bluuebunny/crossref_metadata_2025_split huggingface dataset:
Minimally invasive transanal surgery is safe after incomplete polypectomy of low risk T1 rectal cancer: a systematic review
Authors: de Jong G. M. , Hugen N. 
Published: May 2019

AbstractAimIn patients who have undergone a polypectomy of a malignant rectal polyp without histopathological risk factors other than an involved or unclear resection margin, additional local excision is often performed. Evidence to support this approach is lacking. The aim of this systematic review and meta‐analysis was to determine the outcome in terms of local recurrence, disease‐free survival (DFS) and overall survival (OS) of additional local excision following incomplete polypectomy for low risk T1 rectal cancer.MethodsA comprehensive search for published studies was performed. Only studies in which there was incomplete (or ≤ 1 mm) removal of pT1 rectal polyps or in which the resection plane could not be assessed were included. For each included study data on tumour stage, histological factors, surgical technique, local recurrence rate, 5‐year DFS and 5‐year OS were extracted. The PROSPERO registration number is CRD42017062702.ResultsA total of 580 studies were retrieved by the search in the MEDLINE database, Embase and the Cochrane Library. After careful appreciation, four studies were included in the analysis, comprising 102 patients of whom the majority had undeterminable (Rx) resection margins. Local excision via transanal endoscopic microsurgery was reported most frequently. Only 1% of patients developed a local recurrence. One study reported 5‐year DFS and 5‐year OS of 96% and 87% respectively.ConclusionThis study supports the use of additional local excision techniques for rectal cancer patients who underwent an incomplete polypectomy for a malignant rectal polyp in the absence of risk factors other than an uncertain resection margin.
Addition of canagliflozin to insulin improves glycaemic control and reduces insulin dose in patients with type 2 diabetes mellitus: A randomized controlled trial
Authors: Torimoto Keiichi , Okada Yosuke , Goshima Yukiko , Tokutsu Akemi , Sato Yasunori , Tanaka Yoshiya 
Published: May 2019

AbstractThe aim of this study was to evaluate the efficacy of canagliflozin in reducing the required insulin dose and the risk of hypoglycaemia in type 2 diabetes (T2D). This study was conducted in patients with T2D treated with insulin. They were randomly assigned to the control (n = 17) and canagliflozin (n = 17, plus 100 mg/day canagliflozin) groups. In both groups, a defined insulin dose adjustment protocol was applied to achieve the same level of glycaemic control. The change from baseline in daily insulin dose was significantly smaller in the canagliflozin group (3.9 units/day) than in the control group (13.4 units/day; P = 0.040). Low blood glucose index and predicted % of blood glucose (BG) <70 mg/dL, which are hypoglycaemia‐related variables, worsened significantly in the control group but both remained unchanged in the canagliflozin group. The standard deviation for night‐time BG levels improved significantly only in the canagliflozin group. Supplementation of insulin therapy with 100 mg canagliflozin in patients with T2D reduced the required insulin dose and hypoglycaemic risk and flattened night‐time glycaemic fluctuations while maintaining the same level of glycaemic control.
Human Memory and the Limits of Technology in Education
Authors: Puddifoot Katherine , O'Donnell Cian 
Published: May 2019

AbstractHuman memory systems perform various functions beyond simple storage and retrieval of information. They link together information about events, build abstractions, and perform memory updating. In contrast, typical information storage and access technologies, such as note‐taking applications and Wikipedia, tend to store information verbatim. In this article, Katherine Puddifoot and Cian O'Donnell use results from cognitive psychology, neuroscience, and machine learning to argue that the increased dependence on such technologies in education may come at a price: the missed opportunity for memory systems of student learners to form abstractions and insights from newly learned information. This conclusion has important implications for how technologies should be adopted in education.
More salt, please: global patterns, responses and impacts of foliar sodium in grasslands
Authors: Borer E. T. , Lind E. M. , Firn J. , Seabloom E. W. , Anderson T. M. , Bakker E. S. , Biederman L. , La Pierre K. J. , MacDougall A. S. , Moore J. L. , Risch A. C. , Schutz M. , Stevens C. J. 
Published: May 2019

