bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘It's when you're not doing too much you feel tired’: A qualitative exploration of fatigue in end‐stage kidney disease
Authors: Picariello Federica , Moss‐Morris Rona , Macdougall Iain C , Chilcot Joseph 
Published: December 2017

BackgroundFatigue is commonly experienced in end‐stage kidney disease (ESKD) patients. In order to develop patient‐centred psychosocial interventions to help patients manage fatigue symptoms, a more in‐depth understanding regarding the experience of fatigue is needed.ObjectiveThe objective of this study was to explore renal patients’ experiences of fatigue, across renal replacement therapy (RRT) modalities.MethodsTwenty‐five in‐depth semi‐structured interviews were conducted. Interviews were audio‐taped, transcribed, and analysed using inductive thematic analysis.ResultsMain themes included the strong role of the illness and treatment in the aetiology of fatigue. Two contrasting streams of illness–fatigue interpretations emerged: catastrophizing versus normalizing. Participants emphasized the importance of having a sense of purpose in facilitating active management of fatigue. Many participants described the consequences of fatigue on their functioning. Low mood, frustration, and anger were common emotional consequences of fatigue. Three dominant fatigue management strategies emerged: one related to accommodation of activities around fatigue, another on increasing activities to counteract fatigue, and the third one revolved around self‐compassion. Social support emerged as an important aspect of the fatigue experience, serving as a source of motivation, yet participants were wary of becoming a burden to others.ConclusionFindings identify casual attributions, behavioural and emotional reactions, management strategies, and facilitators of active management of fatigue in ESKD. Untying fatigue from the illness and treatment may help patients to develop alternative less catastrophic perceptions of fatigue, increase their perception of control over fatigue, and facilitate active fatigue management.
Statement of contribution

What is already known on this subject?

Fatigue is persistent and debilitating in end‐stage kidney disease (ESKD), with no consistent treatment model.

Promising evidence is available for psychological fatigue interventions in other chronic conditions.

There is a gap in studies looking at the fatigue experiences of patients with ESKD across renal replacement therapies.

What does this study add?

Fatigue is not inherently negative, but shaped by patients’ beliefs and behaviours.

Findings provide novel insights, for example, on the important role social support seems to play in fatigue.

An in‐depth understanding of fatigue may help to inform a future patient‐centred intervention in ESKD.
Outcomes of subsequent non‐muscle‐invasive bladder cancer treated with intravesical Bacillus Calmette‐Guérin after radical nephroureterectomy for upper urinary tract urothelial carcinoma
Authors: Miyake Makito , Tatsumi Yoshihiro , Matsumoto Hiroaki , Nagao Kazuhiro , Matsuyama Hideyasu , Inamoto Teruo , Azuma Haruhito , Yasumoto Hiroaki , Shiina Hiroaki , Fujimoto Kiyohide ,   The Nishinihon Uro‐Oncology Collaborative Group
Published: December 2017

ObjectivesTo describe the clinicopathological characteristics and prognosis of subsequent non‐muscle‐invasive bladder cancer (NMIBC) after radical nephroureterectomy (RNU) for upper urinary tract urothelial carcinoma (UTUC), and particularly its response to intravesical Bacillus Calmette‐Guérin (BCG).Patients and MethodsAn observational study was conducted in 1463 patients with UTUC who had undergone RNU and in 1555 patients with primary NMIBC. Of the 1463 patients with UTUC, 256 (17%) subsequently developed NMIBC (UTUC‐NMIBC group) and were available for the analysis. The clinicopathological background and outcomes, including intravesical recurrence‐free survival and bladder progression‐free survival, were compared between the patients with UTUC‐NMIBC and the patients with primary NMIBC treated with intravesical BCG. Propensity score matching was performed to adjust for the potential differences in the backgrounds of the two groups. To validate the utility of the CUETO scoring model in the UTUC‐NMIBC group, risk scores were calculated and compared with the published probabilities for recurrence and progression.ResultsCompared with the unadjusted primary NMIBC group (n = 352), the UTUC‐NMIBC group (n = 75) were found to have a worse prognosis for intravesical recurrence and progression, before propensity score matching. After propensity score matching for potential confounding factors, however, a worse prognosis was observed only for intravesical recurrence. The validation test of the CUETO scoring model for the UTUC‐NMIBC group showed a significant difference in the rate of intravesical recurrence and progression for the 0–4 and 5–6 score groups between the UTUC‐NMIBC group and the CUETO risk table reference data.ConclusionCompared with the primary NMIBC group, the UTUC‐NMIBC group had a worse prognosis after intravesical BCG, especially with regard to intravesical recurrence. This suggests that patients with UTUC‐NMIBC are inherently poor responders to BCG exposure. An optimal treatment strategy and risk scoring model to select patients for adjuvant intravesical BCG, chemotherapy or immediate radical cystectomy should be established.
Evolution of cystectomy care over an 11‐year period in a high‐volume tertiary referral centre
Authors: Brassetti Aldo , Möller Axel , Laurin Oscar , Höijer Jonas , Adding Christofer , Miyakawa Ayako , Hosseini Abolfazl , Wiklund Peter 
Published: December 2017

