bluuebunny/crossref_metadata_2025_split huggingface dataset:
Individual choice or collective action? Exploring consumer motives for participating in alternative food networks
Authors: Zoll Felix , Specht Kathrin , Opitz Ina , Siebert Rosemarie , Piorr Annette , Zasada Ingo 
Published: November 2017

AbstractAlternative food networks (AFNs) are growing in number and relevance in Germany. Those networks include new models of production and distribution, such as food cooperatives (FoodCoops), self‐harvest gardens or community‐supported agriculture (CSA) schemes. AFNs, as an alternative to conventional food supply systems, are characterized by a close producer‐consumer interaction. They are typically located within urban or peri‐urban areas. The study aims to identify the rationale and motivation of urban residents in participating in AFNs and developing a consumer typology. We also assess whether AFNs potentially lead to collective action with societal impact. Therefore, we conducted a qualitative content analysis based on 18 interviews with members of existing AFN projects in three German metropolitan regions. Our results revealed that the willingness of urban consumers to participate in AFNs is driven by a broad range of motives. They include personal desire for high‐quality food (in terms of taste or freshness) and health reasons, but also political or environmental motives (opposition to conventional agriculture or short transport distances). Furthermore, consumers often want to support a certain farmer and his/her philosophy or they appreciate the community‐building aspect. Three different consumer types were derived from the motive combinations. Many consumers communicated a sense of belonging to a societal movement, however, our study revealed a lack of organization and collective action. Although AFNs can influence the consumption patterns of individuals, their potential to induce social change and to challenge traditional models of consumption in the near future does not appear to be high.
Clinicopathologic characteristics of early‐onset Becker's nevus in Korean children and adolescents
Authors: Kim Young J. , Roh Mi R. , Lee Ji H. , Na Jung I. , Ko Joo Y. , Jung Joon M. , Lee Jong H. , Chang Sung E. 
Published: November 2017

AbstractBackgroundBecker's nevus (BN) presents as a hairy patch or plaque with or without proliferation of the dermal smooth muscles. BN has been described as acquired as found in a similar entity, congenital smooth muscle hamartoma (CSMH). This study was aimed at evaluating the clinicopathological aspects of BN in Korean cases in differential diagnosis with CSMH.MethodsWe performed a retrospective study of 103 patients histopathologically diagnosed as having BN or CSMH. The cases included 40 cases diagnosed with BN or CSMH before the age of 10 years who had clinical monitoring and a second skin biopsy after puberty to determine the disease course.ResultsAmong cases of children to adolescents (<18 years), we observed a slight male predominance. Among children aged <14 years, sex ratio converged at 1:1. Early‐onset BN showed a female predominance and hyperpigmented skin lesions. All BN cases showed hyperpigmentation, and face and neck involvement tended to make severe cosmetic concerns. In contrast, hypertrichosis was more frequent in CSMH. Either skin‐colored lesion or pseudo‐Darier's sign was not seen in early‐onset BN. BN showed less dermal smooth muscle than CSMH.ConclusionsAndrogens themselves do not seem to be related to the development of BN but play only an aggravating role especially in male patients. Considering high occurrence in exposed areas, BN may distress patients severely. As early laser treatment may be helpful in some patients with BN, early‐onset BN in comparison to CSMH should be diagnosed appropriately.
A narrative review of dermatologic protocols for primary care medical service trips in Latin America and the Caribbean
Authors: Dainton Christopher , Chu Charlene H. 
Published: November 2017

AbstractBackgroundSkin disorders are prevalent on primary care medical service trips in Latin America and the Caribbean and commonly include scabies, superficial mycoses, and pyoderma. There have been no previous attempts to describe protocols that international volunteer clinicians use in managing these patients. The purpose of this study was to collect North American clinical protocols used by sending organizations in their volunteer operations in Latin America and the Caribbean, summarize the most common pharmacologic and nonpharmacologic management strategies, and compare these to published international practice recommendations.MethodsA systematic web search was used to identify North American medical service trip‐sending organizations. Clinical protocols were downloaded from their websites, and organizations were directly contacted to request protocols that were not published online. The protocols obtained were summarized, analyzed thematically, and compared to existing international guidelines.ResultsOf 225 organizations contacted, 112 (49.8%) responded, and 31 of these (27.7%) claimed to possess protocols for their trips, of which 20 were obtained and analyzed. Ten (50%) protocols discussed scabies, eight (40%) discussed superficial mycoses, and five (25%) discussed pyoderma. The protocols discussed clinical assessment, pharmacologic and nonpharmacologic management with variable degrees of accuracy and thoroughness, and with important omissions when compared to international guidelines. None were the product of systematic literature searches, and most were not referenced.ConclusionsTo avoid ineffective treatment and related harms, context‐specific clinical guidelines are needed for volunteer clinicians practicing in remote international settings, and such guidelines should be based on best evidence and stakeholder consensus.
Duopolistic competition with multiple scenarios and different attitudes toward uncertainty
Authors: Monroy L. , Caraballo M.A. , Mármol A.M. 
Published: November 2017

