bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact on clinical follow‐up of the Milan System for salivary gland cytology: A comparison with a traditional diagnostic classification
Authors: Layfield L. J. , Baloch Z. W. , Hirschowitz S. L. , Rossi E. D. 
Published: May 2018

IntroductionNo universally accepted classification exists for salivary gland FNA. The proposed Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) offers a uniform classification with management recommendations. We compared FNA diagnoses from a prior study with specific diagnoses with corresponding MSRSGC diagnoses.MethodsOne‐hundred and sixty‐four cases from a prior cytological study with histological follow‐up were re‐reviewed by one of the authors and assigned to one of the MSRSGC categories. The original and MSRSCG diagnoses were compared, as were follow‐up recommendations.ResultsThe MSRSGC system classified 29 specimens as non‐diagnostic (seven histologically shown to be benign salivary gland, two non‐mucinous cysts, 14 sialadenitis, one pleomorphic adenoma, one haemangioma, one lymphoma, one adenoid cystic carcinoma, one squamous carcinoma and one benign lymphoid proliferation). The original study diagnosed these lesions as: seven benign cysts, 15 benign salivary gland tissue, one benign neoplasm and two insufficient for diagnosis. In seven cases, MSRSGC disagreed with original diagnoses and surgical resection showed lesions where optimal follow‐up was more consistent with original cytological diagnosis. In 10 cases with disagreement, the MSRSGC was associated with a more appropriate follow‐up based on the surgical diagnosis. Malignancy risks for the Milan categories were: non‐diagnostic (12%), non‐neoplastic (5%), atypia of undetermined significance (19%), neoplasm, benign (5%), neoplasm (40%), suspicious for malignancy (60%) and malignant (93%).ConclusionMSRSGC was comparable with the original reported diagnoses in the majority of cases. Both systems had high accuracy for distinguishing benign from malignant lesions and both were associated with appropriate follow‐up in most cases.
Blood glucose reduction by diabetic drugs with minimal hypoglycaemia risk for cardiovascular outcomes: Evidence from meta‐regression analysis of randomized controlled trials
Authors: Huang Chi‐Jung , Wang Wei‐Ting , Sung Shih‐Hsien , Chen Chen‐Huan , Lip Gregory Y. H. , Cheng Hao‐Min , Chiang Chern‐En 
Published: May 2018

AimsTo investigate the effects of blood glucose control with antihyperglycaemic agents with minimal hypoglycaemia risk on cardiovascular outcomes in patients with type 2 diabetes (T2D).Materials and methodsRandomized controlled trials (RCTs) comparing the relative efficacy and safety of antidiabetic drugs with less hypoglycaemia risk were comprehensively researched in MEDLINE, Embase and the Cochrane Library up to January 27, 2018. Mixed‐effects meta‐regression analysis was conducted to explore the relationship between haemoglobin A1c (HbA1c) reduction and the risk of major adverse cardiovascular events (MACE), myocardial infarction, stroke, cardiovascular death, all‐cause death, and hospitalization for heart failure.ResultsTen RCTs comprising 92 400 participants with T2D were included and provided information on 9773 MACE during a median follow‐up of 2.6 years. The mean HbA1c concentration was 0.42% lower (range, 0.27%‐0.86%) for participants given antihyperglycaemic agents than those given placebo. The meta‐regression analysis demonstrated that HbA1c reduction was significantly associated with a decreased risk of MACE (β value, −0.39 to −0.55; P < 0.02) even after adjusting for possible confounding factors including age, sex, baseline HbA1c, duration of follow‐up, difference in achieved systolic blood pressure, difference in achieved body weight, and risk difference in hypoglycaemia. Lowering HbA1c by 1% conferred a significant risk reduction of 30% (95% confidence interval, 17%‐40%) for MACE. By contrast, the meta‐regression analysis for trials using conventional agents failed to demonstrate a significant relationship between achieved HbA1c difference and MACE risk (P > 0.74).ConclusionsCompared with placebo, newer T2D agents with less hypoglycaemic hazard significantly reduced the risk of MACE. The MACE reduction appears to be associated with HbA1c reduction in a linear relationship.
Leaning Against the Wind: Debt Financing in the Face of Adversity
Authors: Brennan Michael J. , Kraft Holger 
Published: May 2018