ObjectivesTo describe the evolution in radical cystectomy (RC) care over 11 years at a referral centre.Patients and MethodsThe clinical data of patients undergoing either open RC (ORC) or robot‐assisted RC (RARC) for cT1‐4aN0M0 bladder cancer (BCa) at our centre between January 2006 and December 2016 were retrospectively evaluated. Crude and propensity score‐weighted log‐binomial regression analyses were conducted to assess the association between pre‐ and peri‐operative variables and the risk of reoperation, intensive care unit (ICU) admission and death <90 days after RC.ResultsA total of 814 patients were considered. The percentage of RARCs performed increased (from 10% to 100%) between 2006 and 2013. Overall, 29% of the patients received neoadjuvant chemotherapy (12–37% from 2006 to 2016). Despite no differences in terms of operating time, pelvic lymph node dissection (PLND) was more commonly attempted during RARC and extended PLND was more frequently performed in the RARC group (72% vs 19%; P < 0.001). Ileal conduit was the preferred urinary diversion in both groups, and more patients in the RARC group underwent neobladder construction (34% vs 14%; P < 0.001). The overall rates of re‐intervention, ICU admission and death within 90 days of RC were 8.9%, 5.4% and 2.9%, respectively. On crude analysis, RARC was associated with a reduced risk of ICU admission (relative risk [RR] 0.42, 95% confidence interval [CI] 0.23–0.77; P = 0.005), reintervention (RR 0.58, 95% CI 0.37–0.90; P = 0.015) and death (RR 0.37, 95% CI 0.16–0.85; P = 0.020); however, these risk reductions were not statistically significant on weighted analyses.ConclusionsThe introduction of RARC has coincided with a reduction in the rate of ICU admission, reoperation and death within 90 days of surgery, without compromising operating time, PLND extent or neobladder utilization.
Simvastatin activates single skeletal RyR1 channels but exerts more complex regulation of the cardiac RyR2 isoform
Authors: Venturi Elisa , Lindsay Chris , Lotteau Sabine , Yang Zhaokang , Steer Emma , Witschas Katja , Wilson Abigail D , Wickens James R , Russell Angela J , Steele Derek , Calaghan Sarah , Sitsapesan Rebecca 
Published: December 2017

Background and PurposeStatins are amongst the most widely prescribed drugs for those at risk of cardiovascular disease, lowering cholesterol levels by inhibiting 3‐hydroxy‐3‐methylglutaryl (HMG)‐CoA reductase. Although effective at preventing cardiovascular disease, statin use is associated with muscle weakness, myopathies and, occasionally, fatal rhabdomyolysis. As simvastatin, a commonly prescribed statin, promotes Ca2+ release from sarcoplasmic reticulum (SR) vesicles, we investigated if simvastatin directly activates skeletal (RyR1) and cardiac (RyR2) ryanodine receptors.Experimental ApproachRyR1 and RyR2 single‐channel behaviour was investigated after incorporation of sheep cardiac or mouse skeletal SR into planar phospholipid bilayers under voltage‐clamp conditions. LC‐MS was used to monitor the kinetics of interconversion of simvastatin between hydroxy‐acid and lactone forms during these experiments. Cardiac and skeletal myocytes were permeabilised to examine simvastatin modulation of SR Ca2+ release.Key ResultsHydroxy acid simvastatin (active at HMG‐CoA reductase) significantly and reversibly increased RyR1 open probability (Po) and shifted the distribution of Ca2+ spark frequency towards higher values in skeletal fibres. In contrast, simvastatin reduced RyR2 Po and shifted the distribution of spark frequency towards lower values in ventricular cardiomyocytes. The lactone pro‐drug form of simvastatin (inactive at HMG‐CoA reductase) also activated RyR1, suggesting that the HMG‐CoA inhibitor pharmacophore was not responsible for RyR1 activation.Conclusion and ImplicationsSimvastatin interacts with RyR1 to increase SR Ca2+ release and thus may contribute to its reported adverse effects on skeletal muscle. The ability of low concentrations of simvastatin to reduce RyR2 Po may also protect against Ca2+‐dependent arrhythmias and sudden cardiac death.
Adiponectin concentration data improve the estimation of atherosclerotic risk in normal and in overweight subjects
Authors: Bertolami Adriana , de Lima‐Júnior José C. , Cintra Riobaldo M. , Carvalho Luiz S. , Gonzaga Carolina de C. , Sulzbach Martha L. , Petisco Ana C.G.P. , Barbosa José E.M. , Faludi André A. , Plutzky Jorge , Bertolami Marcelo C. , Sposito Andrei C. 
Published: December 2017

