bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interferon‐free therapy as the cause of white matter tracts and cerebral perfusion recovery in patients with chronic hepatitis C
Authors: Bladowska Joanna , Pawłowski Tomasz , Fleischer‐Stępniewska Katarzyna , Knysz Brygida , Małyszczak Krzysztof , Żelwetro Agnieszka , Rymer Weronika , Inglot Małgorzata , Waliszewska‐Prosół Marta , Ejma Maria , Podgórski Przemysław , Zimny Anna , Sąsiadek Marek 
Published: January 2019

SummaryThe purpose of this study was to assess cerebral microstructural and perfusion changes in patients with chronic hepatitis C virus (HCV) infection before and after interferon‐free therapy, using advanced magnetic resonance (MR) techniques. Eleven HCV‐positive patients underwent diffusion tensor imaging (DTI) and perfusion‐weighted imaging (PWI) using a 1.5T MR unit, before and 24 weeks after completion of interferon‐free therapy. DTI fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were obtained from 14 white matter tracts. PWI values of relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF) were assessed from 8 areas, including basal ganglia, and cortical and white matter locations. In HCV‐positive patients therapy with ombitasvir, paritaprevir boosted with ritonavir and dasabuvir, with or without ribavirin, was scheduled. Cognitive tests were used to assess cognitive function. We found increased FA values after interferon‐free therapy compared to values obtained before treatment in HCV patients in almost all white matter tracts. We also observed elevated rCBV values in basal ganglia after therapy. There were significant correlations between improvement in the score of cognitive tests and increased FA values in both inferior fronto‐occipital fascicles and left posterior cingulum after treatment. Liver fibrosis regression in elastography, APRI and improvement in cognitive tests were observed. This is the first report of interferon‐free therapy as the cause of white matter tracts recovery as well as cerebral perfusion improvement in HCV‐infected patients, indicating better functioning of frontal lobes after interferon‐free treatment.
Reducing large net foreign liabilities
Authors: Fidora Michael , Schmitz Martin , Tcheng Céline 
Published: January 2019

AbstractIn light of persistently large net foreign liability (NFL) positions in several euro area countries, we analyze 138 episodes of sizeable NFL reductions for a broad sample of advanced and emerging economies. We provide stylized facts on the channels through which NFLs were reduced and estimate factors that make episodes “stable”, that is, sustained over the medium term. Our findings show that while GDP growth and valuation effects contribute most to NFL reductions overall, stable reduction episodes also require positive transaction effects (i.e., current account surpluses), in particular in advanced economies. Considering the different components of a country's external balance sheet, we observe that reduction episodes were almost exclusively driven by a decline in gross external liabilities in emerging economies, while in advanced economies also gross external asset accumulation contributed significantly, in particular in stable episodes. Our econometric analysis shows that NFL reductions are more likely to be sustained if a country records strong average real GDP growth during an episode and exits the episode with a larger current account surplus that consists of a combination of relatively high exports, low imports and low net factor income payments. Moreover, we find evidence that nominal effective exchange rate depreciation during an episode is helpful for achieving episode stability in the short run, while IMF programs and sovereign debt restructurings also contribute to longer term stability.
The first reported case of drug‐induced hemolytic anemia caused by dimethyl fumarate in a patient with multiple sclerosis
Authors: Quintanilla‐Bordás Carlos , Castro‐Izaguirre Emma , Carcelén‐Gadea María , Marín María 
Published: January 2019

