bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers to insulin treatment among Australian Torres Strait Islanders with poorly controlled diabetes
Authors: Taylor Sean , Thompson Fintan , McDermott Robyn 
Published: September 2016

AbstractObjectiveTo explore self reported knowledge and attitudes to insulin treatment among a group of adults with poorly controlled diabetes in the Torres Strait islands.DesignCross‐sectional survey in 2014, interviews with 29 adults with HbA1c ≥ 8.5% (69 mmol mol−1) and not taking insulin, using Insulin Treatment Appraisal Scale (ITAS) and Barriers to Insulin Treatment Questionnaire (BITQ) scores.SettingFive remote Torres Strait Island communities in the Torres Strait region.ParticipantsPoorly controlled insulin‐naïve type 2 diabetics.Main outcome measuresBITQ and ITAS scores on items related to knowledge and attitudes to insulin treatment, clinical and demographic measures.ResultsOverall, 34% of the cohort had poor glycaemic control. Compared to those with HbA1c ≥ 8.5% and taking insulin (n = 37), the 29 insulin‐naïve participants were more obese, more likely to smoke and drink alcohol, have lower mean HbA1c and fewer years with diabetes. Among the insulin‐naïve group, those reporting higher ‘barriers’ (BITQ scores) were older and with lower formal education than those reporting fewer barriers. Torres participants consistently scored low on ‘knowledge’ items in the ITAS, especially those which would guide insulin initiation (insulin improves glucose control and prevents complications).ConclusionCompared to other published studies, the Torres participants had higher scores for BITQ ‘barrier’ items and lower ‘knowledge’ scores. This suggests better education around glycaemic control with medication and discussion of perceptions and exchange of experiences with peers who are taking insulin might improve the uptake of insulin in this high‐risk group.
Dignity, Wisdom, and Tomorrow's Ethical Business Leader
Authors: Hicks Donna , Waddock Sandra 
Published: September 2016

AbstractThis article examines the role wisdom and dignity play in developing ethical business leaders, or what we call shamanic leaders, for the twenty‐first century. We define wisdom as the integration of moral imagination (the good), systems understanding (the true), and aesthetic sensibility (the beautiful) into decisions, actions, and practices in the service of a better world. Dignity is our inherent value, worth, and vulnerability, a core aspect of humanity that each of us is born with. The challenges of developing shamanic leaders, i.e., individuals who evidence the shamanic attributes of healing, connecting, and sensemaking, are discussed, including how to think about and embody wisdom, and the learning that is required to understand and lead with dignity. We argue that dignity and wisdom can be learned and provide the reader with insights into what is required to promote an inclusive and integrated culture where human flourishing and well‐being are at the core of ethical leadership.
A rapid, inexpensive and disposable point‐of‐care blood test for sickle cell disease using novel, highly specific monoclonal antibodies
Authors: Quinn Charles T. , Paniagua Mary C. , DiNello Robert K. , Panchal Anand , Geisberg Mark 
Published: September 2016

Sickle cell disease (SCD) is a significant healthcare burden worldwide, but most affected individuals reside in low‐resource areas where access to diagnostic testing may be limited. We developed and validated a rapid, inexpensive, disposable diagnostic test, the HemoTypeSC™, based on novel monoclonal antibodies (MAbs) that differentiate normal adult haemoglobin (Hb A), sickle haemoglobin (Hb S) and haemoglobin C (Hb C). In competitive enzyme‐linked immunosorbent assays, each MAb bound only its target with <0·1% cross‐reactivity. With the HemoTypeSC™ test procedure, the sensitivity for each variant was <5·0 g/l. The accuracy of HemoTypeSC™ was evaluated on 100 whole blood samples from individuals with common relevant haemoglobin phenotypes, including normal (Hb AA, N = 20), carrier or trait (Hb AS, N = 22; Hb AC, N = 20), SCD (Hb SS, N = 22; Hb SC, N = 13), and Hb C disease (Hb CC, N = 3). The correct haemoglobin phenotype was identified in 100% of these samples. The accuracy of the test was not affected by Hb F (0–94·8% of total Hb) or Hb A2 (0–5·6% of total Hb). HemoTypeSC™ requires <1 μl of whole blood and no instruments or power sources. The total time‐to‐result is <20 min. HemoTypeSC™ may be a practical solution for point‐of‐care testing for SCD and carrier status in low‐resource settings.
Autologous stem cell‐based therapy for sickle cell leg ulcer: a pilot study
Authors: Meneses José Válber L. , Fortuna Vitor , de Souza Eliane Silva , Daltro Gildasio Cerqueira , Meyer Roberto , Minniti Caterina P. , Borojevic Radovan 
Published: September 2016