SummaryBackgroundThe combinations of adipokines and body mass parameters to estimate carotid atherosclerotic disease have not been completely delineated.ObjectiveTo test the combinations of well‐established, easily accessible body mass indices and circulating biomarkers to identify increased carotid intima‐media thickness (cIMT) in a primary prevention setting.Design and patientsIn a cross‐sectional analysis of 339 asymptomatic individuals with no history of cardiovascular events, inflammatory and insulin sensitivity biomarkers as well as adipokine levels were measured and combined with body mass parameters to evaluate the best marker for increased cIMT.ResultsAs isolated parameters, body mass index (BMI) and adiponectin best identified abnormal cIMT (P = .04). Adiponectin levels were also linked to the relationship between BMI and cIMT (β = 0.0371; P = .01). Twenty‐nine individuals with increased cIMT were missed by BMI alone but detected by combining BMI and adiponectin measurements. When compared with BMI alone, the combination of adiponectin plus BMI improved the c‐statistic (0.549‐0.567) and the integrated discrimination improvement index (0.01725; P = .021). Segregation of individuals by the combined use of BMI + adiponectin is associated with significant differences in insulin sensitivity, glomerular filtration rate, systemic inflammatory activity, dyslipidaemia and cIMT.ConclusionsCombining plasma adiponectin measurements and BMI improves estimation of cIMT as compared to anthropometric parameters.
Psychosocial health of cochlear implant users compared to that of adults with and without hearing aids: Results of a nationwide cohort study
Authors: Bosdriesz J.R. , Stam M. , Smits C. , Kramer S.E. 
Published: December 2017

ObjectivesThis study aimed to examine the psychosocial health status of adult cochlear implant (CI) users, compared to that of hearing aid (HA) users, hearing‐impaired adults without hearing aids and normally hearing adults.DesignCross‐sectional observational study, using both self‐reported survey data and a speech‐in‐noise test.SettingData as collected within the Netherlands Longitudinal Study on Hearing (NL‐SH) between September 2011 and June 2016 were used.ParticipantsData from 1254 Dutch adults (aged 23‐74), selected in a convenience sample design, were included for analyses.Mean outcome measuresPsychosocial health measures included emotional and social loneliness, anxiety, depression, distress and somatisation. Psychosocial health, hearing status, use of hearing technology and covariates were measured by self‐report; hearing ability was assessed through an online digit triplet speech‐in‐noise test.ResultsAfter adjusting for the degree of hearing impairment, HA users (N = 418) and hearing‐impaired adults (N = 247) had significantly worse scores on emotional loneliness than CI users (N = 37). HA users had significantly higher anxiety scores than CI users in some analyses. Non‐significant differences were found between normally hearing (N = 552) and CI users for all psychosocial outcomes.ConclusionsPsychosocial health of CI users is not worse than that of hearing‐impaired adults with or without hearing aids. CI users’ level of emotional loneliness is even lower than that of their hearing‐impaired peers using hearing aids. A possible explanation is that CI patients receive more professional and family support, and guidance along their patient journey than adults who are fitted with hearing aids.
Representing, Running, and Revising Mental Models: A Computational Model
Authors: Friedman Scott , Forbus Kenneth , Sherin Bruce 
Published: December 2017