BACKGROUNDDrug‐induced hemolytic anemia is a rare and potentially fatal complication of drug treatment. Specific laboratory tests are crucial to confirm the diagnosis.CASE REPORTA 38‐year‐old woman on treatment with dimethyl fumarate for multiple sclerosis presented with a 7‐day history of weakness and fatigue. Laboratory tests revealed profound hemolytic anemia with hemoglobin levels of 4.7 g/dL (reference, 12.5–16.0), decreased haptoglobin, increased reticulocyte count, and increased indirect bilirubin. A first direct antiglobulin test was negative. The patient was started on prednisone 1 mg/kg/day, and dimethyl fumarate was withdrawn. A blood sample was drawn on Day 7 and sent to a reference laboratory. A direct antiglobulin test performed 7 days later was positive. Furthermore, an indirect antiglobulin test was positive only in the presence of the drug.RESULTSThe patient did not receive a blood transfusion, recovered clinically during the following days, and was discharged on Day 7. On Day 36, the patient's RBCs had normalized. She was changed to another disease‐modifying treatment for her multiple sclerosis, and at 10‐month follow‐up she remained stable without any notable adverse effects.CONCLUSIONThis case describes the first report of a dimethyl fumarate–induced hemolytic anemia. Laboratory results should always be interpreted within the clinical context. Specific laboratory expertise is often needed, given the complexity of the field.
Mapping the entire nerve architecture of the cat cornea
Authors: He Jiucheng , Pham Thang Luong , Bazan Haydee E. P. 
Published: January 2019

AbstractObjectiveTo provide a complete nerve architecture and neuropeptide distribution in the cat cornea.Animals studiedTwo adult domestic cats.ProcedureThe cat corneas were stained with protein gene product (PGP) 9.5 antibody—a pan marker for nerve fibers—and then divided into four quarters and double labeled with calcitonin gene‐related peptide (CGRP) or substance P (SP) antibodies. Relative corneal nerve fiber densities and nerve terminals were evaluated in whole mount images by computer‐assisted analysis.ResultsAn average of 21.5 ± 2.1 thick stromal nerves enters the cornea around the limbus where they split into many branches going up to the anterior stroma. Some branches link to each other, but most of them penetrate the basement membrane in the periphery to give origin to subbasal bundles, which run centripetally and merge to form a whirl‐like structure (vortex) at the center. These nerve bundles send out many fine terminals that innervate the epithelial cells. Subbasal nerve density and nerve terminals were greater in the center than in the periphery of the cornea. Additionally, CGRP‐positive central epithelial nerve fibers and terminals were more abundant than SP‐positive nerves and terminals.ConclusionThe architecture of cat corneal nerves shows similarities to human and mouse cornea innervation. This study provides useful data for researchers who use the cat model to assess corneal nerve pathological alterations, as well as in the veterinary field where corneal opacities, ulcerations, and infections damage the nerves and decrease sensitivity.
Ophthalmic findings in a captive population of Panamanian golden frogs: Atelopus zeteki
Authors: Pelych Lindsey N. , Shellabarger Wynona , Vassallo Mark , Noland Erica , Sledge Dodd , Aquino Susette E. 
Published: January 2019

AbstractPurposeThe aim of this study was to describe normal ocular morphology and establish parameters for select diagnostics in a population of Panamanian Golden Frogs (PGF) Atelopus zeteki maintained at the Detroit Zoo.MethodA total of 22 toads free of ocular disease were included in this study. Ophthalmic diagnostic tests included as follows: endodontic absorbent paper point tear test (EAPPTT), assessment of intraocular pressures (IOP), Rose Bengal stain, palpebral fissure width, blink rate and corneal cultures. Histology was performed on stored postmortem samples.ResultsPanamanian Golden Frogs have a distinct brow ridge and mobile third eyelid. Biomicroscopy revealed avascular, convex corneas with a shallow anterior chamber. Iris color ranged from yellow to green with dark pigmentation of the peripheral iris. Pupil shape was round. Posterior segment and fundus could not be visualized. Total number of blinks observed over a 10‐minute period was one. Mean EAPPTT was 2 ± 1 mm and 3 ± 1 mm in males and females, respectively (P). Mean IOP using rebound tonometry in horizontal and vertical restraint positions were 21.6 ± 2.28 mm Hg and 17.45 ± 3.66 mm Hg, 21.85 ± 2.7 mm Hg and 17.5 ± 3.93 mm Hg in males and females, respectively. Mean palpebral fissure width was 5.02 ± 0.46 mm and 6.12 ± 0.39 mm in males and females, respectively (P). Enterococcus faecalis was isolated from one clinically normal toad.ConclusionsTear production and blink rate were low and not significantly different between males and females. Intraocular pressure was significantly greater in male toads (P value <0.01). Females had a significantly larger palpebral fissure width when compared to males (P value <0.01) 5819. The ophthalmic parameters established in this study can aid in the evaluation and diagnosis of eye diseases in PGF.
Examining the Impact of Knowledge Translation Interventions on Uptake of Evidence‐Based Practices by Care Aides in Continuing Care
Authors: Tworek Kimberly B. , Ickert Carla , Bakal Jeffrey , Eliasziw Misha , Wagg Adrian S. , Jones C. Allyson , Slaughter Susan E. 
Published: January 2019

