bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of major neonatal morbidities on adolescents born at 23–25 weeks of gestation
Authors: Holsti Antti , Serenius Fredrik , Farooqi Aijaz 
Published: June 2018

AbstractAimMore infants born extremely preterm (EPT) are surviving, but major neonatal morbidities are consistently high. This study examined the impact of bronchopulmonary dysplasia (BPD), brain injuries and severe retinopathy of prematurity (ROP) on adolescents who were born EPT.MethodsWe focused on EPT infants born at 23–25 weeks at the Swedish university hospitals in Uppsala and Umeå from January 1992 to December 1998. The poor outcome data covered 140 of 142 who survived to 36 weeks, and the chronic conditions data reported by parents covered 132 of 134 still alive at 10–15 years.ResultsOf the 140 survivors at 36 weeks, 29 (21%) had poor outcomes: eight of 140 (6%) died, and 21 of 132 (16%) adolescent survivors had severe neurodevelopmental disabilities (NDD). BPD, severe ROP and/or brain injuries correlated independently with poor outcome. Of those adolescents who were free from BPD, brain injury and severe ROP, 6% had a severe NDD. The corresponding rates with any one, any two or all three neonatal morbidities were 21, 33 and 67%, respectively. BPD and brain injuries were associated with high rates of chronic conditions at 10–15 years of age resulting in functional limitations.ConclusionIn adolescent EPT survivors, BPD and brain injuries were associated with high rates of chronic conditions and special healthcare needs.
Prevalence of thyroid dysfunction in a Large Southern European Population. Analysis of modulatory factors. The APNA study
Authors: Santos Palacios Silvia , Llavero Valero María , Brugos‐Larumbe Antonio , Díez Juan J. , Guillén‐Grima Francisco , Galofré Juan C. 
Published: June 2018

SummaryContextTo study the prevalence of thyroid dysfunction in a very large unselected population.ObjectiveTo determine the prevalence of abnormal thyroid function and evaluate potential modulatory factors.Design and SettingThe Estudio de Atención Primaria de Navarra, The APNA Study, is a cross‐sectional study conducted in northern Spain. It involved 303 883 people, of 20 years of age and older, who live in the Navarra region. Participants are covered by the public healthcare system and medical records are digitalized.Main Outcome MeasuresThe information was gathered from e‐registered data regarding serum thyrotropin (TSH), thyroid hormones, thyroid antibody concentration and clinical context. Measurements were logged (demographic information and potential thyroid function modulatory factors).ResultsSerum TSH (mU/L) normal range was established at 0.7‐4.28. At the time of the study, 87% of the Navarra population had a TSH level within the normal range. Mean serum TSH in euthyroid individuals was higher in women (2.15) than in men (1.96) (P < .001) and higher in the obese with body mass index (BMI) ≥30 kg/m2 (2.12) as compared to the non‐obese BMI <30 kg/m2 (2.06) (P < .001). Mean TSH for the entire population was 1.9. The native Spanish population had statistically significantly lower TSH (1.87) than non‐native Spanish (2.15) (P < .001). Additionally, we observed that serum TSH levels decreased with age and an increase in the prevalence of hypothyroidism in the elderly and among people with low‐income levels. The prevalence of thyroid dysfunction in Navarra was 12.3%. The prevalence of hypothyroidism (or high TSH) in the population was 8.8% (13.3% in women, 4.2% in men), and the prevalence of hyperthyroidism (or low TSH) was 4.3% (5.6% in women, 3.0% in men).ConclusionsNearly 15% of the general population suffers from biochemical thyroid dysfunction. The serum TSH level appears to be influenced by sex, BMI, age, ethnic origin and socio‐economic status.
Prognostic value and characteristics of N1c colorectal cancer
Authors: Bouquot M. , Creavin B. , Goasguen N. , Chafai N. , Tiret E. , André T. , Flejou J.‐F. , Parc Y. , Lefevre J. H. , Svrcek M. 
Published: June 2018

