bluuebunny/crossref_metadata_2025_split huggingface dataset:
Magnetic Resonance Tumor Regression Grade and Residual Mucosal Abnormality as Predictors for Pathological Complete Response in Rectal Cancer Postneoadjuvant Chemoradiotherapy
Authors: Bhoday Jemma , Smith Fraser , Siddiqui Muhammed R. , Balyasnikova Svetlana , Swift Robert I. , Perez Rodrigo , Habr-Gama Angelita , Brown Gina 
Published: September 2016

BACKGROUND:
Pathological complete response after chemoradiotherapy for rectal cancer occurs in 10% to 30% of patients. The best method to identify such patients remains unclear. Clinical assessment of residual mucosal abnormality is considered the most accurate method. In our institution, magnetic resonance tumor regression grade is performed as routine to assess response.

OBJECTIVE:
The purpose of this study was to compare the sensitivity of magnetic tumor regression grade against residual mucosal abnormality in detecting patients with a pathological complete response.

DESIGN:
Magnetic tumor regression grade scores from reported posttreatment MRI scans were documented. Magnetic tumor regression grade 1 to 3 was defined as likely to predict complete or near complete response. Gross appearances of the mucosa were derived from histopathology reports and used as a surrogate for clinical assessment (previously validated). Final histopathological staging was used to determine response.

SETTINGS:
The study was conducted at Royal Marsden National Health Service Trust, United Kingdom.

PATIENTS:
A total of 143 patients with rectal adenocarcinoma, diagnosed between September 1, 2009, and September 1, 2013, who received neoadjuvant chemoradiotherapy before curative surgery were included.

MAIN OUTCOME MEASURES:
The sensitivity of magnetic tumor regression grade and residual mucosal abnormality in detecting patients with pathological complete response were measured

RESULTS:
Eighteen patients had a pathological complete response. Seventeen were detected using magnetic resonance tumor regression grade 1 to 3, with sensitivity 94% (95% CI, 0.74–0.99), and 10 were detected using residual mucosal abnormality, with sensitivity 62% (95% CI, 0.38–0.81). There was no statistical difference between the false positive rates for either method. Magnetic tumor regression grade identified 10 times more patients with a pathological complete response (diagnostic OR = 10.2 (95% CI, 1.30–73.73)) compared with clinical assessment with RMA.

LIMITATIONS:
Residual mucosal abnormality was used as a surrogate marker for endoscopic appearances.

CONCLUSIONS:
Most patients with rectal cancer who have a pathological complete response do not manifest a complete response at the mucosal level. Magnetic tumor regression grade is able to identify 10 times more patients than clinical assessment, with no significant compromise in the false positive rate.
Consensus Recommendations for Combined Aesthetic Interventions Using Botulinum Toxin, Fillers, and Microfocused Ultrasound in the Neck, Décolletage, Hands, and Other Areas of the Body
Authors: Fabi Sabrina G. , Burgess Cheryl , Carruthers Alastair , Carruthers Jean , Day Doris , Goldie Kate , Kerscher Martina , Nikolis Andreas , Pavicic Tatjana , Rho Nark-Kyoung , Rzany Berthold , Sattler Sonja , Seo Kyle , Werschler William Philip , Sattler Gerhard 
Published: September 2016

BACKGROUND
The popularity of aesthetic procedures in the face has led to greater disparity between treated areas and those that still show evidence of true age. Although many areas of the body often require multiple treatment procedures for optimal rejuvenation, combination therapy for specific areas is not yet well defined.

OBJECTIVE
To develop recommendations for the optimal combination and ideal sequence of botulinum toxin (BoNT), hyaluronic acid, calcium hydroxylapatite (CaHA), and microfocused ultrasound with visualization in nonfacial areas across all skin phototypes.

METHODS
Fifteen specialists convened under the guidance of a certified moderator. Consensus was defined as approval from 75% to 94% of all participants, whereas agreement of ≥95% denoted a strong consensus.

RESULTS
Recommendations have been provided for the neck, décolletage, and hands and include the timing and sequence of specific procedures when used concurrently or over several treatment sessions. Position statements are offered in lieu of consensus for the upper arms, abdomen, buttocks, and knees.