AbstractBackgroundDissemination of evidence‐based practices has been a long‐standing challenge for healthcare providers and policy makers. Research has increasingly focused on effective knowledge translation (KT) in healthcare settings.AimsThis study examined the effectiveness of two KT interventions, informal walkabouts and documentation information sessions, in supporting care aide adoption of new evidence‐based practices in continuing care.MethodsThe Sustaining Transfers through Affordable Research Translation (START) study examined sustainability of a new practice, the sit‐to‐stand activity completed with residents in 23 continuing care facilities in Alberta, Canada. At each facility, two informal walkabouts and two documentation information sessions were conducted with care aides during the first 4 months. To assess their effect, uptake of the sit‐to‐stand activity was compared 4 days prior to and 4 days after each intervention, as well as the entire first and fourth months of the study were compared. Data were analyzed using mixed linear regression models created to estimate the changes in uptake.ResultsData were collected from 227 residents. After controlling for age, sex, dementia, and mobility, a 5.3% (p = .09) increase in uptake of the mobility activity was observed during the day shift and 6.1% (p = .007) increase in uptake of the mobility activity during the evening shift. Site size had a significant effect on the outcome with medium‐sized facilities showing a 12.6% (SE = .07) increase over small sites and a 18.2% (SE = .05) increase over large sites. These results suggest that repeated KT interventions and sufficient time are key variables in the successful implementation of new practices.Linking Evidence to ActionConsideration of time, repetition, and facility‐specific variables such as size may generate simple, cost‐effective KT interventions in healthcare settings.
Association between diabetic retinopathy and incident cognitive impairment
Authors: Gupta Preeti , Gan Alfred Tau Liang , Man Ryan Eyn Kidd , Fenwick Eva K , Sabanayagam Charumathi , Mitchell Paul , Cheung Carol Y , Cheung Ning , Wong Tien Yin , Cheng Ching-Yu , Lamoureux Ecosse Luc 
Published: January 2019

Background/AimThe relationship between diabetic retinopathy (DR) and cognitive impairment (CI) is unclear due to equivocal findings from cross-sectional studies and a lack of long-term data. In this population-based cohort study, we investigated the longitudinal association between the severity of DR and the incidence of CI.Methods682 participants with diabetes, gradable retinal photographs and no CI at baseline 2004–2011) and complete relevant data at follow-up 2010–2016 from the Singapore Epidemiology of Eye Disease Study were included. CI was assessed using the validated Abbreviated Mental Test (AMT), defined as scores of ≤6 and ≤8 for those with 0–6 and >6 years of formal education, respectively. Six-year incident CI was defined as having no CI at baseline but present at the follow-up visit.ResultsOf the 682 included participants, 483 (70.8%) had no DR and 199 (29.2%) had any DR. Of those with DR, 142 (20.8%) had minimal/mild DR and 57 (8.4%) had moderate or worse DR at baseline. At the follow-up visit, 40 (5.9%) participants had incident CI based on AMT. In multivariate analysis compared with participants without DR, those with any DR had more than twofold increased odds of incident CI (OR (95% CI): 2.32 (1.07 to 5.03)). Participants with moderate or worse DR had threefold increased odds of developing CI (3.41 (1.06 to 11.00)), compared with those with no DR.ConclusionsDR, particularly at the more severe stages, is associated with increased risk of developing CI, independent of vision and other risk factors.
Health systems changes after decentralisation: progress, challenges and dynamics in Pakistan
Authors: Zaidi Shehla Abbas , Bigdeli Maryam , Langlois Etienne V , Riaz Atif , Orr David W , Idrees Nasir , Bump Jesse B 
Published: January 2019

