MB2 canals, 92% and 87%, for teeth 16 and 26, respectively. Second maxillary molar teeth showed a lower prevalence of MB2 canals, 69% and 65%, for the 17 and 27, respectively. There were no associations of significance between the prevalence of MB2 canals and patient age or gender. Root morphology and anatomy of permanent maxillary first and second molar teeth was found to be highly variable. The prevalence of additional canals in the MB roots is a frequent finding which has previously been underreported.
Geriatric Psychotropic Stewardship Team to de‐escalate inappropriate psychotropic medications in general medicine inpatients: An evaluation
Authors: Pellicano Olivia A , Tong Erica , Yip Gary , Monk Louise , Loh Xiang , Ananda‐Rajah Michelle , Dooley Michael 
Published: March 2018

ObjectivesTo assess the feasibility and effectiveness of a Geriatric Psychotropic Stewardship Team (GPST) and to achieve inpatient de‐escalation of inappropriate psychotropic medications in patients aged over 65 years on a general medicine ward.MethodsA multidisciplinary GPST conducted twice‐weekly rounds on general medicine inpatients known to be taking psychotropic medications. A consensus recommendation was generated, with subsequent treating team action recorded.ResultsA total of 125 patients taking 180 psychotropic medications were identified for GPST review. Of these, 32 medications (18%) had been ceased by the treating team prior to GPST review. Adoption of GPST recommendations at 24 hours and at discharge occurred for 85 medications (57%) and 79 medications (53%), respectively.ConclusionsThis study demonstrates the feasibility of a structured multidisciplinary approach in the de‐escalation of inappropriate psychotropic medications in older hospital patients on a general medicine ward. Further studies are required to assess scalability and long‐term clinical outcomes.
Patients’ experiences and preferences for opt‐in models and health professional involvement in biobanking consent: A cross‐sectional survey of Australian cancer outpatients
Authors: Fradgley Elizabeth A. , Chong Shu Er , Cox Martine E. , Gedye Craig , Paul Christine L. 
Published: March 2018

AbstractBackgroundMany biobanks rely upon patients’ willingness to donate biospecimens and healthcare professionals to initiate opt‐in consent processes. This study explored if: (1) patients accept opt‐in or opt‐out consent models with varying levels of professional involvement; (2) professionals discuss participation with specific patient groups; and (3) this discussion is associated with patient knowledge of biobanking processes.MethodsOutpatients completed surveys at a tertiary cancer center in New South Wales, Australia. Eligible participants were English‐speaking adults who recently had cancer‐related surgery. Participants completed 27 questions exploring acceptable consent models, biobanking experiences, knowledge, and willingness. Logistic regression and chi‐square tests examined differences in the characteristics and knowledge of participants who were offered the opportunity to participate versus those who were not.ResultsA total of 113 outpatients participated (97% response). Most participants (92%) found opt‐out, patient‐initiated consent acceptable; however, high acceptability was reported for all models except for opt‐in, patient‐initiated consent (58%). University or technical qualifications (P = 0.001) was associated with increased odds (OR = 4.5) of being offered biobanking. The majority did not know what occurred to samples after surgery (59.3%) or pathology review (81.4%) and ability to answer these questions was associated with discussion of participation (P < 0.001). Of the few outpatients who discussed biobanking with their doctor (29%), all consented.ConclusionProfessional‐initiated, opt‐in consent resulted in a few educated patients being approached; greater professional initiation of consent would be fruitful as most patients were willing to participate if asked. However, other consent approaches minimizing professional involvement were as acceptable to participants warranting further consideration.
Efficacy, safety and predictive indicators of apatinib after multilines treatment in advanced nonsquamous nonsmall cell lung cancer: Apatinib treatment in nonsquamous NSCLC
Authors: Wu Di , Liang Li , Nie Ligong , Nie Jun , Dai Ling , Hu Weiheng , Zhang Jie , Chen Xiaoling , Han Jindi , Ma Xiangjuan , Tian Guangming , Han Sen , Long Jieran , Wang Yang , Zhang Ziran , Xin Tao , Fang Jian 
Published: March 2018