AbstractAimThe presence of tumour deposits (TDs) in colorectal cancer (CRC) is associated with poor prognosis. The seventh edition of TNM subclassified a new nodal stage, N1c, characterized by the presence of TDs without any concurrent positive lymph node (LN). It is not clear if the N1c category is or is not equal to LN metastasis. We aimed to examine the prevalence, characteristics and prognostic significance of this new subcategory.MethodConsecutive patients who underwent surgery for CRC in two centres (2011–2014) were analysed. N1 cM0 patients were matched against non‐N1 cM0 (N0, N1a and N1b) patients for 3‐year overall survival (OS) and disease‐free survival (DFS).ResultsWe identified 1122 patients with 648 (57.8%) colonic cancers. In 57 patients (5.1%), N1c status was associated with rectal cancers [rectum = 33/57 (57.9%) vs colon = 24/57 (42.1%); P = 0.029], a higher pathological tumour stage [pT3‐T4 N1c = 55/843 (6.5% vspT3‐T4 non‐N1c = 2/279 (0.7%); P < 0.0001] and vascular emboli [n = 35 (61.4%) vs n = 552 (51.8%); P = 0.0305]. Synchronous metastasis was observed in 23 cases (40%). After a mean follow‐up of 31 months, 3‐year OS for M0 patients, was 89.4%, 89.1%, 86.6% and 81.8% for N0, N1a, N1b and N1c tumours, respectively. DFS was significantly worse for N1c than for N0 (P = 0.0169), with N1c status having a significant effect on DFS in colonic cancers (P = 0.014). The presence of more than one TD was associated with a significantly worse DFS (P = 0.021).ConclusionOur results indicate that N1c CRC patients should be included among high‐risk patients for whom it is widely accepted that adjuvant chemotherapy should be considered.
Internal quality control indicators in cervical cytopathology of a university laboratory
Authors: Cardoso Filho L. I. , Tavares S. B. N. , Siqueira M. L. B. , dos Passos E. N. , Araújo N. L. A. S. , Martins J. M. A. , Ribeiro A. A. , dos Santos S. H. R. 
Published: June 2018

IntroductionTo evaluate the internal quality control indicators and quality management programme in a university cytopathology laboratory.MethodsAll results of conventional cervical smears tests (taken from the SISCAN, the Brazilian cervical cancer screening system) of women aged ≥15 years at the time of Papanicolaou smear specimen collection during January 2007‐December 2014 were included. The final results of the cytopathology were classified in accordance with the Bethesda System. The variables included in the database were the woman's name, date of birth, and age at the time of sampling (15‐30, 31‐40 and older than 40 years).ResultsIn this period, 50 286 cytopathology examinations were carried out. Of these, 44 386 (91.34%) were negative for malignancy or unsatisfactory and 4209 (8.66%) presented epithelial abnormalities. The percentage of the tests consistent with atypical squamous cells (ASC) between satisfactory examinations was 4.12%; the percentage of tests compatible with ASC among abnormal examinations was 47.87%; the ASC/squamous intraepithelial lesion) ratio was 0.97 and the percentage of high‐grade squamous intraepithelial lesion among satisfactory tests was 2.21%, and the 5‐year retrospective review identified 4.97% of false‐negative results.ConclusionAll rates obtained were consistent over the years and within the recommended values by Federal Regulation of Brazil. This demonstrates the efficacy of our established internal quality monitoring and continuing education, reflecting the commitment of the team involved in the release of smear reports.
Generic antiepileptic drugs—Safe or harmful in patients with epilepsy?
Authors: Holtkamp Martin , Theodore William H. 
Published: June 2018

