bluuebunny/crossref_metadata_2025_split huggingface dataset:
Total Mesorectal Excision for Mid-Rectal Cancer Without Anastomosis: Low Hartmann’s Operation or Intersphincteric Abdomino-Perineal Excision?
Authors: Popiolek M. , Dehlaghi K. , Gadan S. , Baban B. , Matthiessen P. 
Published: November 2018

Background and Aims: In mid-rectal cancer, the low colorectal anastomosis is, although feasible, sometimes avoided. The aim was to compare low Hartmann’s procedure with intersphincteric abdomino-perineal excision of the rectum, in patients operated with total mesorectal excision for mid-rectal cancer in whom the low anastomosis was technically feasible but for patient-related reasons undesired. Material and Methods: A total of 64 consecutive patients with mid-rectal cancer who underwent low Hartmann’s procedure (n = 34) or intersphincteric abdomino-perineal excision (n = 30) at one colorectal unit were compared regarding patient demography, short-term oncology, surgical outcome at 3 and 24 months, and long-term overall survival. Results: There were no significant differences between intersphincteric abdomino-perineal excision and Hartmann’s procedure regarding age, gender distribution, body mass index, preoperative radiotherapy, tumor level, or cancer stages. Operation time was shorter in Hartmann’s procedure as compared with intersphincteric abdomino-perineal excision, median 174 and 256 min, (P < 0.001), and intraoperative blood loss was increased, 600 and 500 mL, respectively (P = 0.045). Number of lymph nodes and circumferential resection margin were comparable. In Hartmann’s procedure compared with intersphincteric abdomino-perineal excision, the need for reoperation was 24% and 3%, (P = 0.020), complications classified as Clavien–Dindo 3–4 occurred in 32% and 10%, (P = 0.031), pelvic abscess in 21% and 10%, (P = 0.313), and mortality within 90 days was 3% and 0%, respectively, (P = 0.938). In intersphincteric abdomino-perineal excision, the perineal wound was not healed at 3 months in 13%, and in Hartmann’s procedure 15% had chronic secretion from the anorectal remnant at 2 years postoperatively. Conclusion: The results from this study suggest that intersphincteric abdomino-perineal excision might be an alternative to Hartmann’s procedure in patients with mid-rectal cancer, in whom a low colorectal anastomosis is undesired.
Myostatin serum concentration as an indicator for deviated muscle metabolism in severe burn injuries
Authors: Wallner C. , Wagner J. M. , Dittfeld S. , Drysch M. , Lehnhardt M. , Behr B. 
Published: November 2018

Introduction: Patients experiencing thermal injuries with an extent of over 20% of total body surface area suffer from systemic catabolic disease. The thermal trauma-induced loss of muscle mass causes a higher incidence for comorbidities and subsequently a higher mortality. In this study, we aimed to investigate the role of myostatin in the interplay with follistatin during muscle cachexia. Methods: Patients with burn injuries (>10% total body surface area) between the ages of 18 and 75 were prospectively included within the first 48 h after trauma to determine deviations of parameters connected to muscle catabolism. In the chronic state of burn injury (9–12 months after trauma), we re-evaluated myostatin and follistatin concentrations as well as muscle strength of the non-dominant forearm. Results: We were able to show a time-dependent alteration (9–12 months after burn injury) of myostatin with an initial decrease ( p < 0.001) and long-term increase ( p < 0.001) after thermal injury in blood serum. For follistatin, a reciprocal correlation was observed ( r = −0.707, p = 0.001). Accordingly, muscle strength of the non-dominant hand and forearm was significantly decreased 9–12 months after injury in post-burn patients compared with healthy patients with a significant correlation to myostatin levels ( r = −0.899, p < 0.001). In addition, initial myostatin serum concentration was predictive for long-term muscle strength impairment. Conclusion: With regard to the muscle metabolism after thermal trauma, our data suggest an acute anabolic response, presumably to spare muscle mass, which is converted to catabolic conditions accompanied by muscle strength reduction in the chronic phase. Myostatin plays a crucial role in this orchestration and initial myostatin concentration may predict the long-term muscle strength.
Baseline characteristics of the 1149 patients recruited into the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2) randomized controlled trial
Authors: Bath Philip M , Scutt Polly , Appleton Jason P , Dixon Mark , Woodhouse Lisa J , Wardlaw Joanna M , Sprigg Nikola 
Published: November 2018

