bluuebunny/crossref_metadata_2025_split huggingface dataset:
The first description of the complete natural history of uveal melanoma by two Scottish surgeons, Allan Burns and James Wardrop
Authors: Kivelä Tero T. 
Published: August 2017

AbstractJames Wardrop (1782–1869), a young Scottish surgeon and an early ophthalmologist in Edinburgh, is credited for describing in 1809 retinoblastoma as an entity in his treatise ‘Observations on Fungus Hæmatodes or Soft Cancer’. His treatise also reveals that Allan Burns (1781–1813), another young Scottish surgeon and anatomist, had invited Wardrop to assist in enucleating an eye from a 41‐year‐old Glasgow woman who, in retrospect, had a uveal melanoma. Her eye had become blind 4 months after symptoms of exudative retinal detachment had appeared, and it had become painful after a further 2–4 months. The tumour eventually perforated the sclera, and she died within a year thereafter of hepatic metastases. Burns and Wardrop went on to publish detailed parallel accounts of the symptoms, signs, ophthalmic pathology and post‐mortem findings regarding the primary, recurrent and metastatic tumour. Burns may have performed the post‐mortem after exhuming the body, a common occurrence in early 19th Century Scotland, a thriving hub for teaching morbid anatomy to young surgeons at the time.
Treatment for neovascular age‐related macular degeneration in Sweden: outcomes at seven years in the Swedish Macula Register
Authors: Westborg Inger , Granstam Elisabet , Rosso Aldana , Albrecht Susanne , Karlsson Niklas , Lövestam‐Adrian Monica 
Published: August 2017

AbstractPurposeTo present Swedish Macula Register (SMR) data regarding treatment of neovascular age‐related macular degeneration (AMD) in clinical practice since 2008.MethodsA retrospective register‐based study was conducted. Evaluation of baseline demographics, visual outcome and number of injections during this period is presented.ResultsMean age at diagnosis was 79 ± (SD) 8 years; 65% were female. The proportion of patients with <2 months' duration of symptoms increased from 26% in 2008 to 41% in 2014 (p = 0.001). Mean visual acuity (VA) at baseline increased from 54.3 ± 15.0 early treatment diabetic retinopathy study (ETDRS) letters in 2008 to 57.8 ± 15.6 letters in 2014 (CI95 2.6; 4.3; p < 0.001). Mean VA after 1 year of treatment increased from 57.8 ± 17.7 ETDRS letters for patients who started the treatment in 2008 to 62.8 ± 16.4 ETDRS letters in patients starting treatment in 2014 (CI95 2.67; 4.64; p < 0.001). During all study years, the proportion of patients with an improvement in VA of between 5 and 15 letters was around 30%, while 14% had VA improvement of more than 15 letters. The mean number of injections during the first treatment year increased from 4.3 ± 1.9 in 2008 to 5.9 ± 2.9 in 2014 (CI95 1.40; 1.67; p < 0.001). Seven‐year follow‐up of 322 eyes showed a mean change of −1 letters from baseline, with a mean of 21 injections for the entire period.ConclusionThe duration of symptoms before treatment decreased, while VA at baseline and after 1 year of treatment increased over the years and so did the number of injections. Long‐term follow‐up demonstrated stable VA.
Visual impairment and blindness in Hungary
Authors: Szabó Dorottya , Sándor Gábor László , Tóth Gábor , Pék Anita , Lukács Regina , Szalai Irén , Tóth Georgina Zsófia , Papp András , Nagy Zoltán Zsolt , Limburg Hans , Németh János 
Published: August 2017