SummaryGeneric antiepileptic drugs (AED) are significantly cheaper than brand name drugs, and may reduce overall health care expenditures. Regulatory bodies in Europe and North America require bioequivalence between generic and innovator drugs with regard to area under the plasma concentration–time curve (AUC) and peak plasma concentration (Cmax); strict cutoff values have been defined. The main issue is if bioequivalence ensures therapeutic equivalence. Are switches from brand to generic, or between generic AEDs entirely safe or potentially harmful in patients with epilepsy? We summarized and evaluated the available evidence from bioequivalence, health care utilization, and clinical studies on safety of generic AEDs. In most cases, variations in AUC and Cmax were negligible when comparing innovator and generic AEDs. Due to interindividual pharmacokinetic and pharmacodynamic variability, measured differences between innovator and generic drugs may be the same as differences between different lots of the same brand. Studies from several countries based on insurance data have reported an increase in health care usage after switch from brand to generic AEDs; switchback rates are significantly higher for AEDs compared to other compounds. Patients may be confused, and nonadherence may increase, when AEDs are switched between manufacturers, perhaps due to changes in medication shape and color. But clinical studies do not report changes in seizure frequency and tolerability attributable to generics. Sufficient evidence indicates that most generics are bioequivalent to innovator AEDs; they do not pose a relevant risk for patients with epilepsy. However, some patients are reluctant towards variations in color and shape of their AEDs which may result in nonadherence. We recommend administering generics when a new AED is initiated. Switches from brand to generic AEDs for cost reduction and between generics, which is rarely required, generally seem to be safe, but should be accompanied by thorough counseling of patients on low risks.
Laser ablation for mesial temporal lobe epilepsy: Surgical and cognitive outcomes with and without mesial temporal sclerosis
Authors: Donos Cristian , Breier Joshua , Friedman Elliott , Rollo Patrick , Johnson Jessica , Moss Lauren , Thompson Stephen , Thomas Melissa , Hope Omotola , Slater Jeremy , Tandon Nitin 
Published: June 2018

SummaryObjectivesLaser interstitial thermal therapy (LITT) is a minimally invasive surgical technique for focal epilepsy. A major appeal of LITT is that it may result in fewer cognitive deficits, especially when targeting dominant hemisphere mesial temporal lobe (MTL) epilepsy. To evaluate this, as well as to determine seizure outcomes following LITT, we evaluated the relationships between ablation volumes and surgical or cognitive outcomes in 43 consecutive patients undergoing LITT for MTL epilepsy.MethodsAll patients underwent unilateral LITT targeting mesial temporal structures. FreeSurfer software was used to derive cortical and subcortical segmentation of the brain (especially subregions of the MTL) using preoperative magnetic resonance imaging (MRI). Ablation volumes were outlined using a postablation T1‐contrasted MRI. The percentages of the amygdala, hippocampus, and entorhinal cortex ablated were quantified objectively. The volumetric measures were regressed against changes in neuropsychological performance before and after surgery,ResultsA median of 73.7% of amygdala, 70.9% of hippocampus, and 28.3% of entorhinal cortex was ablated. Engel class I surgical outcome was obtained in 79.5% and 67.4% of the 43 patients at 6 and 20.3 months of follow‐up, respectively. No significant differences in surgical outcomes were found across patient subgroups (hemispheric dominance, hippocampal sclerosis, or need for intracranial evaluation). Furthermore, no significant differences in volumes ablated were found between patients with Engel class IA vs Engel class II‐IV outcomes. In patients undergoing LITT in the dominant hemisphere, a decline in verbal and narrative memory, but not in naming function was noted.SignificanceSeizure‐free outcomes following LITT may be comparable in carefully selected patients with and without MTS, and these outcomes are comparable with outcomes following microsurgical resection. Failures may result from non‐mesial components of the epileptogenic network that are not affected by LITT. Cognitive declines following MTL‐LITT are modest, and principally affect memory processes.
Metastatic tubercular gummas and splenic tuberculoma secondary to tubercular lymphadenitis in an immunocompetent female
Authors: Sanke Sarita , Chander Ram , Dalal Keemi , Agarwal Shilpi 
Published: June 2018

AbstractTubercular gummas and splenic tuberculomas are rare forms of extrapulmonary tuberculosis, usually occurring in immunocompromised individuals. We hereby report a rare combination of multiple tubercular gummas and splenic tuberculoma secondary to TB lymphadenitis in an immunocompetent individual. The patient responded to antitubercular therapy. Thus, in a developing country like ours, tuberculosis can present in a wide clinical spectrum even in an immunocompetent individual.
An Institutional Contingency Perspective of Interlocking Directorates
Authors: Caiazza Rosa , Cannella Jr Albert A. , Phan Phillip H. , Simoni Michele 
Published: June 2018