AbstractAimPatients with advanced nonsquamous nonsmall cell lung cancer (NSCLC) who experienced progression with two or more lines chemotherapy have no treatment options that clearly confer a survival benefit. As a novel vascular endothelial growth factor receptor‐2 tyrosine kinase inhibitor, apatinib has a certain antitumor effect for various solid tumors. The present study evaluated the efficacy and safety of apatinib in advanced nonsquamous NSCLC as salvage treatment in Chinese real‐world practice.MethodsTwenty‐eight patients were enrolled in this observational study from October 2015 to May 2017. Progression‐free survival (PFS) and overall survival (OS) were graphed by Kaplan–Meier curve and intergroup comparisons were carried out by log‐rank test. Objective response rate (ORR), disease control rate (DCR) and adverse effects (AEs) were also evaluated.ResultsSeven patients obtained partial response, and 18 obtained stable disease, representing an ORR of 26% and a DCR of 93%. Median PFS and OS were 3 (95% confidence interval [CI] 2.6–3.4) and 7.4 (95% CI 1.3–13.5) months, respectively. The efficacy analysis showed that Eastern Cooperative Oncology Group (ECOG) performance status 0–1 was correlated with prolonged OS and PFS (P < 0.05), and hypertension during apatinib treatment was correlated with prolonged OS (P < 0.05). Cox regression showed that ECOG performance status (P < 0.01) (RR = 0.231) (95% CI 0.083‐0.642) and hypertension during apatinib treatment (P = 0.05) were predictive indicators for apatinib treatment. Grade 3–4 AEs with incidences of 10% or greater were hypertension (21%), hand‐foot syndrome (14%) and proteinuria (11%) which could be relieved by dose reduction.ConclusionIn conclusion, apatinib has a certain therapeutic effect in patients with advanced nonsquamous NSCLC. ECOG performance status and hypertension during apatinib might be predictive indicators for treatment efficacy.
A modified Continuous Quality Improvement approach to improve culturally and socially inclusive care within rural health services
Authors: Mitchell Olivia , Malatzky Christina , Bourke Lisa , Farmer Jane 
Published: March 2018

AbstractBackgroundThe sickest Australians are often those belonging to non‐privileged groups, including Indigenous Australians, gay, lesbian, bisexual, transsexual, intersex and queer people, people from culturally and linguistically diverse backgrounds, socioeconomically disadvantaged groups, and people with disabilities and low English literacy. These consumers are not always engaged by, or included within, mainstream health services, particularly in rural Australia where health services are limited in number and tend to be generalist in nature.ObjectiveThe aim of this study was to present a new approach for improving the sociocultural inclusivity of mainstream, generalist, rural, health care organisations.DesignThis approach combines a modified Continuous Quality Improvement framework with Participatory Action Research principles and Foucault's concepts of power, discourse and resistance to develop a change process that deconstructs the power relations that currently exclude marginalised rural health consumers from mainstream health services. It sets up processes for continuous learning and consumer responsiveness.ResultsThe approach proposed could provide a Continuous Quality Improvement process for creating more inclusive mainstream health institutions and fostering better engagement with many marginalised groups in rural communities to improve their access to health care.ConclusionThe approach to improving cultural inclusion in mainstream rural health services presented in this article builds on existing initiatives. This approach focuses on engaging on‐the‐ground staff in the need for change and preparing the service for genuine community consultation and responsive change. It is currently being trialled and evaluated.
Bronchiectasis in the Kimberley region of Western Australia
Authors: Barton Justin , Scott Lydia , Maguire Graeme 
Published: March 2018

AbstractObjectiveTo review the work‐up and inpatient management of non‐cystic fibrosis bronchiectasis exacerbations against best practice guidelines in the Kimberley, a remote region of Western Australia, with the ultimate goal of improving treatment in the region.^DesignRetrospective cohort study and audit of remote adult bronchiectasis hospital admissions between 2011 and 2016.SettingRemote hospital inpatients.ParticipantsThirty‐two patients and 110 hospital admissions were included. Patients were ≥15 years old, had computed tomography confirmed bronchiectasis and at least one hospital admission for acute respiratory illness prior to January 2011.Main outcomes measuredThe 5‐year mortality and compliance to a Lung Foundation position statement on non‐cystic fibrosis bronchiectasis which suggests investigating for an underlying cause at diagnosis and during exacerbations prolonged antibiotics (10–14 days) and prolonged hospital admissions (≥7 days) are required.ResultsThe overall 5‐year mortality was 21.8%, with the median age at death of 37 years (interquartile range, 27–63). The median duration of hospital admission was shorter than the recommended 3 days (interquartile range, 2–5) with 11 of 100 (11%) patients admitted for ≥7 days. The median duration of antibiotics was also shorter than the recommended 7 days (interquartile range, 4–10), with 31 of the 98 (32%) patients prescribed ≥10 days and 6 of the 98 (6%) prescribed ≥14 days of therapy.ConclusionWe found under‐treatment and under‐investigation of non‐cystic fibrosis bronchiectasis in the Kimberley region. Five‐year mortality was high, consistent with other rural Australian Indigenous cohorts.§ Following this audit, a strategy to improve awareness, as well as update and promote regional guidelines has been developed.
Safety and efficacy of ledipasvir/sofosbuvir with or without ribavirin in hepatitis C genotype 1 patients including those with decompensated cirrhosis who failed prior treatment with simeprevir/sofosbuvir
Authors: Modi A. A. , Nazario H. E. , Gonzales G. R. , Gonzalez S. A. 
Published: March 2018

