bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic utility of dual 5‐hydroxymethylcytosine/Melan‐A immunohistochemistry in differentiating nodal nevus from metastatic melanoma: An effective first‐line test for the workup of sentinel lymph node specimen
Authors: Siref Andrew B. , Huynh Carissa A.T. , Balzer Bonnie L. , Frishberg David P. , Essner Richard , Shon Wonwoo 
Published: January 2019

BackgroundDistinguishing benign nodal nevus from metastatic melanoma can be diagnostically challenging, with important clinical consequences. Recently, the loss of epigenetic marker, 5‐hydroxymethylcytosine (5‐hmC) expression by immunohistochemistry has been found in melanomas and atypical melanocytic neoplasms.MethodsAbout 41 metastatic melanomas and 20 nodal nevi were retrieved. Nuclear 5‐hmC (brown) and cytoplasmic Melan‐A Red (red) double immunohistochemical staining was performed.ResultsTotal or partial loss of nuclear expression of 5‐hmC was noted in 40/41 metastatic melanomas; these tumor cells were strongly positive for Melan‐A Red, except in one case of desmoplastic melanoma. All cases of nodal nevus showed uniformly retained nuclear expression of 5‐hmC accompanied by strong Melan‐A Red cytoplasmic staining. In two cases containing both nodal nevus and metastatic melanoma, all tumor cells were positive for Melan‐A Red, but a nuclear expression of 5‐hmC was selectively absent only in the melanoma tumor cells.ConclusionDual 5‐hmC/Melan‐A Red immunohistochemistry is highly specific in distinguishing nodal nevus from metastatic melanoma. Our protocol for brown and red chromogens used in this study provides excellent color contrast and is easy to interpret. Furthermore, this dual staining method allows the preservation of limited tumor tissue, which could be used for potential molecular studies.
Interventions to improve upper limb function for children with bilateral cerebral palsy: a systematic review
Authors: Plasschaert Véronique F P , Vriezekolk Johanna E , Aarts Pauline B M , Geurts Alexander C H , Van den Ende Cornelia H M 
Published: January 2019

AimTo systematically review the efficacy of interventions on upper limb function in children 0 to 19 years of age with bilateral cerebral palsy on the basis of outcome measures of upper limb function and measures of activities and/or participation according to the International Classification of Functioning, Disability and Health.MethodCochrane, PubMed, Embase, CINAHL, and Web of Science were searched from inception to September 2017. Methodological quality and strength of evidence were analysed by two independent raters using Sackett's level of evidence and the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) guidelines.ResultsFifteen studies with a large variety of interventions and heterogeneity in outcome measures met the inclusion criteria. Twelve studies provided level IV evidence according to AACPDM guidelines. For three small randomized controlled trials the level of evidence was II. Only one of these trials showed strong methodological quality: a study on hand–arm bimanual intensive therapy including lower extremities.InterpretationWe identified a large variety of interventions, heterogeneity in outcome measures, and generally weak to moderate methodological quality for most studies. We recommend further research specifically aimed at bimanual‐intensive, goal‐directed, and task‐specific training programmes for the upper limb in children with bilateral cerebral palsy, using either high‐quality (multicentre) trials or well‐designed single‐case trials.What this paper adds

There is a large variety of interventions on upper limb function in children with bilateral cerebral palsy.

Heterogeneity of outcome measures and interventions impeded firm conclusions about intervention efficacy.

Most studies had low‐level evidence and weak to moderate methodological quality.

The strongest evidence from a small randomized controlled trial was for hand–arm bimanual intensive therapy including lower extremities.
Religion and development in post‐Famine Ireland
Authors: Henderson Stuart 
Published: January 2019