AbstractInterlocking directorates, in which companies are linked by the directors that serve on their boards, exist globally. It is an expression of hegemonic power exercised by the elites of a society, and has been studied with great interest by organizational sociologists, management scholars and financial economists. The interest emanates from the effect that interlocks have on wealth creation and distribution, and from the perspective that interlocks can tell us how elites in a society are networked. Although diverse theoretical perspectives have informed the research on interlocking directorates, this review shows that the Anglo‐American perspective dominates. This dominance is notable not only in the volume of Anglo‐American studies, but also in theories employed by international studies. For example, most international studies use agency theory to investigate the welfare implications of interlocks, but many countries do not use the Anglo‐American legal regime, which is the basis for agency theory. This paper expands the theoretical basis of the review to include class hegemony and resource dependence, to articulate better the causes and consequences of interlocks in the international context. The paper also extends theory by showing that institutions have an important influence on interlocks, so that the latter can be welfare‐depleting in one institutional setting, while welfare‐enhancing in another. The review concludes by discussing the implication for future research.
The functions of caspase in whitefly Bemisia tabaci apoptosis in response to ultraviolet irradiation
Authors: Wang X.‐R. , Wang C. , Wang X.‐W. , Qian L.‐X. , Chi Y. , Liu S.‐S. , Liu Y.‐Q. , Wang X.‐W. 
Published: June 2018

AbstractWhiteflies (Bemisia tabaci) are phloem feeders, and some invasive species are composed of cryptic species complexes that cause extensive crop damage, particularly via the direct transmission of plant viruses. Apoptosis is a type of programmed cell death essential for organismal development and tissue homeostasis. The caspases belong to a family of cysteine proteases that play a central role in the initiation of apoptosis in many organisms. Here, we employed a comprehensive genomics approach to identity caspases in B. tabaci Middle East Asia Minor 1 (MEAM1), an invasive whitefly that carries a cryptic species complex that is devastating to crops. Four caspase genes were identified, and their motif compositions were predicted. Structures were relatively conserved in both putative effector and initiator caspases. Expression patterns of caspase genes differed across insect developmental stages. Three caspase genes were induced immediately after ultraviolet (UV) treatment. Expression levels of Bt‐caspase‐1 and Bt‐caspase‐3b increased in the midgut and salivary glands during apoptosis induced by UV treatments, whereas silencing of both genes reduced UV‐triggered apoptosis. Our study demonstrates that Bt‐caspase‐1 and Bt‐caspase‐3b, respectively, act as putative initiator and effector apoptotic caspases in the MEAM1 whitefly.
Utility of minimal preparation computed tomography colonography in detecting colorectal cancer in elderly and frail patients
Authors: Meiklejohn David J. , Ridley Lloyd J. , Ngu Meng C. , Cowlishaw James L. , Duller Alex , Ridley William 
Published: June 2018

AbstractBackgroundColorectal cancers result in substantial morbidity and mortality to the Australian society each year. The usual investigation for bowel malignancy is optical colonoscopy (OC), with computed tomography colonography (CTC) used as an alternative investigation. The catharsis and colon insufflation associated with these investigations pose a higher risk in the elderly and frail. Risks include perforation, serum electrolyte disturbance and anaesthesia/sedation risks. Minimal preparation computed tomography colonography (MPCTC) eliminates these risks.AimsTo audit the accuracy of a MPCTC programme for the investigation of colonic masses in symptomatic elderly and frail patients.MethodsThis paper audits a 6‐year period of MPCTC in an Australian tertiary referral hospital. A total of 145 patients underwent MPCTC during the study period.ResultsThere were seven true positives, two false positives and two false negatives. Analysis of this population indicates a sensitivity of 0.78 (95% CI 0.51–1.05), specificity of 0.99 (95% CI 0.97–1.01), positive predictive value (PPV) of 0.78 (95% CI 0.51–1.05) and negative predictive value (NPV) of 0.99 (95% CI 0.97–1.01). These findings are concordant with other published studies.ConclusionsThis audit confirms that minimal preparation CT colonography is a reasonable alternative to OC and CTC in detecting colorectal cancer in symptomatic elderly and frail patients, without the procedural risks inherent in more invasive investigations. For most patients, MPCTC ruled out significant colorectal carcinoma with a high NPV.
Person‐centred pain management for the patient with acute abdominal pain: An ethnography informed by the Fundamentals of Care framework
Authors: Avallin Therese , Muntlin Athlin Åsa , Elgaard Sørensen Erik , Kitson Alison , Björck Martin , Jangland Eva 
Published: June 2018