AbstractWe offer evidence of a new stylized feature of corporate financing decisions: the tendency of managers to rely more on debt financing when earnings prospects are poor. We term this “leaning against the wind” and consider three possible explanations: market timing, precautionary financing, and “making the numbers.” We find no evidence in favor of the first two hypotheses, and provisionally accept the making the numbers hypothesis that managers who are under pressure due to unrealistically optimistic earnings expectations by analysts and deteriorating real opportunities will rely more heavily on debt financing to boost earnings per share and return on equity.
Causes of reduced leaf‐level photosynthesis during strong El Niño drought in a Central Amazon forest
Authors: Santos Victor Alexandre Hardt Ferreira dos , Ferreira Marciel José , Rodrigues João Victor Figueiredo Cardoso , Garcia Maquelle Neves , Ceron João Vitor Barbosa , Nelson Bruce Walker , Saleska Scott Reid 
Published: May 2018

AbstractSustained drought and concomitant high temperature may reduce photosynthesis and cause tree mortality. Possible causes of reduced photosynthesis include stomatal closure and biochemical inhibition, but their relative roles are unknown in Amazon trees during strong drought events. We assessed the effects of the recent (2015) strong El Niño drought on leaf‐level photosynthesis of Central Amazon trees via these two mechanisms. Through four seasons of 2015, we measured leaf gas exchange, chlorophyll a fluorescence parameters, chlorophyll concentration, and nutrient content in leaves of 57 upper canopy and understory trees of a lowland terra firme forest on well‐drained infertile oxisol. Photosynthesis decreased 28% in the upper canopy and 17% in understory trees during the extreme dry season of 2015, relative to other 2015 seasons and was also lower than the climatically normal dry season of the following non‐El Niño year. Photosynthesis reduction under extreme drought and high temperature in the 2015 dry season was related only to stomatal closure in both upper canopy and understory trees, and not to chlorophyll a fluorescence parameters, chlorophyll, or leaf nutrient concentration. The distinction is important because stomatal closure is a transient regulatory response that can reverse when water becomes available, whereas the other responses reflect more permanent changes or damage to the photosynthetic apparatus. Photosynthesis decrease due to stomatal closure during the 2015 extreme dry season was followed 2 months later by an increase in photosynthesis as rains returned, indicating a margin of resilience to one‐off extreme climatic events in Amazonian forests.
Spatial scale dependence of factors driving climate regulation services in the Americas
Authors: Serna‐Chavez Hector M. , Kissling W. Daniel , Veen Lourens E. , Swenson Nathan G. , van Bodegom Peter M. 
Published: May 2018

AbstractAimA key hypothesis in macroecology is that the relative importance of factors driving ecological phenomena changes with spatial scale. However, studies on ecosystem services usually ignore this. Here, we test how the importance of factors related to climate regulation services varies with spatial extent (i.e., area of assessment) and how covariation among factors affects scale dependencies.LocationThe Americas.Time periodPresent.Major taxa studiedPlants.MethodsWe combined a multi‐model inference framework with variance partitioning to quantify the importance of factors that could potentially influence climate regulation services (i.e., albedo, evapotranspiration and primary productivity). We quantified abiotic (climate, soil, heterogeneity in soils/topography), biotic (open vegetation, forest area and biomass, plant functional traits) and anthropogenic (forest fragmentation, managed vegetation, non‐vegetated surfaces) conditions and tested their importance in relation to climate regulation services at spatial extents ranging from 9 × 103 to 1 × 106 km2.ResultsWe found that the importance of abiotic factors in relation to climate regulation services increases with spatial extent. However, we found no evidence for a change from primarily biotically to abiotically driven climate regulation services with increasing spatial extent. All spatial extent dependencies were heavily influenced by covariation between abiotic, biotic and anthropogenic factors. After accounting for covariation, we found a primacy of abiotic factors as drivers of climate regulation services across spatial extents. Biotic and anthropogenic factors were less important than abiotic factors, and their independent effects were conserved across spatial extents.Main conclusionsOur results show that the relative importance of abiotic factors related to climate regulation services depends on spatial extent. Biotic and anthropogenic factors are less important for climate regulation services than abiotic factors, and this hierarchy is scale invariant. Our findings suggest that spatial extent dependence needs to be quantified and assessed in climate‐change mitigation projects that focus on ecosystem services.
The development of central venous thrombosis in hemodialyzed patients is associated with catheter tip depth and localization
Authors: Premuzic Vedran , Perkov Drazen , Smiljanic Ranko 
Published: May 2018