AbstractOver a century ago, Horace Plunkett began a debate about the role of religion in Irish development, pointing to what he saw as the economic shortcomings of Roman Catholicism. Thereafter, however, the debate waned, and only limited scholarship has subsequently investigated the significance of religion in Irish development, especially in statistical terms. In this article that lacuna is addressed, using a quantitative approach to examine the relationship between Roman Catholicism and economic and financial development in the post‐Famine era. Attention is directed to a variety of development indicators, namely, education, occupations, and commerce. By focusing on a selection of measures over time, it is possible to determine more precisely where differences, if any, occurred between the denominations and whether such differences changed over the period. The analysis reveals that Roman Catholicism tends to be initially negatively associated with more advanced development outcomes, but that this association weakens over time. As such, the results point to an economic convergence between Roman Catholics and Protestants, complementing historical evidence on an upward Catholic socioeconomic transition—a ‘Catholic embourgeoisement’—in the post‐Famine era.
Medical reliability of a video‐sharing website: The gingival recession model
Authors: Hamdan Ahmad A. , Shaqman Murad , Abu Karaky Ashraf , Hassona Yazan , Bouchard Philippe 
Published: January 2019

AbstractObjectivesTo evaluate the quality of the scientific/clinical information in dentistry delivered by videos hosted by a popular video‐sharing website.MethodsThe gingival recession condition was used as a model and YouTube™ as the video hosting service. A systematic observation of videos containing information on gingival recession was conducted. Videos were analysed to evaluate (i) the scientific reliability and quality of the information using Global Quality Scale (GQS) and DISCREN criteria; and (ii) the understandability of this information using a tailor‐made custom comprehensiveness index (CI).ResultsOne hundred and eighty videos were identified. Videos dealing with surgical procedures were not included in the present review. After selection, 41 videos were analysed. The mean GQS was 2.34 on a 0‐5 scale, and 25 (61%) videos showed clear aims according to DISCREN criteria. Misleading content was observed in eight videos (19.5%). The scientific sources of information were unclear in 26 (63.4%) videos. All videos failed to give additional references for supplemental information. Only three videos (7%) provided basic information on aetiology, clinical presentations and management of gingival recession. Based on 0‐2 CI scores, three, nine and 29 videos had a score of 2, 1 and 0, respectively.ConclusionThe present model indicates that social media websites aiming to provide health information should be carefully accounted, especially when dealing with dentistry. It also suggests professional involvement to improve the quality of the delivered information.
‘Higher education’ – substance use among Berlin college students
Authors: Viohl Leonard , Ernst Felicitas , Gabrysch Julian , Petzold Moritz B. , Köhler Stephan , Ströhle Andreas , Betzler Felix 
Published: January 2019

AbstractBerlin is internationally known for its intense nightlife associated with high rates of psychoactive substance use. Previous studies conducted in other cities indicated college students as a group at high risk for substance (mis‐)use that was associated with individual psychological and cognitive impairments as well as lower academic performance. The aim of this study was to provide detailed data about the substance use patterns of Berlin college students. In addition, major protective and risk factors were analysed. An online questionnaire assessing sociodemographic data and various relevant aspects of both legal and illegal substance use such as consumption pattern and frequency as well as risk‐taking behaviour was developed and distributed among colleges in Berlin. A sample of 9351 participants from 17 different colleges in Berlin completed the questionnaire. The study revealed high lifetime (69.3%), past year (45.9%) and past month (28.3%) prevalence of illicit substance use in the sample. Daily tobacco‐smoking, a mental disorder diagnosis, a positive screening for problematic consumption (Cage‐AID), bisexual orientation and living in open relationship were main factors positively associated with the prevalence and the extent of illicit substance use. Students in Berlin appear to show higher rates of illicit substance use than was previously reported for age‐matched individuals in the general German population and college students in other cities. Thus, they are a relevant target group for early prevention and intervention concerning substance use and abuse.
Synchronized activation of striatal direct and indirect pathways underlies the behavior in unilateral dopamine‐depleted mice
Authors: Jáidar Omar , Carrillo‐Reid Luis , Nakano Yoko , Lopez‐Huerta Violeta Gisselle , Hernandez‐Cruz Arturo , Bargas José , Garcia‐Munoz Marianela , Arbuthnott Gordon William 
Published: January 2019