AbstractSodium is unique among abundant elemental nutrients, because most plant species do not require it for growth or development, whereas animals physiologically require sodium. Foliar sodium influences consumption rates by animals and can structure herbivores across landscapes. We quantified foliar sodium in 201 locally abundant, herbaceous species representing 32 families and, at 26 sites on four continents, experimentally manipulated vertebrate herbivores and elemental nutrients to determine their effect on foliar sodium. Foliar sodium varied taxonomically and geographically, spanning five orders of magnitude. Site‐level foliar sodium increased most strongly with site aridity and soil sodium; nutrient addition weakened the relationship between aridity and mean foliar sodium. Within sites, high sodium plants declined in abundance with fertilisation, whereas low sodium plants increased. Herbivory provided an explanation: herbivores selectively reduced high nutrient, high sodium plants. Thus, interactions among climate, nutrients and the resulting nutritional value for herbivores determine foliar sodium biogeography in herbaceous‐dominated systems.
On Quantile‐based Asymmetric Family of Distributions: Properties and Inference
Authors: Gijbels Irène , Karim Rezaul , Verhasselt Anneleen 
Published: May 2019

SummaryIn this paper, we provide a detailed study of a general family of asymmetric densities. In the general framework, we establish expressions for important characteristics of the distributions and discuss estimation of the parameters via method‐of‐moments as well as maximum likelihood estimation. Asymptotic normality results for the estimators are provided. The results under the general framework are then applied to some specific examples of asymmetric densities. The use of the asymmetric densities is illustrated in a real‐data analysis.
Channel coordination with price discount mechanism under price‐sensitive market demand
Authors: Sarkar Sumon , Tiwari Sunil , Wee Hui‐Ming , Giri B.C. 
Published: May 2019

AbstractThis paper considers a two‐echelon supply chain with single vendor single buyer for trading a single product. The buyer's demand has been assumed to be price‐sensitive. We have assumed three‐level inspection at the vendor's end in order to maintain good quality of the items delivered to the buyer. We have developed models for both decentralized and centralized scenarios and have determined the optimal solution using the basic concepts of analytic geometry and algebra. In addition, we have proposed a price discount mechanism, where the vendor has provided discounts on the purchase cost to the buyer against the buyer's (increased) order quantity. Finally, in order to illustrate and validate the proposed model, a numerical example and sensitivity analysis is carried out, which has provided some important managerial implications. It has been observed from the numerical study that the proposed price discount policy coordinates the supply chain and has improved the profitability of the supply chain and its members.
New Tensions over Social Europe? The European Pillar of Social Rights and the Debate within the European Parliament
Authors: Vesan Patrik , Corti Francesco 
Published: May 2019

AbstractIn September 2015, the European Commission launched a new political initiative ‐‐ the European Pillar of Social Rights (EPSR) ‐‐ with the stated aim of strengthening the social acquis of the European Union and promoting upward social convergence across eurozone countries. In January 2017, the European Parliament voted in a resolution supporting the EPSR. This article examines the positioning of the parliamentary political groups to grasp the tensions that emerged during the debate. In so doing, it provides empirical evidence of the existence of a complex ‘clash syndrome’ in European social policies which results from the combination of vertical and horizontal forms of euroscepticism. The main argument is that the coexistence of multiple political tensions may hamper the development of a stronger Social Europe, but may also lead to the emergence of new political coalitions through the ‘criss‐crossing’ of different lines of conflict.
Hyperglycemia in non‐obese patients with type 2 diabetes is associated with low muscle mass: The Multicenter Study for Clarifying Evidence for Sarcopenia in Patients with Diabetes Mellitus
Authors: Sugimoto Ken , Tabara Yasuharu , Ikegami Hiroshi , Takata Yasunori , Kamide Kei , Ikezoe Tome , Kiyoshige Eri , Makutani Yukako , Onuma Hiroshi , Gondo Yasuyuki , Ikebe Kazunori , Ichihashi Noriaki , Tsuboyama Tadao , Matsuda Fumihiko , Kohara Katsuhiko , Kabayama Mai , Fukuda Masahiro , Katsuya Tomohiro , Osawa Haruhiko , Hiromine Yoshihisa , Rakugi Hiromi 
Published: May 2019

