bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thalidomide induces haematologic responses in patients with β‐thalassaemia
Authors: Chen Jiangming , Zhu Weijian , Cai Ning , Bu Shengdi , Li Jinyan , Huang Lan 
Published: August 2017

AbstractObjectiveThis study aimed to evaluate the clinical and laboratory outcomes of a group of patients with β‐thalassaemia major or intermedia treated with thalidomide.MethodsClinical and laboratory data were obtained by analysing medical records of β‐thalassaemia patients. Using the self‐control method, the levels of haemoglobin (Hb), foetal haemoglobin (HbF), white blood cells (WBC) and platelets were detected before and after the treatment, and adverse reactions were recorded.ResultsData from the medical records of 9 patients were analysed. The median haemoglobin levels of these patients increased from 5.13 ± 2.15 g/dL before treatment to 10.38 ± 1.19 g/dL after treatment. The average spleen size decreased from a pretreatment length of 8.19 ± 3.10 to 5.49 ± 1.80 cm below the costal margin after treatment. The mean HbF levels increased from a pretreatment value of 35.67% ± 26.82% to 75.67% ± 14.64% after treatment in the 9 patients for whom these measurements were available. All patients no longer needed transfusions by 1 month after treatment. No serious adverse reactions were observed in any of the thalidomide‐treated patients.ConclusionIn this study, thalidomide showed an outstanding effect on β‐thalassaemia patients who required frequent red‐cell transfusions. Thalidomide increased haemoglobin levels without causing serious adverse reactions, but the long‐term curative outcomes and other side effects should be observed continuously.
The management of hodgkin lymphomas in pregnancies
Authors: Moshe Yakir , Bentur Ohad Shimshon , Lishner Michael , Avivi Irit 
Published: August 2017

AbstractHodgkin lymphoma is the most common hematological malignancy in pregnancy. Its management presents several unique challenges, as decisions have to take both maternal and fetal risks into consideration. Using three hypothetical cases, we review current evidence and guidelines and suggest our recommendations for managing pregnant Hodgkin lymphoma patients. The opportunity for a prompt and accurate diagnosis should not be missed; this may be achieved by vigilance to suggestive symptoms, performance of biopsy which is not contraindicated during pregnancy and use of MRI for staging. Most patients should receive treatment with doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) after completion of the first trimester. Bridging therapy with corticosteroids or vinblastine should be considered during the first trimester. In most cases of early disease, the addition of chemotherapy cycles to the treatment plan seems preferable to radiation therapy. Diagnosis at relapse raises unique dilemmas regarding second‐line chemotherapeutic regimens and timing of consolidation with high‐dose therapy and autologous stem cell transplantation, an approach which is contraindicated during pregnancy. Considering the excellent outcomes of Hodgkin lymphoma outside pregnancy, every effort should be made to strive toward a curative treatment plan while balancing the multiple issues and dilemmas which arise when treating this malignancy in a pregnant patient.
Anti‐ictogenic and antiepileptogenic properties of perampanel in mature and immature rats
Authors: Dupuis Nina , Enderlin Julie , Thomas Jeremy , Desnous Béatrice , Dournaud Pascal , Allorge Delphine , Auvin Stéphane 
Published: August 2017

SummaryObjectivePerampanel (PER) is a selective noncompetitive antagonist at α‐amino‐3‐hydroxy‐5‐methyl‐4‐isoxazolepropionic acid receptors, the first of its class approved for the adjunctive treatment of partial onset seizures and generalized seizures. This study explored anti‐ictogenic and antiepileptogenic effects of PER in rats at different stages of development.MethodsUsing a rapid kindling model in postnatal day 14 (P14), P21, P28, and P60 rats, we studied two doses of PER: 1 and 2 mg/kg injected intraperitoneally 30 min before afterdischarge assessment. We also assessed blood and brain concentrations of PER 30 min after the injection.ResultsPER 2 mg/kg significantly increased the afterdischarge threshold (ADT) at all ages, whereas PER at 1 mg/kg increased ADT only in P21 rats. PER 2 mg/kg also shortened the afterdischarge duration in P14 and P28 rats. PER increased the number of stimulations required to achieve a stage 4–5 seizure in a dose‐dependent manner in P14 and P21 rats, with almost complete elimination of stage 4–5 seizures. At P28, only PER 2 mg/kg increased the number of stimulations required to develop a stage 4–5 seizure. In contrast, PER had no effect on the number of stage 4–5 seizures at P60. We did not observed any age‐dependent significant difference in the serum and brain levels of PER 30 min after the injection.SignificancePER exerted anti‐ictogenic effects from P14 to P60 independent of brain maturation. PER also exhibited antiepileptogenic effects with a stronger effect in the younger animals.
The effect of mean stress and stress biaxiality in high‐cycle fatigue
Authors: Koutiri Imade , Bellett Daniel , Morel Franck 
Published: August 2017