AbstractPeople use commonsense science knowledge to flexibly explain, predict, and manipulate the world around them, yet we lack computational models of how this commonsense science knowledge is represented, acquired, utilized, and revised. This is an important challenge for cognitive science: Building higher order computational models in this area will help characterize one of the hallmarks of human reasoning, and it will allow us to build more robust reasoning systems. This paper presents a novel assembled coherence (AC) theory of human conceptual change, whereby people revise beliefs and mental models by constructing and evaluating explanations using fragmentary, globally inconsistent knowledge. We implement AC theory with Timber, a computational model of conceptual change that revises its beliefs and generates human‐like explanations in commonsense science. Timber represents domain knowledge using predicate calculus and qualitative model fragments, and uses an abductive model formulation algorithm to construct competing explanations for phenomena. Timber then (a) scores competing explanations with respect to previously accepted beliefs, using a cost function based on simplicity and credibility, (b) identifies a low‐cost, preferred explanation and accepts its constituent beliefs, and then (c) greedily alters previous explanation preferences to reduce global cost and thereby revise beliefs. Consistency is a soft constraint in Timber; it is biased to select explanations that share consistent beliefs, assumptions, and causal structure with its other, preferred explanations. In this paper, we use Timber to simulate the belief changes of students during clinical interviews about how the seasons change. We show that Timber produces and revises a sequence of explanations similar to those of the students, which supports the psychological plausibility of AC theory.
Contribution of cervical cytology in the diagnostic work‐up of patients with endometrial cancer
Authors: Amkreutz L. C. M. , Pijnenborg J. M. A. , Joosten D. W. L. , Mertens H. J. M. M. , Van Kuijk S. M. J. , Engelen M. J. A. , Bergmans M. , Nolting W. E. , Kruitwagen R. F. P. M. 
Published: December 2017

IntroductionAbnormal cervical cytology in patients with endometrial cancer (EC) has been associated with poor outcome. The aim of this study was to evaluate whether cervical cytology could contribute to an improved preoperative identification of high‐grade EC (serous, clear cell, carcinosarcoma, high‐grade endometrioid EC) in final histology.MethodsA retrospective cohort study was performed in five hospitals in the Netherlands. A total of 554 patients with EC that underwent primary surgical treatment between 2002 and 2010 were included. Primary outcome was defined as the contribution of abnormal cervical cytology in the preoperative identification of high‐grade EC. As secondary outcome, recurrence‐free survival (RFS) and disease‐specific survival were determined based on preoperative cervical cytology, and compared to the currently established risk factors: myometrial invasion, high‐grade and lymph vascular space invasion.ResultsAbnormal cervical cytology was present in 45.1%. For patients with preoperative inconclusive and high‐grade histology, the presence of abnormal cervical cytology contributed to an improved identification of high‐grade EC in final histology (odds ratio [OR] 6.40 [95% confidence interval {CI}: 1.92‐21.26]; OR 2.86 [95% CI: 1.14‐7.14]), respectively.Patients with abnormal cervical cytology had a significant worse 5‐year median RFS. Abnormal cervical cytology was independently related to RFS (hazard ratio 1.67 [95% CI: 1.04‐2.68]) and disease‐specific survival (hazard ratio 3.15 [95% CI: 1.74‐5.71]).ConclusionsAbnormal cytology contributes to the preoperative identification of patients with high‐grade EC, and is associated with compromised outcome. Future studies are warranted to determine whether cervical cytology could be incorporated into preoperative prediction models for lymph node metastasis.
Dapsone for topical use in extemporaneous preparations
Authors: Wohlrab Johannes , Michael Julia 
Published: December 2017

SummaryBackgroundThe sulfone dapsone has an established role in systemic therapy. Its pharmacological and toxicological properties are well known. Topically, dapsone is used in a gel formulation for the treatment of acne vulgaris. In addition, there have been individual case reports on the efficacy of topical dapsone preparations in the treatment of various neutrophilic dermatoses. To date, no finished medicinal product for topical use has been available in Germany.Material and methodsAgainst this background, we set out to develop extemporaneous preparations containing dapsone (5 %) that meet the quality requirements of the European Pharmacopoeia as well as the manufacturing requirements of the German Ordinance on the Operation of Pharmacies (ApBetrO). These formulations included the incorporation of dapsone in a hydrophobic cream base (“hydrophobe Basiscreme DAC”) as well as in methylprednisolone aceponate 0.1 % ointment (alternatively, in the latter's cream base without active ingredient).ResultsTests aimed at investigating the physical, chemical, and microbiological stability of these formulations showed them to meet the aforementioned quality requirements.ConclusionThe extemporaneous formulations presented herein broaden the therapeutic options for topical treatment, in particular for patients with chronic inflammatory dermatoses associated with a neutrophilic pathogenesis.
Protecting Property: The Politics of Redistribution, Expropriation, and Market Openness
Authors: Pond Amy 
Published: December 2017