AbstractAimThe aim of this study was to estimate the prevalence and causes of blindness, severe visual impairment (SVI), moderate visual impairment (MVI), and early visual impairment (EVI) and its causes in an established market economy of Europe.DesignA cross‐sectional population‐based survey.MethodsA sample size of 3675 was calculated using the standard Rapid Assessment of Avoidable Blindness (RAAB) software in Hungary. A total of 105 clusters of 35 people aged 50 years or older were randomly selected with probability proportionate to size by the Hungarian Central Statistical Office. Households within the clusters were selected using compact segment sampling. Visual acuity (VA) was assessed with a Snellen tumbling E‐chart with or without a pinhole in the households.ResultsThe adjusted prevalences of bilateral blindness, SVI, MVI and EVI were 0.9% (95% CI: 0.6–1.2), 0.5% (95% CI: 0.2–0.7), 5.1% (95% CI: 4.3–5.9) and 6.9% (95% CI: 5.9–7.9), respectively. The major causes of blindness in Hungary were age‐related macular degeneration (AMD; 27.3%) and other posterior segment diseases (27.3%), cataract (21.2%) and glaucoma (12.1%). Cataract was the main cause of SVI, MVI and EVI. Cataract surgical coverage (CSC) was 90.7%. Of all bilateral blindness in Hungary, 45.5% was considered avoidable.ConclusionThis study proved that RAAB methodology can be successfully conducted in industrialized countries, which often lack reliable epidemiologic data. The prevalence of blindness was relatively low, with AMD and other posterior segment diseases being the leading causes, and cataract is still a significant cause of visual impairment.
Movements of dams milked for fermented horse milk production in Mongolia
Authors: Bat‐Oyun Tserenpurev , Ito Takehiko Y , Purevdorj Yadamjav , Shinoda Masato , Ishii Satomi , Buho Hoshino , Morinaga Yuki 
Published: August 2017

AbstractAirag, (Fermented horse milk) is a traditional milk product in Mongolia. Herders separate foals from their dams and tie them at a milking site during the daytime to produce airag. To evaluate the effects of horse management on the movement of dams, we tracked three dams in a herd in camp 1 during summer and camp 2 during autumn of 2013 and analyzed their movements during the milking (daytime) and non‐milking (nighttime) periods in an area famous for its high‐quality airag. Dams were gathered every 1.7 ± 0.0 h between 07.46 and 15.47 hours at the milking sites and milked 4.6 ± 0.2 times/day during the study period (86 days). Daily cumulative and maximum linear distances from the milking sites were longer (P < 0.01) during the non‐milking period than during the milking period. Daily home ranges were 91 and 26 times greater during the non‐milking period (P < 0.001) in camps 1 and 2, respectively. The greater range during the non‐milking period would reflect the spatial distributions of water, salt and forage. The dams initially used similar areas and gradually shifted their daily home ranges after several days. This shift suggests that the dams grazed farther afield as forage availability declined around the milking site. For better airag production and sustainable pasture use, our results provide insights useful for evaluating the effects of milking management on vegetation and soil in those pastures, for selecting the appropriate milking times and frequency, and for choosing the right timing to shift milking sites.
The role of heparin in sepsis: much more than just an anticoagulant
Authors: Li Xu , Ma Xiaochun 
Published: August 2017

SummaryDespite progress in antibiotic treatment, mechanical ventilation, fluid resuscitation and blood glucose maintenance, sepsis remains a cause of high mortality in the intensive care unit to date, there are no proven treatment strategies for the routine management of septic patients. The extensive interaction between inflammation and coagulation contributes to the basic pathophysiology of sepsis. Thus, the agents that attenuate the activation of both inflammation and coagulation may improve the outcome in sepsis. Apart from the well‐known anticoagulant effects of heparin, it also possesses various immunomodulatory properties and protects glycocalyx from shedding. Hence, heparin seems to be such an agent. Immunothrombosis plays an important role in early host defence against bacterial dissemination, thus the proper timing for anticoagulant therapy should be determined. We review the available experimental and clinical data supporting the use of heparin in sepsis. At this time the use of heparin in the treatment of sepsis is conflicting. Future trials of heparin therapy for sepsis should concentrate on the very severely ill patients, in whom benefit is most likely to be demonstrated.
Diagnosis of CLL revisited: increased specificity by a modified five‐marker scoring system including CD200
Authors: Köhnke Thomas , Wittmann Veronika K. , Bücklein Veit L. , Lichtenegger Felix , Pasalic Zlatana , Hiddemann Wolfgang , Spiekermann Karsten , Subklewe Marion 
Published: August 2017

SummaryThe modified Matutes score has been the basis for the diagnosis of chronic lymphocytic leukaemia (CLL) by flow cytometry for the past 15 years. To increase the specificity of the current score we systematically evaluated the diagnostic value of established as well as novel markers, such as CD200, in a large cohort of patients with untreated B‐cell malignancies (n = 370). Double positivity for CD5 and CD23 was of very high value to differentiate between CLL and non‐CLL cases. In addition, lack of FMC7 expression as well as CD79b expression intensity showed high sensitivity (90·4% and 92·3%) with acceptable specificity (74·4% and 76·9%). For surface IgM, low or absent expression displayed poor specificity in distinguishing CLL from non‐CLL cases (51,3%; sensitivity 83,7%). Finally, CD200 positivity showed high sensitivity and specificity. Therefore, CD5/CD23, FMC7, CD79b and CD200 were included in our new CLLflow score, which retained high sensitivity (97·1% vs. 98·6% for the Matutes score, P = 0·38), but showed markedly increased specificity (87·2% vs. 53·8%, P < 0·001). These results were confirmed in our validation cohort (sensitivity 97·0% vs. 100%, P = not applicable; specificity 86·4% vs. 59·1%, P = 0·03). Our data support the use of our new CLLflow score for the diagnosis of CLL with significantly higher specificity.
What contributes to action plan enactment? Examining characteristics of physical activity plans
Authors: Fleig Lena , Gardner Benjamin , Keller Jan , Lippke Sonia , Pomp Sarah , Wiedemann Amelie U. 
Published: August 2017