SummaryRecurrent chronic leg ulcers are among the most severe vasculopathic complications of sickle cell disease (SCD). Their treatment remains a challenge. Stem cell therapy with bone marrow mononuclear cells (BMMC) is a promising new therapeutic option for other forms of chronic ulcers. This prospective pilot study was performed to evaluate safety and feasibility of BMMC implantation in patients with SCD and chronic leg ulcers (SCLU). Ulcer closure, recurrence and local pain were evaluated. BMMC were successfully administered to 23 SCLU patients and no serious adverse events occurred. During the 6‐month follow‐up period, 91·3% of patients had improved ulcer pain compared with baseline and 29·2% of the treated ulcers achieved total healing. The frequency of progenitor stem cells (CD34CD45low and fibroblast colony‐forming units) in BMMC was found to be significantly reduced in SCLU patients and compared to SCD patients without ulcers (P < 0·004 and P < 0·01, respectively). No relationship was observed between treatment outcome and the number of implanted BM progenitor stem cells. In conclusion, BMMC implantation is a feasible and safe procedure, showing favourable outcomes for the treatment of SCLU, and encouraging further controlled clinical trials.
Conservation implications of anthropogenic impacts on visual communication and camouflage
Authors: Delhey Kaspar , Peters Anne 
Published: September 2016

AbstractAnthropogenic environmental impacts can disrupt the sensory environment of animals and affect important processes from mate choice to predator avoidance. Currently, these effects are best understood for auditory and chemosensory modalities, and recent reviews highlight their importance for conservation. We examined how anthropogenic changes to the visual environment (ambient light, transmission, and backgrounds) affect visual communication and camouflage and considered the implications of these effects for conservation. Human changes to the visual environment can increase predation risk by affecting camouflage effectiveness, lead to maladaptive patterns of mate choice, and disrupt mutualistic interactions between pollinators and plants. Implications for conservation are particularly evident for disrupted camouflage due to its tight links with survival. The conservation importance of impaired visual communication is less documented. The effects of anthropogenic changes on visual communication and camouflage may be severe when they affect critical processes such as pollination or species recognition. However, when impaired mate choice does not lead to hybridization, the conservation consequences are less clear. We suggest that the demographic effects of human impacts on visual communication and camouflage will be particularly strong when human‐induced modifications to the visual environment are evolutionarily novel (i.e., very different from natural variation); affected species and populations have low levels of intraspecific (genotypic and phenotypic) variation and behavioral, sensory, or physiological plasticity; and the processes affected are directly related to survival (camouflage), species recognition, or number of offspring produced, rather than offspring quality or attractiveness. Our findings suggest that anthropogenic effects on the visual environment may be of similar importance relative to conservation as anthropogenic effects on other sensory modalities.
The accuracy of preoperative imaging in measuring the length of the ileocolic segment affected by Crohn's disease: a prospective cohort study
Authors: Brouquet A. , Rangheard A.‐S. , Ifergan J. , Lazure T. , Carbonnel F. , Penna C. , Benoist S. 
Published: September 2016