AbstractAims/IntroductionHyperglycemia is a risk factor for sarcopenia when comparing individuals with and without diabetes. However, no studies have investigated whether the findings could be extrapolated to patients with diabetes with relatively higher glycemic levels. Here, we aimed to clarify whether glycemic control was associated with sarcopenia in patients with type 2 diabetes.Materials and MethodsStudy participants consisted of patients with type 2 diabetes (n = 746, the average age was 69.9 years) and an older general population (n = 2,067, the average age was 68.2 years). Sarcopenia was defined as weak grip strength or slow usual gait speed and low skeletal mass index.ResultsAmong patients with type 2 diabetes, 52 were diagnosed as having sarcopenia. The frequency of sarcopenia increased linearly with glycated hemoglobin (HbA1c) level, particularly in lean individuals (HbA1c <6.5%, 7.0%, ≥6.5% and <7.0%: 18.5%; HbA1c ≥7.0% and <8.0%: 20.3%; HbA1c ≥8.0%: 26.7%). The linear association was independent of major covariates, including anthropometric factors and duration of diabetes (HbA1c <6.5%: reference; ≥6.5% and <7.0%: odds ratio [OR] 4.38, P = 0.030; HbA1c ≥7.0% and <8.0%: 4.29, P = 0.024; HbA1c ≥8.0%: 7.82, P = 0.003). HbA1c level was specifically associated with low skeletal mass index (HbA1c ≥8.0%: OR 5.42, P < 0.001) rather than weak grip strength (OR 1.89, P = 0.058) or slow gait speed (OR 1.13, P = 0.672). No significant association was observed in the general population with a better glycemic profile.ConclusionsPoor glycemic control in patients with diabetes was associated with low muscle mass.
Co‐infection of rainbow trout (Oncorhynchus mykiss) with infectious hematopoietic necrosis virus and Flavobacterium psychrophilum
Authors: Ma Jie , Bruce Timothy J. , Oliver Luke P. , Cain Kenneth D. 
Published: May 2019

AbstractCo‐infection of rainbow trout with infections haematopoietic necrosis virus (IHNV) and Flavobacterium psychrophilum is known to occur, and it has been speculated that a combined infection can result in dramatic losses. Both pathogens can persist in fish in an asymptomatic carrier state, but the impact of co‐infection has not been well characterized or documented. In this study, it was hypothesized that fish co‐infected with F. psychrophilum and IHNV would exhibit greater mortality than fish infected with either pathogen alone. To test this, juvenile rainbow trout were co‐infected with low doses of either IHNV or F. psychrophilum, and at 2 days post‐initial challenge, they were given a low dose of the reciprocal pathogen. This combined infection caused high mortality (76.2%–100%), while mortality from a single pathogen infection with the same respective dose was low (5%–20%). The onset of mortality was earlier in the co‐infected group (3–4 days) when compared with fish infected with F. psychrophilum alone (6 days) or IHNV (5 days), confirming the synergistic interaction between both pathogens. Co‐infection led to a significant increase in the number of F. psychrophilum colony‐forming units and IHNV plaque‐forming units within tissues. This finding confirms that when present together in co‐infected fish, both pathogens are more efficiently recovered from tissues. Furthermore, pathogen genes were significantly increased in co‐infected groups, which parallel the findings of increased systemic pathogen load. Extensive tissue necrosis and abundant pathogen present intracellularly and extracellularly in haematopoietic tissue. This was pronounced in co‐infected fish and likely contributed to the exacerbated clinical signs and higher mortality. This study provides novel insight into host–pathogen interactions related to co‐infection by aquatic bacterial and viral pathogens and supports our hypothesis. Such findings confirm that mortality in fish exposed to both pathogens is greatly elevated compared to a single pathogen infection.
Mixed species biofilms of Lactobacillus plantarum and Listeria innocua show facilitated entrance to the VBNC state during chlorine‐induced stress
Authors: Olszewska Magdalena A. , Białobrzewski Ireneusz 
Published: May 2019

