bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pharmacological effects and safety monitoring of anabolic androgenic steroid use: differing perceptions between users and healthcare professionals
Authors: Hill Stephanie A. , Waring W. Stephen 
Published: June 2019

Background: Androgenic anabolic steroids (AASs) have a number of licensed clinical indications but are also subject to abuse within the body building community. They have a number of potentially important adverse pharmacological effects, and users require health monitoring, including selected laboratory investigations. The extent to which AAS users are able to seek medical supervision and the ability of healthcare providers to respond to the needs of users is uncertain. The present study sought to ascertain how AAS abusers interact with healthcare providers, and self-reported knowledge among doctors regarding the healthcare effects and need for monitoring of AAS users. Methods: Questionnaires were administered, and there were 216 respondents among AAS users and 134 doctors. Results: A high proportion of AAS users cited various barriers to accessing healthcare, including 136 of 189 (72%) that reported a fear of reproach, and 107 of 194 (55%) that had avoided seeking medical advice; 137 of 193 respondents (71%) did not disclose AAS use to healthcare professionals. Doctors across a broad range of seniority stated a lack of knowledge of AASs; 130 (97%) had received no formal training, and 109 (82%) did not know which blood tests could be used for safety monitoring. Conclusions: The present study has highlighted some perceptions among the body-building community that create obstacles to them accessing appropriate safety monitoring while using AASs. Doctors may not have adequate knowledge of AASs, which may prevent them giving accurate and complete information. Further work is needed to address the barriers of communication between users and health professionals in order to facilitate better healthcare monitoring and drug safety.
Isolating therapeutic procedures to investigate mechanisms of change in cognitive behavioral therapy for depression
Authors: Bruijniks Sanne J. E. , Sijbrandij Marit , Schlinkert Caroline , Huibers Marcus J. H. 
Published: June 2019

Background: Isolating a therapeutic procedure might be a powerful way to enhance our understanding of how cognitive behavior therapy (CBT) works. The present study explored new methods to isolate cognitive procedures and to study their direct impact on hypothesized underlying processes and CBT outcome. Method: The effects of a cognitive therapy skill acquisition procedure ( n = 36) were compared to no procedure ( n = 36) on cognitive therapy skills, dysfunctional thinking, distress, and mood in response to induced distress following a social stress test in healthy participants. Results: Participants reported more cognitive therapy skills after the procedure that focused on the acquisition of cognitive therapy skills compared to no procedure, but there were no differences in dysfunctional thinking, distress, and mood between the groups. Conclusions: By demonstrating an experimental approach to investigate mechanisms of change, including the pitfalls that come along with it, the present experiment provides a blueprint for other researchers interested in the underlying mechanisms of change in CBT for depression.
No differential gene expression for CD4+ T cells of MS patients and healthy controls
Authors: Brorson Ina S , Eriksson Anna , Leikfoss Ingvild S , Celius Elisabeth G , Berg-Hansen Pål , Barcellos Lisa F , Berge Tone , Harbo Hanne F , Bos Steffan D 
Published: June 2019

Background Multiple sclerosis-associated genetic variants indicate that the adaptive immune system plays an important role in the risk of developing multiple sclerosis. It is currently not well understood how these multiple sclerosis-associated genetic variants contribute to multiple sclerosis risk. CD4+ T cells are suggested to be involved in multiple sclerosis disease processes. Objective We aim to identify CD4+ T cell differential gene expression between multiple sclerosis patients and healthy controls in order to understand better the role of these cells in multiple sclerosis. Methods We applied RNA sequencing on CD4+ T cells from multiple sclerosis patients and healthy controls. Results We did not identify significantly differentially expressed genes in CD4+ T cells from multiple sclerosis patients. Furthermore, pathway analyses did not identify enrichment for specific pathways in multiple sclerosis. When we investigated genes near multiple sclerosis-associated genetic variants, we did not observe significant enrichment of differentially expressed genes. Conclusion We conclude that CD4+ T cells from multiple sclerosis patients do not show significant differential gene expression. Therefore, gene expression studies of all circulating CD4+ T cells may not result in viable biomarkers. Gene expression studies of more specific subsets of CD4+ T cells remain justified to understand better which CD4+ T cell subsets contribute to multiple sclerosis pathology.
Early promising result of bicompartmental knee replacement in middle-aged patients
Authors: Tang Bruce Yan Ho , Cheung Chi Nok , Tsui Hon For , Wong Hok Leung 
Published: June 2019

