bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and efficacy of Gamma Knife radiosurgery in hypothalamic hamartomas with severe epilepsies: A prospective trial in 48 patients and review of the literature
Authors: Régis Jean , Lagmari Medhi , Carron Romain , Hayashi Motohiro , McGonigal Aileen , Daquin Géraldine , Villeneuve Nathalie , Laguitton Virginie , Bartolomei Fabrice , Chauvel Patrick 
Published: June 2017

SummaryEpilepsies associated with hypothalamic hamartomas (HHs) are frequently drug resistant with severe psychiatric and cognitive comorbidities. We performed a prospective trial to evaluate the safety and efficacy of Gamma Knife radiosurgery (GKS). Between October 1999 and October 2007, a total of 57 patients were investigated, included and treated by GKS in Timone University Hospital. Preoperative workup and 3‐year postoperative evaluation consisted of seizure diary, neuropsychological, psychiatric, endocrinologic, visual field, and visual acuity examinations. Follow‐up of >3 years was available for 48 patients. Topologic type was type I in 11 patients, type II in 15, type III in 17, type IV in one, type V in one, type VI in one, and mixed type in 2. The median marginal dose was 17 Gy (min 14 and max 25 Gy). The median target volume was 398 mm3(28–1,600 mm3). Due to partial results, 28 patients (58.3%) required a second treatment. The median follow‐up was 71 months (36–153 months). At last follow‐up, the rate of Engel class I outcome was 39.6%, Engel class II was 29.2% (I+II 68.8%), and Engel class III was 20%. Global psychiatric comorbidity was considered cured in 28%, improved in 56%, stable in 8%, and continued to worsen in 8%. No permanent neurologic side effect was reported (in particular, no memory deficit). Nondisabling transient poikilothermia was observed in three patients (6.2%). A transient increase of seizure frequency was reported in 8 patients (16.6%) with a median duration of 30 days (9–90 days). Microsurgery was proposed because of insufficient efficacy of GKS in seven patients (14.5%) with a postoperative Engel class I–II in 28.6%. This prospective trial demonstrates very good long‐term safety and efficacy of GKS for 2 patients. Beyond seizure reduction, the improvement of psychiatric and cognitive comorbidities along with better school performance and social functioning, being better socially integrated, having friends having a social life, working, participating to group activities turn out to be major benefits of GKS in this group of patients with frequently catastrophic epilepsy.
Hypothalamic hamartoma: Epileptogenesis beyond the lesion?
Authors: Scholly Julia , Staack Anke Maren , Kahane Philippe , Scavarda Didier , Régis Jean , Hirsch Edouard , Bartolomei Fabrice 
Published: June 2017

SummaryThe discovery of intrinsic epileptogenicity of the hypothalamic hamartoma (HH) marked a new area in understanding the associated clinical syndrome, often manifesting as progressive epileptic encephalopathy. However, therapeutic procedures targeting theHHproved to be inefficient to cure seizures in up to 50% of cases, whereas in cases with partial improvement, the electroclinical patterns of persisting seizures suggest an involvement of distant cortical regions. The concept of kindling‐like secondary epileptogenesis has been suggested as a possible underlying mechanism. Yet the role of the hypothalamic lesion in the pathophysiology of the syndrome remains debatable. In the Strasbourg‐Kork series, the best outcomes were obtained when the duration of epilepsy before endoscopicHHsurgery did not exceed 10 years. In two patients withHHablation followed at a later time by a temporal lobectomy, only this second surgical step allowed complete seizure freedom. These findings suggest the existence of an independent, third stage of secondary epileptogenesis in human. In the Grenoble series, stereotactic intracerebral recordings (stereo electroencephalography [SEEG]) of fiveHHcases demonstrated that gelastic/dacrystic seizures were correlated with discharges within theHH,whereas other seizure types were related to discharges affecting cortical regions, which sometimes seemed to be triggered byHH. In the Marseille series, two cases explored bySEEGprovided evidence of extended epileptogenicity outside the limits of theHH, forming complex epileptogenic networks, withHHstill triggering clusters of neocortical seizures in the first, but not obligatory involved in spontaneous seizures in the second case. Taken together, our data argue for the existence of dynamic ictal network organization, with possible “kindling‐like” relationships between theHHand the neocortex or widespread epileptogenesis. Despite the existence of secondary epileptogenesis, the epileptogenic zone could still be limited to the hamartoma, for which early surgical treatment should be pragmatically considered as a first surgical step.
Beta diversity of plants, birds and butterflies is closely associated with climate and habitat structure
Authors: Zellweger Florian , Roth Tobias , Bugmann Harald , Bollmann Kurt 
Published: June 2017