AbstractBiofilms of Lactobacillus plantarum and Listeria innocua were grown under single‐ and mixed‐culture conditions in a bioreactor with either half‐strength brain heart infusion (BHI) medium or BHI medium with sodium dichloroisocyanurate (150 ppm) for 24 hr. A quantitative approach using plate counts and fluorescence in situ hybridization (FISH) was applied, representing the culturable and viable cells, respectively. Species contribution to the single and mixed species biofilms was similar, reaching ca. 6.5 and 7.0 log cfu (cells)/mL for L. plantarum and L. innocua, respectively. In the presence of chlorine, species contribution to the single or mixed species biofilms was 10‐ to 100‐times lower than in the absence of this chemical for L. plantarum and L. innocua, respectively. Notably, a large difference was observed between the culturable and the viable cells in the mixed species biofilms, reaching 1.5 and 2.5 log units for L. plantarum and L. innocua, respectively. L. innocua achieved almost complete nonculturability during an early stage of biofilm growth in the coculture, indicating that the physiological state of cells was significantly affected not only by chlorine challenge but also by interspecies interactions. Importantly, all biofilms consisted of culturable cells during the late stage of growth, which represented a potential source of contamination.Practical ApplicationsFluorescence‐based methods for bacterial viability measurement have remained useful for a wide diversity of applications. In our study, the approach employing FISH in a parallel with plate counting allowed us to enumerate viable and culturable cells of L. plantarum and L. innocua under either single‐ or mixed‐culture conditions. Thus, we recommend it for accurate estimation of viable but nonculturable cells in the experimental set‐up comprising single‐/mixed‐culture sessile community.
Integrated Home‐ and Community‐Based Services Improve Community Survival Among Independence at Home Medicare Beneficiaries Without Increasing Medicaid Costs
Authors: Valluru Girish , Yudin Jean , Patterson Christine L. , Kubisiak Joanna , Boling Peter , Taler George , De Jonge Karl Eric , Touzell Steve , Danish Ann , Ornstein Katherine , Kinosian Bruce 
Published: May 2019

OBJECTIVESTo determine the effect of home‐based primary care (HBPC) for frail older adults, operating under Independence at Home (IAH) incentive alignment on long‐term institutionalization (LTI).DESIGNCase‐cohort study using HBPC site, Medicare administrative data, and National Health and Aging Trends Study (NHATS) benchmarks.SETTINGThree IAH‐participating HBPC sites in Philadelphia, PA, Richmond, VA, and Washington, DC.PARTICIPANTSHBPC integrated with long‐term services and supports (LTSS) cases (n = 721) and concurrent comparison groups (HBPC not integrated with LTSS: n = 82; no HBPC: n = 573). Cases were eligible if enrolled at one of the three HBPC sites from 2012 to 2015. Independence at Home‐qualified (IAH‐Q) concurrent comparison groups were selected from Philadelphia, PA; Richmond, VA; and Washington, DC.INTERVENTIONHBPC integrated with LTSS under IAH demonstration incentives.MEASUREMENTSMeasurements include LTI rate and mortality rates, community survival, and LTSS costs.RESULTSThe LTI rate in the three HBPC programs (8%) was less than that of both concurrent comparison groups (IAH‐Q beneficiaries not receiving HBPC, 16%; patients receiving HBPC but not in the IAH demonstration practices, 18%). LTI for patients at each HBPC site declined over the three study years (9.9%, 9.4%, and 4.9%, respectively). Costs of home‐ and community‐based services (HCBS) were nonsignificantly lower among integrated care patients ($2151/mo; observed‐to‐expected ratio = .88 [.68‐1.09]). LTI‐free survival in the IAH HBPC group was 85% at 36 months, extending average community residence by 12.8 months compared with IAH‐q participants in NHATS.CONCLUSIONHBPC integrated with long‐term support services delays LTI in frail, medically complex Medicare beneficiaries without increasing HCBS costs.
A multi‐center comparative efficacy and safety study of two different hyaluronic acid fillers for treatment of nasolabial folds in a Chinese population
Authors: Li Dong , Sun Jiaming , Wu Sufan 
Published: May 2019

