bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long‐term neurocognitive functioning after electroconvulsive therapy in patients with late‐life depression
Authors: Obbels J. , Verwijk E. , Vansteelandt K. , Dols A. , Bouckaert F. , Schouws S. , Vandenbulcke M. , Emsell L. , Stek M. , Sienaert P. 
Published: July 2018

ObjectiveThere is ongoing concern about the possible negative impact of ECT on neurocognitive functioning in older patients. In this study, we aimed to characterize the long‐term cognitive effects of ECT in patients with late‐life depression, using an extensive neuropsychological battery.MethodsA total of 110 patients aged 55 years and older with unipolar depression, referred for ECT were included. The neuropsychological test battery was assessed prior to ECT and 6 months after the last ECT session.ResultsThere were no statistically significant group‐level changes from baseline to 6 months post‐ECT in any of the neuropsychological measurements. Individual differences in cognitive performance were detected using the Reliable Change Index.ConclusionPatients with late‐life depression do not show deleterious cognitive effects 6 months following an ECT index course, although there are considerable differences at an individual level. Clinicians should not hesitate to prescribe ECT in older patients, as most of these patients will tolerate the treatment course and a small group will even experience a cognitive enhancement. However, clinicians should be aware that a small group of patients can experience cognitive side‐effects. Further study is needed to predict which patients have a higher risk of developing cognitive side‐effects.
Incipient signs of genetic differentiation among African elephant populations in fragmenting miombo ecosystems in south‐western Tanzania
Authors: Lobora Alex L. , Nahonyo Cuthbert L. , Munishi Linus K. , Caro Tim , Foley Charles , Prunier Jérôme G. , Beale Colin M. , Eggert Lori S. 
Published: July 2018

AbstractHabitat fragmentation can play a major role in the reduction of genetic diversity among wildlife populations. The Ruaha‐Rungwa and Katavi‐Rukwa ecosystems in south‐western Tanzania comprise one of the world's largest remaining African savannah elephant metapopulations but are increasingly threatened by loss of connectivity and poaching for ivory. To investigate the genetic structure of populations, we compared the genotypes for nine microsatellite loci in the western, central and eastern populations. We found evidence of genetic differentiation among the three populations, but the levels were low and mostly concerned the younger cohort, suggesting recent divergence probably resulting from habitat loss between the two ecosystems. We identified weak isolation by distance, suggesting higher gene flow among individuals located less than 50 km apart. In a long‐lived species with overlapping generations, it takes a long time to develop genetic substructure even when there are substantial obstacles to migration. Thus, in these recently fragmented populations, inbreeding (and the loss of heterozygosity) may be less of an immediate concern than the loss of adults due to illegal hunting.
Multiple Robust Estimation of Marginal Structural Mean Models for Unconstrained Outcomes
Authors: Babino Lucia , Rotnitzky Andrea , Robins James 
Published: July 2018

Summary
We consider estimation, from longitudinal observational data, of the parameters of marginal structural mean models for unconstrained outcomes. Current proposals include inverse probability of treatment weighted and double robust (DR) estimators. A difficulty with DR estimation is that it requires postulating a sequence of models, one for the each mean of the counterfactual outcome given covariate and treatment history up to each exposure time point. Most natural models for such means are often incompatible. Robins et al., (2000b) proposed a parameterization of the likelihood which implies compatible parametric models for such means. Their parameterization has not been exploited to construct DR estimators and one goal of this article is to fill this gap. More importantly, exploiting this parameterization we propose a multiple robust (MR) estimator that confers even more protection against model misspecification than DR estimators. Our methods are easy to implement as they are based on the iterative fit of a sequence of weighted regressions.
A Useful Design Utilizing the Information Fraction in a Group Sequential Clinical Trial With Censored Survival Data
Authors: Hsu Chih-Yuan , Chen Chen-Hsin , Hsu Ken-Ning , Lu Ya-Hung 
Published: July 2018