CONCLUSION
Nonfacial rejuvenation often requires multiple procedures for optimal results in individuals with significant age-related changes. Further clinical studies are recommended to raise awareness of non-facial indications and provide clinicians with the best evidence for best treatment practices.
Personality Disorders in DSM-5: A Commentary on the Perceived Process and Outcome of the Proposal of the Personality and Personality Disorders Work Group
Authors: Silk Kenneth R. 
Published: September 2016

Abstract
There has been much discussion and controversy concerning the process undertaken and the decisions made with respect to the Personality and Personality Disorders Work Group (PPDWG) proposal for DSM-5, as well as the rejection of the work group’s final proposal, by the American Psychiatric Association Board of Trustees. This commentary suggests that the way the PPDWG members were selected and the perceived secrecy associated with the PPDWG’s deliberations almost assured that, despite the hard work and good intentions of the group members, the proposal would raise controversy and could ultimately fail. This commentary provides a personal perspective on some of the issues, assumptions, and preconceptions that arose between members of different theoretical and conceptual camps within the field of personality disorders. It concludes with suggestions as to how we might avoid these mistakes in the future and also how we might take advantage of the PPDWG’s substantive work as we make future attempts to improve diagnosis in the area of personality disorders.
“Good Enough” Psychiatric Residency Training in Borderline Personality Disorder: Challenges, Choice Points, and a Model Generalist Curriculum
Authors: Unruh Brandon T. , Gunderson John G. 
Published: September 2016

Abstract
While the public health burden posed by borderline personality disorder (BPD) rivals that associated with other major mental illnesses, the prevailing disposition of psychiatrists toward the disorder remains characterized by misinformation, stigma, aversive attitudes, and insufficient familiarity with effective generalist treatments that can be delivered in nonspecialized health care settings. Residency training programs are well positioned to better equip the next generation of psychiatrists to address these issues, but no consensus or guidelines currently exist for what and how residents should be taught about managing BPD. Instead, disproportionately limited curricular time, teaching of non-evidence-based approaches, and modeling of conceptually confused combinations of techniques drawn from specialty BPD treatments are offered. In this article, we (1) explain why training in a generalist model is sensible and why alternative approaches are not appropriate for residents, (2) propose a plan for giving residents adequate training via a generalist model, highlighting minimal didactic and clinical-training objectives (dubbed “core competencies” and “milestones”) and a model curriculum developed at the Massachusetts General Hospital/McLean Hospital residency program, and (3) describe obstacles to implementation of effective generalist training posed by infrastructural, faculty-centered, and resident-centered variables.
Cognitive Rehabilitation for Military Service Members With Mild Traumatic Brain Injury: A Randomized Clinical Trial
Authors: Cooper Douglas B. , Bowles Amy O. , Kennedy Jan E. , Curtiss Glenn , French Louis M. , Tate David F. , Vanderploeg Rodney D. 
Published: September 2016

Objective:
To compare cognitive rehabilitation (CR) interventions for mild traumatic brain injury (mTBI) with standard of care management, including psychoeducation and medical care for noncognitive symptoms.

Setting:
Military medical center.

Participants:
A total of 126 service members who received mTBI from 3 to 24 months before baseline evaluation and reported ongoing cognitive difficulties.

Interventions:
Randomized clinical trial with treatment outcomes assessed at baseline, 3-week, 6-week, 12-week, and 18-week follow-ups. Participants were randomly assigned to one of four 6-week treatment arms: (1) psychoeducation, (2) computer-based CR, (3) therapist-directed manualized CR, and (4) integrated therapist-directed CR combined with cognitive-behavioral psychotherapy (CBT). Treatment dosage was constant (10 h/wk) for intervention arms 2 to 4.

Measures:
Paced Auditory Serial Addition Test (PASAT); Symptom Checklist–90 Revised (SCL-90-R); Key Behaviors Change Inventory (KBCI).

Results:
No differences were noted between treatment arms on demographics, injury-related characteristics, or psychiatric comorbidity apart from education, with participants assigned to the computer arm having less education. Using mixed-model analysis of variance, all 4 treatment groups showed a significant improvement over time on the 3 primary outcome measures. Treatment groups showed equivalent improvement on the PASAT. The therapist-directed CR and integrated CR treatment groups had better KBCI outcomes compared with the psychoeducation group. Improvements on primary outcome measures during treatment were maintained at follow-up with no differences among arms.