AbstractFor more than three decades it has been known, that striatal neurons become hyperactive after the loss of dopamine input, but the involvement of dopamine (DA) D1‐ or D2‐receptor‐expressing neurons has only been demonstrated indirectly. By recording neuronal activity using fluorescent calcium indicators in D1 or D2 eGFP‐expressing mice, we showed that following dopamine depletion, both types of striatal output neurons are involved in the large increase in neuronal activity generating a characteristic cell assembly of particular neurons that dominate the pattern. When we expressed channelrhodopsin in all the output neurons, light activation in freely moving animals, caused turning like that following dopamine loss. However, if the light stimulation was patterned in pulses the animals circled in the other direction. To explore the neuronal participation during this stimulation we infected normal mice with channelrhodopsin and calcium indicator in striatal output neurons. In slices made from these animals, continuous light stimulation for 15 s induced many cells to be active together and a particular dominant group of neurons, whereas light in patterned pulses activated fewer cells in more variable groups. These results suggest that the simultaneous activity of a large dominant group of striatal output neurons is intimately associated with parkinsonian symptoms.
Nitrogen addition does not reduce the role of spatial asynchrony in stabilising grassland communities
Authors: Zhang Yunhai , Feng Jinchao , Loreau Michel , He Nianpeng , Han Xingguo , Jiang Lin 
Published: January 2019

AbstractWhile nitrogen (N) amendment is known to affect the stability of ecological communities, whether this effect is scale‐dependent remains an open question. By conducting a field experiment in a temperate grassland, we found that both plant richness and temporal stability of community biomass increased with spatial scale, but N enrichment reduced richness and stability at the two scales considered. Reduced local‐scale stability under N enrichment arose from N‐induced reduction in population stability, which was partly attributable to the decline in local species richness, as well as reduction in asynchronous local population dynamics across species. Importantly, N enrichment did not alter spatial asynchrony among local communities, which provided similar spatial insurance effects at the larger scale, regardless of N enrichment levels. These results suggest that spatial variability among local communities, in addition to local diversity, may help stabilise ecosystems at larger spatial scales even in the face of anthropogenic environmental changes.
Patterns of risk behaviors in Brazilian older adults: A latent class analysis
Authors: de Mello Gabrielli T , da Silva Kelly S , da Costa Bruno GG , Borgatto Adriano F 
Published: January 2019

AimThe aim of the present study was to describe the clustering of diet, physical activity, television viewing, and tobacco and alcohol use among Brazilian older adults (aged ≥60 years).MethodsWe carried out a secondary analysis of the Brazilian National Health Survey of 2013. Brazilian older adults (n = 11 177) reported their consumption of fruit and vegetables, leisure physical activity, television viewing, tobacco smoking, and alcohol intake. Latent class analysis was used to identify behavior patterns.ResultsThree classes of behaviors were identified. The “Healthy” class (34.8%) had the highest probability of meeting recommendations for physical activity, and fruit and vegetable consumption; the “Poor diet and PA” class (46.5%) presented low probabilities of meeting recommendations for physical activity and alcohol consumption; and the “Smoking and binge drinking” class (18.7%) had the highest probability of smoking and binge drinking.ConclusionsThree behavioral patterns were identified in the Brazilian older population. Even in the “Healthy” class, less than half of the older adults were considered physically active, suggesting that there is no completely healthy profile. Nevertheless, physical activity and fruit and vegetable consumption behaviors clustered, as did smoking and binge drinking. Geriatr Gerontol Int 2019; 19: 245–248.
Favorable outcomes of culture‐based Helicobacter pylori eradication therapy in a region with high antimicrobial resistance
Authors: Lee Jung W. , Kim Nayoung , Nam Ryoung H. , Lee Sun M. , Kwon Yong H. , Sohn So D. , Kim Jung M. , Lee Dong H. , Jung Hyun C. 
Published: January 2019