AbstractThis article presents a review of selected multiaxial high‐cycle fatigue criteria with an emphasis on their ability to take into account the mean stress effect and the effect of a biaxial stress state. It is shown that the predictions of the various criteria are very different for the case of biaxial tensile loads. This is in contrast to the case of combined tension‐torsion loads, where the predictions are very similar. The second part of the article investigates which mechanical parameter (eg, the hydrostatic stress or the normal stress) is the most appropriate to take into account these cyclic stress states.
Spatial distributions of Southern Ocean mesozooplankton communities have been resilient to long‐term surface warming
Authors: Tarling Geraint A. , Ward Peter , Thorpe Sally E. 
Published: August 2017

AbstractThe biogeographic response of oceanic planktonic communities to climatic change has a large influence on the future stability of marine food webs and the functioning of global biogeochemical cycles. Temperature plays a pivotal role in determining the distribution of these communities and ocean warming has the potential to cause major distributional shifts, particularly in polar regions where the thermal envelope is narrow. We considered the impact of long‐term ocean warming on the spatial distribution of Southern Ocean mesozooplankton communities through examining plankton abundance in relation to sea surface temperature between two distinct periods, separated by around 60 years. Analyses considered 16 dominant mesozooplankton taxa (in terms of biomass and abundance) in the southwest Atlantic sector of the Southern Ocean, from net samples and in situ temperature records collected during the Discovery Investigations (1926–1938) and contemporary campaigns (1996–2013). Sea surface temperature was found to have increased significantly by 0.74°C between the two eras. The corresponding sea surface temperature at which community abundance peaked was also significantly higher in contemporary times, by 0.98°C. Spatial projections indicated that the geographical location of community peak abundance had remained the same between the two eras despite the poleward advance of sea surface isotherms. If the community had remained within the same thermal envelope as in the 1920s–1930s, community peak abundance would be 500 km further south in the contemporary era. Studies in the northern hemisphere have found that dominant taxa, such as calanoid copepods, have conserved their thermal niches and tracked surface isotherms polewards. The fact that this has not occurred in the Southern Ocean suggests that other selective pressures, particularly food availability and the properties of underlying water masses, place greater constraints on spatial distributions in this region. It further demonstrates that this community is thermally resilient to present levels of sea surface warming.
Long‐term ecological changes in marine mammals driven by recent warming in northwestern Alaska
Authors: Szpak Paul , Buckley Michael , Darwent Christyann M. , Richards Michael P. 
Published: August 2017

AbstractCarbon and nitrogen isotopes analyses were performed on marine mammal bone collagen from three archaeological sites (ad 1170–1813) on Cape Espenberg (Kotzebue Sound, northwestern Alaska) as well as modern animals harvested from the same area to examine long‐term trends in foraging ecology and sea ice productivity. We observed significant and dramatic changes in ringed seal stable isotope values between the early 19th and early 21st centuries, likely due to changing sea ice productivity and reduced delivery of organic matter to the benthos driven by recent warming in the Arctic. These data highlight the importance of the archaeological record for providing a long‐term perspective on environmental variation and interpreting recent changes driven by anthropogenic processes.
Patient powered prophylaxis: A 12‐month study of individualized prophylaxis in adults with severe haemophilia A
Authors: Sun Haowei (Linda) , McIntosh Kam A. , Squire Sandra J. , Yang Ming , Bartholomew Claude , Gue Deb S. , Camp Pat G. , Jackson Shannon C. 
Published: August 2017

