bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of perampanel in generalized and focal to bilateral tonic‐clonic seizures: A comparative study of Asian and non‐Asian populations
Authors: Nishida Takuji , Lee Sang Kun , Wu Tony , Tiamkao Somsak , Dash Amitabh 
Published: March 2019

SummaryPerampanel is an approved adjunctive treatment for focal seizures with or without focal to bilateral tonic‐clonic (FBTC) seizures and generalized tonic‐clonic (GTC) seizures. We compared efficacy and safety of perampanel vs placebo in Asian and non‐Asian populations in a post hoc analysis of pooled data from 5 randomized phase 3 studies. Patients (≥12 years old) with focal + FBTCseizures received perampanel 2, 4, 8, or 12 mg or placebo; patients withGTCseizures received perampanel 8 mg or placebo (titration: 4‐6 weeks; maintenance: 13 weeks). Efficacy endpoints included median percentage change inFBTCorGTCseizure frequency per 28 days and 50% responder rate relative to baseline. Median percentage change inFBTCseizure frequency was significantly greater for perampanel 8 and 12 mg than placebo in the Asian population (median difference from placebo: −30.32%,P = 0.0017; −30.06%,P = 0.0008, respectively) and perampanel 4, 8, and 12 mg in the non‐Asian population (−35.07%,P = 0.0001; −37.78%,P < 0.0001; −34.53%,P < 0.0001, respectively). In both populations, median percentage change inGTCseizure frequency was significantly greater for perampanel 8 mg than placebo (median difference from placebo: Asian, −37.37%,P = 0.0139; non‐Asian, −27.04%,P = 0.0006). The 50% responder rates were significantly greater than placebo for perampanel 8 and 12 mg forFBTCseizures (Asian: 58.0%,P = 0.0017 and 58.6%,P = 0.0013, respectively; non‐Asian: 59.3%,P < 0.0001 and 54.3%,P = 0.0050, respectively) and perampanel 8 mg forGTCseizures (Asian: 57.6%,P = 0.0209; non‐Asian: 68.8%,P = 0.0329). PooledFBTC/GTCseizure data showed generally similar patterns of response to perampanel in both populations. The most frequent treatment‐related adverse events were fatigue, irritability, dizziness, somnolence, and headache. Perampanel was effective, well tolerated, and can be considered a therapeutic option forFBTC/GTCseizures in Asian populations.
Trends in mortality from cutaneous malignant melanoma in Spain (1982–2016): sex‐specific age‐cohort‐period effects
Authors: Gutiérrez‐González E. , López‐Abente G. , Aragonés N. , Pollán M. , Pastor‐Barriuso R. , Sánchez M.J. , Pérez‐Gómez B. 
Published: March 2019

AbstractBackgroundMortality from malignant cutaneous melanoma increased alarmingly during the second half of the 20th century in Spain and other European countries.ObjectiveThe aim was to analyse sex‐ and age‐specific trends in melanoma mortality in Spain in the period 1982–2016.MethodsEuropean age‐standardized melanoma mortality rates during the period 1982–2016 were calculated from mortality figures provided by the National Statistics Institute. Joinpoint regressions were used to identify significant points of change in trends and to compute average annual per cent change (AAPC). Age‐cohort‐period models were fitted to explore the effect of these variables on mortality.ResultsDuring the period 1982–2016, age‐standardized melanoma mortality rates increased in Spain from 0.90 to 1.80 deaths per 100 000 people in men and from 0.64 to 1.11 per 100 000 in women, rising noticeably from 1982 to 1995 in both sexes and in all age groups. From the mid‐90s different trends were observed depending on sex and age: there was a decrease in mortality in the population younger than 45 years (AAPC ‐2 in both sexes) and aged 45–64 years (AAPC ‐1 among men and ‐0.2 among women), but in the group over 64 years rates continued to increase (AAPC 1.7 and 0.2, respectively, for men and women). The mortality sex ratio decreased in the younger population but increased in older individuals. A cohort effect was observed with lower mortality in the cohorts born after 1943 in men and 1956 in women. There was also a period effect with decreased mortality rates at the beginning of the 1990s.ConclusionsMelanoma mortality rates in Spain increased during the last decades of the 20th century; however, later they stabilized in women and began to decrease in younger cohorts and middle‐aged men. Promotion of primary and secondary prevention measures should continue, with particular emphasis on males over 65 years.
Exploring the Influence of Judge Proficiency on Standard‐Setting Judgments
Authors: Peabody Michael R. , Wind Stefanie A. 
Published: March 2019

