bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of a Patient Blood Management monitoring and feedback programme on allogeneic blood transfusions and related costs
Authors: Kaserer A. , Rössler J. , Braun J. , Farokhzad F. , Pape H.‐C. , Dutkowski P. , Plass A. , Horisberger T. , Volbracht J. , Manz M. G. , Spahn D. R. 
Published: August 2019

SummaryA Patient Blood Management programme was established at the University Hospital of Zurich, along with a monitoring and feedback programme, at the beginning of 2014 with a first analysis reported in 2015. Our study aimed to investigate the further impact of this Patient Blood Management monitoring and feedback programme on transfusion requirements and related costs. We included adult patients discharged between 2012 and 2017. A total of 213,882 patients underwent analysis: 66,659 patients in the baseline period (2012–2013); 35,309 patients in the year after the introduction of the Patient Blood Management monitoring and feedback programme (2014) and 111,914 patients in the continued sustainability period (2015–2017). The introduction of the Patient Blood Management monitoring and feedback programme reduced allogeneic blood product transfusions by 35%, from 825 units per 1000 hospital discharges in 2012 to 536 units in 2017. The most sustained effect was an approximately 40% reduction in red blood cell transfusions, from 535 per 1000 discharges to 319 units. Fewer patients were transfused in the periods after the introduction of the Patient Blood Management monitoring and feedback programme (6251 (9.4%) vs. 2932 (8.3%) vs. 8196 (7.3%); p < 0.001). Compared with 2012, the yearly OR for being exposed to any blood transfusion declined steadily after the introduction of the Patient Blood Management monitoring and feedback programme to 0.64 (95%CI 0.61–0.68; p < 0.001) in 2017. For patients requiring extracorporeal membrane oxygenation, transfusion requirements were also sustainably reduced. This reduction in allogeneic blood transfusions led to savings of 12,713,754 Swiss francs (£ 9,497,000 sterling; EUR 11,100,000; US$ 12,440,000) in blood product acquisition costs over 4 years. In‐hospital mortality was not affected by the programme. The Patient Blood Management monitoring and feedback programme sustainably reduced transfusion requirements and related costs, without affecting in‐hospital mortality.
Surgically treated ovarian lesions in preadolescent girls
Authors: Ripatti Liisi , Taskinen Mervi , Koivusalo Antti , Taskinen Seppo 
Published: August 2019

AbstractIntroductionThe purpose of this study was to investigate the epidemiology and characteristics of surgically treated ovarian lesions in preadolescent girls.Material and methodsThis was a retrospective cohort study including all 0‐ to 11‐year‐old girls operated at a single center from 1999 to 2016 for ovarian cysts, neoplasms or torsions. Patient charts were reviewed for symptoms, preoperative radiological imaging, operative details and histopathology.ResultsWe identified 78 girls, resulting in a population‐based incidence of 4.2/100 000. Infants (n = 44) presented with benign cysts (42/44, 95%, one bilateral), a benign neoplasm (1/44, 2%) and a torsion without other pathology (1/44, 2%). Torsion was found in 25/29 (86%) ovaries with complex cysts and in 3/15 (21%) ovaries with simple cysts in preoperative imaging (P < 0.001). Most infants were symptomless. Lesions in 1‐ to 11‐year‐old girls (n = 34) included benign neoplasms (n = 21/34, 62%), malignant neoplasms (n = 5/34, 15%), a cyst with torsion (n = 1/34, 3%) and torsions without other pathology (n = 7/34, 21%). Torsion was more common in benign (17/21, 81%) than in malignant neoplasms (1/5, 20%) (P < 0.020). Ovarian diameter did not differ between ovaries with or without torsion (P = 0.238) or between benign and malignant neoplasms (P = 0.293). The duration of symptoms in lesions with or without torsion was similar.ConclusionsThe majority of surgically treated ovarian lesions in preadolescent are benign lesions with torsion. Surgery should be ovary‐preserving and performed without delay.
Optical coherence tomography (OCT) to image active and inactive retinoblastomas as well as retinomas
Authors: Nadiarnykh Oleg , McNeill‐Badalova Nuray A. , Gaillard Marie‐Claire , Bosscha Machteld I. , Fabius Armida W.M. , Verbraak Frank D. , Munier Francis L. , de Boer Johannes F. , Moll Annette C. 
Published: August 2019