ObjectivesIndividuals with chronic conditions can benefit from formulating action plans to engage in regular physical activity. However, the content and the successful translation of plans into action, so‐called plan enactment, are rarely adequately evaluated. The aim of this study was to describe the content of user‐specified plans and to examine whether participants were more likely to enact their plans if these plans were highly specific, viable, and instrumental.Design and methodsThe study presents secondary analyses from a larger behavioural intervention in cardiac and orthopaedic rehabilitation. The content of 619 action plans from 229 participants was evaluated by two independent raters (i.e., qualitative analyses and ratings of specificity) and by participants themselves (i.e., instrumentality and viability). Plan enactment was also measured via self‐reports. Multilevel analyses examined the relationship between these plan characteristics and subsequent plan enactment, and between plan enactment and aggregated physical activity.ResultsParticipants preferred to plan leisure‐time physical activities anchored around time‐based cues. Specificity of occasion cues (i.e., when to act) and highly instrumental plans were positively associated with plan enactment. Interestingly, individuals who planned less specific behavioural responses (i.e., what to do) were more likely to enact their plans. Plan enactment was positively associated with aggregated behaviour.ConclusionsInterventions should not only emphasize the importance of planning, but also the benefits of formulating specific contextual cues. Planning of the behavioural response seems to require less precision. Allowing for some flexibility in executing the anticipated target behaviour seems to aid successful plan enactment.
Statement of Contribution

What is already known on this subject?

Action planning interventions are efficacious in promoting health behaviour.

Characteristics of plan content (i.e., specificity) matter for unconditional behaviour change.

Plan enactment (i.e., degree to which plan is followed through) is positively linked to behaviour change.

What does this study add?

Specificity of occasion cues (i.e., when to act) and highly instrumental plans were positively associated with plan enactment.

Individuals who planned less specific behavioural responses (i.e., what to do) were more likely to enact their plans.

Planning interventions should focus on specificity of context cues but flexibility of behavioural action.
Feasibility and safety of focal irreversible electroporation as salvage treatment for localized radio‐recurrent prostate cancer
Authors: Scheltema Matthijs J. , van den Bos Willemien , Siriwardana Amila R. , Kalsbeek Anton M.F. , Thompson James E. , Ting Francis , Böhm Maret , Haynes Anne‐Maree , Shnier Ron , Delprado Warick , Stricker Phillip D. 
Published: August 2017