Introduction: Partial knee replacement (PKR) is one of the treatment options in middle-aged patients with less extensive knee osteoarthritis, with unicompartmental knee replacement (UKR) most commonly done for medial osteoarthritis. There are numerous advantages like bone/ligament preserving and faster recovery. However, the indications of UKR remain controversial, as most patients have some patellofemoral joint (PFJ) osteoarthritis. We performed modular bicruciate-retaining bicompartmental knee replacement (BKR) in this group of patients and compared the outcome with total knee replacement (TKR). Materials and Methods: From 2016 to 2017, 14 BKR were performed in patients with medial and PFJ osteoarthritis. They were retrospectively compared with 14 TKR performed in patients with similar age and severity. The incision length, operative time, blood loss (in terms of hemoglobin drop), and length of stay were recorded. Pre- and postoperative range of motion and Knee Society knee score at 1-year follow-up were compared. Results: The mean incision length for BKR was shorter than TKR (130.1 vs. 185.1 mm), but the mean operative time was also longer (152.6 vs. 88.1 min). There was also less mean hemoglobin drop (1.8 vs. 2.6 g/dL) and shorter length of stay (7.4 vs. 9.2 days). The mean postoperative function score is better in BKR group (90.4 vs. 77.5), and the mean postoperative knee score (87.2 vs 88.9) and flexion (115.7° vs. 111.4°) were similar for both groups. Discussion: In selected patients, BKR is a good alternative to TKR. It preserves advantages of UKR while also tackle the PFJ which is the most controversial aspect of UKR. The early clinical outcome in our study is promising. However, there is a learning curve. Longer follow-up is necessary to study on the performance and survivorship as compared with UKR and TKR.
One-Step Autologous Minced Cartilage Procedure for the Treatment of Knee Joint Chondral and Osteochondral Lesions: A Series of 27 Patients With 2-Year Follow-up
Authors: Massen Felix Kurt , Inauen Cyril Raphael , Harder Laurent Pascale , Runer Armin , Preiss Stefan , Salzmann Gian Max 
Published: June 2019

Background: Chondral and osteochondral lesions are being detected with increasing frequency. For large-diameter lesions, cell-based treatment modalities are speculated to result in the best possible outcome. Purpose: To prospectively evaluate the 2-year clinical and radiological results after the treatment of chondral and osteochondral knee joint lesions by a single-step autologous minced cartilage procedure. Study Design: Case series; Level of evidence, 4. Methods: From February 2015 to June 2016, a total of 27 consecutive patients suffering from chondral or osteochondral lesions of the knee joint were treated using a single-step autologous minced cartilage procedure. All patients underwent preoperative and postoperative magnetic resonance imaging for the collection of AMADEUS (Area Measurement and Depth and Underlying Structures) and MOCART (magnetic resonance observation of cartilage repair tissue) scores. Clinical analysis was conducted by a numeric analog scale (NAS) for pain and knee function before the intervention and at 12 and 24 months postoperatively. Results: A total of 12 female and 15 male patients (mean age, 28.7 years) were evaluated for a mean of 28.2 ± 3.8 months. The mean cartilage defect size encountered intraoperatively was 3.1 ± 1.6 cm2. There was a significant decrease in pain from 7.2 ± 1.9 preoperatively to 1.8 ± 1.6 ( P < .001) at 2-year follow-up. Knee function improved from a mean of 7.2 ± 2.0 preoperatively to 2.1 ± 2.3 ( P < .001) at 2 years after surgery. The mean preoperative AMADEUS score was 57.4 ± 21.4. Postoperatively, the mean MOCART score was 40.6 ± 21.1 at 6-month follow-up. No correlation was observed between the clinical data and the MOCART or AMADEUS scores. Conclusion: Overall, the findings of this study demonstrated that patients undergoing a single-step autologous minced cartilage procedure had a satisfactory outcome at 2-year follow-up. As a result, the single-step autologous minced cartilage procedure does represent a possible alternative to standard autologous chondrocyte implantation. Longer follow-up and larger cohorts are required to define the benefits of this procedure.
Earlier IV thrombolysis and mechanical thrombectomy in acute ischemic stroke are associated with a better recanalization
Authors: Nicastro Nicolas , Eger Antoine F , Boukrid Iman I , Mueller Hubertus FG , Machi Paolo , Vargas Maria Isabel , Poletti Pierre-Alexandre , Platon Alexandra , Sztajzel Roman F 
Published: June 2019

