bluuebunny/crossref_metadata_2025_split huggingface dataset:
High risk of permanent stoma after anastomotic leakage in anterior resection for rectal cancer
Authors: Jutesten H. , Draus J. , Frey J. , Neovius G. , Lindmark G. , Buchwald P. , Lydrup M. L. 
Published: November 2018

AbstractAimThis study investigates how often bowel continuity was restored after anastomotic leakage in anterior resection for rectal cancer and assesses the clinical factors associated with permanent stoma.MethodThe Swedish Colorectal Cancer Registry was used to identify cases of anastomotic leakage registered in southern Sweden between January 2001 and December 2011. Patient characteristics, surgical details and clinical information about the anastomotic leakages were retrieved from medical records.ResultsOf the 1442 patients operated on with anterior resection in 11 hospitals, 144 (10%) were diagnosed with anastomotic leakage after anterior resection for rectal cancer. After a median follow‐up of 87 months (range 21–165), the overall rate of permanent stoma among patients with anastomotic leakage was 65%. Age ≥ 70 years (P = 0.02) and re‐laparotomy (P < 0.001) were independently related to permanent stoma. Compared with nondefunctioned patients with anastomotic leakage, defunctioned patients with anastomotic leakage at the index procedure less often required re‐laparotomy at some point during the entire clinical course (P < 0.001), but nondefunctioned and defunctioned patients with anastomotic leakage both had permanent stoma to the same extent (67% and 62%, respectively).ConclusionAnastomotic leakage is highly associated with permanent stoma after anterior resection, especially in patients aged ≥ 70 years. In this cohort of patients with anastomotic leakage, 65% had permanent stoma at long‐term follow‐up. A defunctioning stoma ameliorates the clinical course but does not affect the end result of bowel continuity in established anastomotic leakage after anterior resection.
Feeding and swallowing impairment in children with stroke and unilateral cerebral palsy: a systematic review
Authors: Sherman Victoria , Greco Elissa , Moharir Mahendranath , Beal Deryk , Thorpe Kevin , Martino Rosemary 
Published: November 2018

AimThis systematic review targeted frequency estimates of dysphagia (feeding and swallowing problems), related health outcomes, and caregiver burden in children with stroke or unilateral cerebral palsy (CP).MethodSix electronic databases were searched from their inception to November 2017 along with a manual search of eight relevant journals. Two blinded raters assessed abstracts and full articles for eligibility. Discrepancies were resolved by consensus. Accepted articles were evaluated for quality. Data were extracted and analysed descriptively.ResultsOf 1660 abstracts, five met inclusion criteria, of which three focused on stroke and two unilateralCP. Across studies, operational definitions of feeding and swallowing varied. Insufficient details were provided on assessment methods and timing. Reported frequencies of dysphagia ranged from 24.2% to 88.6%. One study reported dysphagia‐related health outcomes and none reported caregiver burden.InterpretationThese results suggest that dysphagia is common in children with stroke and unilateralCP; however, its frequency is yet unknown as is its impact on health and caregiver burden. Availability of a standardized tool to identify dysphagia in these children accurately is a recommended first step to address this evidence gap.What this paper addsThere is limited data on the incidence of dysphagia after childhood stroke and unilateral cerebral palsy.Available evidence shows reported dysphagia frequencies from 24.2% to 88.6%.Only one study reported on dysphagia‐related health outcomes.No study reported on caregiver burden.
Prevalence and predictors of gestational diabetes mellitus: a nationwide multicentre prospective study
Authors: Aydın H. , Çelik Ö. , Yazıcı D. , Altunok Ç. , Tarçın Ö. , Deyneli O. , Sancak S. , Kıyıcı S. , Aydın K. , Yıldız B.O. ,   the TURGEP Study Group
Published: November 2018