Conclusions:
Both therapist-directed CR and integrated CR with CBT reduced functional cognitive symptoms in service members after mTBI beyond psychoeducation and medical management alone.
Efficacy of Orbital Color Doppler Imaging and Neuroimaging in the Diagnosis of Carotid Cavernous Fistulas
Authors: Srinivasan Archana , Biro Nicolas G. , Murchison Ann P. , Sergott Robert C. , Moster Mark L. , Jabbour Pascal M. , Bilyk Jurij R. 
Published: September 2016

Purpose:
To evaluate the diagnostic sensitivity and specificity of orbital color Doppler imaging (CDI) and conventional neuroimaging (CT/MRI) compared with cerebral angiography in patients with carotid-cavernous fistulas (CCFs).

Methods:
The study design was a retrospective patient chart and imaging review. The authors reviewed 655 charts of all patients who underwent CDI and neuroimaging (CT/MRI) between 2006 and 2015 at one institution. Sixty patients had a presumptive diagnosis of CCF without thrombosis. Thirty-seven patients with 43 events met the inclusion criteria of the study. The diagnostic sensitivity of the 3 noninvasive imaging modalities (CDI, CT, MRI) for CCF was compared with the gold standard 6-vessel cerebral angiography. Significance testing was performed using the 2-tailed Fisher test.

Results:
Color Doppler imaging had high sensitivity (96.8%) but low specificity (41.7%) for the diagnosis of CCFs with anterior orbital findings. A negative CDI had more diagnostic value than a positive CDI. While an arterial wave form in the superior ophthalmic vein was the most common finding of CCF on CDI, enlargement of the superior ophthalmic vein was the only statistically significant finding. Posterior cortical venous drainage was noted in about 10% of the patients with indirect (low-flow) fistulas, who presented with unilateral orbital signs and symptoms, a finding not previously reported in the literature.

Conclusion:
Color Doppler imaging is a useful noninvasive, radiation-free modality for diagnosis of CCF with anterior drainage, with higher sensitivity than CT or MRI, but equivalent specificity. A significant limitation of CDI is the lack of usefulness in diagnosing fistulas with posterior cortical venous drainage, which carry a risk of intracerebral hemorrhage and stroke. In this series, 10% of unilateral CCFs with anterior orbital signs and symptoms showed angiographic evidence of posterior cortical venous drainage.
Induced Hypothermia in Neurocritical Care: A Review
Authors: Cook Courtney J. 
Published: September 2016

ABSTRACT
Induced hypothermia (IH) continues to become a more prevalent treatment modality in neurocritical care. Reducing core temperature has been shown to protect brain tissue during injury and disease. IH has been particularly beneficial in the medical management of refractory intracranial hypertension and malignant cerebral edema. These pathologies are often the result of diffuse cerebral edema after traumatic brain injury, malignant ischemic stroke, or intracerebral hemorrhage. Although there are many benefits to IH, it is not without complications. Chief among these is shivering, which decreases oxygen delivery to brain tissue, increases metabolic demands, and consequently reduces nutrient delivery. This article will review indications for IH administration, methods of providing IH, nursing responsibilities, and identifying and/or managing complications.
Hematopoietic stem cell transplantation for acquired aplastic anemia
Authors: Georges George E. , Storb Rainer 
Published: September 2016

Purpose of review
There has been a steady improvement in outcomes with allogeneic bone marrow transplantation (BMT) for severe aplastic anemia (SAA), because of progress in optimization of the conditioning regimens, donor hematopoietic cell source, and supportive care. Here, we review recently published data that highlight the improvements and current issues in the treatment of SAA.

Recent findings
Approximately one-third of aplastic anemia patients treated with immune suppressive therapy (IST) have acquired mutations in myeloid cancer candidate genes. Because of the greater probability for eventual failure of IST, human leukocyte antigen (HLA)-matched sibling donor BMT is the first-line of treatment for SAA. HLA-matched unrelated donor (URD) BMT is generally recommended for patients who have failed IST. However, in younger patients for whom a 10/10-HLA-allele matched URD can be rapidly identified, there is a strong rationale to proceed with URD BMT as first-line therapy. HLA-haploidentical BMT using posttransplant cyclophosphamide conditioning regimens is now a reasonable second-line treatment for patients who failed IST.