AbstractAimThe study aimed to evaluate the accuracy of imaging for measurement of the length of the ileocolic segment affected by Crohn's disease.MethodFifty‐four consecutive patients who underwent resection between 2011 and 2014 for ileocolic Crohn's disease were prospectively studied. All had preoperative MR or CT enterography. Two independent radiologists measured the length of the diseased intestinal segment. The measurements were compared with the length of disease assessed on pathology of the non‐fixed surgical specimen.ResultsThe median preoperative length of the Crohn's disease segment on imaging was 20.5 (2–73) cm and 20 (3–90) cm, as measured by the two radiologists. Interobserver agreement was substantial (κ = 0.69) with a correlation coefficient (r) of 0.82 (P < 0.001). The median length of the Crohn's disease segment on pathological examination was 16.5 (2–75) cm and was closely correlated with the radiological measurement (r = 0.76, P < 0.001). The length of the Crohn's disease segment on imaging was correct to within 5 cm of the value on pathology. It was correct in 30 (55%) patients and was underestimated and overestimated in 6 (11.1%) and 18 (33.3%). A length of disease of less than 20 cm found on imaging in 26 patients was confirmed in 25 (96%) on pathology, whereas a length of more than 20 cm found on imaging in 28 patients was confirmed in 18 (64%) on pathology. The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of imaging for predicting a length of less than 20 cm were 71%, 95%, 96%, 64% and 79%.ConclusionImaging accurately identifies the length of the ileocolic segment of Crohn's disease when it is 20 cm or less on pathological examination. In patients with more extensive disease, imaging tends to overestimate the length and should be interpreted with caution.
Acute pulmonary thromboembolism in emergency room: gray‐scale versus color doppler ultrasound evaluation
Authors: Ghanem Maha Kamel , Makhlouf Hoda Ahmed , Hasan Ali Abdel‐Azeem , Alkarn Ahmed Atef 
Published: September 2016

AbstractBackgroundPulmonary thromboembolism (PTE) remains under‐diagnosed fatal disease at emergency units suggesting the need for alternative, easy, and noninvasive bedside diagnostic approaches.ObjectivesTo determine the diagnostic role of gray‐scale and color Doppler transthoracic ultrasonography (TUS) in patients with PTE.Patients and MethodsBlinded to 64 multi‐detectors CT pulmonary angiography (MDCTPA) examination as a gold standard, 60 patients with clinically suspected PTE underwent gray‐scale and then color Doppler TUS examination. Results were compared and diagnostic accuracy of TUS was assessed.ResultsForty patients proved to have PTE by MDCTPA. TUS showed typical lesions in 33 patients with the mean of 2 lesions per patient. Most lesions were hypoechoic, wedge‐ shaped, and pleural‐ based and the majority (80%) was located in the lower lobes. Consolidation with little perfusion was detected by Color Doppler ultrasound in 97% of lesions. Isolated central PTE was significantly higher in TUS negative patients. For gray –scale TUS, sensitivity, specificity, positive and negative predictive values and accuracy were 82%, 90%, 94%, 72%, and 85%. Meanwhile the sensitivity, specificity, positive and negative predictive values and accuracy of color Doppler TUS were 80%, 95%, 97%, 70% and 87%, respectively.ConclusionTUS is a reliable diagnostic bedside test for PTE in critically ill and immobile patients. Adding color Doppler to gray–scale TUS increases the specificity and accuracy and consequently the confidence in the diagnosis of peripheral pulmonary infarctions and differentiates them from other pulmonary lesions that allow initiation of anticoagulants.
Study on small airway function in asthmatics with fractional exhaled nitric oxide and impulse oscillometry
Authors: Liu Lin , Liu Wen , Liu Chunhong , Wang Dexiang , Zhao Jiping , Wang Junfei , Wu Jinxiang , Liu Tian , Zhang Yuanyuan , Liu Yahui , Cao Liuzhao , Dong Liang 
Published: September 2016