AbstractAimPrevalence rates of gestational diabetes mellitus (GDM) show considerable variation among different countries and regions of the world. The primary aim of this study was to determine the nationwide prevalence and predictors of GDM in Turkey.MethodsWe conducted prospective nationwide screening among pregnant women. Between August 2016 and November 2017, a total of 2643 pregnant women from 51 centres in 12 different regions were enrolled. A two‐step screening method and Carpenter and Coustan criteria were used in the diagnosis of GDM. Clinical and biochemical data were obtained using electronic database software.ResultsThe national prevalence of GDM was found to be 16.2% [95% confidence intervals (CI) 15.0% to 17.4%] without a significant difference between urban and rural regions. Women with GDM were older (mean age: 32 ± 5 vs. 28 ± 5 years, P < 0.001) and heavier (mean BMI: 27.2 ± 5.1 vs. 24.7 ± 4.7 kg/m2, P < 0.001) than their counterparts without GDM. The prevalence of GDM tended to increase with age (< 25 years, 6.9%; 26–35 years, 15.6%; and 36–45 years, 32.7%; P < 0.001). Maternal age, maternal BMI, history of previous GDM and family history of diabetes mellitus were independent predictors of developing GDM (P < 0.05 for all). Low‐risk women (age < 25 years, BMI < 25 kg/m2, no family history of diabetes) comprised 10.7% of the total population and the prevalence of GDM in these women was 4.5% (95% CI 2.4% to 7.8%).ConclusionThe results of this nationwide study indicate that GDM is very common, affecting one in seven pregnancies in Turkey. Implementation of international guidelines on screening and management of this public health problem is required.
Evidence‐based diabetes care for older people with Type 2 diabetes: a critical review
Authors: Sinclair A. J. , Abdelhafiz A. H. , Forbes A. , Munshi M. 
Published: November 2018

AbstractIn our ageing society diabetes imposes a significant burden in terms of the numbers of people with the condition, diabetes‐related complications including disability, and health and social care expenditure. Older people with diabetes can represent some of the more complex and difficult challenges facing the clinician working in different settings, and the recognition that we have only a relatively small (but increasing) evidence base to guide us in diabetes management is a limitation of our current approaches. Nevertheless, in this review we attempt to explore what evidence there is to guide us in a comprehensive scheme of treatment for older adults, often in a high‐risk clinical state, in terms of glucose lowering, blood pressure and lipid management, frailty care and lifestyle interventions. We strive towards individualized care and make a call for action for more high‐quality research using different trial designs.
Two‐dimensional speckle tracking to image ventricular‐arterial coupling in uremia
Authors: Ye Fu‐Yong , Liang Yin‐Ting , Lin Xiao‐Chun 
Published: November 2018

ObjectiveTo study ventricular‐arterial coupling(VAC) in uremic patients by application of two‐dimensional speckle tracing imaging (2DSTI).MethodsOne hundred uremic patients were divided into two groups based on left ventricular ejection fraction (LVEF): group 1 with LVEF ≥ 5%, and group 2 with LVEF < 55%. Forty healthy subjects were recruited as a control group. Conventional echocardiography was performed; VAC components and myocardial performance index were calculated. Longitudinal strain (LS) of 17 segments was measured using 2DSTI. Mean base (LSBA), papillary muscle (LSPM), and apex values (LSAP) were calculated.ResultsCompared to subjects in the control group and group 1, subjects in group 2 exhibited decreased LV end‐diastolic volume (EDV), end‐systolic volume (ESV), LV mass index (LVMI), and VAC (P < 0.05). EF, fractional shortening (FS), end‐systolic elastance (Ees) were significantly higher in group 2 (P < 0.05). SLBA, SLPM, and SLAP differed significantly among the groups (all P < 0.05). SLBA, SLPM, and SLAP correlated positively with Ees, EF, and FS (all P < 0.05) but negatively with arterial elastance (Ea), VAC, systemic vascular resistance index (SVRI), and rate‐pressure product (RPP) (all P < 0.05). Multiple regression analysis revealed that relative wall thickness (RWT), LVMI, LSAP, and stroke works (SW) were independent predictors of VAC (b′ = −0.443, 0.537, −0.470, and −0.491, all P < 0.05).ConclusionsIn patients with uremia, LV myocardial LS gradually decreased as LV systolic dysfunction decreased. VAC correlated negatively with left ventricular LS, and LSAP was an independent predictor for VAC.
Periodicity, repression, and the molecular architecture of the mammalian circadian clock
Authors: Rosensweig Clark , Green Carla B. 
Published: November 2018