IntroductionAdults with severe haemophilia A (SHA) may experience breakthrough bleeds despite standard weight‐based FVIII prophylaxis three times weekly. Individualized prophylaxis has evolved to optimize patient outcomes.AimsThis study aimed to evaluate the impact of a standardized approach to individualized prophylaxis on annualized bleeding rates (ABR), factor utilization, physical activity and quality of life in adults with SHA.MethodsIn this prospective cohort study, patients with baseline FVIII:C <2% and ABR >3 on weight‐based prophylaxis received a standardized approach to individualized prophylaxis. Changes in ABR, annualized FVIII consumption and adherence from the 12‐month prestudy and 12‐month intervention period were compared. Changes in Haemo‐QoL‐A total score, Physical Functioning (PF) subscale and physical activity level measured by accelerometry were also examined.ResultsEighteen patients participated (median age 26 years). Individualized prophylaxis decreased total bleeds in the population by 69% and traumatic bleeds by 73%. The median ABR decreased from 7.5 to 2 (P<.001). Annualized factor consumption increased by 7.3%, as a result of 66% reduction in factor utilization for treatment of bleeds and 25% increase in factor utilization for prophylaxis. Adherence scores for frequency and dosing did not change. There was a significant increase in the Haemo‐QoL‐A total score (P=.02) and PF score (P=.01) from baseline to 4 months but no change in physical activity.ConclusionPatients with SHA who switched from standard to individualized prophylaxis show reduced ABR and increased FVIII consumption, and also improved their health‐related quality of life. The mechanism is independent of adherence to prescribed prophylactic regimen.
Preference‐based valuation of treatment attributes in haemophilia A using web survey
Authors: Steen Carlsson K. , Andersson E. , Berntorp E. 
Published: August 2017

IntroductionClinical trials have shown promising results for extended half‐life factor VIII concentrates but little is known about individuals' valuation of haemophilia treatment attributes.AimTo assess patient/caregiver and population valuation of treatment attributes of prophylactic regimens for people with severe haemophilia A.MethodsMembers ≥16 years of the Swedish Haemophilia Society (FBIS) and of a web‐panel representative of the Swedish population were invited to participate in a web‐survey investigating preferences for haemophilia treatment attributes using the Time Trade‐Off methodology which ranks health states on a scale 0 (dead) to 1 (full health). All respondents assessed the same four treatment scenarios for severe haemophilia A, each described by three stylized attributes: injection interval (every 2nd or 5th day); participation in physical activity (Y/N); annual risk of bleed (1‐2 or 5‐6 bleeds).ResultsThe survey had 1657 respondents (68% complete responses; 184/1233 from FBIS/web‐panel gave informed consent; mean age 52 years, 51% men). Respondents from FBIS and from the web‐panel had the same preference ranking of the four treatment scenarios, but members of FBIS consistently rated significantly higher health utilities; range 0.67‐0.73 vs 0.54‐0.60. Participation in physical activity implied +0.023 (95% confidence interval 0.015‐0.030); a longer injection interval implied +0.038 (0.03; 0.45); and fewer bleeds implied +0.022 (0.015‐0.029) utility points.ConclusionsPatient/caregiver and population preferences indicate that treatment attributes such as frequency of injections and the possibility of participating in physical activity are important attributes impacting quality of life in addition to the control and prevention of bleeding episodes.
Immunologic properties and therapeutic efficacy of a multivalent epitope‐based vaccine against four Helicobacter pylori adhesins (urease, Lpp20, HpaA, and CagL) in Mongolian gerbils
Authors: Guo Le , Yin Runting , Xu Guangxian , Gong Xiaojuan , Chang Zisong , Hong Dantong , Liu Hongpeng , Ding Shuqin , Han Xuebo , Li Yuan , Tang Feng , Liu Kunmei 
Published: August 2017