Background High blood pressure is common in acute stroke and associated with a worse functional outcome. Glyceryl trinitrate, a nitric oxide donor, lowers blood pressure in acute stroke and may improve outcome. Aims Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2) tested the feasibility of performing a UK multicenter ambulance-based stroke trial, and the safety and efficacy of glyceryl trinitrate when administered by paramedics before hospital admission. Methods Paramedic-led ambulance-based multicenter prospective randomized single-blind blinded-endpoint parallel-group controlled trial of transdermal glyceryl trinitrate (given for four days) versus sham in patients with ultra-acute (<4 h) presumed stroke. Data are number (%), median (interquartile range) or mean (standard deviation). Results Recruitment ran from October 2015 to 31 May 2018. A total 1149 patients were recruited from eight UK ambulance services and taken to 54 acute hospitals. Baseline characteristics include: mean age 73 (15) years; female 555 (48%); median time from stroke to randomization 70 (45, 115) min; face-arm-speech scale score 2.6 (0.5); and blood pressure 162 (25)/92 (18) mmHg. The final diagnosis was ischemic stroke 52%, hemorrhagic stroke 13%, Transient Ischemic Attack (TIA) 9%, and mimic 25%. The main trial results will be presented in quarter 4 2018. The results will also be included in updated Cochrane systematic reviews, and individual patient data meta-analyses of all relevant randomized controlled trials. Conclusion It was feasible to perform a multicenter ambulance-based ultra-acute stroke trial in the UK and to treat with glyceryl trinitrate versus sham. The relatively unselected cohort of stroke patients is broadly representative of those admitted to hospital in the UK. Trial registration ISRCTN26986053.
Impact of Design on Emotional, Psychological, or Social Well-Being for People With Cognitive Impairment
Authors: Karol Elizabeth , Smith Dianne 
Published: November 2018

Aim: The objective of this article is to identify and analyze what is known about characteristics in and around the home that support well-being for those with cognitive impairment. This could provide direction for designers of homes in general, but specifically for designers trying to meet the needs of people with cognitive impairment. Background: It has been established that there is a relationship between psychological well-being and a person’s environment. Research also shows that particular design aspects can reduce the impact of cognitive impairment. However, there is limited design expertise in the Australian housing market to create supportive spaces which will help to reduce the impact of the disability for those with cognitive impairment. Method: A literature review was carried out to determine the extent and details of what is known about the relationship of home design and its impact on emotional, psychological, or social well-being for people with cognitive impairment. Conclusions: The study indicates that researchers in various disciplines understand that pragmatic design inputs such as thermal comfort and adequate lighting are important for people with cognitive impairment. In addition, some researchers have shown or surmise that there are other “intangible” designer-controlled elements that have beneficial impacts on people with cognitive impairment. Details of these intangible elements are sparse, and how much they might improve the quality of life for a person with cognitive impairment is not well understood. Further research is required to meet a growing need.
Blood Flow–Restricted Training for Lower Extremity Muscle Weakness due to Knee Pathology: A Systematic Review
Authors: Barber-Westin Sue , Noyes Frank R. 
Published: November 2018