AbstractIn this paper, we address duopolistic competition when the firms have to assess the results of the interaction at different scenarios. Specifically, we consider the case in which the scenarios are identified with several states of nature and, therefore, the firms face uncertainty on their results. The probability of occurrence of the scenarios is unknown by the firms and they make their output decision before uncertainty is resolved. Within this framework, we analyze competition between firms when these firms exhibit extreme and neutral attitudes toward uncertainty with respect to the final profits. For the variety of cases that can occur, we characterize the sets of equilibria, and provide procedures to determine them. The analysis proposed can also be applied to study situations in a deterministic setting with simultaneous multiple scenarios, and to the analysis of multiple criteria duopolistic competition.
Early electrophysiological findings in acute inflammatory demyelinating polyradiculoneuropathy variant of Guillain‐Barre syndrome in the Pakistani population – a comparison with global data
Authors: Wali Ahmad , Kanwar Dureshahwar , Khan Safoora A. , Khan Sara 
Published: November 2017

AbstractAcute inflammatory demyelinating polyradiculoneuropathy (AIDP) and acute motor axonal neuropathy are the most common variants of Guillian‐Barre syndrome documented in the Asian population. However, the variability of early neurophysiologic findings in the Asian population compared to western data has not been documented. Eighty‐seven cases of AIDP were retrospectively reviewed for their demographic, clinical, electrophysiological, and laboratory data. Mean age of subjects was 31 ± 8 years with males more commonly affected. Motor symptoms (97%) at presentation predominated. Common early nerve conduction findings included low motor amplitudes (85%), recordable sural sensory responses (85%), and absent H‐reflex responses (65%). Prolonged F‐latencies were found most commonly in posterior tibial nerves (23%) in the lower limbs and median and ulnar nerves (18%) in the upper limbs. Blink reflex (BR) studies were performed in 57 patients and were abnormal in 80% of those with clinical facial weakness and in 17 of 52 patients (33%) with no clinical cranial nerve signs, suggesting subclinical cranial nerve involvement. Abnormal motor and sensory amplitudes are seen early. Prolonged distal latencies, temporal dispersion/conduction blocks and sural sparing pattern are other common early nerve conduction study findings of AIDP seen in the Pakistani population. There are no significant differences in abnormalities of conduction velocities and delayed reflex responses compared to published data. The BR can help in the early diagnosis of AIDP.
A multi‐centre randomised clinical trial of oral hygiene interventions following stroke—A 6‐month trial
Authors: Ab Malik N. , Mohamad Yatim S. , Abdul Razak F. , Lam O. L. T. , Jin L. , Li L. S. W. , McGrath C. 
Published: November 2017