AbstractObjectivesThe invasive techniques can be direct and objective to assess small airway function, but they have significant risks and inconveniences for patients and cannot be repeated often. Some sophisticated techniques such as fractional exhaled nitric oxide (FeNO) and impulse oscillometry (IOS) may surmount such restrictions. Therefore, we investigated the relation among FeNO, IOS, and small airway function in asthmatic patients.MethodsWe recruited 140 asthmatic patients including 69 patients with small airway normal function and 71 patients with small airway dysfunction. FeNO, eosinophil（EOS）count and total immunoglobulin E (IgE) in peripheral blood, pulmonary function, as well as IOS were measured.ResultsThe levels of FeNO, the reactance area (AX), the resonant frequency Fres and EOS were significantly increased in small airway dysfunction group compared with small airway normal function group (P < 0.01 respectively). A multiple regression model showed that FeNO, AX and Fres were correlative factors of mid forced expiratory flow of percentages of predicted values [FEF25–75 (%pred)] (P < 0.01, respectively). A receiver operating characteristic (ROC) analysis showed that the combination of FeNO, AX and Fres had a greater area under the ROC curve (AUC) than each of them (AUC: 0.881, P < .001, 95％CI: 0.815‐0.929).ConclusionFeNO and IOS are helpful in diagnosis of small airway dysfunction with high sensitivity and specificity, and FeNO combined with IOS can better evaluate the small airway function in asthmatic patients.
Erhöhtes Lungenkrebs‐Risiko bei Ekzempatienten: eine landesweite Kohortenstudie in Taiwan
Authors: Juan Chao‐Kuei , Shen Jui‐Lung , Lin Cheng‐Li , Kim Karen Wang , Chen Wen‐Chi 
Published: September 2016

ZusammenfassungHintergrundDer Zusammenhang zwischen Lungenkrebs und Ekzemen bleibt umstritten. Frühere Studien haben zu widersprüchlichen Ergebnissen geführt. Diese retrospektive populationsbasierte Kohortenstudie zielt darauf ab, das Risiko von Lungenkrebs im Zusammenhang mit Ekzemen abzuklären.Patienten und MethodenIn der Forschungsdatenbank der taiwanesischen nationalen Krankenversicherung identifizierten wir 43719 Patienten, bei denen in den Jahren 2000 bis 2010 ein Ekzem neu diagnostiziert wurde. Die Vergleichskohorte bildeten 87438 zufällig ausgewählte, altersangepasste Patienten ohne Ekzem. Die Fälle aus diesen beiden Kohorten wurden bis 2011 verfolgt. Zur Kalkulation des Lungenkrebsrisikos bei Ekzempatienten wurde die Cox‐Regression verwendet. Die Datenbank enthielt keine Informationen über Raucherstatus, Alkoholkonsum, sozioökonomischen Status oder Familienanamnese.ErgebnisseNach der Bereinigung um Alter und Komorbidität hatte die Population mit Ekzemen ein um 2,80 erhöhtes Risiko für die Entwicklung von Lungenkrebs gegenüber der Vergleichskohorte (bereinigte Hazard‐Ratio 2,80, 95 % Konfidenzinterval 2,59–3,03). Ekzempatienten mit Begleiterkrankungen, darunter Asthma, chronisch obstruktive Lungenerkrankungen, alkoholbedingten Leberschäden oder Diabetes, hatten ein höheres Lungenkrebsrisiko als Patienten ohne Ekzeme oder Komorbidität.SchlussfolgerungenEkzeme gehen mit einem höheren Risiko für die Entwicklung von Lungenkrebs einher. Weitere Studien mit umfassenderen Informationen über weitere potentielle Einflussfaktoren sind sinnvoll.
Mitotic rate in primary melanoma: interobserver and intraobserver reliability, analyzed using H&E sections and immunohistochemistry
Authors: Garbe Claus , Eigentler Thomas K. , Bauer Jürgen , Blödorn‐Schlicht Norbert , Cerroni Lorenzo , Fend Falko , Hantschke Markus , Kurschat Peter , Kutzner Heinz , Metze Dieter , Mielke Volker , Preßler Harald , Reusch Michael , Reusch Ursula , Stadler Rudolf , Tronnier Michael , Yazdi Amir , Metzler Gisela 
Published: September 2016