Introduction: Combined intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) are the recommended treatment options for acute ischemic stroke (AIS). It is unclear whether earlier IVT and MT management can predict complete vessel recanalization. Methods: In this single-center retrospective observational study, we included 81 consecutive subjects with proximal middle cerebral artery AIS (age 70.5 ± 14.2 years, 53% female) who had both IVT and MT. We assessed recanalization after mechanical procedure according to modified thrombolysis in cerebral infarction (TICI) score as well as the National Institute of Health Stroke Scale (NIHSS) score at 24 h. Outcomes were modified Rankin Scale (mRS) at discharge, mRS at 3 months, death at 3 months, and prevalence of intracerebral hemorrhage during hospitalization. Results: Multinomial logistic regression ( χ 2 = 49.4, p = 0.0075, pseudo- R 2 = 0.26) showed that complete recanalization (TICI score = 3) was predicted by lower door-to-MT time ( p = 0.014, 95% confidence interval (CI) = −0.09 to −0.01) and lower symptoms-to-IVT time ( p = 0.045, 95% CI = −0.038 to −0.0004). An NIHSS score ≥10 at 24 h was predicted by higher baseline NIHSS ( p < 0.0001) and lower TICI score ( p = 0.009). Lower NIHSS at 24 h predicted a good outcome according to mRS at 3 months ( p = 0.006). Similarly, higher NIHSS at 24 h was a predictor of death at 3 months ( p = 0.013). Conclusions: The present study suggests that bridging therapy may improve vascular recanalization when both IVT and MT are performed earlier.
Advance decisions to refuse treatment and suicidal behaviour in emergency care: ‘it's very much a step into the unknown’
Authors: Quinlivan Leah , Nowland Rebecca , Steeg Sarah , Cooper Jayne , Meehan Declan , Godfrey Joseph , Robertson Duncan , Longson Damien , Potokar John , Davies Rosie , Allen Neil , Huxtable Richard , Mackway-Jones Kevin , Hawton Keith , Gunnell David , Kapur Nav 
Published: June 2019

BackgroundComplex challenges may arise when patients present to emergency services with an advance decision to refuse life-saving treatment following suicidal behaviour.AimsTo investigate the use of advance decisions to refuse treatment in the context of suicidal behaviour from the perspective of clinicians and people with lived experience of self-harm and/or psychiatric services.MethodForty-one participants aged 18 or over from hospital services (emergency departments, liaison psychiatry and ambulance services) and groups of individuals with experience of psychiatric services and/or self-harm were recruited to six focus groups in a multisite study in England. Data were collected in 2016 using a structured topic guide and included a fictional vignette. They were analysed using thematic framework analysis.ResultsAdvance decisions to refuse treatment for suicidal behaviour were contentious across groups. Three main themes emerged from the data: (a) they may enhance patient autonomy and aid clarity in acute emergencies, but also create legal and ethical uncertainty over treatment following self-harm; (b) they are anxiety provoking for clinicians; and (c) in practice, there are challenges in validation (for example, validating the patient’s mental capacity at the time of writing), time constraints and significant legal/ethical complexities.ConclusionsThe potential for patients to refuse life-saving treatment following suicidal behaviour in a legal document was challenging and anxiety provoking for participants. Clinicians should act with caution given the potential for recovery and fluctuations in suicidal ideation. Currently, advance decisions to refuse treatment have questionable use in the context of suicidal behaviour given the challenges in validation. Discussion and further patient research are needed in this area.Declaration of interestD.G., K.H. and N.K. are members of the Department of Health's (England) National Suicide Prevention Advisory Group. N.K. chaired the National Institute for Health and Care Excellence (NICE) guideline development group for the longer-term management of self-harm and the NICE Topic Expert Group (which developed the quality standards for self-harm services). He is currently chair of the updated NICE guideline for Depression. K.H. and D.G. are NIHR Senior Investigators. K.H. is also supported by the Oxford Health NHS Foundation Trust and N.K. by the Greater Manchester Mental Health NHS Foundation Trust.
Safety and Efficacy of Nivolumab in Brain Metastases From Renal Cell Carcinoma: Results of the GETUG-AFU 26 NIVOREN Multicenter Phase II Study
Authors: Flippot Ronan , Dalban Cécile , Laguerre Brigitte , Borchiellini Delphine , Gravis Gwénaelle , Négrier Sylvie , Chevreau Christine , Joly Florence , Geoffrois Lionnel , Ladoire Sylvain , Mahammedi Hakim , Rolland Frédéric , Gross-Goupil Marine , Deluche Elise , Priou Frank , Laramas Mathieu , Barthélémy Philippe , Narciso Bérengère , Houedé Nadine , Culine Stéphane , Oudard Stéphane , Chenot Marina , Tantot Florence , Chabaud Sylvie , Escudier Bernard , Albiges Laurence 
Published: June 2019