Summary
Improved outcomes have led to an increased first-line role of BMT for treatment of SAA. The optimal cell source from an HLA-matched donor is bone marrow. Additional studies are needed to determine the optimal conditioning regimen for HLA-haploidentical donors.
Low Childhood Cholesterol Absorption Predisposes to Gallstone Disease
Authors: Nissinen Markku J. , Simonen Piia , Gylling Helena , Viikari Jorma , Hutri‐Kähönen Nina , Jokinen Eero , Tossavainen Päivi , Laitinen Tomi , Raitakari Olli , Juonala Markus , Pakarinen Mikko P. 
Published: September 2016

ABSTRACTObjectives:Unraveling pathogenesis of gallstones could help to diminish its enormous disease burden. We hypothesized that certain properties of childhood cholesterol metabolism predict gallstone disease in adulthood.Methods:Childhood serum cholestanol and plant sterols (surrogates for cholesterol absorption), cholesterol precursors (surrogates for cholesterol synthesis), lipids, demographics, and dietary habits were compared between individuals diagnosed with gallstone disease subsequently in adulthood (n = 95) and control subjects (n = 190) matched for age, sex, and body mass index in 1980. Subjects were participants of prospective Cardiovascular Risk in Young Finns Study.Results:In 1980, at mean age of 11.4 years gallstone cohort was characterized by 5.8% lower cholestanol (P = 0.038), and 11.2% to 12.2% (P range = 0.003–0.008) lower plant sterols campesterol, sitosterol, and avenasterol compared with controls. Mean lathosterol/sitosterol ratio was 16.3% higher in gallstone compared with control cohort (P = 0.028). Female gallstone group had 5.4% lower mean cholestanol compared with controls (P < 0.05), and, respectively, those of campesterol, sitosterol, and avenasterol were 12.7% to 14.0% lower (P < 0.05 for each). Body mass index was inversely related to cholestanol and sitosterol (r range = −0.161 to −0.208, P < 0.05 for each) in controls, but not among patients with gallstone. In whole study population, surrogates of cholesterol absorption (eg, campesterol, P = 0.018) and low dietary intake of vegetables (P = 0.009) were significant predictors of gallstones in logistic regression model.Conclusions:Cholesterol metabolism trait characterized by low serum levels of surrogate markers of cholesterol absorption precedes adult gallstone disease already in childhood. Low serum cholestanol and plant sterol ratios during normal Western diet may have role as predictive biomarkers for gallstones.
Influence of Gestational Age, Secretor, and Lewis Blood Group Status on the Oligosaccharide Content of Human Milk
Authors: Kunz Clemens , Meyer Christina , Collado Maria Carmen , Geiger Lena , García‐Mantrana Izaskun , Bertua‐Ríos Bibiana , Martínez‐Costa Cecilia , Borsch Christian , Rudloff Silvia 
Published: September 2016

ABSTRACTObjectives:Human milk oligosaccharides (HMOs) are considered to play an important role for the infant. As the biotechnical production of some HMOs is feasible today and clinical studies are being designed, the individual variation of the total amount of HMOs and of single components is of particular importance. Our objectives were to investigate whether differences exist between term and preterm milk, milk from mothers with secretor or nonsecretor status, and a Lewis blood group (a+b−), (a−b+), or (a−b−) pattern.Methods:Within a longitudinal study 96 milk samples (colostrum, transitional, and mature milk) from 32 mothers with preterm (n = 18) and term (n = 14) infants were collected. Delipidated and deproteinized milk was subjected to porous graphitized carbon cartridges followed by high pH anion exchange chromatography with pulsed amperometric detection.Results:Quantitation of 16 single HMOs revealed changes during the first weeks of lactation without discrepancies between term and preterm milk. Significant differences occurred between “secretor” and “nonsecretor” milk (median approximately 10 vs 5 g/L total HMOs). Lacto‐N‐tetraose (LNT) and lacto‐N‐fucopentaose (LNFP) II comprised > 55% of the total HMO content in Lewis blood group (a+b−), “nonsecretor” milk and LNT together with 2'fucosyllactose, LNFP I, and difucosyllactose approximately 60% in Lewis (a−b+), “secretor” milk. In Lewis (a−b−), “secretor” milk 80% of oligosaccharides are due to LNT, 2'fucosyllactose, and LNFP I.Conclusions:There are marked differences in total HMOs and single HMOs in milk depending on Lewis blood group and secretor status, which need to be taken into account in clinical studies.
Promoting patient-centred palliative care: a scoping review of the patient dignity question
Authors: Arantzamendi María , Belar Alazne , Martínez Marina 
Published: September 2016