AbstractAimThe aim was to investigate the relationship between climate, topography and soil pH, as well as vegetation structure and the beta diversity of plants, butterflies and birds; and to investigate the correlations of (woody) plant beta diversity with animal beta diversity.LocationSwitzerland (central Europe).MethodsWe used pairwise Sørensen dissimilarity as measure of total beta diversity and partitioned it into its turnover and nestedness components. Variation partitioning was used to assess the independent and cumulative effects of environmental predictors, with vegetation structure being derived from airborne light detection and ranging (LiDAR) data. We also checked for independent effects of plant and woody plant beta diversity on butterfly and bird beta diversity, respectively, and for independent effects of spatial distance on beta diversity.ResultsClimate emerged as the strongest statistical predictor of beta diversity across taxonomic groups, with large independent effects on species turnover. Climate effects were most pronounced for plants, followed by butterflies and birds. We also found large independent effects of vegetation structure on total beta diversity and its turnover component across taxonomic groups, particularly for birds. Plant and woody plant beta diversity substantially improved the predictions of butterfly and bird beta diversity, respectively. Spatial distance had hardly any independent effect on beta diversity.Main conclusionsClimate is a stronger filter for plant communities than for butterfly and bird communities, which are more affected by vegetation structure, probably owing to associated resources and niches. Vegetation structure is a crucial predictor of beta diversity, and therefore contiguous and detailed 3‐D habitat structure data are highly relevant to further our understanding of niche‐based community assembly. Plant and animal beta diversity appear to be non‐independent, suggesting that differences in the response times of interacting taxa should be accounted for in environmental change impact assessments on biodiversity.
Characterization of a “low‐risk” cohort of grade group 2 prostate cancer patients: Results from the Shared Equal Access Regional Cancer Hospital database
Authors: McGinley Kathleen F , Sun Xizi , Howard Lauren E , Aronson William J , Terris Martha K , Kane Christopher J , Amling Christopher L , Cooperberg Matthew R , Freedland Stephen J 
Published: June 2017

ObjectivesTo examine if there is a subset of men with grade group 2 prostate cancer who could be potential candidates for active surveillance.MethodsWe used the Shared Equal Access Regional Cancer Hospital database to identify 776 men undergoing radical prostatectomy from 2006 to 2015 with >8 biopsy cores obtained and complete information. We compared men who fulfilled low‐risk disease criteria (clinical stage T1c/T2a; grade group 1; prostate‐specific antigen ≤10 ng/mL) with the exception of grade group 2 versus men who met all three low‐risk criteria. Logistic regression was used to test the association between grade group and radical prostatectomy pathological features. Biochemical recurrence was examined using Cox models. To examine whether there was a subset of men with low‐volume grade group 2 with comparable outcomes to low‐risk men, we repeated all analyses limiting the percentage of positive cores in the grade group 2 group to ≤33%, and positive cores to ≤4, ≤3 or ≤2.ResultsGrade group 2 low‐risk men had increased risk of pathological grade group 3 or higher (P < 0.001), extraprostatic extension (P < 0.001), seminal vesicle invasion (P < 0.001) and higher risk of biochemical recurrence (hazard ratio = 1.76, P = 0.006). Using increasingly strict definitions of low‐volume disease, at ≤2 positive cores there was no difference in adverse pathology between groups (all P > 0.2), except higher pathological grade group (P = 0.006). Biochemical recurrence was similar in men in grade group 1 and grade group 2 (hazard ratio = 1.24; P = 0.529).ConclusionsAmong men with prostate‐specific antigen ≤10 ng/mL and clinical stage T1c/T2a, those in grade group 2 with ≤2 total positive cores have similar rates of adverse pathology and biochemical recurrence as men with grade group 1.
Perioperative management of new oral anticoagulants in patients undergoing elective surgery at a tertiary hospital
Authors: Wamala Henry , Scott Ian A. , Caney Xenia 
Published: June 2017