SummaryBackgroundIn 2009, the AJCC issued a revised melanoma staging system. In addition to tumor thickness and ulceration, the mitotic rate was introduced as the third major prognostic parameter for the classification of primary cutaneous melanoma. Given that, according to the 2009 AJCC classification, the detection of one or more dermal tumor mitoses leads to an upstaging – from stage Ia to Ib – of melanomas with a tumor thickness of ≤ 1.0 mm, we set out to investigate the reproducibility of this new parameter.MethodsIn order to assess interobserver reliability, 17 dermatopathologists und pathologists – all well versed in the diagnosis of cutaneous melanoma – analyzed the mitotic rate in 15 thin primary cutaneous melanomas (mean tumor thickness 0.91 mm) using identical slides. Mitotic rates were determined on H&E and phosphohistone H3 (Ser10)‐stained samples. Without knowledge of their previous assessment, five of the aforementioned examiners reevaluated the samples after more than one year in order to ascertain intraobserver reliability.ResultsInterobserver reliability of the mitotic rate in thin primary melanomas is disappointing and independent of whether H&E or immunohistochemically stained samples are used (kappa value: 0.088 [H&E], 0.154 [IH], respectively). Kappa values improved to 0.345 (H&E) and 0.403 (IH) when using a cutoff of 0/1 vs. 2+ mitoses. Similarly unsatisfactory, kappa values for intraobserver reliability ranged from 0.18 and 0.348, depending on the individual examiner.DiscussionGiven the unsatisfactory reproducibility and large variations in assessing the mitotic rate, it remains a matter of debate whether this diagnostic parameter should play a role in therapeutic decisions.
Therapeutic management of cutaneous and genital warts
Authors: Ockenfels Hans Michael 
Published: September 2016

SummaryDuring their lifetime, at least 10 % of the population will be infected by human papillomaviruses (HPV), clinically characterized by the formation of cutaneous or genital warts. Although warts are ubiquitous, there are no defined treatments. Especially in the first six months, warts frequently resolve without therapeutic intervention. This complicates the interpretation of study data, given that many studies do not differentiate between newly infected patients and those with infections that have persisted for a long time. Similarly, most studies do not take location, size, and thickness of lesions into account, either. The objective of the present review article is to analyze the study data currently available, taking into consideration both subtypes and locations – factors exceedingly crucial in clinical practice. In particular, the distinction between new‐onset and chronic recalcitrant warts is reflected in a therapeutic algorithm. In the case of genital warts, the algorithm is more clearly determined by the extent of the area affected rather than the longevity of lesions. In immunocompetent individuals, any therapeutic intervention must be aimed at achieving complete resolution.
Therapeutisches Management kutaner und genitaler Warzen
Authors: Ockenfels Hans Michael 
Published: September 2016

ZusammenfassungMindestens 10 % der Bevölkerung erkranken während ihres Lebens an einer Infektion mit humanen Papillomaviren (HPV), welche sich klinisch anhand der Ausbildung kutaner oder genitaler Warzen manifestiert. Obwohl Warzen ubiquitär sind, existieren keine definierten Behandlungen. Warzen zeigen, insbesondere in den ersten sechs Monaten, eine erhöhte Selbstheilungsrate. Dieser Umstand erschwert die Interpretation von Studien, da häufig Patienten mit Neuinfektionen zusammen mit Patienten mit Altinfektionen behandelt werden. Lokalisationen, Größe und Dicke der Warzen sind ebenfalls in den meisten Fällen nicht berücksichtigt. Ziel dieses Übersichtsartikels ist eine Analyse des vorliegenden Studienmaterials, unter der für den klinischen Alltag so wichtigen Berücksichtigung von Subtypen und Lokalisationen. Insbesondere die Abgrenzung zwischen frischen und chronisch‐therapieresistenten Verrucae vulgares spiegelt sich in einem Therapiealgorithmus wider. Bei genitalen Warzen wird der Therapiealgorithmus deutlicher durch das Ausmaß der infizierten Fläche als durch das Alter der Warzen bestimmt. Bei immunkompetenten Personen muss es mit den hier aufgezeigten therapeutischen Methoden immer das Ziel sein, eine komplette Abheilung zu erzielen.
Körperdysmorphe Symptome, soziale Anpassung und Motivation zu psychotherapeutischer Beratung bei ambulanten dermatologischen Patienten
Authors: Ritter Viktoria , Fluhr Joachim W. , Schliemann‐Willers Sibylle , Elsner Peter , Strauß Bernhard , Stangier Ulrich 
Published: September 2016