AbstractPurposeTo illustrate Optical Coherence Tomography (OCT) images of active and inactive retinoblastoma (Rb) tumours.MethodsCurrent observational study included patients diagnosed with retinoblastoma and retinoma who were presented at Amsterdam UMC and Jules‐Gonin Eye Hospital, between November 2010 and October 2017. Patients aged between 0 and 4 years were imaged under general anaesthesia with handheld OCT in supine position. Patients older than 4 years were imaged with the conventional OCT (Heidelberg Engineering, Heidelberg Spectralis, Germany). All patients included were divided into two groups: active and inactive tumours (retinoma and regression patterns). Patients’ medical records and OCT images were analysed during meetings via discussions by ophthalmologists and physicists.ResultsTwelve Dutch and 8 Swiss patients were divided into two groups: 2 patients with active tumour versus 18 patients with inactive tumour. Subsequently, inactive group could be divided in two groups, which consisted of 10 patients with retinoma and 8 patients with different regression pattern types. Of all included patients, 15 were male (75%). Median age at diagnosis was 18.0 months (range 0.19–715.2 months). A total of 12 retinoblastoma (active and inactive) and 8 retinoma foci were investigated by OCT. No distinction could be made between active and inactive tumours using only OCT.ConclusionOptical coherence tomography alone cannot distinguish between active and inactive Rbs. However, handheld OCT adds useful information to the established imaging techniques in the monitoring and follow‐up of retinoblastoma patients. With this study, we provide an overview of OCT images of active and inactive Rbs.
Review article: direct‐acting antivirals for the treatment of HCV during pregnancy and lactation ‐ implications for maternal dosing, foetal exposure, and safety for mother and child
Authors: Freriksen Jolien J. M. , van Seyen Minou , Judd Ali , Gibb Diana M. , Collins Intira J. , Greupink Rick , Russel Frans G. M. , Drenth Joost P. H. , Colbers Angela , Burger David M. 
Published: August 2019

SummaryBackgroundWith the global efforts to eradicate hepatitis C virus (HCV), treatment during pregnancy is becoming a priority for research as this, and maternal cure should reduce vertical transmission. However, as information on the efficacy and safety of direct‐acting antivirals (DAAs) in pregnancy is generally lacking, treatment of HCV infection during pregnancy is not currently recommended.AimTo provide an overview of current knowledge regarding maternal exposure, placental handling and safety of DAAs during pregnancy and lactationMethodsA literature search was performed focusing on the effect of pregnancy on maternal exposure to DAAs, the placental handling of DAAs, the safety of DAAs for mother and child during pregnancy and the safety of DAAs during lactation.ResultsExposure to all DAAs studied is likely to be altered during pregnancy, mostly related to pregnancy‐induced effects on drug absorption and metabolism. Although animal studies show that most DAAs are reported to cross the placenta and transfer into breast milk, most DAA combinations show a favourable safety profile. Because of the rapid viral decline after treatment initiation, and to avoid the critical period of organogenesis, treatment may be started at the end of the second trimester or early third trimester.ConclusionsTreatment of HCV infection during pregnancy is realistic, as DAAs are highly effective and treatment duration is relatively short. There is an urgent need to study DAAs during pregnancy and lactation to contribute to the goal of HCV elimination.
A geostatistical framework for combining spatially referenced disease prevalence data from multiple diagnostics
Authors: Amoah Benjamin , Diggle Peter J. , Giorgi Emanuele 
Published: August 2019