SummaryBackgroundNonsurgical injectable treatments, including hyaluronic acid (HA) fillers, are increasingly used in Asian patients.AimsTo demonstrate the efficacy and safety of Restylane Lyft compared to Restylane for the correction of nasolabial folds (NLFs).Patients/MethodsThis was a randomized, evaluator‐blinded, split‐face, 12‐month study conducted in China using Restylane Lyft in the aesthetic correction of moderate to severe NLFs among adult subjects. One NLF was treated with Restylane Lyft, and the opposite NLF with the comparator Restylane. Efficacy outcomes included improvement in the Wrinkle Severity Rating Scale (WSRS) and aesthetic improvement (using the Global Aesthetic Improvement Scale [GAIS] assessed by the subject and blinded evaluator) for each treatment at Months 3, 6 (primary objective based on WSRS), 9, and 12. Safety was evaluated by the incidence of injection site reactions and adverse events (AEs).ResultsA total of 100 subjects were randomized to the treatments. Noninferiority for Restylane Lyft was established according to blinded evaluation of WSRS at 6 months after last treatment. Similarly, the WSRS improved throughout the study, and the responder rate (improvement in WSRS of ≥1 grade from Baseline) was sustained after 6 months (64% and 65% for NLFs treated with Restylane and Restylane Lyft, respectively). For GAIS after 6 months, improvement was approximately 80% in both groups. No treatment‐related serious AEs were reported. The safety profiles were similar between the two treatments.ConclusionsSimilar to Restylane, Restylane Lyft was effective and well tolerated for treatment of moderate to severe NLFs in this Chinese population.
Whitening effects of cosmetic formulation in the vascular component of skin pigmentation
Authors: Pereira Andréia Feital Costa , Igarashi Mamy Honda , Mercuri Maurizio , Pereira Amanda Francielli , Pinheiro Ana Lucia Tabarini Alves , da Silva Michelle Sabrina , Facchini Gustavo , Eberlin Samara 
Published: May 2019

AbstractBackgroundMelanin plays an important role in protecting the skin against the harmful effects of solar radiation, but its abnormal accumulation may become an aesthetic problem, such as melasma and age spots.AimsThe aim of this study was to evaluate the antiangiogenic and whitening effects of a depigmentation formulation (BLTX) using an in vitro model of human cell and skin culture.MethodsHuman fibroblasts, keratinocytes or melanocytes were treated with BLTX and subjected to oxidative stress by UV radiation or inflammatory stress with IL‐1α for quantification of melanin, tyrosinase, endothelin‐1, PAR‐2, VEGF and iNOS. Fragments of human skin, from elective plastic surgery, were treated with BLTX and subjected to histological evaluation with hematoxylin/eosin associated with Fontana‐Masson technique for melanin view. A parametric method, the one‐way analysis of variance (ANOVA) followed by the Bonferroni test, was used to compare data among all groups.ResultsThe results demonstrated that BLTX promotes a reduction in VEGF and iNOS protein synthesis in cultured dermal fibroblasts, indicating an antiangiogenic property. In relation to whitening effect, BLTX was able to reduce the production of melanin in both systems, melanocytes and human skin cultures. The depigmenting action was also revealed by decreasing the levels of endothelin‐1, PAR‐2 and activity of tyrosinase, when compared to cultures exposed to UV radiation.ConclusionThe results allow us to infer that BLTX presents an antiangiogenic effect indicating a role in the vascular component of melasma. Furthermore, the whitening property observed reinforces its use in the prevention and treatment of melasma.
Dual‐plane hyaluronic acid treatment for atrophic acne scars
Authors: Artzi Ofir , Cohen Sarit , Koren Amir , Niv Roni , Friedman Or 
Published: May 2019

AbstractBackgroundAcne is a common condition that affects up to 80% of all adolescents. Scarring may affect some 95% as a function of severity and delay before treatment. The pathogenesis includes enzymatic degradation of collagen fibers and subcutaneous fat.ObjectiveThis study aimed to treat atrophic acne scars using the Dual‐Plane injection of Hyaluronic Acid.MethodsA total of 12 patients with moderate‐to‐severe atrophic acne scars were treated with a novel NAHYCO™ based Hyaluronic Acid filler, using a dual‐plane technique for two treatment sessions at a 4‐week interval. Results were objectively assessed by two blinded Dermatologists and subjectively evaluated by the patients themselves.ResultsA total of 8 out of the 12 patients reported moderate improvement, two indicated marked improvement and two rated minimal improvement. Dermatologists' mean global evaluation score was 2.5 ± 0.43.LimitationsThe small sample size and regional nature of a single‐center study. Nevertheless, both the expert dermatologists' and the patients' evaluations of standardized high‐resolution medical photographs were consistent, suggesting that this inherent bias was negligible.ConclusionThe treatment led to impressive improvement in the depth of the scars, suggesting that this technique can result in safe and rapid amelioration of atrophic acne scars in only two sessions.