PURPOSE Nivolumab is standard of care for patients with metastatic clear cell renal cell carcinoma (ccRCC) after failure of antiangiogenic therapies, but its activity on brain metastases from ccRCC remains unknown, because these patients were excluded from pivotal studies. We aimed to assess the activity of nivolumab in this population. METHODS The GETUG-AFU 26 NIVOREN phase II trial assessed the activity and safety of nivolumab in patients with metastatic ccRCC who failed vascular endothelial growth factor–directed therapies ( ClinicalTrials.gov identifier: NCT03013335 ). Patients with asymptomatic brain metastases were prospectively identified and underwent dedicated brain evaluation. Two cohorts were constituted: cohort A comprised patients with previously untreated brain metastases, and cohort B comprised patients whose brain metastases underwent prior therapy. The primary end point was intracranial response rate in cohort A. RESULTS Seventy-three patients with brain metastases were included: 39 in cohort A and 34 in cohort B. Intracranial response rate was 12% in cohort A; no objective response was reported in patients with brain lesions that were multiple or larger than 1 cm. Median intracranial progression-free survival was 2.7 months (95% CI, 2.3 to 4.6 months) in cohort A and 4.8 months (95% CI, 3.0 to 8.0 months) in cohort B, with adjusted hazard ratio of 2.04 (95% CI, 1.08 to 3.83). Overall survival rate at 12 months was 67% (95% CI, 49.6% to 79.1%) in cohort A and 59% (95% CI, 40.6% to 73.2%) in cohort B. Most patients in cohort A (72%) needed subsequent focal brain therapy. Nivolumab was well tolerated, with no unexpected toxicity. CONCLUSION Nivolumab activity is limited in patients with untreated brain metastases from ccRCC. Brain imaging and focal therapy should be considered before immune checkpoint inhibitors in patients with metastatic ccRCC.
Effects of the Timing of Sex-Steroid Exposure in Adolescence on Adult Health Outcomes
Authors: Chan Yee-Ming , Feld Amalia , Jonsdottir-Lewis Elfa 
Published: June 2019

AbstractContextVariation in pubertal timing is associated with a wide range of adult risks and outcomes, but it is unclear whether these associations are causal, and it is largely unknown whether these associations can be modified by treatment.Evidence AcquisitionWe conducted PubMed searches to identify Mendelian randomization (MR) studies on the influence of pubertal timing on adult health and studies on sex-steroid treatment of the following conditions associated with reduced reproductive endocrine function in adolescence: constitutional delay, Turner syndrome, and Klinefelter syndrome.Evidence SynthesisResults of MR studies suggest that earlier pubertal timing increases body mass index; increases risk for breast, ovarian, endometrial, and prostate cancers; elevates fasting glucose levels and blood pressure; impairs lung capacity and increases risk for asthma; leads to earlier sexual intercourse and first birth; decreases time spent in education; and increases depressive symptoms in adolescence. Later pubertal timing appears to lower bone mineral density (BMD). Although studies of constitutional delay have not shown that sex-steroid treatment alters adult height or BMD, studies of girls with Turner syndrome and boys with Klinefelter syndrome suggest that earlier initiation of sex-steroid treatment improves physical and neurocognitive outcomes.ConclusionsDespite having some limitations, MR studies suggest that pubertal timing causally influences many adult conditions and disease risks. Studies of Turner syndrome and Klinefelter syndrome suggest that earlier sex-steroid exposure may have short- and long-term benefits. The mechanisms underlying these findings and the effects of trends and treatments affecting pubertal timing remain to be determined.
Autism seminary for public engagement: evaluation of knowledge and attitudes of traditional medical practitioners in Mali
Authors: Sangare Modibo , Dembele Bakary , Toure Amadou , Diakite Seidina , Awandare Gordon , Kouyate Modibo , Doumbia Seydou , Diakite Mahamadou , Togora Arouna , Coulibaly Souleymane , Dolo Housseini 
Published: June 2019