Context: Blood flow–restricted training (BFRT) has been suggested to treat lower extremity muscle weakness. The efficacy of BFRT for muscle problems related to knee pathology is unclear. Objective: To determine whether BFRT (1) improves muscle strength and cross-sectional area (CSA) for chronic knee-related lower extremity atrophy and (2) prevents muscle atrophy after knee surgery. Data Sources: A systematic review of the literature from 1974 to 2017 was conducted using the PubMed and Cochrane databases. Study Selection: Controlled trials that used BFRT to treat chronic knee-related lower extremity muscle atrophy or to prevent muscle atrophy after knee surgery that measured the effects on quadriceps or hamstrings muscle strength or CSA were included. Study Design: Systematic review. Level of Evidence: Level 2. Data Extraction: Data were extracted as available from 9 studies (8 level 1, 1 level 2). Assessment of study quality was rated using the Physiotherapy Evidence Database or Methodological Index for Non-Randomized Studies instruments. Results: BFRT was used after anterior cruciate ligament reconstruction and routine knee arthroscopy and in patients with knee osteoarthritis or patellofemoral pain. There were a total of 165 patients and 170 controls. Vascular occlusion and exercise protocols varied; all studies except 1 incorporated exercises during occlusion, most of which focused on the quadriceps. Six of 7 studies that measured quadriceps strength reported statistically significant improvements after training. Few benefits in quadriceps CSA were reported. Hamstrings strength was only measured in 2 studies. There were no complications related to training. Conclusion: Published limited data show BFRT to be safe and potentially effective in improving quadriceps muscle strength in patients with weakness and atrophy related to knee pathology. The use of short-duration vascular occlusion and light-load resistance exercises appears safe after knee surgery or in arthritic knees. This treatment option requires further investigation to refine protocols related to cuff pressure and exercise dosage and duration.
How I treat cancer-associated venous thromboembolism
Authors: Kraaijpoel Noémie , Carrier Marc 
Published: November 2018

Abstract
Venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism, is a common complication of cancer and is associated with significant morbidity and mortality. Several cancer-related risk factors contribute to the development of VTE including cancer type and stage, chemotherapy, surgery, and patient-related factors such as advanced age and immobilization. Patients with cancer frequently undergo diagnostic imaging scans for cancer staging and treatment response evaluation, which is increasing the underlying risk of VTE detection. The management of cancer-associated VTE is challenging. Over the years, important advances have been made and, recently, randomized controlled trials have been published helping clinicians’ management of this patient population. In this review, we will discuss common cancer-associated VTE scenarios and critically review available evidence to guide treatment decisions.
CD19-positive antibody-secreting cells provide immune memory
Authors: Groves C. J. , Carrell J. , Grady R. , Rajan B. , Morehouse C. A. , Halpin R. , Wang J. , Wu J. , Shrestha Y. , Rayanki R. , Kolbeck R. , Wang Y. , Herbst R. 
Published: November 2018

AbstractLong-lived antibody-secreting cells (ASCs) are critical for the maintenance of humoral immunity through the continued production of antibodies specific for previously encountered pathogen or vaccine antigens. Recent reports describing humoral immune memory have suggested the importance of long-lived CD19− bone marrow (BM) ASCs, which secrete antibodies recognizing previously encountered vaccine antigens. However, these reports do not agree upon the unique contribution of the CD19+ BM ASC subset toward humoral immunity. Here, we found both CD19+ and negative ASCs from human BM were similar in functional capacity to react to a number of vaccine antigens via ELISpot assays. The CD19+ cells were the predominant ASC population found in lymphoid tissues, and unlike the CD19− ASCs, which were found only in spleen and BM, the CD19+ ASCs were found in tonsil and blood. CD19+ ASCs from the BM, spleen, and tonsil were capable of recognizing polio vaccine antigens, indicating the CD19+ ASC cells play a novel role in long-lasting immune defense. Comparative gene expression analysis indicated CD19+ and negative BM ASCs differed significantly by only 14 distinct messenger RNAs and exhibited similar gene expression for cell cycle, autophagy, and apoptosis control necessary for long life. In addition, we show identical CDR-H3 sequences found on both BM ASC subsets, indicating a shared developmental path. Together, these results provide novel insight for the distribution, function, genetic regulation, and development of long-lived ASCs and may not only impact improved cell therapies but also enhance strategies for vaccine development.
Associations between schizophrenia genetic risk, anxiety disorders and manic/hypomanic episode in a longitudinal population cohort study
Authors: Richards Alexander , Horwood John , Boden Joseph , Kennedy Martin , Sellers Ruth , Riglin Lucy , Mistry Sumit , Jones Hannah , Smith Daniel J. , Zammit Stanley , Owen Michael , O'Donovan Michael C. , Harold Gordon T. 
Published: November 2018