AbstractLarge molecular machines regulate daily cycles of transcriptional activity and help generate rhythmic behavior. In recent years, structural and biochemical analyses have elucidated a number of principles guiding the interactions of proteins that form the basis of circadian timing. In its simplest form, the circadian clock is composed of a transcription/translation feedback loop. However, this description elides a complicated process of activator recruitment, chromatin decompaction, recruitment of coactivators, expression of repressors, formation of a repressive complex, repression of the activators, and ultimately degradation of the repressors and reinitiation of the cycle. Understanding the core principles underlying the clock requires careful examination of molecular and even atomic level details of these processes. Here, we review major structural and biochemical findings in circadian biology and make the argument that shared protein interfaces within the clockwork are critical for both the generation of rhythmicity and timing of the clock.
Naltrexone differentially modulates the neural correlates of motor impulse control in abstinent alcohol‐dependent and polysubstance‐dependent individuals
Authors: Nestor Liam J. , Paterson Louise M. , Murphy Anna , McGonigle John , Orban Csaba , Reed Laurence , Taylor Eleanor , Flechais Remy , Smith Dana , Bullmore Edward T. , Ersche Karen D. , Suckling John , Elliott Rebecca , Deakin Bill , Rabiner Ilan , Lingford Hughes Anne , Sahakian Barbara J. , Robbins Trevor W. , Nutt David J. ,   ICCAM Consortium
Published: November 2018

AbstractIdentifying key neural substrates in addiction disorders for targeted drug development remains a major challenge for clinical neuroscience. One emerging target is the opioid system, where substance‐dependent populations demonstrate prefrontal opioid dysregulation that predicts impulsivity and relapse. This may suggest that disturbances to the prefrontal opioid system could confer a risk for relapse in addiction due to weakened ‘top‐down’ control over impulsive behaviour. Naltrexone is currently licensed for alcohol dependence and is also used clinically for impulse control disorders. Using a go/no‐go (GNG) task, we examined the effects of acute naltrexone on the neural correlates of successful motor impulse control in abstinent alcoholics (AUD), abstinent polysubstance‐dependent (poly‐SUD) individuals and controls during a randomised double blind placebo controlled fMRI study. In the absence of any differences on GNG task performance, the AUD group showed a significantly greater BOLD response compared to the control group in lateral and medial prefrontal regions during both placebo and naltrexone treatments; effects that were positively correlated with alcohol abstinence. There was also a dissociation in the positive modulating effects of naltrexone in the orbitofrontal cortex (OFC) and anterior insula cortex (AIC) of the AUD and poly‐SUD groups respectively. Self‐reported trait impulsivity in the poly‐SUD group also predicted the effect of naltrexone in the AIC. These results suggest that acute naltrexone differentially amplifies neural responses within two distinct regions of a salience network during successful motor impulse control in abstinent AUD and poly‐SUD groups, which are predicted by trait impulsivity in the poly‐SUD group.
Soil aggregates as biogeochemical reactors and implications for soil–atmosphere exchange of greenhouse gases—A concept
Authors: Wang Bin , Brewer Paul E. , Shugart Herman H. , Lerdau Manuel T. , Allison Steven D. 
Published: November 2018

AbstractSoil–atmosphere exchange significantly influences the global atmospheric abundances of carbon dioxide (CO2), methane (CH4), and nitrous oxide (N2O). These greenhouse gases (GHGs) have been extensively studied at the soil profile level and extrapolated to coarser scales (regional and global). However, finer scale studies of soil aggregation have not received much attention, even though elucidating the GHG activities at the full spectrum of scales rather than just coarse levels is essential for reducing the large uncertainties in the current atmospheric budgets of these gases. Through synthesizing relevant studies, we propose that aggregates, as relatively separate micro‐environments embedded in a complex soil matrix, can be viewed as biogeochemical reactors of GHGs. Aggregate reactivity is determined by both aggregate size (which determines the reactor size) and the bulk soil environment including both biotic and abiotic factors (which further influence the reaction conditions). With a systematic, dynamic view of the soil system, implications of aggregate reactors for soil–atmosphere GHG exchange are determined by both an individual reactor's reactivity and dynamics in aggregate size distributions. Emerging evidence supports the contention that aggregate reactors significantly influence soil–atmosphere GHG exchange and may have global implications for carbon and nitrogen cycling. In the context of increasingly frequent and severe disturbances, we advocate more analyses of GHG activities at the aggregate scale. To complement data on aggregate reactors, we suggest developing bottom‐up aggregate‐based models (ABMs) that apply a trait‐based approach and incorporate soil system heterogeneity.
Disability studies and development geography: Empirical connections, theoretical resonances, and future directions
Authors: Jampel Catherine , Bebbington Anthony 
Published: November 2018