AbstractBackgroundIncreasing numbers of patients receiving new oral anticoagulants (NOAC) are undergoing elective surgery. The extent to which perioperative interruption of NOAC therapy and use of bridging heparin are concordant with best evidence is uncertain.AimsTo determine: (i) concordance of NOAC and bridging heparin use with guidelines; and (ii) associations between guideline concordance and patient characteristics, surgical factors and perioperative adverse events.MethodsRetrospective study of consecutive adult patients undergoing elective surgery at a tertiary hospital between 1 January 2014 and 30 June 2015 and were receiving NOAC for at least 3 months prior to surgery. Concordance of perioperative anticoagulation management with hospital guidelines was rated by two independent researchers according to explicit thrombosis and bleeding risk tables.ResultsOne hundred and fifty patients of mean (±SD) age 72.0 (±11.6) years were studied; 75% had atrial fibrillation as NOAC indication. Decision to interrupt anticoagulation in 142 patients was rated guideline‐concordant in 59 (41.5%) based on low bleeding risk in all cases and high thrombotic risk in one‐third. Concordant decisions were associated with past myocardial infarction (P = 0.009), chronic kidney disease (P = 0.05), use of dabigatran (P = 0.06) and major surgery (P < 0.001). Bridging heparin was prescribed in 51 (35.9%) patients and not prescribed in 91 (64.1%), with 64 (45.1%) decisions rated guideline‐discordant comprising 27 decisions to prescribe and 37 not to prescribe. Guideline concordant bridging was associated with chronic kidney disease (P = 0.02); discordant bridging with use of dabigatran (P = 0.04), high thrombotic risk (P = 0.004), past ischaemic stroke (P = 0.07). At 30 days, only one adverse event (major bleed) was noted.ConclusionConsiderable discordance exists between guideline recommendations and perioperative NOAC management. Assistive tools are required that better align decision‐making with current best practice.
Introduction of a drug‐detection dog programme in mental health inpatient units: A mixed‐methods study of consumer, staff, and carers' perceptions
Authors: McEvedy Samantha M. , Furness Trentham , McKenna Brian 
Published: June 2017

AbstractMany consumers admitted to mental health inpatient units also use illicit drugs, and some continue to do so while receiving treatment. In an attempt to curb the impact of illicit drug use, one of Australia's largest mental health services introduced a programme of drug‐detection dog (DDD) searches. Our aim was to evaluate perceptions of the DDD programme among mental health consumers, staff, and carers. A mixed‐methods research design using a concurrent triangulation approach was adopted, involving three focus group discussions with consumer, staff, and carer groups, and a structured survey among 94 consumers who were receiving treatment and 102 staff working in the units at the time of a DDD visit. Data were analysed using thematic analysis, and descriptive and inferential statistics. Major themes were that: (i) drug use in these units is perceived as ‘prevalent’ and ‘destructive’; (ii) the DDD programme is ‘beneficial’ but ‘incongruous’ in a health‐care setting; (iii) consumers are ‘uninformed’; and (iv) consequences should be ‘customized’ to circumstances. Survey results corroborated qualitative themes, with the exception that although concerns about incongruity do exist, they were not prevalent and were outweighed by positive perceptions of the programme. Most perceptions were consistent between consumers and staff. However, consumers tended to think that, if found, drugs should be confiscated, whereas staff were more strongly in favour of the consumer being discharged. In conclusion, the DDD programme was seen as a positive step towards addressing drug use in mental health units. However, improved dissemination of information to consumers through verbal and written communication is required.
Firefighter learning at a distance – a longitudinal study
Authors: Holmgren R. , Haake U. , Söderström T. 
Published: June 2017