BackgroundStudies involving clinically recruited samples show that genetic liability to schizophrenia overlaps with that for several psychiatric disorders including bipolar disorder, major depression and, in a population study, anxiety disorder and negative symptoms in adolescence.AimsWe examined whether, at a population level, association between schizophrenia liability and anxiety disorders continues into adulthood, for specific anxiety disorders and as a group. We explored in an epidemiologically based cohort the nature of adult psychopathology sharing liability to schizophrenia.MethodSchizophrenia polygenic risk scores (PRSs) were calculated for 590 European-descent individuals from the Christchurch Health and Development Study. Logistic regression was used to examine associations between schizophrenia PRS and four anxiety disorders (social phobia, specific phobia, panic disorder and generalised anxiety disorder), schizophrenia/schizophreniform disorder, manic/hypomanic episode, alcohol dependence, major depression, and – using linear regression – total number of anxiety disorders. A novel population-level association with hypomania was tested in a UK birth cohort (Avon Longitudinal Study of Parents and Children).ResultsSchizophrenia PRS was associated with total number of anxiety disorders and with generalised anxiety disorder and panic disorder. We show a novel population-level association between schizophrenia PRS and manic/hypomanic episode.ConclusionsThe relationship between schizophrenia liability and anxiety disorders is not restricted to psychopathology in adolescence but is present in adulthood and specifically linked to generalised anxiety disorder and panic disorder. We suggest that the association between schizophrenia liability and hypomanic/manic episodes found in clinical samples may not be due to bias.Declarations of interestNone.
Unleashing talent in mental health sciences: gender equality at the top
Authors: Breedvelt Josefien J. F. , Rowe Sarah , Bowden-Jones Henrietta , Shridhar Sunita , Lovett Kate , Bockting Claudi , Lingford-Hughes Anne , Strathdee Geraldine , Tracy Derek K. 
Published: November 2018

SummarySociety is undergoing a shift in gender politics. Science and medicine are part of this conversation, not least as women's representation and pay continue to drop as one progresses through more senior academic and clinical levels. Naming and redressing these inequalities needs to be a priority for us all.Declaration of interestNone.
Adjuvant Letrozole and Tamoxifen Alone or Sequentially for Postmenopausal Women With Hormone Receptor–Positive Breast Cancer: Long-Term Follow-Up of the BIG 1-98 Trial
Authors: Ruhstaller Thomas , Giobbie-Hurder Anita , Colleoni Marco , Jensen Maj-Britt , Ejlertsen Bent , de Azambuja Evandro , Neven Patrick , Láng István , Jakobsen Erik Hugger , Gladieff Laurence , Bonnefoi Hervé , Harvey Vernon J. , Spazzapan Simon , Tondini Carlo , Del Mastro Lucia , Veyret Corinne , Simoncini Edda , Gianni Lorenzo , Rochlitz Christoph , Kralidis Elena , Zaman Khalil , Jassem Jacek , Piccart-Gebhart Martine , Di Leo Angelo , Gelber Richard D. , Coates Alan S. , Goldhirsch Aron , Thürlimann Beat , Regan Meredith M. ,   for the members of the BIG 1-98 Collaborative Group and the International Breast Cancer Study Group
Published: November 2018

Purpose Luminal breast cancer has a long natural history, with recurrences continuing beyond 10 years after diagnosis. We analyzed long-term follow-up (LTFU) of efficacy outcomes and adverse events in the Breast International Group (BIG) 1-98 study reported after a median follow-up of 12.6 years. Patients and Methods BIG 1-98 is a four-arm, phase III, double-blind, randomized trial comparing adjuvant letrozole versus tamoxifen (either treatment received for 5 years) and their sequences (2 years of one treatment plus 3 years of the other) for postmenopausal women with endocrine-responsive early breast cancer. When pharmaceutical company sponsorship ended at 8.4 years of median follow-up, academic partners initiated an observational, LTFU extension collecting annual data on survival, disease status, and adverse events. Information from Denmark was from the Danish Breast Cancer Cooperative Group Registry. Intention-to-treat analyses are reported. Results Of 8,010 enrolled patients, 4,433 were alive and not withdrawn at an LTFU participating center, and 3,833 (86%) had at least one LTFU report. For the monotherapy comparison of letrozole versus tamoxifen, we found a 9% relative reduction in the hazard of a disease-free survival event with letrozole (hazard ratio [HR], 0.91; 95% CI, 0.81 to 1.01). HRs for other efficacy end points were similar to those for disease-free survival. Efficacy of letrozole versus tamoxifen for contralateral breast cancer varied significantly over time (0- to 5-, 5- to 10-, and > 10-year HRs, 0.62, 0.47, and 1.35, respectively; treatment-by-time interaction P = .005), perhaps reflecting a longer carryover effect of tamoxifen. Reporting of specific long-term adverse events seemed more effective with national registry than with case-record reporting of clinical follow-up. Conclusion Efficacy end points continued to show trends favoring letrozole. Letrozole reduced contralateral breast cancer frequency in the first 10 years, but this reversed beyond 10 years. This study illustrates the value of extended follow-up in trials of luminal breast cancer.
СОПОСТАВИТЕЛЬНЫЙ АНАЛИЗ РЕАЛИЗАЦИИ КОММУНИКАТИВНЫХ СТРАТЕГИЙ В РЕКЛАМНЫХ СЛОГАНАХ КОНДИТЕРСКИХ ИЗДЕЛИЙ (НА ПРИМЕРЕ РУССКОЯЗЫЧНОЙ И АНГЛОЯЗЫЧНОЙ РЕКЛАМЫ)
Authors: Strizhkova Olga Valerevna , Streneva Natalya Vladimirovna 
Published: November 2018