Decentralisation is widely practised but its scrutiny tends to focus on structural and authority changes or outcomes. Politics and process of devolution implementation needs to be better understood to evaluate how national governments use the enhanced decision space for bringing improvements in the health system and the underlying challenges faced. We use the example of Pakistan’s radical, politically driven provincial devolution to analyse how national structures use decentralisation opportunities for improved health planning, spending and carrying out transformations to the health system. Our narrative draws on secondary data sources from the PRIMASYS study, supplemented with policy roundtable notes from Pakistan.Our analysis shows that in decentralised Pakistan, health became prioritised for increased government resources and achieved good budgetary use, major strides were made contextualised sector-wide health planning and legislations, and a proliferation seen in governance measures to improve and regulate healthcare delivery. Despite a disadvantaged and abrupt start to devolution, high ownership by politicians and bureaucracy in provincial governments led to resourcing, planning and innovations. However, effective translation remained impeded by weak institutional capacity, feeble federal–provincial coordination and vulnerability to interference by local elites.Building on this illustrative example, we propose (1) political management of decentralisation for effective national coordination, sustaining stable leadership and protecting from political interfere by local elites; (2) investment in stewardship capacity in the devolved structures as well as the central ministry to deliver on new roles.
Meta-analysis of the diagnostic value of Wisteria floribunda agglutinin-sialylated mucin1 and the prognostic role of mucin1 in human cholangiocarcinoma
Authors: Tang Zengwei , Yang Yuan , Wang Xiaolu , Meng Wenbo , Li Xun 
Published: January 2019

ObjectiveSerum carbohydrate antigen 19–9 (CA19-9) is a widely used tumour marker for cholangiocarcinoma (CCA). However, it is not a necessarily good CCA marker in terms of diagnostic accuracy. The purpose of this study is to evaluate the diagnostic value ofWisteria floribundaagglutinin-sialylated Mucin1 (WFA-MUC1) and the prognostic role of Mucin1 (MUC1) in human CCA.DesignMeta-analysis.Data sourcesStudies published in PubMed, Web of Science, The Cochrane Library and the China National Knowledge Infrastructure up to 11 October 2017.Eligibility criteriaWe included reports assessing the diagnostic capacity of WFA-MUC1 and the prognostic role of MUC1 in CCA. The receiver operating characteristic curve (ROC) of WFA-MUC1 and/or CA19-9 was described, and the HRs including 95% CI and the corresponding p value for MUC1 can be extracted.Data extraction and synthesisTwo independent researchers extracted data and assessed risk of bias. The diagnostic sensitivity and specificity data of WFA-MUC1 were extracted and analysed as bivariate data. Pooled HRs and its 95% CI for MUC1 were calculated with a random-effects meta-analysis model on overall survival of resectable CCA.ResultsSixteen reports were included in this study. The pooled sensitivity and specificity of WFA-MUC1 were 0.76 (95% CI 0.71 to 0.81) and 0.72 (95% CI 0.59 to 0.83) in serum, 0.85 (95% CI 0.81 to 0.89) and 0.72 (95% CI 0.64 to 0.80) in bile and 0.72 (95% CI 0.50 to 0.87) and 0.85 (95% CI 0.70 to 0.93) in tissue, respectively. The summary ROC (SROC) were 0.77 (95% CI 0.73 to 0.81) in serum, 0.88 (95% CI 0.85 to 0.90) in bile and 0.86 (95% CI 0.83 to 0.89) in tissue, respectively. Furthermore, the pooled sensitivity and specificity and the SROC of CA19-9 in serum were 0.67 (95% CI 0.61 to 0.72), 0.86 (95% CI 0.75 to 0.93) and 0.75 (95% CI 0.71 to 0.79), respectively. The pooled HRs for MUC1 was 2.20 (95% CI 1.57 to 3.01) in CCA and 4.17 (95% CI 1.71 to 10.17) in mass-forming intrahepatic CCA.ConclusionsCompared with CA19-9, WFA-MUC1 was shown to possess stronger diagnostic capability. MUC1 could serve as a prognosis factor for poor outcomes of CCA, particularly, mass-forming intrahepatic CCA.
Reporting, presentation and wording of recommendations in clinical practice guideline for gout: a systematic analysis
Authors: Yang Nan , Yu Yang , Zhang Anqi , Estill Janne , Wang Xiaoqin , Zheng Mingfu , Zhou Qi , Zhang Jingyi , Luo Xufei , Qian Changli , Mao Yifang , Wang Qi , Yang Yantao , Chen Yaolong 
Published: January 2019