AbstractSetting performance standards is a judgmental process involving human opinions and values as well as technical and empirical considerations. Although all cut score decisions are by nature somewhat arbitrary, they should not be capricious. Judges selected for standard‐setting panels should have the proper qualifications to make the judgments asked of them; however, even qualified judges vary in expertise and in some cases, such as highly specialized areas or when members of the public are involved, it may be difficult to ensure that each member of a standard‐setting panel has the requisite expertise to make qualified judgments. Given the subjective nature of these types of judgments, and that a large part of the validity argument for an exam lies in the robustness of its passing standard, an examination of the influence of judge proficiency on the judgments is warranted. This study explores the use of the many‐facet Rasch model as a method for adjusting modified Angoff standard‐setting ratings based on judges’ proficiency levels. The results suggest differences in the severity and quality of standard‐setting judgments across levels of judge proficiency, such that judges who answered easy items incorrectly tended to perceive them as easier, but those who answered correctly tended to provide ratings within normal stochastic limits.
Bias and Bias Correction Method for Nonproportional Abilities Requirement (NPAR) Tests
Authors: Ip Edward H. , Strachan Tyler , Fu Yanyan , Lay Alexandra , Willse John T. , Chen Shyh‐Huei , Rutkowski Leslie , Ackerman Terry 
Published: March 2019

AbstractTest items must often be broad in scope to be ecologically valid. It is therefore almost inevitable that secondary dimensions are introduced into a test during test development. A cognitive test may require one or more abilities besides the primary ability to correctly respond to an item, in which case a unidimensional test score overestimates the primary ability and creates interpretability problems. In this article, we demonstrate the nonproportional abilities requirement, a phenomenon with which secondary abilities are more required for difficult items. A novel and practical method for correcting bias in the primary ability is proposed and illustrated using a real data set from an international assessment. Simulation data are also used to evaluate the performance of the method.
Association between ultrasonographic appearance of urine and urinalysis in dogs and cats
Authors: Valls Sanchez F. , Puig J. , Olivares G. , Holloway A. , Seth M. 
Published: March 2019

ObjectiveTo evaluate association between ultrasonographic urine echogenicity and sediment examination in dogs and cats.Materials and MethodsDogs and cats undergoing ultrasound‐guided cystocentesis at a multidisciplinary referral hospital. Ultrasonographic images were stored and reviewed by a single, blinded, board‐certified radiologist. Urine appearance was described as “echoic” or “anechoic”. Urine sediment was examined for bacteriuria, pyuria, haematuria, crystalluria and urine‐specific gravity and then classified as “active” or “inactive.”ResultsOf the 194 cases included in this study, urine was echoic in 52 and anechoic in 142. Sediment was active in 52 and inactive in 142 samples. Sensitivity and specificity of echoic urine for active sediment were 40% (95% CI: 27 to 55%) and 78% (95% CI: 70 to 85%), respectively. Positive predictive value and negative predictive value of echoic urine for active sediment were 40% (CI 30 to 52%) and 78% (CI 74 to 82%), respectively. If urine‐specific gravity was <1.015 urine was always described ultrasonographically as anechoic.Clinical SignificanceAssociation between sediment analysis and ultrasonographic appearance of urine is poor. Echoic urine had low positive predictive value for active sediment in this study, suggesting that echoic urine alone should not prompt urinary investigations in the absence of other clinical suspicion. Despite a negative predictive value of 78%, urinalysis is still indicated for anechoic urine, especially if urine specific gravity is low.
Mast cell infiltration associated with loss of interstitial cells of Cajal and neuronal degeneration in achalasia
Authors: Liu Zu‐Qiang , Chen Wei‐Feng , Wang Yun , Xu Xiao‐Yue , Zeng Yi‐Gang , Lee Dillon Dustin , Cheng Jing , Xu Mei‐Dong , Zhong Yun‐Shi , Zhang Yi‐Qun , Yao Li‐Qing , Zhou Ping‐Hong , Li Quan‐Lin 
Published: March 2019