ZusammenfassungHintergrund und ZieleDie Dermatologie ist zunehmend mit Patienten konfrontiert, die unter einer körperdysmorphen Störung (KDS) leiden. Die KDS ist gekennzeichnet durch die übermäßige Beschäftigung mit einem oder mehreren wahrgenommenen Defekten oder Makeln in der äußeren Erscheinung, die für andere nicht oder allenfalls minimal erkennbar sind. Bislang gibt es nur wenige Prävalenzstudien bei KDS im ambulanten dermatologischen Setting. Darüber hinaus wurde die Motivation zu psychotherapeutischer Beratung bei ambulanten dermatologischen Patienten mit körperdysmorphen Symptomen noch nicht systematisch erfasst. Ziel der vorliegenden Studie war daher, die Häufigkeit körperdysmorpher Symptome, die soziale Anpassung sowie die Motivation zu psychotherapeutischer Beratung bei ambulanten dermatologischen Patienten zu untersuchen.Patienten und Methodik252 ambulante Patienten einer Universitäts‐Hautpoliklinik wurden konsekutiv rekrutiert und mittels Dysmorphic Concerns Questionnaire, Soziale Aktivität Selbstbeurteilungs‐Skala sowie Veränderungsstadien‐Skala untersucht.Ergebnisse7,9 % der unselektierten Gesamtstichprobe erzielten Testresultate, die auf klinisch relevante körperdysmorphe Symptome hinweisen. Patienten mit klinisch relevanten körperdysmorphen Symptomen wiesen eine geringe soziale Anpassung auf. Entgegen den Erwartungen zeigten sie eine hohe Veränderungsmotivation und Bedarf an Psychotherapie.SchlussfolgerungenDie Ergebnisse bestätigen die bisherigen Prävalenzraten bei KDS im ambulanten dermatologischen Setting und verdeutlichen die Notwendigkeit psychotherapeutischer Beratungsangebote in der Dermatologie.
Neue Entwicklungen in der Berufsdermatologie
Authors: Diepgen Thomas L. 
Published: September 2016

ZusammenfassungBerufsbedingte Hautkrankheiten nach BK‐Nr. 5101 stehen in Deutschland seit vielen Jahren an der Spitze der angezeigten Berufskrankheiten. Durch die Optimierung von Maßnahmen der primären, sekundären und tertiären Prävention können heutzutage die meisten Betroffenen im Beruf verbleiben. Zum 01.01.2015 wurde die Berufskrankheitenverordnung (BKV) novelliert und es wurde die BK‐Nr. 5103 „Plattenepithelkarzinome oder multiple aktinische Keratosen der Haut durch natürliche UV‐Strahlung“ als neue Berufskrankheit in die BK‐Liste der BKV aufgenommen. Die Definition von „multipel“ bedeutet dabei entweder mehr als fünf einzelne aktinische Keratosen innerhalb eines Zeitraums von 12 Monaten oder das Vorliegen einer Feldkanzerisierung von größer 4 cm2. Wichtige Aspekte dieser neuen Berufskrankheit werden aufgezeigt und diskutiert sowie Neuerungen bei der BK 5101 angesprochen.