Резюме. Статья посвящена проблеме выявления сходных и отличных языковых единиц выражения коммуникативных тактик в реализации коммуникативных стратегий в рекламном дискурсе продуктов питания.Автор ставит целью провести сопоставительный прагмалингвистический анализ, направленный на описание конкретно-языковых и типологических характеристик средств выражения коммуникативного намерения в англо- и русскоязычных слоганах рекламы кондитерских изделий.Метод или методология проведения работы. Основу исследования образует метод сопоставительного анализа, включающего приемы количественного анализа и статистической обработки материала.Результаты. Автор выявляет коммуникативные стратегии и тактики, сходные для англо- и русскоязычного рекламного дискурса продуктов питания, а также лексические и синтаксические языковые средства выражения интенции адресанта, наиболее распространенные для каждого из анализируемых языков.Область применения результатов. Результаты исследования могут быть применены в сфере лингвокультурной коммуникации при составлении учебных пособий по сравнительной типологии англо- и русскоязычных рекламных текстов.
Association of Weekend Admission and Weekend Discharge with Length of Stay and 30‐Day Readmission in Children's Hospitals
Authors: Markham Jessica L , Richardson Troy , Hall Matthew , Bonafide Christopher P , Williams Derek J , Auger Katherine A. , Wilson Karen M , Shah Samir S ,   Pediatric Research in Inpatient Settings (PRIS) Network
Published: November 2018

BACKGROUNDWorse outcomes among adults presenting for/receiving care on weekends (ie, “the weekend effect”) have been observed for many diseases. However, little is known about the overall impact of the weekend effect in hospitalized children.OBJECTIVETo determine the association between weekend admission and length of stay (LOS) and between weekend discharge and 30‐day all‐cause readmission.METHODSWe conducted a retrospective, cross‐sectional study of children hospitalized between October 1, 2014 and September 30, 2015 using the Pediatric Health Information System. Birth hospitalizations and planned procedures were excluded. We used generalized linear mixed modeling to assess the independent association between weekend admission and LOS and weekend discharge and readmission risk.RESULTSAmong 390,745 hospitalizations across 43 hospitals, the median LOS was 41 hours (interquartile range [IQR] 24‐71) and the 30‐day readmission rate was 8.2% (IQR 7.2‐9.4). We observed no association between weekend admission and LOS (adjusted LOS [95% CI] weekend 63.70 [61.01‐66.52] hours vs weekday 63.40 [60.73‐66.19] hours, P = .112). Weekend discharge was associated with slightly increased odds of readmission compared with weekday discharge (adjusted probability of readmission [95% CI]: weekend 0.13 [0.12‐0.13] vs weekday 0.11 [0.11‐0.12]; P < .001) but was variable among individual hospitals. Patient characteristics (ie, number of chronic conditions) were more strongly associated with LOS and readmission risk than weekend admission or discharge.CONCLUSIONSPatient‐level factors (ie, clinical and demographic characteristics) are more indicative of longer LOS and readmission risk than weekend admissions or discharges. The overall impact of the weekend effect across children's hospitals was minimal.