AbstractScholarship that jointly considers disability and development has advanced over the past decade to include greater attention to the shared histories of colonialism, racism, and the disability category and the relationships among developmental states, ideas about disability, and development projects. A handful of geographers have also directly addressed disability and development or disability in the “developing world” context. This paper reviews current scholarship and highlights three areas where disability studies and development geography share under‐explored empirical connections and theoretical resonances: the disability–poverty nexus, interventions in the name of improvement and cure, and mobility and migration. Yet bringing greater attention to disability in development must be done carefully, given the fraught nature of the disability category. As such, this paper also considers how development geographers might contribute to the literature while accounting for the ways in which ideas about what constitutes “disability” and what constitutes “development” emerge through sets of processes and relationships.
Concizumab restores thrombin generation potential in patients with haemophilia: Pharmacokinetic/pharmacodynamic modelling results of concizumab phase 1/1b data
Authors: Eichler Hermann , Angchaisuksiri Pantep , Kavakli Kaan , Knoebl Paul , Windyga Jerzy , Jiménez‐Yuste Victor , Harder Delff Philip , Chowdary Pratima 
Published: November 2018

IntroductionConcizumab enhances thrombin generation (TG) potential in haemophilia patients by inhibiting tissue factor pathway inhibitor (TFPI). In EXPLORER3 (phase 1b), a dose‐dependent pharmacokinetic/pharmacodynamic (PK/PD) relationship was confirmed between concizumab dose, free TFPI and TG potential.AimDetermine the association between concizumab exposure, PD markers (free TFPI; peak TG) and bleeding episodes to establish the minimum concizumab concentration for achieving sufficient efficacy.MethodsFree TFPI predictions were generated using an estimated concizumab‐free TFPI exposure‐response (Emax) model based on concizumab phase 1/1b data for which simultaneously collected concizumab and free TFPI samples were available. Concizumab concentration at the time of a bleed was predicted using a PK model, based on available data for concizumab doses >50 μg/kg to ≤9 mg/kg. Peak TG vs concizumab concentration analyses and an Emax model were constructed based on EXPLORER3 observations.ResultsThe Emax model showed a tight PK/PD relationship between concizumab exposure and free TFPI; free TFPI decreased with increasing concizumab concentration. A strong correlation between concizumab concentration and peak TG was observed; concizumab >100 ng/mL re‐established TG potential to within the normal reference range. Estimated EC50 values for the identified concizumab‐free TFPI and concizumab‐TG potential models were very similar, supporting free TFPI as an important biomarker. A correlation between bleeding episode frequency and concizumab concentration was indicated; patients with a concizumab concentration >100 ng/mL experienced less frequent bleeding. The PK model predicted that once‐daily dosing would minimize within‐patient concizumab PK variability.ConclusionConcizumab phase 2 trials will target an exposure ≥100 ng/mL, with a once‐daily regimen.
Comparison of biocompatibility in polysulfone dialysis membranes with different sterilization
Authors: Togo Konomi , Yamamoto Masahito , Ono Takahisa , Imai Motoyuki , Akiyama Keiichi , Ebine Kunio , Yamashita Akihiro C. 
Published: November 2018

AbstractIntroduction: Polysulfone (PSf) membrane has been widely used for hemodialysis. A few studies have been reported in which a method of sterilization may affect biocompatibility. In this study, the comparison was made between two PSf membranes in order to evaluate the effect of sterilization from the biocompatibility point of view.Methods: We investigated the biocompatibility of the following two dialyzers, that is, APS‐11SA (Asahi Kasei medical Co., Tokyo, Japan), sterilized by gamma‐ray irradiation, and RENAK PS‐1.0 (Kawasumi laboratories, Tokyo, Japan), sterilized by autoclave. Heparin of 40 units/mL was put in a syringe, and test blood was collected from healthy volunteers. Then, the dialyzer and blood circuit were filled with the test blood. Subsequently, the blood was circulated by a roller pump at the rate of 200 mL/min. We measured the platelet counts, CD41 and CD42b platelet surface markers, beta‐thromboglobulin (beta‐TG) and platelet factor 4 (PF4) at 30, 120, and 240 minutes, respectively.Findings: The platelet counts at 30, 120, and 240 minutes decreased significantly from the initiation of blood circulation in both dialyzers. The average beta‐TG and PF4 increased from 61.3 ± 22.1 and 17.0 ± 6.4 ng/mL to 680.7 ± 217.1 and 550.7 ± 116.7 ng/mL with APS‐11SA and to 454.3 ± 85.6 and 402.0 ± 58.0 ng/mL with RENAK PS‐1.0, respectively. The average expression of CD41 and CD42b in APS‐11SA and RENAK PS‐1.0 was similar.Discussion: There are some reports that the gamma‐ray irradiation changes the membrane structure of the PSf membrane, crosslinking the polyvinylpyrrolidone (PVP), a hydrophilic agent, on to the membrane. On the other hand, excess amount of PVP may have been eluted during the rinsing procedure in RENAK PS‐1.0 because it was sterilized with autoclave. Because both these factors influenced on our results, APS‐11SA and RENAK PS‐1.0 dialyzers showed excellent blood compatibility.
Recruitment of CCR6+ Foxp3+ regulatory gastric infiltrating lymphocytes in Helicobacter pylori gastritis
Authors: Wu Yi‐Ying , Hsieh Chin‐Tung , Tsay Gregory J. , Kao Jung‐Ta , Chiu Ying‐Ming , Shieh Dong‐Chen , Lee Yi‐Ju 
Published: November 2018