Summary
Lan and DeMets (1983) proposed the alpha spending function for group sequential trials to permit the use of unspecified frequencies and timings of interim analyses in the trial design. Regarding a trial with censored time to endpoint, Lan and DeMets (1989) later defined information time at an interim analysis in a maximum duration trial. To compare two survival curves utilizing such a design, information times for group sequential logrank and Wilcoxon-type statistics have been developed by assuming that the survival time follows an exponential distribution or a Weibull distribution without considering the censoring distribution. To better address the practical concerns inherent in clinical trials with survival endpoints, we present a new approach to adequately design a group sequential trial using the Harrington–Fleming (1982) test based on our proposed information fractions by assuming the censoring distribution depends on the patient's accrual time according to various entry distributions and by extending the underlying survival distribution to the generalized gamma distribution. We also determine associated sample sizes, expected number of events and expected stopping time. Two phase III trials of non-small-cell lung cancer originally designed using fixed-sample tests are utilized to illustrate the potential advantages of using a group sequential design with the proposed approach. This enhanced method facilitates the design and analysis of group sequential clinical trials studying survival endpoints by increasing implemental flexibility.
Does urinary cytology have a role in haematuria investigations?
Authors: Tan Wei Shen , Sarpong Rachael , Khetrapal Pramit , Rodney Simon , Mostafid Hugh , Cresswell Joanne , Watson Dawn , Rane Abhay , Hicks James , Hellawell Giles , Davies Melissa , Srirangam Shalom J. , Dawson Louise , Payne David , Williams Norman , Brew‐Graves Chris , Feber Andrew , Kelly John D. ,   DETECT I trial collaborators
Published: July 2018

ObjectivesTo determine the diagnostic accuracy of urinary cytology to diagnose bladder cancer and upper tract urothelial cancer (UTUC) as well as the outcome of patients with a positive urine cytology and normal haematuria investigations in patients in a multicentre prospective observational study of patients investigated for haematuria.Patient and methodsThe DETECT I study (clinicaltrials.gov NCT02676180) recruited patients presenting with haematuria following referral to secondary case at 40 hospitals. All patients had a cystoscopy and upper tract imaging (renal bladder ultrasound [RBUS] and/ or CT urogram [CTU]). Patients, where urine cytology were performed, were sub‐analysed. The reference standard for the diagnosis of bladder cancer and UTUC was histological confirmation of cancer. A positive urine cytology was defined as a urine cytology suspicious for neoplastic cells or atypical cells.ResultsOf the 3 556 patients recruited, urine cytology was performed in 567 (15.9%) patients from nine hospitals. Median time between positive urine cytology and endoscopic tumour resection was 27 (IQR: 21.3–33.8) days. Bladder cancer was diagnosed in 39 (6.9%) patients and UTUC in 8 (1.4%) patients. The accuracy of urinary cytology for the diagnosis of bladder cancer and UTUC was: sensitivity 43.5%, specificity 95.7%, positive predictive value (PPV) 47.6% and negative predictive value (NPV) 94.9%. A total of 21 bladder cancers and 5 UTUC were missed. Bladder cancers missed according to grade and stage were as follows: 4 (19%) were ≥ pT2, 2 (9.5%) were G3 pT1, 10 (47.6%) were G3/2 pTa and 5 (23.8%) were G1 pTa. High‐risk cancer was confirmed in 8 (38%) patients. There was a marginal improvement in sensitivity (57.7%) for high‐risk cancers. When urine cytology was combined with imaging, the diagnostic performance improved with CTU (sensitivity 90.2%, specificity 94.9%) superior to RBUS (sensitivity 66.7%, specificity 96.7%). False positive cytology results were confirmed in 22 patients, of which 12 (54.5%) had further invasive tests and 5 (22.7%) had a repeat cytology. No cancer was identified in these patients during follow‐up.ConclusionsUrine cytology will miss a significant number of muscle‐invasive bladder cancer and high‐risk disease. Our results suggest that urine cytology should not be routinely performed as part of haematuria investigations. The role of urine cytology in select cases should be considered in the context of the impact of a false positive result leading to further potentially invasive tests conducted under general anaesthesia.
Three‐ to Four‐Year‐Old Children Rapidly Adapt Their Predictions and Use Them to Learn Novel Word Meanings
Authors: Havron Naomi , de Carvalho Alex , Fiévet Anne‐Caroline , Christophe Anne 
Published: July 2018