SummaryBackgroundCombination therapy of simeprevir (SIM)/sofosbuvir (SOF) is an approved treatment for hepatitis C genotype (gen) 1 with overall SVR12 rate of 85%‐95%. The single tablet fixed‐dose combination of ledipasvir (LDV)/SOF is also approved for gen 1 with sustained virologic response at 12 weeks (SVR12) rates ≥95%. No data are available on the efficacy of retreatment with LDV/SOF in patients who failed initial treatment with SIM/SOF.AimTo evaluate the efficacy of retreatment with LDV/SOF ± ribavirin (RBV) in gen 1 patients who had previously failed treatment with SIM/SOF.MethodsData from a combined treatment cohort of 2 hepatology centres, which included patients previously treated with SIM/SOF ± RBV for 12 weeks but failed to achieve SVR and then underwent retreatment with LDV/SOF ± RBV, were analysed (n = 30). LDV/SOF ± RBV was administered for 12‐24 weeks based on the discretion of the treating hepatologist.ResultsOf the 30 patients, 23 (77%) were male, 77% were Caucasian and 26 (87%) were gen 1a. 26 (86%) had cirrhosis, of which 16 (62%) had decompensated, Child's class B or C cirrhosis. Three patients were liver transplant recipients with recurrent hepatitis C. Overall, 27/30 (90%) achieved SVR. Treatment was well tolerated with 37% reporting no adverse events. The most common adverse events were fatigue, headache, insomnia and nausea. Two patients with Child's B cirrhosis required hospitalization during treatment for variceal haemorrhage and abdominal pain respectively. However, no treatment discontinuations or deaths occurred.ConclusionSingle tablet fixed‐dose combination LDV/SOF ± RBV is efficacious and well tolerated in patients who previously failed treatment with SIM/SOF, including those with decompensated cirrhosis and recurrent hepatitis C following liver transplantation.
Health problems associated with irritable bowel syndrome: analysis of a primary care registry
Authors: Clevers E. , Vaes B. , Henrard S. , Goderis G. , Tack J. , Törnblom H. , Simrén M. , Van Oudenhove L. 
Published: March 2018

SummaryBackgroundAssociations between irritable bowel syndrome and other health problems have been described, but comprehensive reports are missing, especially in primary care.AimsTo investigate which health problems are associated with irritable bowel syndrome, how they cluster together and when they are typically diagnosed relative to irritable bowel syndrome.MethodsWe used Intego, a general practice registry in Flanders, Belgium. Patients with an irritable bowel syndrome diagnosis (n = 13 701) were matched with controls without gastrointestinal diagnosis and controls with organic gastrointestinal disease. Long‐term prevalences of 680 symptoms and diagnoses were compared between patients and controls. Results were summarised using functional enrichment analysis and visualised in a network and we calculated incidence rate ratios in the 10 years before and after the irritable bowel syndrome diagnosis for the network's key components.ResultsVarious symptoms and infections, but not neoplasms, were enriched in irritable bowel syndrome patients compared to both control groups. We characterised the comorbidities of irritable bowel syndrome as psychosocial health problems, urogenital symptoms and infections, musculoskeletal symptoms and other somatic symptoms. These had a uniform incidence in the years around the irritable bowel syndrome diagnosis, and did not structurally precede or follow irritable bowel syndrome.ConclusionsIrritable bowel syndrome shares long‐term associations with psychosocial health problems, urogenital symptoms and infections, musculoskeletal symptoms and other somatic symptoms in primary care. Clinicians are encouraged to take comorbidities into account when diagnosing and managing irritable bowel syndrome, as this may have important treatment implications.
Risk factors for diagnostic delay in Crohn's disease and their impact on long‐term complications: how do they differ in a tuberculosis endemic region?
Authors: Banerjee R. , Pal P. , Girish B. G. , Reddy D. N. 
Published: March 2018