AbstractMultiple diagnostic tests are often used due to limited resources or because they provide complementary information on the epidemiology of a disease under investigation. Existing statistical methods to combine prevalence data from multiple diagnostics ignore the potential overdispersion induced by the spatial correlations in the data. To address this issue, we develop a geostatistical framework that allows for joint modelling of data from multiple diagnostics by considering two main classes of inferential problems: (a) to predict prevalence for a gold‐standard diagnostic using low‐cost and potentially biased alternative tests; (b) to carry out joint prediction of prevalence from multiple tests. We apply the proposed framework to two case studies: mapping Loa loa prevalence in Central and West Africa, using miscroscopy, and a questionnaire‐based test called RAPLOA; mapping Plasmodium falciparum malaria prevalence in the highlands of Western Kenya using polymerase chain reaction and a rapid diagnostic test. We also develop a Monte Carlo procedure based on the variogram in order to identify parsimonious geostatistical models that are compatible with the data. Our study highlights (a) the importance of accounting for diagnostic‐specific residual spatial variation and (b) the benefits accrued from joint geostatistical modelling so as to deliver more reliable and precise inferences on disease prevalence.
Tinnitus groups: A model of social support and social connectedness from peer interaction
Authors: Pryce Helen , Moutela Tiago , Bunker Colette , Shaw Rachel 
Published: August 2019

Tinnitus is a chronic condition for which there is no medical treatment. Tinnitus groups are a widely available resource for people with tinnitus.ObjectivesOur objectives were to explore the active ingredients of tinnitus support groups in terms of their mechanisms for providing support, the contextual factors that elicit such mechanisms, and the outcomes in terms of coping enhancement.DesignWe adopted a pluralist and iterative approach informed by the realist evaluation method.MethodsWe conducted ethnographic data generation at tinnitus support groups involving observations (n = 160), focus groups (n = 130), and individual interviews (n = 20). Inductive analyses were conducted following the constant comparison method of grounded theory. We then interrogated the inductive themes to identify evidence of Contexts, Mechanisms, and Outcomes. We then produced a model which was tested in a survey of tinnitus group members (n = 65) in effect providing large‐scale respondent validation of the data‐driven model created through our inductive analysis.ResultsWe identified that tinnitus groups can facilitate social connectedness between group members. This experience appeared to build resilience among those experiencing tinnitus‐related distress. Groups also played a role in building a sense of control related to knowledge and information sharing. Additionally, we identified risks associated with not accessing social support in a group environment.ConclusionsOur findings contribute to the growing understanding of the power of social connectedness as building shared social identity when living with tinnitus.
Statement of contribution

What is already known on this subject?

Tinnitus is a prevalent condition with approximately 10–15% of the population experiencing a spontaneous sound without obvious source.

Tinnitus is an invisible health and chronic condition. People with tinnitus experience high levels of distress, anxiety, and depression.

Group support is beneficial to people with many health problems.

What does this study add?

This study describes the mechanisms by which tinnitus support groups can support coping in tinnitus.

This is the first study to comprehensively explore the views of those who attend tinnitus groups.

The study identifies the key features of support groups that facilitate social connectedness among group members.

The most valued features of groups are the knowledge and information provided, the sense of belonging communicated to group members, and the creation and maintenance of a sense of hope towards the tinnitus.

This study contributes new insights to both the tinnitus field and adds to the literature on support groups in health.
Sleep disturbance in patients with mild‐moderate chronic obstructive pulmonary disease
Authors: Lee Sang Hee , Kim Ki Uk , Lee Haejung , Park Hye‐Kyung , Kim Yun Seong , Lee Min Ki 
Published: August 2019