AbstractIntroduction: The aim of our work was to analyze the incidence of tunneled hemodialysis catheters‐related thrombosis in hemodialyzed patients depending on catheter tip depth and position and to evaluate the impact of other established risk factors responsible for development of central venous thrombosis.Methods: The presence of central vein thrombosis, location, and the depth of the catheter tip was reviewed by two experienced radiologists. All patients with suspected central venous thrombosis had factor V Leiden, lupus anticoagulant, and cardiolipin antibodies checked (acIgM and acIgG) and were evaluated with cat‐scan venography.Findings: A total of 68 tunneled hemodialysis catheters were analyzed with CT venography for central venous thrombosis. There were no signs of central venous thrombosis when catheter tips were placed in the right atrium. There was significantly higher number of catheter tips located on the vein wall than located centrally in patients with central venous thrombosis. Higher percentage of central venous thrombosis, smaller number of tips placed in the right atrium, higher values of IgM cardiolipin antibodies, and higher number of patients with positive factor V Leiden mutation were found in group of patients with catheter tips located on vein wall.Discussion: Higher incidence of central venous thrombosis in patients with the catheter tip placed on the vein wall is a consequence of a catheter tip depth proximal of the right atrium. Increased factor V Leiden mutation and acIgM values in these patients should be observed as a result of the vein stasis caused by inappropriate catheter tip depth and localization.
Standardized extract of wild apple fruit in alkyl‐polyglucoside‐based cosmetic cream – estimation of stability, safety, antioxidant activity and efficiency
Authors: Stojiljković D. , Tadić V. , Stanković M. , Roganović S. , Arsić I. 
Published: May 2018

AbstractObjectiveThe aim of this study was in vitro and in vivo characterization of cosmetic cream with 6% of wild apple fruit water extract, containing 3.5% of alpha‐hydroxyacids‐AHAs and polyphenolic compounds, stabilized by biodegradable alkyl‐polyglucoside emulsifiers.MethodsIn vitro characterization of cream included organoleptic and physico‐chemical (pH values and electrical conductivity) analysis, antioxidant activity‐AA estimation (using DPPH test) during 180 days of storage at 22 ± 2°C and determination of cosmetic active substances content‐AHAs (using HPLC analysis). In vivo estimation of skin irritation potential after creams application under occlusion during 24 h was investigated employing the biophysical methods on 12 healthy volunteers; hydration efficiency, transepidermal water loss‐TEWL, skin pH, erythema‐EI and melanin index‐MI on 10 healthy volunteers after 28 days of cream application and bleaching efficiency on 10 healthy volunteers after 7 days of cream application after artificially induced skin hyperpigmentation.ResultsInvestigated cosmetic cream was pale beige colour, odourless, semi‐solid consistency and homogeneous, with pH values of 6.53 ± 0.14, electrical conductivity above 50 μS cm−1 and AA of 24.96%RSC after preparation and these characteristics were stable during investigated period. In vivo measurements revealed the absence of skin irritation after cream application under occlusion, which was part of its safety profile. Increase in skin hydration after 14 days of cream application was 17.28 ± 12.23 and after 28 days 21.19 ± 7.59. In addition, in performed experiment, TEWL and skin pH values during cream application remained unchanged. Cream application after artificial hyperpigmentation induced decrease in MI (∆MI after 7 days was −45.30 ± 18.55).ConclusionFormulated cosmetic cream with 6% of standardized wild apple fruit water extract and stabilized by biodegradable alkyl‐polyglucoside emulsifiers demonstrated good stability, acceptable level of in vitro antioxidant activity, absence of skin irritation after cream application under occlusion and positive effects of cream on human skin after application (hydrating and bleaching effects). All mentioned properties make the cream suitable for possible usage as cosmetic product for preventing the skin damages caused by oxidative stress, for moisturizing the dry skin and bleaching of skin hyperpigmentation.
Utility of photoplethysmography for heart rate estimation among inpatients
Authors: Koshy Anoop N. , Sajeev Jithin K. , Nerlekar Nitesh , Brown Adam J. , Rajakariar Kevin , Zureik Mark , Wong Michael C. , Roberts Louise , Street Maryann , Cooke Jennifer , Teh Andrew W. 
Published: May 2018