AbstractBackgroundAchalasia is a motility disorder of unknown etiology. Previous studies supported the hypothesis that autoimmune‐mediated inflammatory responses produce inhibitory neuronal degeneration. This study was designed to explore the role of mast cells in achalasia.MethodsWe collected information from 116 patients with achalasia who underwent peroral endoscopic myotomy between December 2016 and May 2017. Lower esophageal sphincter (LES) muscle biopsy was performed in all patients with achalasia, as well as 20 control subjects. The number of mast cells, interstitial cells of Cajal (ICCs), nNOS‐positive cells, and S‐100‐positive cells in the LES were evaluated by immunohistochemistry. Pathological and clinical data were compared between groups.Key ResultsCompared with controls, the LES of patients with achalasia had significantly fewer ICCs, nNOS‐positive cells, and S‐100‐positive cells and a higher number of mast cells (all P < 0.001). Furthermore, the increased mast cell infiltration was significantly associated with decreased ICCs, nNOS‐positive cells, and S‐100‐positive cells in patients with achalasia (all P < 0.05). Clinically, the number of strongly positive mast cells was highest in patients with type I achalasia and lowest in those with type III achalasia (P < 0.001). In addition, patients with a history of autoimmune disease or viral infection had greater mast cell infiltration in the LES muscle (P = 0.040).Conclusions & InferencesIn patients with achalasia, mast cell infiltration in the LES muscle is increased, in association with loss of ICCs and neuronal degeneration. Mast cells may thereby play a crucial role in the development of achalasia.
Automatic lesion border selection in dermoscopy images using morphology and color features
Authors: Mishra Nabin K. , Kaur Ravneet , Kasmi Reda , Hagerty Jason R. , LeAnder Robert , Stanley Ronald J. , Moss Randy H. , Stoecker William V. 
Published: March 2019

AbstractPurposeWe present a classifier for automatically selecting a lesion border for dermoscopy skin lesion images, to aid in computer‐aided diagnosis of melanoma. Variation in photographic technique of dermoscopy images makes segmentation of skin lesions a difficult problem. No single algorithm provides an acceptable lesion border to allow further processing of skin lesions.MethodsWe present a random forests border classifier model to select a lesion border from 12 segmentation algorithm borders, graded on a “good‐enough” border basis. Morphology and color features inside and outside the automatic border are used to build the model.ResultsFor a random forests classifier applied to an 802‐lesion test set, the model predicts a satisfactory border in 96.38% of cases, in comparison to the best single border algorithm, which detects a satisfactory border in 85.91% of cases.ConclusionThe performance of the classifier‐based automatic skin lesion finder is found to be better than any single algorithm used in this research.
Regulatory actors and alternative routes for Arabidopsis seed germination are revealed using a pathway‐based analysis of transcriptomic datasets
Authors: Ponnaiah Maharajah , Gilard Françoise , Gakière Bertrand , El‐Maarouf‐Bouteau Hayat , Bailly Christophe 
Published: March 2019

SummaryRegulation of seed germination by dormancy relies on a complex network of transcriptional and post‐transcriptional modifications during seed imbibition that controls seed adaptive responses to environmental cues. High‐throughput technologies have brought significant progress in the understanding of this phenomenon and have led to identify major regulators of seed germination, mostly by studying the behaviour of highly differentially expressed genes. However, the actual models of transcriptome analysis cannot catch additive effects of small variations of gene expression in individual signalling or metabolic pathways, which are also likely to control germination. Therefore, the comprehension of the molecular mechanism regulating germination is still incomplete and to gain knowledge about this process we have developed a pathway‐based analysis of transcriptomic Arabidopsis datasets, to identify regulatory actors of seed germination. The method allowed quantifying the level of deregulation of a wide range of pathways in dormant versus non‐dormant seeds. Clustering pathway deregulation scores of germinating and dormant seed samples permitted the identification of mechanisms involved in seed germination such as RNA transport or vitamin B6 metabolism, for example. Using this method, which was validated by metabolomics analysis, we also demonstrated that Col and Cvi seeds follow different metabolic routes for completing germination, demonstrating the genetic plasticity of this process. We finally provided an extensive basis of analysed transcriptomic datasets that will allow further identification of mechanisms controlling seed germination.
Development of an online secondary prevention programme for stroke survivors: Prevent 2nd Stroke
Authors: Denham Alexandra M J , Guillaumier Ashleigh , McCrabb Sam , Turner Alyna , Baker Amanda L , Spratt Neil J , Pollack Michael , Magin Parker , Oldmeadow Christopher , Collins Clare , Callister Robin , Wallis Mark , Wynne Olivia , Bonevski Billie 
Published: March 2019