ObjectivesWe systematically analysed recommendations from gout guidelines as an example, to provide a basis for developing a reporting standard of recommendations in clinical practice guidelines (CPGs).DesignSystematic review without meta-analysis.MethodsWe systematically searched MEDLINE and all relevant guideline websites (National Institute for Health and Care Excellence, National Guideline Clearinghouse, Scottish Intercollegiate Guidelines Network, WHO, Guidelines International Network, DynaMed, UpTodate, Best Practice) from their inception to January 2017 to identify and select gout CPGs. We used search terms such as ‘gout’, ‘hyperuricemia’ and ‘guideline’. We included the eligible CPGs of gout according to the predefined inclusion and exclusion criteria after screening titles, abstracts and full texts. The characteristics of recommendations reported in the included guidelines were extracted and analysed.ResultsA total of 15 gout guidelines with a range of 5–80 recommendations were retrieved. Several indicators were used in the gout guidelines to facilitate identification of recommendations, including grouping all recommendations in a summary section, formatting recommendations in a particular or special way, using locating words for recommendations and indicating the strength of recommendation and quality of evidence. We found some components commonly used in the recommendations. The wording of recommendations varied across guidelines. Recommendations were detailed and explained in the section of rationale and explanation of recommendations. In some guidelines, recommendations were accompanied with other material to assist their reporting.ConclusionsVariability and inconsistency were found on the reporting and presentation of recommendations in gout guidelines. Several points for reporting recommendation can be summarised. First, we suggested summarising and highlighting the core recommendations in a guideline. Second, guideline developers should try to structure and write recommendations reasonably. Third, it was necessary to detail and explain the recommendations and their rationale. Finally, describing and providing other potential useful contents was also a helpful way for clear reporting.
Association between allostatic load and health behaviours: a latent class approach
Authors: Forrester Sarah N , Leoutsakos Jeannie-Marie , Gallo Joseph J , Thorpe Roland J , Seeman Teresa E 
Published: January 2019

BackgroundAllostatic load (AL) has been characterised in many ways throughout the literature; however, its relationship to health behaviours has only been studied in limited populations. We aimed to uncover qualitative patterns of biological indicators in AL and determine if those patterns were associated with certain health behaviours.MethodsWe conducted latent class analysis using biological indicators from a multiethnic population. We fit latent class regression of class on health behaviours (smoking, poor diet, physical activity and alcohol use) to measure the association between each latent class of AL and each health behaviour.ResultsFour classes, ‘Metabolic+Cholesterol, ‘Blood Pressure’, ‘Metabolic+Blood Pressure’ and ‘Low’, were found in the sample. Latent class regression showed that physical activity and alcohol use were significantly associated with the ‘Metabolic+Blood Pressure’ class.ConclusionLess physical activity was required to improve AL than was previously found. Low to moderate alcohol use was beneficial for lower AL. Implications of the amount of physical activity necessary to lower AL is discussed.
What’s in a smile? A review of the benefits of the clinician’s smile
Authors: Beamish Andrew James , Foster Jessica Jane , Edwards Harry , Olbers Torsten 
Published: January 2019

AbstractFor millennia, the smile has been recognised as a powerful communication device, offering benefits to both giver and receiver with few drawbacks. A sign of compassion, empathy and friendliness, smiling can benefit healthcare professionals and their patients, helping to build a relationship of trust. But beware the false smile, which is all too easily identified and may do more harm than good. In this review, we explore the literature surrounding smiling in healthcare and beyond, discussing the many reasons to be cheerful, from good health to a happy marriage, among aviators, table waiters, doctors, dentists and even dogs.