AbstractIntroductionAlthough sleep problems have an important impact on daily life and health outcome measures in patients with chronic obstructive pulmonary disease (COPD), patterns of sleep disturbance in patients with mild‐moderate COPD remain unknown.ObjectiveThe aim of this study was to investigate patterns of sleep disturbance and factors associated with sleep impairment in patients with mild‐moderate COPD.MethodsThis prospective cross‐sectional study enrolled 148 male patients with COPD. At enrolment, all patients completed a disease‐specific sleep measure, the COPD and Asthma Sleep Impact Scale (CASIS) to assess sleep impairment. Health‐related quality of life (HRQL) was measured using the St. George's Respiratory Questionnaire (SGRQ) and the 36‐item Short‐Form health survey (SF‐36). Anxiety and depression status were assessed using the Hospital Anxiety and Depression Scale (HADS). Self‐efficacy was measured by the COPD Self‐Efficacy Scale (CSES).ResultsThe mean age of the subjects was 67 years [standard deviation (SD) = 8.11]. The proportion of patients who indicated that they had a bad night's sleep was 33.1%. Univariated analysis showed that CASIS score was significantly correlated with the modified Medical Research Council (mMRC) dyspnea scale, SGRQ, SF‐36 Physical Component Summary, SF‐36 Mental Component Summary, HADS‐anxiety, HADS‐depression and CSES scores (all P < 0.05). In a multivariate analysis, SGRQ and CSES were independently associated with CASIS score.ConclusionPoorer HRQL and lower self‐efficacy are significantly associated with sleep disturbance and perhaps may be improved by better sleep quality. Future research is required to enhance sleep quality in patients with mild‐moderate COPD.
Tooth and consequences: Heterodonty and dental replacement in piranhas and pacus (Serrasalmidae)
Authors: Kolmann Matthew A. , Cohen Karly E. , Bemis Katherine E. , Summers Adam P. , Irish Frances J. , Hernandez L. Patricia 
Published: August 2019

AbstractTooth replacement in piranhas is unusual: all teeth on one side of the head are lost as a unit, then replaced simultaneously. We used histology and microCT to examine tooth‐replacement modes across carnivorous piranhas and their herbivorous pacu cousins (Serrasalmidae) and then mapped replacement patterns onto a molecular phylogeny. Pacu teeth develop and are replaced in a manner like piranhas. For serrasalmids, unilateral tooth replacement is not an “all or nothing” phenomenon; we demonstrate that both sides of the jaws have developing tooth rows within them, albeit with one side more mineralized than the other. All serrasalmids (except one) share unilateral tooth replacement, so this is not an adaptation for carnivory. All serrasalmids have interlocking teeth; piranhas interdigitate lateral tooth cusps with adjacent teeth, forming a singular saw‐like blade, whereas lateral cusps in pacus clasp together. For serrasalmids to have an interlocking dentition, their teeth need to develop and erupt at the same time. We propose that interlocking mechanisms prevent tooth loss and ensure continued functionality of the feeding apparatus. Serrasalmid dentitions are ubiquitously heterodont, having incisiform and molariform dentitions reminiscent of mammals. Finally, we propose that simultaneous tooth replacement be considered as a synapomorphy for the family.
Plasticity‐led evolution: A survey of developmental mechanisms and empirical tests
Authors: Levis Nicholas A. , Pfennig David W. 
Published: August 2019

AbstractRecent years have witnessed increased interest in evaluating whether phenotypic plasticity can precede, facilitate, and possibly even bias adaptive evolution. Despite accumulating evidence for “plasticity‐led evolution” (i.e., “PLE”), critical gaps remain, such as: how different developmental mechanisms influence PLE; whether some types of traits and taxa are especially prone to experience PLE; and what studies are needed to drive the field forward. Here, we begin to address these shortcomings by first speculating about how various features of development—modularity, flexible regulation, and exploratory mechanisms—might impact and/or bias whether and how PLE unfolds. We then review and categorize the traits and taxa used to investigate PLE. We do so both to identify systems that may be well‐suited for studying developmental mechanisms in a PLE context and to highlight any mismatches between PLE theory and existing empirical tests of this theory. We conclude by providing additional suggestions for future research. Our overarching goal is to stimulate additional work on PLE and thereby evaluate plasticity's role in evolution.
Animal learning as a source of developmental bias
Authors: Laland Kevin N. , Toyokawa Wataru , Oudman Thomas 
Published: August 2019