Adults create and update predictions about what speakers will say next. This study asks whether prediction can drive language acquisition, by testing whether 3‐ to 4‐year‐old children (n = 45) adapt to recent information when learning novel words. The study used a syntactic context which can precede both nouns and verbs to manipulate children's predictions about what syntactic category will follow. Children for whom the syntactic context predicted verbs were more likely to infer that a novel word appearing in this context referred to an action, than children for whom it predicted nouns. This suggests that children make rapid changes to their predictions, and use this information to learn novel information, supporting the role of prediction in language acquisition.
Differential impact of socioeconomic position across life on oral cancer risk in Kerala, India: An investigation of life‐course models under a time‐varying framework
Authors: ThekkePurakkal Akhil Soman , Naimi Ashley I. , Madathil Sreenath A. , Kumamangalam Puthiyannal Shahul H. , Netuveli Gopalakrishnan , Sacker Amanda , Schlecht Nicolas F. , Nicolau Belinda 
Published: July 2018

AbstractObjectivesThe incidence of oral cancer has been rapidly increasing in India, calling for evidence contributing to a deeper understanding of its determinants. Although disadvantageous life‐course socioeconomic position (SEP) is independently associated with the risk of these cancers, the explanatory mechanisms remain unclear. Possible pathways may be better understood by testing which life‐course model most influences oral cancer risk. We estimated the association between life‐course SEP and oral cancer risk under three life‐course models: critical period, accumulation and social mobility.MethodsWe recruited incident oral cancer cases (N = 350) and controls (N = 371) frequency‐matched by age and sex from two main referral hospitals in Kozhikode, Kerala, India, between 2008 and 2012. We collected information on childhood (0‐16 years), early adulthood (17‐30 years) and late adulthood (above 30 years) SEP and behavioural factors along the life span using interviews and a life‐grid technique. Odds ratios (OR) and 95% confidence intervals (CI) were estimated for the association between life‐course SEP and oral cancer risk using inverse probability weighted marginal structural models.ResultsRelative to an advantageous SEP in childhood and early adulthood, a disadvantageous SEP was associated with oral cancer risk [(OR = 2.76, 95% CI: 1.99, 3.81) and (OR = 1.84, 95% CI: 1.21, 2.79), respectively]. In addition, participants who were in a disadvantageous (vs advantageous) SEP during all three periods of life had an increased oral cancer risk (OR = 4.86, 95% CI: 2.61, 9.06). The childhood to early adulthood social mobility model and overall life‐course trajectories indicated strong influence of exposure to disadvantageous SEP in childhood on the risk for oral cancer.ConclusionsUsing novel approaches to existing methods, our study provides empirical evidence that disadvantageous childhood SEP is critical for oral cancer risk in this population from Kerala, India.
Diagnostic accuracy of parathyroid hormone levels in washout samples of suspicious parathyroid adenomas: A single‐centre retrospective cohort study
Authors: Gökçay Canpolat Asena , Şahin Mustafa , Ediboğlu Elif , Erdoğan Murat Faik , Güllü Sevim , Demir Özgür , Emral Rıfat , Çorapçıoğlu Demet 
Published: July 2018