BackgroundStroke events often result in long-term negative health outcomes. People who experience a first stroke event are 30%–40% more likely to experience a second stroke event within 5 years. An online secondary prevention programme for stroke survivors may help stroke survivors improve their health risk behaviours and lower their risk of a second stroke.ObjectivesThis paper describes the development and early iteration testing of the usability and acceptability of an online secondary prevention programme for stroke survivors (Prevent 2nd Stroke, P2S). P2S aims to address six modifiable health risk behaviours of stroke: blood pressure, physical activity, nutrition, depression and anxiety, smoking, and alcohol consumption.MethodsP2S was developed as an eight-module online secondary prevention programme for stroke survivors. Modelled on the DoTTI (Design and development, Testing early iterations, Testing for effectiveness, Integration and implementation) framework for the development of online programmes, the following stages were followed during programme development: (1) content development and design; and (2) testing early iteration. The programme was pilot-tested with 15 stroke survivors who assessed P2S on usability and acceptability.ResultsIn stage 1, experts provided input for the content development of P2S. In stage 2, 15 stroke survivors were recruited for usability testing of P2S. They reported high ratings of usability and acceptability of P2S. P2S was generally regarded as ‘easy to use’ and ‘relevant to stroke survivors’. Participants also largely agreed that it was appropriate to offer lifestyle advice to stroke survivors through the internet.ConclusionsThe study found that an online secondary prevention programme was acceptable and easily usable by stroke survivors. The next step is to conduct a randomised controlled trial to assess the effectiveness of the programme regarding behaviour change and determine the cost-effectiveness of the intervention.
Lateral episiotomy versus no episiotomy to reduce obstetric anal sphincter injury in vacuum-assisted delivery in nulliparous women: study protocol on a randomised controlled trial
Authors: Bergendahl Sandra , Ankarcrona Victoria , Leijonhufvud Åsa , Hesselman Susanne , Karlström Sofie , Kopp Kallner Helena , Brismar Wendel Sophia 
Published: March 2019

IntroductionObstetric anal sphincter injury (OASIS) occurs in 5%–7% of normal deliveries and increases with vacuum extraction (VE) to 12%–14% in nulliparous women in Sweden. Lateral/mediolateral episiotomy may reduce the prevalence of OASIS at VE in nulliparous women. The current use of episiotomy is restrictive. The protective effect and consequences are uncertain. This trial will investigate if lateral episiotomy can reduce the prevalence of OASIS and assess short-term and long-term effects.Methods and analysisThis is a multicentre randomised controlled trial of lateral episiotomy versus no episiotomy in nulliparous women with a singleton, live fetus, after gestational week 34+0 with indication for VE. A lateral episiotomy of 4 cm is cut at crowning, 1–3 cm from the midline, at a 60° angle. The primary outcome is OASIS by clinical diagnosis analysed according to intention to treat. To demonstrate a 50% reduction in OASIS prevalence (from 12.4% to 6.2%), 710 women will be randomised at a 1:1 ratio. Secondary outcomes are pain, blood loss, other perineal injuries, perineal complications, Apgar score, cord pH and neonatal complications. Web-based questionnaires at baseline, 2 months, 1 and 5 years will be used to assess pain, incontinence, prolapse, sexual function, quality of life and childbirth experience. A subset of women will receive follow-up by pelvic floor sonography and pelvic examination. Mode of delivery and recurrence of OASIS/episiotomy in subsequent pregnancies will be assessed at 5 and 10 years using register data.Ethics and disseminationThe trial is open for enrolment. The trial has received ethical approval from the Regional Ethical Review Board of Stockholm and full funding from the Swedish Research Council. Women are interested in participation. The predominant restrictive view on episiotomy may limit recruitment. Results are of global interest and will be disseminated in peer-reviewed journals and at international congresses.Trial registration numberNCT02643108; Pre-results.
Randomised controlled trial of a video intervention and behaviour contract to improve medication adherence after renal transplantation: the VECTOR study protocol
Authors: Mansell Holly , Rosaasen Nicola , West-Thielke Patricia , Wichart Jenny , Daley Christopher , Mainra Rahul , Shoker Ahmed , Liu Juxin , Blackburn David 
Published: March 2019