AbstractAs a form of adaptive plasticity that allows organisms to shift their phenotype toward the optimum, learning is inherently a source of developmental bias. Learning may be of particular significance to the evolutionary biology community because it allows animals to generate adaptively biased novel behavior tuned to the environment and, through social learning, to propagate behavioral traits to other individuals, also in an adaptively biased manner. We describe several types of developmental bias manifest in learning, including anadaptive bias, historical bias, origination bias, andtransmission bias, stressing that these can influence evolutionary dynamics through generating nonrandom phenotypic variation and/or nonrandom environmental states. Theoretical models and empirical data have established that learning can impose direction on adaptive evolution, affect evolutionary rates (both speeding up and slowing down responses to selection under different conditions) and outcomes, influence the probability of populations reaching global optimum, and affect evolvability. Learning is characterized by highly specific, path‐dependent interactions with the (social and physical) environment, often resulting in new phenotypic outcomes. Consequently, learning regularly introduces novelty into phenotype space. These considerations imply that learning may commonly generate plasticity first evolution.
Autoimmune thrombocytopenia: Current treatment options in adults with a focus on novel drugs
Authors: Witkowski Michał , Witkowska Magdalena , Robak Tadeusz 
Published: August 2019

AbstractImmune thrombocytopenia (ITP) is an autoimmune disease characterized by platelet destruction and reduced platelet production resulting in decreased platelet level and an increased risk of bleeding. Based on the immunologic mechanism of ITP, front‐line standard therapy consists of corticosteroids and intravenous immunoglobulins (IVIG). If patients do not respond to the first‐line treatment, or if continuous therapy is required, the disorder is called refractory ITP, and second‐line therapy is indicated. This treatment may consist of rituximab, thrombopoietin receptor agonists, splenectomy, or cytotoxic drugs. Despite significant advances, many patients do not respond to any the treatments listed below, and new treatment options need to be developed for this relapsed and refractory group. Recent clinical studies have indicated promising outcomes for novel drugs, either as single agents or in combination with traditional drugs. This review discusses the latest and the most promising novel drugs for ITP in adults.
Evidence of rapid adaptive trait change to local salinity in the sperm of an invasive fish
Authors: Green Leon , Havenhand Jonathan N. , Kvarnemo Charlotta 
Published: August 2019

AbstractInvasive species may quickly colonize novel environments, which could be attributed to both phenotypic plasticity and an ability to locally adapt. Reproductive traits are expected to be under strong selection when the new environment limits reproductive success of the invading species. This may be especially important for external fertilizers, which release sperm and eggs into the new environment. Despite adult tolerance to high salinity, the invasive fish Neogobius melanostomus (round goby) is absent from fully marine regions of the Baltic Sea, raising the possibility that its distribution is limited by tolerance during earlier life stages. Here, we investigate the hypothesis that the spread of N. melanostomus is limited by sperm function in novel salinities. We sampled sperm from two invasion fronts with higher and lower salinities in the Baltic Sea and tested them across a range of salinity levels. We found that sperm velocity and percentage of motile sperm declined in salinity levels higher and lower than those currently experienced by the Baltic Sea populations, with different performance curves for the two fronts. Sperm velocity also peaked closer to the home salinity conditions in each respective invasion front, with older localities showing an increased fit to local conditions. By calculating how the sperm velocity has changed over generations, we show this phenotypic shift to be in the range of other fish species under strong selection, indicating ongoing local adaptation or epigenetic acclimation to their novel environment. These results show that while immigrant reproductive dysfunction appears to at least partly limit the distribution of invasive N. melanostomus in the Baltic Sea, local adaptation to novel environments could enable future spread beyond their current boundaries.