SummaryIntroductionMinimally invasive surgery is an alternative surgical approach for primary hyperparathyroidism with less surgical trauma and anaesthesia complications. When combined with intraoperative measurement of parathyroid hormone (PTH), cure rates are exceeding 97%. Preoperative intact PTH determination in washout samples is really very useful when parathyroid lesions cannot be easily distinguished from thyroid lesions or sometimes lymph nodes. Herein, we aimed to report our institutional experience about parathyroid fine‐needle aspiration (FNA) method and suggest a cut‐off ratio for this purpose.MethodsIn our clinic, we performed ultrasonography (USG)‐guided parathyroid FNA procedure for 131 patients diagnosed with primary hyperparathyroidism between January 2005 and January 2016. Both cytologic evaluation and intact PTH determination were performed in washout samples. Eighty‐seven of the study group also had a parathyroid scintigraphy. Both demographic features and laboratory results were all recorded.ResultsMedian serum PTH level was 142 (113‐197), while mean PTH washout level was 1824 (0‐3953). When three of the localization techniques are compared with each other, FNA‐PTH washout group had a better diagnostic accuracy (90.8%) when compared to cytology (7.92%) and MIBI (67.8%) groups. Both MIBI and FNA‐PTH washout group had 100% positive predictive value (PPV) and 100% specificity. We found values greater than 436.5 pg/mL for FNA‐PTH washout with a sensitivity of 90.3% and specificity of 88.9% (P < 0.01 and AUC 94.3 (87.8‐100)) and a cut‐off for FNA/serum PTH greater than 3.05 with a sensitivity of 91.2% and specificity of 89% (P = 0.02 and AUC 94.5 (88.8‐100)) which implicate parathyroid lesions.ConclusionAccording to the literature, PTH determination in washout samples has a specificity of 75%‐100% and sensitivity of 70%‐100%. This approach has better results than both cytology and scintigraphy in case of concomitant multinodular thyroid disease in experienced hands. Although there is not a definite cut‐off for PTH levels in washout samples, we agree with the need of ratios rather than cut‐offs in this issue.
Limits of monetization in protecting ecosystem services
Authors: Temel Julia , Jones Aled , Jones Nikoleta , Balint Lenke 
Published: July 2018

AbstractThe monetary valuation of ecosystem services is gaining traction in policy and business communities. Several tools and decision‐making processes have been proposed, including criteria to assess the appropriateness of using monetary valuation for biodiversity conservation outcomes. These criteria include measures such as scale, uniqueness, and threat. We used case studies of monetization projects for which the outcomes were measured to explore the limitations and application of these criteria. There was limited evidence of the effectiveness of such schemes. The majority of the schemes were established in areas where the criteria specifically excluded their use in isolation. Thus, although some aspects of monetization may be beneficial for biodiversity conservation, these schemes were not being used appropriately and require some quantitative minimum (or maximum) measurements to be applied through additional policy or governance measures to ensure biodiversity conservation outcomes.
Incorporating biotic interactions reveals potential climate tolerance of giant pandas
Authors: Wang Fang , Zhao Qing , McShea William J. , Songer Melissa , Huang Qiongyu , Zhang Xiaofeng , Zhou Lingguo 
Published: July 2018

AbstractMany studies have overestimated species’ range shifts under climate change because they treat climate as the only determinant while ignoring biotic factors. To assess the response of giant pandas to climate change, we incorporated spatial effects in modeling bamboo distributions, which in turn was incorporated to represent giant panda–bamboo biotic interactions in predicting giant panda distribution. Our study revealed potential tolerance of giant pandas to climate change. We found significant residual spatial correlation in the bamboo models. The biotic interactions with bamboo understories and anthropogenic activities had large effects on panda distribution, which lowered the relative importance of climatic variables. Our results are fundamentally different from previous studies that used climate‐only and nonspatial approaches, which may have overestimated the effects of climate change on panda and lead to inappropriate conservation recommendations. We strongly advocate that giant panda conservation planning continues to focus on protecting bamboo forest and reducing anthropogenic interferences.
Peace in Colombia is a critical moment for Neotropical connectivity and conservation: Save the northern Andes–Amazon biodiversity bridge
Authors: Clerici Nicola , Salazar Camilo , Pardo‐Díaz Carolina , Jiggins Chris D. , Richardson James E. , Linares Mauricio 
Published: July 2018