Background: Autism spectrum disorders (ASD) are stigmatizing in Africa and traditional medical practitioners occupy the first line of diagnosis and treatment due to the cultural perception of ASD, and the scarcity of conventional health services in Mali. We aimed to assess the knowledge, attitudes, and practices (KAP) concerning autism among traditional medical practitioners in Bamako, Mali. Methods: We conducted a 6-week cross-sectional survey following a 1-day autism awareness seminary on September 9th, 2017 in Bamako. A questionnaire was designed to assess the KAP regarding autism. To assess their practices, parents of autistic children were asked about their experiences with traditional medical practitioners. Results: Of the 37 study participants 67.60% were males and 56.8% had not heard about autism before the seminary. After the seminary, 73% claimed to understand the diagnosis criteria of autism, but only 16.2% could recall symptoms from all the three domains (reciprocal social interaction, verbal and nonverbal communication, and stereotyped behaviors/restricted interests) of a child development impaired by autism. Of traditional medical practitioners, 73% believed autism was caused by devils, God’s will, bad luck and divine punishment of maternal misbehavior; 65% were used to treating mental illness, and 78.4% felt traditional healing was the only treatment option in autism. Negative attitudes towards autistic children were present in 18.9%, suggesting a very strong cultural mindset on autism. Conclusion: Knowledge on autism was poor among traditional medical practitioners. A culturally tailored autism public engagement strategy is necessary to positively change the mindset of Malian traditional medical practitioners.
Cost-effectiveness of invasive devices versus non-invasive devices for screening of anemia in field settings in India: A study protocol
Authors: Neogi Sutapa Bandyopadhyay , John Denny , Sharma Jyoti , Kar Rakhee , Kar Sitanshu Sekhar , Bhattacharya Maitreyee , Tiwari Kartavya , Saxena Renu 
Published: June 2019

In India, an estimated 53% of women and 58% of children are anemic. The accuracy of Sahli’s hemoglobinometer, commonly used for detecting anemia in public health settings, is questionable. This study presents the protocol for assessment of cost and cost effectiveness of devices for screening of anemia using invasive devices (HemoCue 301 and True Hb), and non-invasive devices (AJO Spectroscopic Test and Masimo Pulse Oximetery test) compared to automated auto-analyser (reference test). The study population will include all adult patients attending the outpatient department in urban/rural health centres for routine investigations. Each included patient will undergo either one or two index tests apart from the reference test, on a predefined weekly schedule to avoid bias. The total and incremental costs of the intervention will be measured prospectively by measuring both screening and provider costs. Since the priority of the national program is detection of severe anemia, detection rates of anemia and severe anemia will be considered to calculate effectiveness. Cost comparisons of median, average and range of costs across the invasive and non-invasive devices will be calculated. Cost-effectiveness analysis will be compared for four devices within time horizon of 1 year. Ethics approval for the study has been obtained from the institutional ethics committees of the hospitals. The study protocol will generate evidence on the use of cost effectiveness of medical devices to influence policy decisions.
The evaluation of potato virus Y transfer by some beneficial bugs (Hemiptera: Heteroptera)
Authors: PAZYUK IRINA M , FOMINYKH TATYANA S 
Published: June 2019

Abstract. Pazyuk IM, Fominykh TS. 2019. The evaluation of potato virus Y transfer by some beneficial bugs (Hemiptera: Heteroptera). Biodiversitas 20: 1222-1227. The predatory bugs Podisus maculiventris, Orius majusculus, Nesidiocoris tenuis, and Macrolophus pygmaeus were commonly used for control of pests in potato meristem culture in greenhouses. In this study, the risk of transmission of potato virus Y (PVY) by entomophagous bugs was estimated in cage experiments. It has been shown that none of the bugs tested was capable of transmitting the PVY. However, N. tenuis and M. pygmaeus have been shown to damage potato seedlings in the absence of animal food (pests or factitious food). The bug N. tenuis caused severer damage to potato plants than did the bug M. pygmaeus. Therefore, we can recommend only P. maculiventris and O. majusculus for pest control in potato meristem culture in greenhouses.