ObjectivesTo evaluate the feasibility, safety, early quality‐of‐life (QoL) and oncological outcomes of salvage focal irreversible electroporation (IRE) for radio‐recurrent prostate cancer (PCa).Patients and MethodsPatients with localized, radio‐recurrent PCa without evidence of metastatic or nodal disease were offered focal IRE according to the consensus guidelines. Patients with a minimum follow‐up of 6 months were eligible for analysis. Adverse events were monitored using the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE version 4.0). Patient‐reported QoL data were collected at baseline, 6 weeks, 3, 6 and 12 months using the Expanded Prostate Cancer Index Composite (EPIC), the American Urological Association (AUA) symptom score and the 12‐item short‐from health survey (SF‐12) physical and mental component summary questionnaires. Oncological control was evaluated according to serial prostate‐specific antigen (PSA), 6‐month multiparametric magnetic resonance imaging (mpMRI) and 12‐month prostate biopsy. Wilcoxon's signed rank test was used to assess QoL differences over time in paired continuous variables.ResultsA total of 18 patients were included in the analysis. The median follow‐up was 21 months. No high‐grade adverse events (CTCAE >2) or recto‐urethral fistulae occurred. No statistically significant declines were observed in QoL outcomes (n = 11) on the EPIC bowel domain (P = 0.29), AUA symptom score (P = 0.77), or the SF‐12 physical (P = 0.17) or SF‐12 mental component summary (P = 0.77) questionnaires. At 6 months, patients who had undergone salvage therapy experienced a decline in EPIC sexual domain score (median of 38–24; P = 0.028) and urinary domain (median of 96–92; P = 0.074). Pad‐free continence and erections sufficient for intercourse were preserved in 8/11 patients and 2/6 patients at 6 months, respectively. The mpMRI was clear in 11/13 patients, with two single out‐field lesions (true‐positive and false‐positive, respectively). The median (interquartile range) nadir PSA was 0.39 (0.04–0.43) μg/L. Three and four patients experienced biochemical failure using the Phoenix and Stuttgart definitions of biochemical failure, respectively. Eight out of 10 of the patients were clear of any PCa on follow‐up biopsy, whereas two patients had significant PCa on follow‐up biopsy (International Society of Urological Pathology grade 5).ConclusionOur short‐term safety, QoL and oncological control data show that focal IRE is a feasible salvage option for localized radio‐recurrent PCa. A prospective multicentre study (FIRE trial) has been initiated that will provide further insight into the ability of focal IRE to obtain oncological control of radio‐recurrent PCa with acceptable patient morbidity.
Iron metabolism in patients with Graves’ hyperthyroidism
Authors: Fischli Stefan , von Wyl Viktor , Trummler Michael , Konrad Daniel , Wueest Stephan , Ruefer Axel , Heering Kerstin , Streuli Regina , Steuer Christian , Bernasconi Luca , Recher Mike , Henzen Christoph 
Published: August 2017

SummaryObjectivesGraves’ hyperthyroidism (GH) interferes with iron metabolism and elevates ferritin. The precise mechanisms remain unclear. The influence of thyroid hormones on the synthesis/regulation of hepcidin, an important regulator of iron metabolism, remains uncharacterized.DesignProspective observational study.PatientsWe included patients (n = 31) with new‐onset and untreated GH.MeasurementsLaboratory parameters indicative of iron metabolism (ferritin, transferrin, hepcidin), inflammatory markers/cytokines and smoking status were assessed at the diagnosis of GH (T0) and at euthyroidism (T1) in the same patients using multivariable analyses. Hepcidin was measured by mass spectrometry (hepcidinMS) and ELISA (hepcidinEL). The impact of T3 on hepatic hepcidin expression was studied in a cell culture model using HepG2 cells.ResultsMedian ferritin levels were significantly lower and transferrin significantly higher at T1 than at T0. HepcidinMS levels were lower in males and females at T1 (statistically significant in males only). No statistically significant difference in hepcidinEL was detected between T0 and T1. Plasma levels of inflammatory markers (high‐sensitive CRP, procalcitonin) and cytokines (interleukin 6, interleukin 1ß, tumour necrosis factor α) were not different between T0 and T1. Smokers tended to have lower fT3 and fT4 at T0 than nonsmoking GH patients. T3 significantly induced hepcidin mRNA expression in HepG2 cells.ConclusionsIron metabolism in patients with GH undergoes dynamic changes in patients with GH that resemble an acute‐phase reaction. Inflammatory parameters and cytokines were unaffected by thyroid status. Gender and smoking status had an impact on ferritin, hepcidin and thyroid hormones.
An Economic Analysis of Western Canadian Grain Export Capacity
Authors: Torshizi Mohammad , Gray Richard 
Published: August 2017