AbstractThis article presents a summary analysis of a 5‐year study on the implementation of a technology‐supported distance firefighter training programme in Sweden, focused on the firefighter students' learning processes regarding challenges, contradictions and changes that occurred during the implementation period. With activity theory as the theoretical basis, three data collections were carried out. The analysis, based on interviews with firefighter students and instructors as well as observation logbooks and educational documents, identified two phases, an implementation phase and a dissemination phase. The implementation phase is characterized by the distance students developing a self‐directed and goal‐oriented learning, supported by the revised and technology‐supported training design. During the dissemination phase, when many technology‐inexperienced instructors become involved in the distance programme, a number of challenges and contradictions are identified, which, however, turn out to be a driving force for the students to develop alternative learning strategies. Finally, vocational distance training is discussed in terms of potential opportunities for developing vocational students' learning processes.
Possible involvement of chemokine C‐C receptor 7−programmed cell death‐1+ follicular helper T‐cell subset in the pathogenesis of autoimmune hepatitis
Authors: Kimura Naruhiro , Yamagiwa Satoshi , Sugano Tomoyuki , Setsu Toru , Tominaga Kentaro , Kamimura Hiroteru , Takamura Masaaki , Terai Shuji 
Published: June 2017

AbstractBackground and AimRecent studies have demonstrated that B cells and follicular helper T (Tfh) cells, which are central regulators of humoral immune response, contribute to the development and progression of autoimmune diseases. Because Tfh cells can be divided into several subsets with distinct functional properties, this study aimed to examine the roles of different subsets of circulating Tfh cells in the immune pathogenesis of autoimmune hepatitis (AIH).MethodsThirty‐five patients with AIH, 28 patients with primary biliary cholangitis, 22 patients with chronic hepatitis B (CHB), and 44 health controls (HC) were enrolled. The frequencies of different Tfh subsets in the blood and liver were examined by flow cytometry and immunohistochemical staining. The function of circulating Tfh subsets was examined after in vitro stimulation.ResultsIn newly diagnosed AIH patients, the frequency of circulating chemokine C‐C receptor 7−programmed cell death‐1+ Tfh subset was significantly increased compared with that in CHB patients and HC, significantly correlated with clinical parameters, including serum IgG, prothrombin time and albumin levels, and significantly decreased after corticosteroid treatment. In the liver of AIH patients, the frequencies of activated Tfh subsets were significantly increased and positively correlated with those in the blood. Moreover, the ability to produce interleukin‐21 and interleukin‐17 from circulating Tfh cells was significantly increased in AIH patients compared with HC.ConclusionsThese results significantly extend our understanding of Tfh subsets in AIH and suggest a potential role of dysregulated chemokine C‐C receptor 7−programmed cell death‐1+ Tfh subset in the pathogenesis and disease progression of AIH.
Sacrifice for Nothing: The Movement of Kenosis in Jan Patočka's Thought
Authors: Koci Martin 
Published: June 2017

AbstractThis article focuses on the idea of sacrifice in the work of the Czech phenomenologist Jan Patočka. It presents and examines this philosopher from a theological perspective against the background of the theological turn in contemporary philosophy. First, the article focuses on Patočka's reflections on the kenotic sacrifice, which he defines as the sacrifice for nothing. Second, Patočka's thought is put into dialog with Jean‐Luc Marion's phenomenological sketch of sacrifice embedded in his phenomenology of the gift. Although both Patočka and Marion share an interest in sacrifice, a phenomenon of high theological importance, only the latter enjoys reception on the part of theology. Yet, the article argues, on the basis of further inquiry into Patočka's writings, Patočka presents a complementary and alternative perspective that not only precedes the theological turn but also challenges and opens new ways for theology. The conclusion thus portrays a kenotic form of Christianity after the end of Christianity, drawn from Patočka, as a specific spiritual being‐in‐the‐world.
Educational needs of nurses to provide genetic services in prenatal care: A cross‐sectional study from Turkey
Authors: Seven Memnun , Eroglu Kafiye , Akyüz Aygül , Ingvoldstad Charlotta 
Published: June 2017