SummaryMaintaining good oral hygiene is important following stroke. This study aimed to evaluate the effectiveness of two oral health promotion (OHP) programmes to reduce dental plaque levels following stroke. A multi‐centre randomised clinical control trial was conducted among patients hospitalised following stroke in Malaysia. Patients were randomly allocated to two OHP groups: (i) control group who received the conventional method for plaque control—daily manual tooth brushing with a standardised commercial toothpaste, (ii) test group—who received an intense method for plaque control—daily powered tooth brushing with 1% Chlorhexidine gel. Oral health assessments were performed at baseline, at 3 months and 6 months post‐intervention. Within‐ and between‐group changes in dental plaque were assessed over time. Regression analyses were conducted on dental plaque levels at 6 months controlling for OHP group, medical, dental and socio‐demographic status. The retention rate was 62.7% (54 of 86 subjects). Significant within‐group changes of dental plaque levels were evident among the test group (P < .001) and the control group (P < .001). No significant between‐group changes of dental plaque levels were apparent (P > .05). Regression analyses identified that baseline plaque levels (adjusted ß = 0.79, P < .001) and baseline functional dependency level (adjusted ß = −0.34, P < .05) were associated with dental plaques levels at the end of the trial (6 months). Both, “Conventional” and “Intense” oral health promotion programmes may successfully reduce dental plaque during stroke rehabilitation and are of comparable effectiveness. Baseline dental plaque levels and functional dependency level were key factors associated with dental plaque levels at follow‐up at 6 months.
Formation and mosaicity of coccolith segment calcite of the marine algae Emiliania huxleyi
Authors: Yin Xiaofei , Ziegler Andreas , Kelm Klemens , Hoffmann Ramona , Watermeyer Philipp , Alexa Patrick , Villinger Clarissa , Rupp Ulrich , Schlüter Lothar , Reusch Thorsten B. H. , Griesshaber Erika , Walther Paul , Schmahl Wolfgang W. 
Published: November 2017

Coccolithophores belong to the most abundant calcium carbonate mineralizing organisms. Coccolithophore biomineralization is a complex and highly regulated process, resulting in a product that strongly differs in its intricate morphology from the abiogenically produced mineral equivalent. Moreover, unlike extracellularly formed biological carbonate hard tissues, coccolith calcite is neither a hybrid composite, nor is it distinguished by a hierarchical microstructure. This is remarkable as the key to optimizing crystalline biomaterials for mechanical strength and toughness lies in the composite nature of the biological hard tissue and the utilization of specific microstructures.To obtain insight into the pathway of biomineralization of Emiliania huxleyi coccoliths, we examine intracrystalline nanostructural features of the coccolith calcite in combination with cell ultrastructural observations related to the formation of the calcite in the coccolith vesicle within the cell. With TEM diffraction and annular dark‐field imaging, we prove the presence of planar imperfections in the calcite crystals such as planar mosaic block boundaries. As only minor misorientations occur, we attribute them to dislocation networks creating small‐angle boundaries. Intracrystalline occluded biopolymers are not observed. Hence, in E. huxleyi calcite mosaicity is not caused by occluded biopolymers, as it is the case in extracellularly formed hard tissues of marine invertebrates, but by planar defects and dislocations which are typical for crystals formed by classical ion‐by‐ion growth mechanisms. Using cryo‐preparation techniques for SEM and TEM, we found that the membrane of the coccolith vesicle and the outer membrane of the nuclear envelope are in tight proximity, with a well‐controlled constant gap of ~4 nm between them. We describe this conspicuous connection as a not yet described interorganelle junction, the “nuclear envelope junction”. The narrow gap of this junction likely facilitates transport of Ca2+ ions from the nuclear envelope to the coccolith vesicle. On the basis of our observations, we propose that formation of the coccolith utilizes the nuclear envelope–endoplasmic reticulum Ca2+‐store of the cell for the transport of Ca2+ ions from the external medium to the coccolith vesicle and that E. huxleyi calcite forms by ion‐by‐ion growth rather than by a nanoparticle accretion mechanism.
Disappearance of perihepatic lymph node enlargement after hepatitis C viral eradication with direct‐acting antivirals
Authors: Hikita H. , Sato Masaya , Endo Momoe , Sato Mamiko , Soroida Y. , Kobayashi T. , Gotoh H. , Iwai T. , Nakagomi R. , Tateishi R. , Komuro T. , Sone S. , Koike K. , Yatomi Y. , Ikeda H. 
Published: November 2017