AbstractBackgroundTherapeutic vaccination is a desirable alternative for controlling Helicobacter pylori (H. pylori) infection. Attachment to the gastric mucosa is the first step in establishing bacterial colonization, and adhesins, which are on the surface of H. pylori, play a pivotal role in binding to human gastric mucosa.Materials and MethodsIn the present study, we constructed a multivalent epitope‐based vaccine named CFAdE with seven carefully selected antigenic fragments from four H. pylori adhesins (urease, Lpp20, HpaA and CagL). The specificity, immunogenicity and ability to produce neutralizing antibodies of CFAdE were evaluated in BALB/c mice. After that, its therapeutic efficacy and protective immune mechanisms were explored in H. pylori‐infected Mongolian gerbils.ResultsThe results indicated that CFAdE could induce comparatively high levels of specific antibodies against urease, Lpp20, HpaA and CagL. Additionally, oral therapeutic immunization with CFAdE plus polysaccharide adjuvant (PA) significantly decreased H. pylori colonization compared with oral immunization with urease plus PA, and the protection was correlated with IgG and sIgA antibody and antigen‐specific CD4+ T cells.ConclusionsThis study indicated that the multivalent epitope‐based vaccine, which targeted multiple adhesins in adherence of H. pylori to the gastric mucosa, is more effective than the univalent vaccine targeting urease only. This multivalent epitope‐based vaccine may be a promising therapeutic candidate vaccine against H. pylori infection.
Interlaboratory concordance of PD‐L1 immunohistochemistry for non‐small‐cell lung cancer
Authors: Scheel Andreas H , Baenfer Gudrun , Baretton Gustavo , Dietel Manfred , Diezko Rolf , Henkel Thomas , Heukamp Lukas C , Jasani Bharat , Jöhrens Korinna , Kirchner Thomas , Lasitschka Felix , Petersen Iver , Reu Simone , Schildhaus Hans‐Ulrich , Schirmacher Peter , Schwamborn Kristina , Sommer Ulrich , Stoss Oliver , Tiemann Markus , Warth Arne , Weichert Wilko , Wolf Jürgen , Büttner Reinhard , Rüschoff Josef 
Published: August 2017

AimsProgrammed death ligand 1 (PD‐L1) immunohistochemistry has become a mandatory diagnostic test in the treatment of lung cancer. Several research initiatives have started to harmonise the five PD‐L1 immunohistochemistry assays that have been used in clinical trials. Here, we report data on interlaboratory and interassay concordance for commercial assays (‘assays’) and laboratory‐developed tests (LDTs) at 10 German testing sites.Methods and resultsTo assess interlaboratory concordance, a tissue microarray containing 21 pulmonary carcinoma specimens was centrally prepared. Pre‐cut sections were stained at 10 sites by the use of assays 28‐8, 22C3, SP263, and SP142, as well as 11 LDTs. Assay performance was evaluated with a second tissue microarray containing 11 cell lines with defined PD‐L1 expression. Quality control was centrally performed by manual and digital analyses. The assays yielded reproducible IHC staining patterns at all sites. In agreement with previous studies, 22C3, 28‐8 and SP263 showed similar staining patterns, whereas SP142 was distinct. Among the LDTs, six of 11 protocols showed staining patterns similar to those of assays 22C3 and 28‐8. Interlaboratory concordance of tumour cell scoring by use of a six‐step system was moderate (Light's κ = 0.43–0.69), whereas the clinically approved cut‐offs of ≥1% and ≥50% showed substantial concordance (κ = 0.73–0.89). Immune cell scoring by the use of SP142 yielded moderate concordance (κ = 0.42).ConclusionsThe data confirm the previously described staining patterns of the assays, and show that they can be reproducibly employed at different sites. LDTs with staining results similar to those of the assays are implementable, but have to be carefully validated.
Perception of nurse prescribing among nurses and psychiatrists in a developing country: A cross‐sectional survey
Authors: Badnapurkar Ashish , Bressington Daniel , Jones Martin , Nelson Deborah , Thomas Dona , Mehndi Mohammed , Gray Richard 
Published: August 2017

AbstractNurse prescribing has the potential to improve patients’ access to, and experiences of, treatment. The aim of the present study was to examine nurse and psychiatrist attitudes about this extended role in a developing country. We conducted a cross‐sectional survey using a previously‐used, 65‐item, seven subscale measure of attitudes to nurse prescribing in mental health. We achieved a 79% response rate. The majority of participants had trained in developing countries where nurse prescribing has yet to be implemented. Across five subscales (general beliefs, impact, uses, training, and supervision), both groups reported positive attitudes about nurse prescribing. Both groups scored the training subscale particularly highly. Compared with psychiatrists, nurses were more confident about the range of clinical settings where nurse prescribing could be applied (e.g. acute inpatient and substance use). Although both groups had less favourable attitudes on the two subscales relating to clinical and legal responsibility, compared to nurses, psychiatrists were more undesirable. Although, overall, clinician attitudes do not seem to represent a barrier towards the potential implementation of nurse prescribing in the study setting, clarity about clinical and legal responsibility needs to be addressed.
Challenges in providing end‐of‐life care for people with intellectual disability: Health services access
Authors: Wark Stuart , Hussain Rafat , Müller Arne , Ryan Peta , Parmenter Trevor 
Published: August 2017