AbstractBackgroundThe eradication rate of Helicobacter pylori has declined, mainly due to antimicrobial resistance. To overcome resistance‐associated treatment failure, the efficacy of culture‐based, susceptibility‐guided therapy was demonstrated as the first‐line eradication therapy for H pylori infection.AimsTo evaluate the efficacy of culture‐based therapy as the first‐line eradication therapy in regions with high levels of antimicrobial resistance.MethodsHelicobacter pylori‐positive patients without previous eradication treatment history were recommended to undergo culture to determine the minimal inhibitory concentration (MIC). If they consented, 7‐day clarithromycin‐containing PPI triple; 7‐day esomeprazole, moxifloxacin, and amoxicillin (MEA) therapy; or 7‐ or 14‐day esomeprazole, bismuth, metronidazole, and tetracycline (quadruple) therapy were administered based on the agar dilution‐determined MIC. Eradication, treatment compliance, and adverse events were examined.ResultsIn total, 74 patients were enrolled, and 69 patients completed the protocols. The overall resistance rates to amoxicillin, clarithromycin, metronidazole, and moxifloxacin were 6.7%, 31.0%, 41.8%, and 39.2%, respectively. The patients were allocated to the PPI triple (n = 50), MEA (n = 8) or quadruple (n = 16) therapy. The eradication rate in the intention‐to‐treat analysis was 93.1% (69 of 74 patients). The eradication rates in the per‐protocol analysis were 100.0% (69 of 69 patients). Epigastric pain, nausea, and vomiting were less common than those of other empirical therapies.ConclusionsCulture‐based, susceptibility‐guided therapy is effective first‐line eradication therapy, especially in regions with high levels of antimicrobial resistance.
Hope, disappointment and perseverance: Reflections of people with Myalgic encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Multiple Sclerosis participating in biomedical research. A qualitative focus group study
Authors: Lacerda Eliana M. , McDermott Clare , Kingdon Caroline C. , Butterworth Jack , Cliff Jacqueline M. , Nacul Luis 
Published: January 2019

AbstractBackgroundThe Clinical Understanding and Research Excellence in ME/CFS group (CureME) at the London School of Hygiene & Tropical Medicine has supported and undertaken studies in immunology, genetics, virology, clinical medicine, epidemiology and disability. It established the UK ME/CFS Biobank (UKMEB), which stores data and samples from three groups: participants with ME/CFS, Multiple Sclerosis (MS) and healthy controls. Patient and public involvement have played a central role from its inception.AimTo explore the views of participants with ME/CFS and MS on CureME research findings, dissemination and future biomedical research priorities.MethodFive ME/CFS and MS focus groups were conducted at two UK sites. Discussions were transcribed and analysed thematically.ResultsA total of 28 UKMEB participants took part: 16 with ME/CFS and 12 with MS. Five themes emerged: (a) Seeking coherence: participants’ reactions to initial research findings; (b) Seeking acceptance: participants explore issues of stigma and validation; (c) Seeking a diagnosis: participants explore issues around diagnosis in their lives; (d) Seeking a better future: participants’ ideas on future research; and (e) Seeking to share understanding: participants’ views on dissemination. Focus groups perceived progress in ME/CFS and MS research in terms of “putting together a jigsaw” of evidence through perseverance and collaboration.ConclusionThis study provides insight into the emotional, social and practical importance of research to people with MS and ME/CFS, suggesting a range of research topics for the future. Findings should inform biomedical research directions in ME/CFS and MS, adding patients’ voices to a call for a more collaborative research culture.
Rehabilitation environments: Service users’ perspective
Authors: Killington Maggie , Fyfe Dean , Patching Allan , Habib Paul , McNamara Annabel , Kay Rachael , Kochiyil Venugopal , Crotty Maria 
Published: January 2019

AbstractBackgroundDesign of rehabilitation environments is usually “expert” driven with little consideration given to the perceptions of service users, especially patients and informal carers. There is a need to engage with consumers of services to gain their insights into what design aspects are required to facilitate optimum physical activity, social interaction and psychological responses when they are attempting to overcome their limitations and regain function.Research designQualitative exploratory study.MethodInterviews were conducted with patients (n = 54) and informal carers (n = 23), and focus groups with rehabilitation staff (n = 90), from the three metropolitan South Australia rehabilitation health services, comprising different building and environmental configurations. Thematic analysis was assisted by the use of NVivo 11 qualitative software, with pooled data from all interviews and focus groups undergoing open, axial and finally selective coding.ResultsFour major themes were identified as follows: (a) choice can be an Illusion in a rehabilitation ward; (b) access to outside areas is a priority and affects well‐being; (c) socialization can be facilitated by the environment; and (d) ward configuration should align with the model of care.Discussion and ConclusionParticipants who encountered the most restrictive environments accepted their situation until probed to consider alternatives; those who enjoyed the most choice and access to facilities showed the greatest enthusiasm for these affordances. Future architectural designers should therefore consider the perceptions of a wide range of consumers with varying experiences to ensure they understand the complex requirements of patients and that the ward design facilitates the optimum rehabilitation model of care.
De‐simplifying single‐tablet antiretroviral treatments: uptake, risks and cost savings
Authors: Krentz HB , Campbell S , Lahl M , Gill MJ 
Published: January 2019