AbstractThis paper develops a formal model to disentangle the competing political incentives for redistribution, expropriation, and market openness. Although redistribution and expropriation are both types of government extraction, redistribution re‐allocates wealth within the citizenry, while expropriation re‐allocates wealth from citizens to the government. Representative political institutions increase redistribution and reduce expropriation. Market openness changes these incentives, as foreign investors prefer reductions in both redistribution and expropriation. When political institutions are representative, the government will rely more on reducing expropriation, rather than limiting redistribution, to attract foreign investment. Under representative institutions then, openness partially reinforces the preferences of voters rather than undermining them. In addition, market liberalization occurs only when the policy changes needed to attract foreign investment are relatively small. If existing policies are satisfactory to foreign investors, moves toward openness may be accompanied by greater redistribution and expropriation, as governments are tempted by a larger base for extraction. Thus, openness has ambiguous effects on economic policy, at times encouraging and at times constraining extraction.
Migration and movement profiles of a potadromous fish (Brachymystax lenok Pallas 1773) in a highly connected river system (Mongolia)
Authors: Kaus Andrew , Büttner Olaf , Karthe Daniel , Schäffer Michael , Borchardt Dietrich 
Published: December 2017

AbstractUnderstanding a species’ spatial and temporal movements along with the way these shift under extreme environmental conditions is vital for developing scientifically sound conservation and management strategies. The aim of this research was to describe and quantify the seasonal migration patterns and fine‐scale movement profiles of Brachymystax lenok, a threatened, potadromous salmonid that inhabits the highly connected, boreal river basins of Siberia and northern Asia. During this study 21 mature individuals were monitored over a 15 month period in the upper Eroo River basin, Mongolia, using passive acoustic telemetry. Mean (±SD) B. lenok home ranges were 19.1 ± 15.1 km (median = 11.5 km), with maximum longitudinal movements detected > 45.3 km. Two periods of increased movements were identified; the first in late summer/early autumn when 10 B. lenok moved into deeper, overwintering pools, with the second period occurring in late spring and early summer when nine B. lenok were detected entering the surrounding tributaries. Diel activity and depth typically increased during daylight hours followed by decreased activity or resting periods in shallower river sections at night. These results highlight the need to maintain a high level of river connectivity and adequate fishing season closures by implementing and enforcing an expansive spatiotemporal management plan that can better protect and recover the Mongolian B. lenok populations. Such measures should be transferable to other threatened, potadromous fish species residing throughout the world's boreal river basins.
Monoclonal gammopathies: Electronic subspecialty consultation
Authors: Burwick Nicholas , Stein Jacob , Garcia David A. , Broudy Virginia C. , Richard Robert E. 
Published: December 2017

AbstractImportanceElectronic consultation (e‐consult) is an important component of care for patients in the Veterans Health Administration who require subspecialty consultation but not urgent face‐to‐face evaluation. Monoclonal gammopathy of undetermined significance (MGUS) is a common reason for e‐consult. While often benign, MGUS requires careful evaluation and persistent surveillance over time.ObjectiveTo identify areas to improve MGUS care delivery by e‐consult.MethodsWe performed a retrospective review of our e‐consult database and identified a cohort of 152 MGUS patients triaged for e‐consult over a 5‐year period (2010‐2014).ResultsThe median time to completion of an e‐consult was 2 days. Ninety‐six percent of MGUS e‐consults had a hemoglobin >10 g/dL, and 90% had a creatinine <2 mg/dL. While the majority of e‐consults were low risk, paraprotein surveillance varied over time and tracked with consult utilization. With a median follow‐up of 44 months, there were 6 documented progression events, representing a mean rate of progression of 1% per year.ConclusionsE‐consult is a helpful mechanism for the evaluation of MGUS, reducing the need for outpatient appointments. However, timely risk stratification and persistent surveillance over time are critical for e‐consult to work well.