IntroductionNon-adherence after kidney transplantation contributes to increased rejections, hospitalisations and healthcare expenditures. Although effective adherence interventions are sorely needed, increasing education and support to transplant recipients demands greater use of care providers’ time and resources in a healthcare system that is stretched. The objective of this clinical trial is to determine the effectiveness of an electronically delivered video series and adherence behaviour contract on improving medication adherence to immunosuppressant medications.Methods and analysisA multicentre, parallel arm, randomised controlled trial will be conducted with four sites across North America (Saskatoon, Calgary, Halifax, Chicago). Adult patients will be randomised (1:1) to either the intervention (ie, home-based video education +behaviour contract plus usual care) or usual care alone. De novo transplant recipients will be enrolled prior to their hospital discharge and will be provided with electronic access to the video intervention (immediately) and adherence contract (1 month post-transplant). Follow-up electronic surveys will be provided at 3 and 12 months postenrolment. The primary outcome will be adherence at 12 months post-transplant, as measured by self-report Basel Assessment of Adherence to Immunosuppressive medications and immunosuppressant levels. Secondary outcomes include the difference in knowledge score between the intervention and control in groups (measured by the Kidney Transplant Understanding Tool); differences in self-efficacy (Generalised Self-efficacy Scale), Beliefs of Medicine Questionnaire (BMQ), quality of life (Short Form-12), patient satisfaction and cost utilisation. The study aims to recruit at least 200 participants across participating sites.Ethics and disseminationEthical approval was obtained from the University of Saskatchewan Behavioural Ethics Committee (Beh 18–63), and all patients provide informed consent prior to participating. This educational intervention aims to improve information retention and self-efficacy, leading to improved medication adherence after kidney transplantation, at low cost, with little impact to existing healthcare personnel. If proven beneficial, delivery can be easily implemented into standard of care.Trial registration numberNCT03540121; Pre-results.
Exercise and incidence of myocardial infarction, stroke, hypertension, type 2 diabetes and site-specific cancers: prospective cohort study of 257 854 adults in South Korea
Authors: Kim Youngwon , Sharp Stephen , Hwang Semi , Jee Sun Ha 
Published: March 2019

ObjectiveThe objective of this study was to examine the longitudinal associations of exercise frequency with the incidence of myocardial infarction, stroke, hypertension, type 2 diabetes and 10 different cancer outcomes.DesignA prospective cohort study.SettingPhysical examination data linked with the entire South Korean population’s health insurance system: from 2002 to 2015.Participants257 854 South Korean adults who provided up to 7 repeat measures of exercise (defined as exercises causing sweat) and confounders.Primary outcome measuresEach disease incidence was defined using both fatal and non-fatal health records (a median follow-up period of 13 years).ResultsCompared with no exercise category, the middle categories of exercise frequency (3–4 or 5–6 times/week) showed the lowest risk of myocardial infarction (HR 0.79; 95% CI 0.70 to 0.90), stroke (HR 0.80; 95% CI 0.73 to 0.89), hypertension (HR 0.86; 95% CI 0.85 to 0.88), type 2 diabetes (HR 0.87; 95% CI 0.84 to 0.89), stomach (HR 0.87; 95% CI 0.79 to 0.96), lung (HR 0.80; 95% CI 0.71 to 0.91), liver (HR 0.85; 95% CI 0.75 to 0.98) and head and neck cancers (HR 0.76; 95% CI 0.63 to 0.93; for 1–2 times/week), exhibiting J-shaped associations. There was, in general, little evidence of effect modification by body mass index, smoking, alcohol consumption, family history of disease and sex in these associations.ConclusionsModerate levels of sweat-inducing exercise showed the lowest risk of myocardial infarction, stroke, hypertension, type 2 diabetes, stomach, lung, liver and head and neck cancers. Public health and lifestyle interventions should, therefore, promote moderate levels of sweat-causing exercise as a behavioural prevention strategy for non-communicable diseases in a wider population of East Asians.