Purpose of review
In recent years, there has been a growing interest in promoting dignity in care, and specific interventions have been developed to include it at the end of life. The patient dignity question (PDQ) is a recent, novel and simple intervention that healthcare professionals can implement; however, little information is known about its impact. This scoping review aims to examine and map out the PDQ literature.

Recent findings
Studies suggest that patients, families and professionals have a positive view of the PDQ in that it helps to get to know patients and provide them with the best care possible. The PDQ seems to promote an environment of care focused on the person and the prevalence of more human aspects in clinical encounters between professionals and patients. This is especially so in situations in which human aspects of the healthcare relationship at baseline received lower marks. Healthcare professionals thought that performing the PDQ to determine what is important to the patient is a feasible and effective exercise.

Summary
The published literature suggests that PDQ is a beneficial intervention for approaching and getting to know a patient as a person. More studies are needed that measure pre–post-PDQ changes and that demonstrate their impact on patient care.
The impact of recent population history on the deleterious mutation load in humans and close evolutionary relatives
Authors: Simons Yuval B. , Sella Guy 
Published: September 2016

AbstractOver the past decade, there has been both great interest and confusion about whether recent demographic events—notably the Out-of-Africa-bottleneck and recent population growth—have led to differences in mutation load among human populations. The confusion can be traced to the use of different summary statistics to measure load, which lead to apparently conflicting results. We argue, however, that when statistics more directly related to load are used, the results of different studies and data sets consistently reveal little or no difference in the load of non-synonymous mutations among human populations. Theory helps to understand why no such differences are seen, as well as to predict in what settings they are to be expected. In particular, as predicted by modeling, there is evidence for changes in the load of recessive loss of function mutations in founder and inbred human populations. Also as predicted, eastern subspecies of gorilla, Neanderthals and Denisovans, who are thought to have undergone reductions in population sizes that exceed the human Out-of-Africa bottleneck in duration and severity, show evidence for increased load of non-synonymous mutations (relative to western subspecies of gorillas and modern humans, respectively). A coherent picture is thus starting to emerge about the effects of demographic history on the mutation load in populations of humans and close evolutionary relatives.
Five years investigation of female and male genotypes in Périgord black truffle (Tuber melanosporumVittad.) revealed contrasted reproduction strategies
Authors: De la Varga Herminia , Le Tacon Françis , Lagoguet Mélanie , Todesco Flora , Varga Torda , Miquel Igor , Barry-Etienne Dominique , Robin Christophe , Halkett Fabien , Martin Francis , Murat Claude 
Published: September 2016

SummaryThe Périgord black truffle (Tuber melanosporumVittad.) is a heterothallic ascomycete that establishes ectomycorrhizal symbiosis with trees and shrubs. Small-scale genetic structures of female genotypes in truffle orchards are known, but it has not yet been studied in male genotypes. In this study, our aim was to characterize the small-scale genetic structure of both male and female genotypes over five years in an orchard to better understand theT. melanosporumsexual reproduction strategy, male genotype dynamics, and origins. Two-hundred forty-one ascocarps, 475 ectomycorrhizas, and 20 soil cores were harvested and genotyped using microsatellites and mating type genes. Isolation by distance analysis revealed pronounced small-scale genetic structures for both female and male genotypes. The genotypic diversity was higher for male than female genotypes with numerous small size genotypes suggesting an important turnover due to ascospore recruitment. Larger and perennial female and male genotypes were also detected. Only three genotypes (1.5 %) were found as both female and male genotypes (hermaphrodites) while most were detected only as female or male genotype (dioecy). Our results suggest that germinating ascospores act as male genotypes, but we also proposed that soil mycelium could be a reservoir of male genotypes.