AbstractHelicobacter pylori (H. pylori) infection is associated with an inflammatory response in the gastric mucosa, leading to chronic gastritis, peptic ulcers, and gastric cancer. Increased T‐cell infiltration is found at sites of H. pylori infection. The CCR6+ subset of CD4+ regulatory T cells (Tregs), a newly characterized subset of Tregs, has been reported to contribute to local immune inhibition. However, whether CCR6+ Tregs are present in H. pylori gastritis, and what their relationship is to disease prognosis, remains to be elucidated. In this study, gastric infiltrating lymphocytes were isolated from endoscopic biopsy specimens of H. pylori gastritis patients and analyzed. We found that in gastric infiltrating lymphocytes, CCR6+ CD4+ CD25high Tregs, which express high levels of CD45RO, are positively associated with more severe inflammation in gastric mucosa during H. pylori infection. Furthermore, the frequency of CCR6+ Tregs in gastric infiltrating lymphocytes, but not CCR6− Tregs, is significantly increased in inflamed gastric tissues, which is inversely correlated with significantly lower expression of IFN‐γ+ CD8+ T cells. We also found that the frequency of CCR6+ Tregs is positively correlated with the frequency of CD4+ IFN‐γ+ T cells. In addition, the frequency of CCR6+ Tregs, but not that of CCR6− Tregs, is significantly correlated with increased inflammation in H. pylori gastritis. This study demonstrates that immunosuppression in H. pylori gastritis might be related to the activity of CCR6+ Tregs, which could influence disease prognosis.
Evaluation of the potential use of discard species for fish silage and assessment of its oils for human consumption
Authors: Özyurt Gülsün , Özkütük Ali Serhat , Uçar Yılmaz , Durmuş Mustafa , Ozogul Yesim 
Published: November 2018

SummaryWaste or by‐products contains a substantial amount of nutrients. Fish silage is an alternative way for assessment of fish discards and waste generated in the fish processing industries. The aim of the study was to evaluate the potential use of discard species (Equulites klunzingeri, marine fish and Carassius gibelio, freshwater fish) for fish silage and chemical quality of fish oil extracted from fish silages prepared with acid and fermented methods. Lipid quality of fish oils extracted from fish silages with LAB strains was evaluated in terms of thiobarbituric acid (TBA), peroxide value (PV), p‐Anisidine (AV), totox values and fatty acid composition. The results showed that PV, TBA, AV and totox values of all extracted fish oils were within the acceptable limits for edible oils. Recovered fish oils from silage contained high level of polyunsaturated fatty acids (PUFAs), especially eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), serving as a source of good quality fish oil for human consumption.
Effects of green tea powder on the quality attributes of hard red winter wheat flour and Chinese steamed bread
Authors: Ning Jingming , Hou Gary G. , Sun Jingjing , Zhang Zhengzhu , Wan Xaiochun 
Published: November 2018

SummaryThe effects of green tea powder (GTP) on the properties of hard red winter (HRW) flour and Chinese steamed bread were investigated. GTP was blended with HRW flour at levels of 0.00, 1.00, 2.00, 3.00 and 4.00 g GTP/100 g wheat flour. With the addition of GTP, the maximum torque of flour became stronger. The resilience and degree of green colour of steamed bread increased, while hardness and chewiness decreased, with the addition of GTP. The addition of 1.00% GTP did not significantly affect the specific volume, but remarkably influenced the hardness and resilience of steamed bread. In steamed bread formulated with GTP, the antioxidant activity was 0.84 mm TE per g at 1.00% of GTP and increased with GTP levels. The steamed bread had a pleasant flavour, and the degree of overall liking of steamed bread increased with GTP levels to the maximum used in this work.