SummaryPerihepatic lymph node enlargement (PLNE) which has been shown to be negatively associated with hepatocellular carcinoma (HCC) occurrence is frequently observed in chronic liver disease; however, changes in the state of perihepatic lymph nodes after eradication of hepatitis C virus (HCV) have not been investigated yet. We aimed to evaluate this issue. We enrolled 472 patients with chronic HCV infection who achieved viral eradication with direct‐acting antivirals (DAA). We investigated whether the status of perihepatic lymph nodes changed before and after HCV eradication (primary endpoint). We also evaluated the association between PLNE and clinical findings such as liver fibrosis or hepatocellular injury before HCV eradication (secondary endpoint). Perihepatic lymph node enlargement was detected in 164 of 472 (34.7%) patients before DAA treatment. Surprisingly, disappearance of PLNE was observed in 23.8% (39 patients) of all PLNE‐positive patients after eradication of HCV. Disappearance of PLNE was not associated with baseline clinical parameters or changing rates of clinical findings before and after DAA treatment. At baseline, presence of PLNE was significantly associated with a lower serum HCV‐RNA level (P = .03), a higher serum AST level (P = .004) and a higher ALT level (P < .001) after adjustment for sex and age. In conclusion, PLNEs became undetectable after DAA treatment in 23.8% of PLNE‐positive patients. Further study with a longer follow‐up period is needed to clarify the clinical importance of this phenomenon especially in relationship with the risk of HCC development.
Unconventional T cells in chronic hepatitis B patients on long‐term suppressive therapy with tenofovir followed by a Peg‐IFN add‐on strategy: A randomized study
Authors: Cannizzo E. S. , Tincati C. , Binda F. , Ronzi P. , Cazzaniga F. A. , Antinori S. , d'Arminio Monforte A. , Marchetti G. , Milazzo L. 
Published: November 2017

SummaryHBV eradication in chronic hepatitis B (CHB) subjects is rarely achieved with either nucleos(t)ide analogues (NA) or pegylated interferon (Peg‐IFN), which both have a limited effect in restoring immune responses. Thirty CHB subjects on long‐term treatment with tenofovir (TDF) and HBV suppression were enrolled and randomized 1:2 to either receive Peg‐IFN‐α‐2a add‐on therapy or continue TDF alone. We studied γδ T and iNKT frequency and function (by flow cytometry) at baseline, at 12 weeks and 12 weeks after the end of treatment. A higher reduction in qHBsAg occurred in the add‐on group compared with the NA group at W12 (P = .016) and at W24 (P = .012). A decline of qHBsAg ≥0.5 log10 at week 24 occurred in 4 of 10 patients in the add‐on arm and 1 of 20 in the NA arm, respectively (P = .03). HBsAg loss was seen in 20% of subjects in the add‐on group and in none of the NA group. Compared to HBV negative, CHB on TDF showed lower frequency of iNKT (P = .03) and γδ T cells (P = .03) as well as fewer γδ T cells expressing Vδ2 T‐cell receptors (P = .005). No changes in unconventional T‐cell frequency and function were shown in both add‐on and NA patients nor were differences detected between the two treatment groups. We report persistent impairment of unconventional T cells in CHB. Despite a greater qHBsAg decline of add‐on patients, our data failed to detect any effect of Peg‐IFN treatment on unconventional T cells.
Late potentials and their correlation with ventricular structure in patients with ventricular arrhythmias
Authors: Marstrand Peter , Axelsson Anna , Thune Jens Jakob , Vejlstrup Niels , Pehrson Steen , Bundgaard Henning , Theilade Juliane 
Published: November 2017

AbstractIntroductionThe presence of late potentials (LP) may indicate a predisposition to ventricular arrhythmias and sudden cardiac death. We investigated the association between presence of LP and structural cardiac anomalies assessed by magnetic resonance (CMR) in patients presenting with ventricular arrhythmias.MethodsWe included 42 patients admitted with ventricular tachycardia or fibrillation who had undergone both signal‐averaged ECG recording and CMR imaging. Clinical data and CMR findings were compared in patients with and without LP.ResultsThe majority, 26 (62%) patients, were sudden cardiac death survivors and the remaining 16 (38%) were admitted with ventricular tachycardia. After full diagnostic work‐up, the most common diagnoses in the cohort were idiopathic ventricular tachycardia/ventricular fibrillation (25 patients, 60%) or cardiomyopathies (11 patients, 26%). LPs were positive in 29 (69%) when using the revised Task Force criteria. When comparing patients with and without late potentials, there were no significant differences in right ventricular size relative to body surface area (102 mL/m2 vs 92 mL/m2), right ventricular ejection fraction (55% vs 58%), or positive late gadolinium enhancement (29% vs 24%).ConclusionsAmong patients with malignant arrhythmias, the presence of LP does not distinguish between patients with normal and abnormal RV structure or function on CMR. LP may indicate the presence of an arrhythmic heart disease beyond what can be inferred from CMR. The frequent finding of late potentials indicates that the diagnostic value of LP as an ARVC criteria should be tested in larger studies comparing ARVC patients and controls.
The effect of an ultra‐low frame rate and antiscatter grid‐less radiation protocol for cardiac device implantations
Authors: Attanasio Philipp , Schreiber Tobias , Parwani Abdul , Lacour Philipp , Pieske Burkert , Haverkamp Wilhelm , Blaschke Florian , Huemer Martin 
Published: November 2017