AbstractColombia is one of the most biodiverse countries in the world that has historically and is currently experiencing extensive deforestation and habitat fragmentation. Here we show how the most extensive region acting as a natural corridor between the Colombian Andes and Amazon biogeographical regions, the Picachos–Tinigua–Sierra de la Macarena–Chiribiquete megacorridor, is being eroded by large‐scale agricultural expansion endangering the maintenance and connection of gene flow and biodiversity exchange. Several phylogenetic studies indicate that the complex dynamics between the Andean highlands and the Amazonian lowlands have strongly influenced the origin and maintenance of Neotropical biodiversity. We appeal for the attention of international conservation and governmental organizations to direct resources and promote projects focused on the preservation and sustainable management of this strategic Andes–Amazon bridge in both protected and unprotected areas. In the current postconflict era, Colombia has a unique opportunity to create a new social and economic paradigm based on long‐term sustainably developed landscapes and more equitable sharing of wealth. We believe improved management and conservation efforts for the Picachos–Tinigua–Macarena–Chiribiquete megacorridor would demonstrate a collective will in helping to achieve this goal.
What is the significance of non‐specific pleuritis? A trick question
Authors: Janssen Julius , Maldonado Fabien , Metintas Muzaffer 
Published: July 2018

AbstractNon‐specific pleuritis (NSP) is defined as fibrinous or inflammatory pleuritis which cannot be attributed to a specific benign or malignant etiology. It can be diagnosed in biopsies in up to 30% of cases of exudative pleuritis after thoracoscopy, with a mean of 19.2%. In 66 out of 469 (14.2%) patients in combined series, a malignant pleural disease (mostly mesothelioma) was found during a follow‐up of at least 21 months. Most likely, a follow‐up time of 12 months is sufficient, although the current routine is a follow‐up of 2 years. Because of a benign course in 85% of patients with NSP, a repeated invasive procedure after thoracoscopy is only indicated in a limited group of patients. The most important indications for a repeated pleural biopsy are persistent chest pain, recurrent pleural effusion, radiologic findings suggestive for malignant pleural disease.
Migration strategies of brown trout (Salmo trutta) in a subarctic river system as revealed by stable isotope analysis
Authors: Ruokonen Timo J. , Kiljunen Mikko , Erkinaro Jaakko , Orell Panu , Sivonen Olli , Vestola Eero , Jones Roger I. 
Published: July 2018

AbstractWe estimated the proportions of anadromous and freshwater‐resident brown trout (Salmo trutta) in different parts of the subarctic River Näätämöjoki/Neidenelva system (Finland and Norway) using carbon, nitrogen and hydrogen stable isotope analyses of archived scales as identifiers of migration strategy. Our results showed that carbon stable isotope values were the best predictor of migration strategy. Most individuals fell into two clearly distinct groups representing anadromous (47%) or freshwater‐resident (42%) individuals, but some fish had intermediate carbon values suggesting repeated movement between freshwater and the sea. The proportion of anadromous individuals decreased steadily with distance from the sea forming a spatial continuum in migration strategies which is probably maintained by the combination of several factors such as divergent availability of food resources, variable migration costs and genetic differences. These within‐catchment differences in migration strategies should be taken into account in fisheries management practices.
Feeling nothing: Numbness and emotional absence
Authors: Roberts Tom 
Published: July 2018

AbstractI argue that it is possible for a subject to undergo experiences of emotional absence, during which she becomes aware of her own failure to be moved by the world around her. Just as a part of one's body feels numb when it manifestly fails to incur the ordinary sensory consequences of transactions at the surface of the skin, so an individual feels emotional absence when her affective condition manifestly fails to vary in predictable ways as she navigates her surroundings. Experiences of emotional absence, such as feeling numb with shock or grief, feeling unamused, or feeling fearless, are not simply flat or neutral states of awareness, but can bear psychological and epistemic significance for the agent.