AbstractThe accuracy of photoplethysmography (PPG) for heart rate (HR) estimation in cardiac arrhythmia is unknown. PPG‐HR was evaluated in 112 hospitalised inpatients (cardiac arrhythmias (n = 60), sinus rhythm (n = 52)) using a continuous electrocardiogram monitoring as a reference standard. Strong agreement was observed in sinus rhythm HR < 100 and atrial flutter (bias 1 beat), modest agreement in sinus tachycardia (bias 24 beats) and complete heart block (bias −6 beats) and weak agreement with significant HR underestimation was seen in atrial fibrillation (bias 23 beats). Routine utilisation of PPG for HR estimation may delay early recognition of clinical deterioration in certain arrhythmias and sinus tachycardia.
Seafood‐borne parasitic diseases in Australia: are they rare or underdiagnosed?
Authors: Shamsi Shokoofeh , Sheorey Harsha 
Published: May 2018

AbstractAustralia is a multicultural country surrounded by water where seafood is regularly consumed. Literature suggests that some popular edible fish sold in fish markets may be infected with parasites transmissible to humans (notably, anisakids and other helminths); however the number of reported human cases due to these parasites is low. In this article we critically review topical publications to understand whether the low number of human infection is due to lack of expertise in Australia to identify and diagnose accurately seafood‐borne parasitic infections. The risk these parasites pose to humans may be underestimated due to: (i) errors or inability of diagnosing these infections, primarily due to less sensitive and specific serological tests and misidentifying parasites without a taxonomist in the diagnostic team; and (ii) medical practitioners not being aware of these parasites or not considering them in the differential diagnosis even in patients with history of regular raw or undercooked seafood consumption.
Predicting student performance in a blended MOOC
Authors: Conijn R. , Van den Beemt A. , Cuijpers P. 
Published: May 2018

AbstractPredicting student performance is a major tool in learning analytics. This study aims to identify how different measures of massive open online course (MOOC) data can be used to identify points of improvement in MOOCs. In the context of MOOCs, student performance is often defined as course completion. However, students could have other learning objectives than MOOC completion. Therefore, we define student performance as obtaining personal learning objective(s). This study examines a subsample of students in a graduate‐level blended MOOC who shared on‐campus course completion as a learning objective. Aggregated activity frequencies, specific course item frequencies, and order of activities were analysed to predict student performance using correlations, multiple regressions, and process mining. All aggregated MOOC activity frequencies related positively to on‐campus exam grade. However, this relation is less clear when controlling for past performance. In total, 65% of the specific course items showed significant correlations with final exam grade. Students who passed the course spread their learning over more days compared with students who failed. Little difference was found in the order of activities within the MOOC between students who passed and who failed. The results are combined with course evaluations to identify points of improvement within the MOOC.
Overactivity, impulsivity and repetitive behaviour in males with fragile X syndrome: contrasting developmental trajectories in those with and without elevated autism symptoms
Authors: Crawford H. , Moss J. , Stinton C. , Singla G. , Oliver C. 
Published: May 2018