AbstractBackground and aimsAntiscatter grids improve image contrast by absorbing scattered x‐ray beams, although by removing the antiscatter grid patient dose can be reduced as more x‐ray beams reach the image receptor. Additionally, there is a trend toward ultra‐low frame rates for radiation dose reduction during various electrophysiology procedures. As for most cardiac device implantations (CIED) image quality demands are usually modest, the purpose of this study was to assess the safety and efficacy of an ultra‐low frame rate and scatter grid‐less radiation protocol.Methods/resultsA total of 140 patients undergoing CIED implantation between 2014 and 2017 were included in the study. Seventy patients (50%) implanted after implementation of the antiscatter grid‐less and ultra‐low frame rate protocol were matched to controls before the dose‐reduction protocol was established. Forty patients (28.6%) had a one‐chamber pacemaker or one‐chamber implantable cardioverter defibrillator (ICD) implantation/revision, 60 (42.9%) had a two‐chamber pacemaker or two‐chamber ICD implantation/revision, and 40 (28.6%) patients had a cardiac resynchronization therapy device implantation/revision. Removing the antiscatter‐grid and lowering the frame rate led to a 73% reduction of the overall dose area product (1,206 ± 2,015 vs 324 ± 422 μGym, P < 0.001). Procedural duration (95 ± 51 minutes vs 82 ± 44 minutes, P = 0.053) and rate of complications were not significantly different between the two groups.ConclusionThe use of an ultra‐low frame rate and antiscatter grid‐less radiation protocol significantly reduced radiation dose for implantation of CIED and led to very low average patient doses, while procedural duration and complication rates did not increase.
Age of platelet concentrates and time to the next transfusion
Authors: Caram‐Deelder Camila , van der Bom Johanna G. , Putter Hein , Leyte Anja , Kerkhof Daan van de , Evers Dorothea , Beckers Erik A. , Weerkamp Floor , Hudig Francisca , Zwaginga Jaap Jan , Rondeel Jan M.M. , de Vooght Karen M.K. , Péquériaux Nathalie C.V. , Visser Otto , Wallis Jonathan P. , Middelburg Rutger A. 
Published: November 2017

BACKGROUNDStorage time of platelet (PLT) concentrates has been negatively associated with clinical efficacy outcomes. The aim of this study was to quantify the association between storage time of PLT concentrates and interval to the next PLT transfusion for different types of PLT components, stored for up to 7 days and transfused to transfusion‐dependent hematooncology patients with thrombocytopenia.STUDY DESIGN AND METHODSFrom a cohort of patients from 10 major Dutch hospitals, patients were selected whose transfusion patterns were compatible with PLT transfusion dependency due to hematooncologic disease. Mean time to the next transfusion and mean differences in time to the next transfusion for different storage time categories (i.e., fresh, <4 days; intermediate, 4‐5 days; and old, >5 days) were estimated, per component type, using multilevel mixed‐effects linear models.RESULTSAmong a cohort of 29,761 patients who received 140,896 PLT transfusions we selected 4441 hematooncology patients who had received 12,724 PLT transfusions during periods of PLT transfusion dependency. Transfusion of fresh, compared to old, buffy coat–derived PLTs in plasma was associated with a delay to the next transfusion of 6.2 hours (95% confidence interval [CI], 4.5‐8.0 hr). For buffy coat–derived PLTs in PAS‐B and ‐C this difference was 7.7 hours (95% CI, 2.2‐13.3 hr) and 3.9 hours (95% CI, –2.1 to 9.9 hr) while for apheresis PLTs in plasma it was only 1.8 hours (95% CI, –3.5 to 7.1 hr).CONCLUSIONOur results indicate that the time to the next transfusion shortens with increasing age of transfused buffy coat–derived PLT concentrates. This association was not observed for apheresis PLTs.