SummaryBackgroundThe diagnosis of Crohn's disease (CD) can be delayed in clinical practice. In tuberculosis endemic areas, empirical anti‐tubercular therapy further delays treatment.Aim(s)To assess risk factors for diagnostic delay and its impact on the long‐term complications of Crohn's disease in India where tuberculosis is endemic.MethodsData from a large prospectively established inflammatory bowel disease registry were analysed retrospectively. The time from onset of symptoms to diagnosis (diagnostic delay) was calculated and categorised into two groups based on median diagnostic delay. The risk factors for delay including anti‐tubercular therapy were analysed. Logistic regression analysis was done to assess impact of diagnostic delay on development of stenotic and fistular complications including need for surgery.ResultsSeven hundred and twenty Crohn's disease patients (60.3% male, median: 28 years) were included. Main outcome measures were stenosis, fistula and need for surgery. Subjects with diagnostic delay >18 months (median) developed significantly higher stenotic complications and surgery (OR 4.12; 95% CI: 2.74‐6.33, P < 0.001 and OR 2.41, 95% CI: 1.68‐3.42, P < 0.001), respectively, compared to those ≤18 months. There was no difference in the development of fistulous complications. 193/720 (27%) received anti‐tubercular therapy which significantly contributed to diagnostic delay (OR: 2.47; 95% CI: 1.76‐3.47, P < 0.001) with 47% showing initial clinical response (Crohn's disease activity index‐ CDAI decrease >100). Moreover, the incidence of stenotic complications was significantly higher in patients who had received prior anti‐tubercular therapy (55/193 (28.49%) vs 78/527 (14.8%), P < 0.001, OR: 2.60, 95% CI: 1.64‐4.12).ConclusionsDiagnostic delay in Crohn's disease is associated with significantly higher stenotic complications and need for surgery. Empirical anti‐tubercular therapy is the single largest contributor to diagnostic delay in tuberculosis endemic areas. Despite initial clinical response to anti‐tubercular therapy, long‐term stenotic complications are higher.
Patients’ preoperative background causes gastric stasis after laparoscopy‐assisted pylorus‐preserving gastrectomy
Authors: Nishizawa Nobuyuki , Hosoda Kei , Moriya Hiromitsu , Mieno Hiroaki , Ema Akira , Ushiku Hideki , Ishii Satoru , Tanaka Toshimichi , Washio Marie , Yokoi Keigo , Harada Hiroki , Watanabe Masahiko , Yamashita Keishi 
Published: March 2018

AbstractIntroductionDespite technical improvements in laparoscopic gastrectomy, gastric stasis is still a serious problem in laparoscopy‐assisted pylorus‐preserving gastrectomy (LAPPG). The aim of this study was to investigate the factors that might cause gastric stasis in LAPPG.MethodsFrom April 2004 through November 2012, 85 patients with cT1N0 middle‐third gastric cancer who underwent LAPPG at Kitasato University Hospital; these patients were included in the present study. Infra‐pyloric vein (IPV)‐preserving LAPPG was performed in 41 patients. We compared the rate of gastric stasis in the IPV‐preserving and the IPV–non‐preserving groups, and analyzed the clinicopathological factors that might have caused gastric stasis.ResultsWe did not demonstrate that preservation of the IPV could prevent gastric stasis in the early and late postoperative periods. Symptoms of gastric stasis were most frequently recognized 1 year after surgery. A significantly higher proportion of preoperative ASA class 2 patients had gastric stasis than did not (80.0% [12/15] vs 48.6% [34/70], P=0.02). Among the ASA class 2 patients, a significantly greater proportion of those with depressed activities of daily living than those with normal activities of daily living had gastric stasis (66.7% [4/6] vs 20.0% [8/40], P = 0.015).ConclusionsThe clinical significance of the IPV preservation in LAPPG could not be demonstrated. LAPPG should be performed for ASA class 1 patients or those with maintained preoperative activities of daily living.
A Snapshot of the Australian Taxpayer
Authors: Bond David , Wright Anna 
Published: March 2018

AbstractUsing the most recent Australian Taxation Office published data, along with other sources of data, we provide detailed descriptive evidence on the income, deductions and other items (including superannuation) of the individual taxpayer in Australia. We provide these details across tax bracket, occupation, gender and location. In addition, we explore who is accessing negative gearing and by how much, thus contributing to the ongoing debate that surrounds this area of tax law. We show that individuals with a higher taxable income are more likely to access negative gearing, and we provide estimates of how the removal of this deduction would affect federal tax revenue. We discuss other reported areas such as deductions for gifts and donations, as well as providing a discussion on the use and potential use of the government‐provided pre‐filled tax information for individuals. Overall, this study is of interest to academics, government and tax practitioners alike.