AbstractBackgroundHyperactivity and repetitive behaviour are characteristic features of fragile X syndrome (FXS). However, little is known about the influence of autism symptomatology on how these characteristics develop over time. We investigate the profiles and developmental trajectories of overactivity, impulsivity and repetitive behaviour, in males with FXS over three time points spanning 8 years.MethodParticipants formed two subgroups, those who displayed elevated symptoms of autism at Time 1 (n = 37; Mage = 16.32; age range = 6.61–43.51) and those who did not (n = 32; Mage = 8.43; age range = 8.94–47.49).ResultsParticipants without elevated symptoms of autism showed a reduction in impulsivity and repetitive questioning over time, whereas those with elevated symptoms of autism did not. Differences between the two subgroups in several topographies of repetitive behaviour emerged at Time 3 only.ConclusionsThese results further understanding of the relationship between autistic phenomenology and behavioural characteristics in FXS.
The reliability of the Epworth Sleepiness Score in a sleep clinic population
Authors: Taylor Elisabeth , Zeng Irene , O'Dochartaigh Conor 
Published: May 2018

SummaryDespite the Epworth Sleepiness Score being widely used, there are limited studies of its reliability in clinical practice. The aim of this study was to assess the reliability of the Epworth Sleepiness Score in a clinical population. The study included patients referred to Middlemore Hospital sleep service between October and November 2014, aged over 17 years, with at least two Epworth Sleepiness Score measurements at up to three different points on the diagnostic pathway: on General Practitioner referral (GP Epworth Sleepiness Score); at overnight oximetry assessment (Oximetry Epworth Sleepiness Score); and at a specialist clinic (Specialist Epworth Sleepiness Score). No treatment was administered between scores. One‐hundred and thirty‐three patients were included in the study. There was a median of 91 days from GP Epworth Sleepiness Score to Oximetry Epworth Sleepiness Score, and 11 days from Oximetry Epworth Sleepiness Score to Specialist Epworth Sleepiness Score. There was poor test–retest reliability between GP Epworth Sleepiness Score and Specialist Epworth Sleepiness Score; 72.4% and 17.8% of patients had an absolute difference of more than 2 and 8 Epworth Sleepiness Score points, respectively. A Bland–Altman plot of mean Epworth Sleepiness Score versus the difference between GP Epworth Sleepiness Score and Specialist Epworth Sleepiness Score demonstrated a wide scatter of data and 95% confidence interval for the difference in Epworth Sleepiness Score for an individual patient of −14 to +10. There was similar variability between GP Epworth Sleepiness Score and Oximetry Epworth Sleepiness Score. The reliability of the Epworth Sleepiness Score is unproven in clinical settings. This study shows poor test–retest reliability of Epworth Sleepiness Score, particularly between primary and secondary care, arguing against the use of Epworth Sleepiness Score for clinical decision‐making or prioritisation of services without first assessing the reliability of the Epworth Sleepiness Score in the relevant clinical population.
Declarative virtual water maze learning and emotional fear conditioning in primary insomnia
Authors: Kuhn Marion , Hertenstein Elisabeth , Feige Bernd , Landmann Nina , Spiegelhalder Kai , Baglioni Chiara , Hemmerling Johanna , Durand Diana , Frase Lukas , Klöppel Stefan , Riemann Dieter , Nissen Christoph 
Published: May 2018

SummaryHealthy sleep restores the brain's ability to adapt to novel input through memory formation based on activity‐dependent refinements of the strength of neural transmission across synapses (synaptic plasticity). In line with this framework, patients with primary insomnia often report subjective memory impairment. However, investigations of memory performance did not produce conclusive results. The aim of this study was to further investigate memory performance in patients with primary insomnia in comparison to healthy controls, using two well‐characterized learning tasks, a declarative virtual water maze task and emotional fear conditioning. Twenty patients with primary insomnia according to DSM‐IV criteria (17 females, three males, 43.5 ± 13.0 years) and 20 good sleeper controls (17 females, three males, 41.7 ± 12.8 years) were investigated in a parallel‐group study. All participants completed a hippocampus‐dependent virtual Morris water maze task and amygdala‐dependent classical fear conditioning. Patients with insomnia showed significantly delayed memory acquisition in the virtual water maze task, but no significant difference in fear acquisition compared with controls. These findings are consistent with the notion that memory processes that emerge from synaptic refinements in a hippocampal–neocortical network are particularly sensitive to chronic disruptions of sleep, while those in a basic emotional amygdala‐dependent network may be more resilient.