ObjectivesAs more HIV‐positive individuals receive antiretroviral therapy (ART), payers are seeking options for covering these increased and sustained drug costs. Strategic use of available generic antiretroviral (ARV) formulations may be feasible. De‐simplifying a single‐tablet co‐formulation (STF) into two or more tablets using both brand and generic drugs has been proposed. We determine if voluntary de‐simplification of one STF could be utilized as a cost‐saving strategy. We report on the challenges, uptake, outcomes and cost savings of this initiative.MethodsPatients stable on the most commonly used STF (Triumeq®) were offered the option of remaining on Triumeq® or switching to generic abacavir/lamivudine and Tivicay® between 1 January 2015 and 1 January 2018; those starting ART consisting of abacavir/lamivudine/doulutegravir in the same period were offered the option of starting Triumeq® or generic abacavir/laminvudine and Tivicay®. No incentives were provided. We examined the acceptance/decline rates, patient satisfaction, health care outcomes and annual cost savings.ResultsOf 626 patients receiving Triumeq®, 321 were approached; 177 (55.1%) agreed to de‐simplify. Of patients initiating ART, 62.7% chose the generic co‐formulation. Patients switching to or starting on the generic co‐formulation were more likely to be male, > 45 years old, Caucasian, men who have sex with men (MSM) and more HIV‐experienced, and to have more comorbidities (all P < 0.05). Preference for STF was cited for declining de‐simplification. No concern about generic ARVs was expressed. The rate of viral load > 500 HIV‐1 RNA copies/mL after baseline was 2.7% in switched patients compared with 7.0% in those declining to switch. No de novo resistance occurred. A saving of Cdn$1 319 686 was achieved in the first year.ConclusionsReliance on altruism, while respecting patient autonomy, achieved de‐simplification in > 50% of patients approached, and generated immediate cost savings with no increased risk of adverse events, viral breakthrough or resistance.
Evaluation of weight‐based prescription of antiretroviral therapy in children
Authors: Dakshina S , Olaru ID , Khan P , Raman L , McHugh G , Bwakura–Dangarembizi M , Nathoo K , Munyati S , Mujuru H , Ferrand RA 
Published: January 2019

ObjectivesThe aim of the study was to investigate the extent of and factors associated with incorrect dosing of antiretroviral therapy (ART) in HIV‐infected children in Harare, Zimbabwe.MethodsAll children aged 0–10 years and children aged 11–17 years who weighed < 35 kg and taking ART were recruited from the paediatric HIV clinic at Harare Hospital. Their current doses of ART drugs were compared against doses recommended by the national guidelines.ResultsAmong 309 children recruited [55% male; median age 7 years (interquartile range (IQR) 5–10 years)], the median CD4 count was 899 cells/μL and the median duration of their current ART regimen was 11.2 months (IQR 4.9–17.1 months). Overall, 110 (35.6%) children were prescribed incorrect doses of at least one drug component within their ART regimen; 64 (20.7%) under‐dosed and 49 (15.9%) over‐dosed on at least one drug. Children receiving a higher than recommended dose of at least one drug were younger compared with correctly dosed children (median 6 versus 7 years, respectively; P = 0.001), had been on their current ART regimen for a shorter time (median 7.2 versus 13 months, respectively; P = 0.003) and were less likely to be receiving a three‐drug fixed‐dose combination (FDC; 42.9 versus 63.3%, respectively; P = 0.009). Those who were under‐dosed were also less likely to be on a three‐drug FDC (25 versus 63.3%, respectively; P < 0.001).ConclusionsOver a third of children were prescribed incorrect doses of ART. Children taking triple‐drug FDCs were likely to be correctly dosed. Our study highlights the importance of weight monitoring at each clinical contact, training of health care providers on paediatric drug dosing and the need for wider availability of FDCs for children.