AbstractThe latest advances in genetics/genomics have significantly impacted prenatal screening and diagnostic tests. This cross‐sectional descriptive study was conducted in inpatient and outpatient obstetric clinics in 24 hospitals in Turkey to determine knowledge of genetics related to prenatal care and the educational needs of perinatal nurses. A total of 116 nurses working in these clinics agreed to participate. The results included the level of knowledge among nurses was not affected by sociodemographic factors. Also, there is a lack of knowledge and interest in genetics among prenatal nurses and in clinical practice to provide education and counseling related to genetics in prenatal settings as a part of prenatal care.
Validity and reliability of Abbreviated Mental Test Score (AMTS) among older Iranian
Authors: Foroughan Mahshid , Wahlund Lars‐Olof , Jafari Zahra , Rahgozar Mehdi , Farahani Ida G. , Rashedi Vahid 
Published: June 2017

BackgroundCognitive impairment is common among older people and is associated with increased morbidity and mortality. The main aim of this study was to evaluate the validity of the Persian version of the Abbreviated Mental Test Score (AMTS) as a screening tool for dementia.MethodsData were obtained from a cross‐sectional study. One hundred and one older adults who were members of Iranian Alzheimer Association and 101 of their siblings were entered into this study by convenient sampling. The Diagnostic and Statistical Manual of Mental Disorders, 4th edition, criteria for diagnosing dementia and the Mini‐Mental State Examination were used as the study tools. The gathered data were analyzed by the Mann–Whitney U‐test, the Kruskal–Wallis test, Spearman's rank correlation coefficient, and the receiver–operating characteristic.ResultsThe AMTS could successfully differentiate the dementia group from the non‐dementia group. Scores were significantly correlated with Diagnostic and Statistical Manual of Mental Disorders diagnosis for dementia and Mini‐Mental State Examination scores (P < 0.001). Educational level (P < 0.001) and male sex (P = 0.015) were positively associated with AMTS, whereas (P < 0.001) was negatively associated with AMTS. Total Cronbach's α coefficient was 0.90. The scores 6 and 7 showed the optimum balance between sensitivity (99% and 94%, respectively) and specificity (85% and 86%, respectively).ConclusionsThe Persian version of the AMTS is a valid cognitive assessment tool for older Iranian adults and can be used for dementia screening in Iran.
Assessment of HNA alloimmunisation risk in Northeastern Thais, Burmese and Karen
Authors: Simtong P. , Puapairoj C. , Leelayuwat C. , Santoso S. , Romphruk A. V. 
Published: June 2017

SUMMARYObjectivesThis study aimed to determine human neutrophil antigen (HNA) frequency, estimate possible HNA incompatibilities and predict the risk of HNA alloimmunisation in the Northeastern Thai, Burmese and Karen populations.BackgroundAlloantibodies against HNA are implicated in a number of clinical conditions, including immune‐mediated neutropenia and transfusion reactions.MethodsA total of 400 unrelated healthy Thais, 261 Burmese and 249 Karen was included in this study. DNA samples were typed for HNA‐1, ‐3, ‐4 and ‐5 systems using polymerase chain reactions with sequence‐specific primers (PCR‐SSP).ResultsIn this cohort, HNA‐1a was more prevalent than HNA‐1b. Accordingly, the possible risk of HNA‐1a alloimmunisation against HNA‐1a is lower than HNA‐1b (0·0802–0·1351 vs 0·2293–0·2497). This is in contrast to the situation reported in Caucasian and African populations. The predicted risk of HNA‐3 incompatibility in Thais, Burmese and Karen were 28·09%, 30·66% and 22·77%, respectively. The possible risks of HNA‐3a alloimmunisation were 0·0493 in Thais, 0·0608 in Burmese and 0·0196 in Karen, respectively. No individuals were found to be homozygous for HNA‐4bb. The probability of developing alloantibodies against HNA‐4a was low in these populations and every population in Asia. In contrast, the overall frequency of HNA‐5bb homozygous individuals was high in this study, peaking at 0·192.ConclusionsThis is the first study that reported the allele frequencies of HNA‐1, ‐3, ‐4, and ‐5 in a large sample of healthy unrelated individuals from ethnic Thais, Burmese and Karen. Our results indicated the high possible risk of HNA‐1, ‐3 and ‐5 alloimmunisation in these populations.