AbstractAimsTo explore and describe the impact of the organizational culture on and the patient–practitioner patterns of actions that contributes to or detract from successful pain management for the patient with acute abdominal pain (AAP) across the acute care pathway.BackgroundAlthough pain management is a recognized human right, unmanaged pain continues to cause suffering and prolong hospital care. Unanswered questions about how to successfully manage pain relate to both organizational culture and individual practitioners’ performance.DesignFocused ethnography, applying the Developmental Research Sequence and the Fundamentals of Care framework.MethodsParticipant observation and informal interviews (92 hr) were performed at one emergency department (ED) and two surgical wards at a University Hospital during April–November 2015. Data include 261 interactions between patients, aged ≥18 years seeking care for AAP at the ED and admitted to a surgical ward (N = 31; aged 20–90 years; 14 men, 17 women; 9 with communicative disabilities) and healthcare practitioners (N = 198).ResultsThe observations revealed an organizational culture with considerable impact on how well pain was managed. Well‐managed pain presupposed the patient and practitioners to connect in a holistic pain management including a trustful relationship, communication to share knowledge and individualized analgesics.ConclusionsPerson‐centred pain management requires an organization where patients and practitioners share their knowledge of pain and pain management as true partners. Leaders and practitioners should make small behavioural changes to enable the crucial positive experience of pain management.
Factors that have an impact on knowledge, attitude and practice related to kangaroo care: National survey study among neonatal nurses
Authors: Deng Qingqi , Zhang Yao , Li Qiufang , Wang Hua , Xu Xinfen 
Published: June 2018

Aims and objectivesTo explore factors that impact nurses’ knowledge, perceptions and practice related to kangaroo care in neonatal intensive care units in China.BackgroundIt is recognised extensively that kangaroo care is an effective intervention for improving the outcomes of preterm infants and has been recommended as a routine practice for neonatal care. However, this practice is uncommon in China and little is known about neonatal nurses’ knowledge and attitude.DesignA descriptive cross‐sectional survey.MethodsAn online questionnaire was completed by 830 neonatal nurses. Data were analysed using measures of central tendency, dispersion, ANOVA,ttests and the general linear model.ResultsA total of 48.2% of the participants reported practicing kangaroo care. Range of score for each scale was knowledge 0–16 (M = 9.62), perceptions 28–103 (M = 79.99), barriers 17–85 (M = 65.40) and practice 11–55 (M = 34.44). Experience in using kangaroo care was a primary factor for the scores of four scales. Particularly, experienced nurses had higher level of knowledge and perceived less barriers. Respondents’ role in neonatal intensive care units considerably influenced perceptions and practice level. Nurses’ highest education and neonatal intensive care unit level also influenced the knowledge and practice score, separately. A major barrier to practice was the reluctance of physicians, nurses and parents.ConclusionNeonatal nurses’ knowledge, attitude and practice levels related to kangaroo care were relatively low. Results suggested that leadership and knowledgeable practitioners could initiate education and clinical training to improve nurses’ knowledge and awareness on the efficacy of kangaroo care. Moreover, initiatives and behaviours would be enhanced following increased knowledge and perceived value. Such barriers as the reluctance of medical staff may likewise be lowered or removed after experiencing kangaroo care.Relevance to clinical practiceNeonatal nurses’ knowledge and belief need to be improved for optimal practice of kangaroo care. Organisational support and clear guidelines are also in need for successful kangaroo care.