AbstractRecord grain supplies combined with insufficient grain export capacity in the 2013–14 and 2014–15 crop years resulted in depressed Western Canadian grain prices costing producers several billion dollars. The exceptional size of the crop and the harsh winter weather contributing to this costly event raise an important question as to whether additional investment in export capacity is warranted. This study systematically assesses the need for additional grain export capacity in Western Canada. Somewhat conservative grain production forecasts and rational expectations storage are used within a spatial mathematical programming model to simulate a competitive market, moving grain to export positions. We find in the absence of additional export capacity there will be increasingly frequent periods of costly congestion. A 10 million tonnes (Mt) (5 Mt) improvement in both rail and West Coast capacity implies $9.2 billion ($6.0 billion) of cost‐saving benefits for the producers over the 2016–25 period. While these estimates are sensitive to future realized production levels, their magnitude suggests that innovation to increase export capacity is economically important for grain producers in Western Canada.Des approvisionnements records de grains combinés à une capacité exportatrice insuffisante de ces derniers en 2013–14 et en 2014–15 ont engendré le bas prix du grain de l'Ouest canadien représentant une perte de milliards de dollars pour les producteurs. La production exceptionnelle et l'hiver particulièrement rude ont contribué à cet événement coûteux et soulèvent une question importante concernant le besoin pour des investissements additionnels en capacité exportatrice. Cette étude évalue systématiquement le besoin pour une capacité exportatrice accrue des céréales provenant de l'Ouest canadien. Les prévisions relativement prudentes de production de grains et l'anticipation rationnelle de stockage servent dans le cadre d'un modèle de programmation mathématique spatiale pour simuler un marché compétitif, transportant le grain vers les points d'exportation. Les trouvailles indiquent qu'en l'absence de capacité supplémentaire exportatrice, surviendront des périodes de plus en plus fréquentes de congestion coûteuse. Une amélioration de 10 Mt (5 Mt) à la capacité ferroviaire et de la Côte Ouest suppose des réductions de coûts à la hauteur de 9,2 milliards de dollars (6 milliards de dollars) pour les producteurs pour la période entre 2016 et 2025. Ces estimations étant liées à l'atteinte de futurs niveaux de production, leur importance suggère que l'innovation en vue d'accroître la capacité exportatrice s'avère économiquement essentielle pour les producteurs céréaliers de l'ouest du Canada.
The prevalence and fate of the defunctioning stoma in patients with anal cancer: a regional experience following the ACT II trial
Authors: Poynter L. R. , Raman R. , Wegstapel H. , Summers J. , Lawes D. A. 
Published: August 2017

AbstractAimUK guidance advises the creation of a defunctioning stoma for anal tumours infiltrating the vagina, impending obstruction or significant faecal incontinence. Other patients may be offered a defunctioning stoma at the discretion of the clinician. The purpose of this study was to establish the prevalence and fate of defunctioning stomas in a regional anal cancer service, with reference to the results from the recent ACT II trial.MethodOncological treatment was standardized as described in the ACT II trial. All patients from 2010 to 2013 inclusive were included. Collected data were correlated with both the IMRT guidelines and the outcomes of the ACT II trial. Kaplan–Meier survival analysis was applied to stoma‐free survival to the end of the study period.ResultsSeventy‐six patients were identified during the study period, of whom 51% had a defunctioning stoma. Twenty were performed for anterior tumours without infiltration into the vagina (Group A), whilst 19 had a stoma for indications as set out by the guidelines (Group B). Stoma reversal was performed in 41% of patients, 13/20 in Group A and 3/19 in Group B. The median time to reversal was 11 months. Eleven deaths were recorded and six patients still had their stomas at time of death. Stoma‐free survival was 74%. No new ano‐vaginal fistulation occurred as a consequence of treatment.ConclusionThe tumour features that are indications for defunctioning as advised by the UK IMRT guidelines are associated with a poorer overall outcome, and these stomas are less likely to be reversed. The majority of stomas, however, were formed for anterior tumours without infiltration into the vagina and were more likely to be successfully reversed.
GBA mutations in Parkinson disease: earlier death but similar neuropathological features
Authors: Adler C. H. , Beach T. G. , Shill H. A. , Caviness J. N. , Driver‐Dunckley E. , Sabbagh M. N. , Patel A. , Sue L. I. , Serrano G. , Jacobson S. A. , Davis K. , Belden C. M. , Dugger B. N. , Paciga S. A. , Winslow A. R. , Hirst W. D. , Hentz J. G. 
Published: August 2017

Background and purposeMutations in the glucocerebrosidase (GBA) gene are known to be a risk factor for Parkinson's disease (PD). Data on clinicopathological correlation are limited. The purpose of this study was to determine the clinicopathological findings that might distinguish PD cases with and without mutations in the GBA gene.MethodsData from the Arizona Study of Aging and Neurodegenerative Disorders were used to identify autopsied PD cases that did or did not have a GBA gene mutation. Clinical and neuropathological data were compared.ResultsTwelve PD cases had a GBA mutation and 102 did not. The GBA mutation cases died younger (76 vs. 81 years of age) but there was no difference in disease duration or clinical examination findings. No neuropathological differences were found in total or regional semi‐quantitative scores for Lewy‐type synucleinopathy, senile plaques, neurofibrillary tangles, white matter rarefaction or cerebral amyloid angiopathy scores.ConclusionsIn longitudinally assessed, autopsied PD cases, those with GBA mutations had a younger age at death but there was no evidence for clinical or neuropathological differences compared to cases without GBA mutations. Due to the small GBA group size, small differences cannot be excluded.