BackgroundIncreasing life expectancy for people with intellectual disability is resulting in greater need for end‐of‐life care services. However, limited knowledge is available regarding what barriers to accessing end‐of‐life care support are evident, particularly comparatively across rural and metropolitan locations.MethodsFocus group interviews were undertaken with 35 direct‐care staff from four rural and two metropolitan locations. A semistructured interview guide was used, with a focus on health service access. All focus group data were independently transcribed, with thematic analysis then performed.ResultsFrequency analysis identified 262 statements relating to health services access. Thematic analysis identified four key areas of “isolation,” “support from doctors,” “general health support access” and “internal staffing issues.”ConclusionsImproved access to end‐of‐life services is urgently required across both rural and metropolitan areas. Development of specialist training and support models for both disability and general healthcare staff may assist to reduce some identified barriers.
Teledermoscopy images acquired in primary health care and hospital settings – a comparative study of image quality
Authors: Dahlén Gyllencreutz J. , Johansson Backman E. , Terstappen K. , Paoli J. 
Published: August 2017

AbstractBackgroundThe incidence of melanoma and non‐melanoma skin cancer is increasing, which has also lead to an increase in referrals between primary health care (PHC) and dermatology departments, putting a strain on healthcare services. Teledermoscopy (TDS) referrals from PHC can improve the triage process for patients with suspicious skin tumours, but the quality of the images included could potentially affect its usefulness.ObjectiveTo critically appraise the quality of the dermoscopic images of a smartphone TDS system, by comparing the TDS referral images with images of the same tumours acquired at the department of dermatology.MethodsTwo dermatologists rated the image quality of two image sets from 172 skin tumours separately. The dermatologists also decided on a main diagnosis, differential diagnoses and described the visible dermoscopic structures.ResultsThe images acquired in PHC were rated as having slightly lower quality, but there was no significant difference. PHC images and dermatology images were of intermediate‐to‐high quality in 95.5%–97.7% and 96.5%–98.8%, respectively. There was no difference in agreement between the TDS diagnosis based on the two image sets with the final clinical or histopathological diagnosis. Most image pairs (81.4% and 83.7%) received the same main diagnosis by the two evaluators. When this was not the case, the most common reasons were poor focus, excessive pressure applied when acquiring the image or inadequate amount of zoom.ConclusionTDS performed in PHC with a smartphone‐based system does not seem to negatively affect the usefulness of TDS referrals. Thus, physicians at PHC do not necessarily need to be trained photographers to ensure adequate TDS image quality. Knowledge about technical difficulties could however be used when training PHC staff, to improve the image quality further.
Nail apparatus melanoma: dermoscopic and histopathologic correlations on a series of 23 patients from a single centre
Authors: Starace M. , Dika E. , Fanti P.A. , Patrizi A. , Misciali C. , Alessandrini A. , Bruni F. , Piraccini B.M. 
Published: August 2017

AbstractBackgroundNail apparatus melanoma (NAM) is an uncommon tumour, and there are few studies focused on its dermoscopic features.ObjectiveThe aims of our study were to evaluate the diagnostic accuracy of dermoscopy in NAM. A diagnostic algorithm for adult patients with suspected NAM is proposed.MethodsWe collected NAM dermoscopic images of patients with a proven histopathology from 2008 until 2015. Clinical and dermoscopic images were blindly examined by two dermatologists, and correlations between histopathological aspects and dermoscopic features were investigated.ResultsWe retrospectively collected NAM dermoscopic images associated with a proven histopathology of 23 Caucasian patients. Only cases with available both preoperative dermoscopic images and bioptic specimens were included. Seventeen women and six men were included. The mean age at diagnosis was 63 years (range 18–92).ConclusionWe created an algorithm to indicate the correct way to follow an adult patient with suspected NAM. This algorithm may ameliorate management in case of suspected NAM and possibly facilitate an early diagnosis.