bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physicians' Non‐Uniform Approach to Prescribing Drugs to Older Patients – A Qualitative Study
Authors: Christensen Line Due , Petersen Janne , Andersen Ove , Kaae Susanne 
Published: June 2017

AbstractMulti‐morbidity and polypharmacy are common in older patients and increase their susceptibility to adverse drug events and hospitalizations. Rational drug prescription is critical; however, little is known about physicians' perspectives on how to prescribe drugs for older patients. The aim of this study was to explore physicians' approach to prescribe drugs to older patients, including identifying the drugs that physicians perceive to be risk drugs for older patients and comparing them with established lists of potentially inappropriate medications. Short semi‐structured interviews were conducted with 50 medical specialists in 23 different specialities throughout Denmark who had contact with older patients. Content analysis was performed to identify the relevant themes. Regardless of their medical or surgical background and how often they prescribed drugs for older patients in daily work, all physicians expressed a cautious approach when prescribing risk drugs. Despite their shared caution, physicians had different strategies for prescribing drugs to older patients. The following strategies were identified: (1) ‘Start low, go slow’, (2) ‘Trial and error’, (3) ‘Dose reduction’, and (4) ‘Never prescribe’. The most frequently mentioned risk drugs considered to cause hospitalization were vitamin K antagonists, opioids and diuretics; these drugs are relatively highly consistent with established lists of PIMs. Physicians were relatively knowledgeable about risk drugs. Although the physicians agreed that a cautious approach was needed when prescribing drugs for older people, there was no consensus about how to best accomplish this in practice.
Antilipase and antiproliferative activities of novel fluoroquinolones and triazolofluoroquinolones
Authors: Arabiyat Shereen , Kasabri Violet , Al‐Hiari Yusuf , Bustanji Yasser K. , Albashiti Rabab , Almasri Ihab M. , Sabbah Dima A. 
Published: June 2017

Fluoroquinolones (FQs) have been identified recently as potent inhibitors of pancreatic lipase (PL). The aim of this study was to synthesize novel FQs and triazolofluoroquinolones (TFQs) and to evaluate them in vitro with respect to their antilipolytic efficacy and potency properties. The PL‐IC50 values of 12 FQs and TFQs (3 (a–c)–6 (a–c)) were in the range of 12.5–189.1 μm. These values are further supported by docking studies. The suggested association between obesity and colorectal cancer initiated the evaluation of antiproliferative activity of the new FQs and TFQs against a panel of obesity‐related colorectal cells (HT29, HCT116, SW620 CACO2, and SW480). Sulforodamine B colorimetric assay revealed that some derivatives exhibited unselective cytotoxicity against HT29, HCT116, SW620 CACO2, and SW480. Remarkably, FQ 4a's selective cytotoxicity against HCT116 was found valuable with IC50 value of 4.2 μm which exceeds that of cisplatin with a substantial selective cytotoxicity in periodontal ligament fibroblasts. In conclusion, FQ and TFQ derivatives may unveil new antiobesity and anticancer agents in the future.
Obstructive sleep apnoea and polycystic ovary syndrome: A comprehensive review of clinical interactions and underlying pathophysiology
Authors: Kahal Hassan , Kyrou Ioannis , Tahrani Abd A. , Randeva Harpal S. 
Published: June 2017

SummaryPolycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder in women of reproductive age. PCOS is associated with multiple comorbidities including, obesity, insulin resistance and type 2 diabetes, as well as mood disorders and impaired quality of life (QoL). Obstructive sleep apnoea (OSA) is also a common medical condition that is often undiagnosed, particularly in women. OSA is associated with a similar spectrum of comorbidities to that observed in PCOS, including manifestations of the metabolic syndrome and impaired QoL, whilst obesity frequently constitutes a common denominator in the pathophysiology of both OSA and PCOS. Hence, it is not surprising that OSA and PCOS may coexist in women of reproductive age, and the current clinical guidelines on the management of PCOS recommend screening for OSA symptoms in overweight/obese women with PCOS. In this review, we examine the relationship between OSA and PCOS and explore the potential underlying mechanisms that link these two conditions.
Bias in protected‐area location and its effects on long‐term aspirations of biodiversity conventions
Authors: Venter Oscar , Magrach Ainhoa , Outram Nick , Klein Carissa Joy , Possingham Hugh P. , Di Marco Moreno , Watson James E.M. 
Published: June 2017

AbstractTo contribute to the aspirations of recent international biodiversity conventions, protected areas (PAs) must be strategically located and not simply established on economically marginal lands as they have in the past. With refined international commitments under the Convention on Biological Diversity to target protected areas in places of “importance to biodiversity,” perhaps they may now be. We analyzed location biases in PAs globally over historic (pre‐2004) and recent periods. Specifically, we examined whether the location of protected areas are more closely associated with high concentrations of threatened vertebrate species or with areas of low agricultural opportunity costs. We found that both old and new protected areas did not target places with high concentrations of threatened vertebrate species. Instead, they appeared to be established in locations that minimize conflict with agriculturally suitable lands. This entrenchment of past trends has substantial implications for the contributions these protected areas are making to international commitments to conserve biodiversity. If protected‐area growth from 2004 to 2014 had strategically targeted unrepresented threatened vertebrates, >30 times more species (3086 or 2553 potential vs. 85 actual new species represented) would have been protected for the same area or the same cost as the actual expansion. With the land available for conservation declining, nations must urgently focus new protection on places that provide for the conservation outcomes outlined in international treaties.
Estimating abundance without recaptures of marked pallid sturgeon in the Mississippi River
Authors: Friedenberg Nicholas A. , Hoover Jan Jeffrey , Boysen Krista , Killgore K. Jack 
Published: June 2017

AbstractAbundance estimates are essential for assessing the viability of populations and the risks posed by alternative management actions. An effort to estimate abundance via a repeated mark‐recapture experiment may fail to recapture marked individuals. We devised a method for obtaining lower bounds on abundance in the absence of recaptures for both panmictic and spatially structured populations. The method assumes few enough recaptures were expected to be missed by random chance. The upper Bayesian credible limit on expected recaptures allows probabilistic statements about the minimum number of individuals present in the population. We applied this method to data from a 12‐year survey of pallid sturgeon (Scaphirhynchus albus) in the lower and middle Mississippi River (U.S.A.). None of the 241 individuals marked was recaptured in the survey. After accounting for survival and movement, our model‐averaged estimate of the total abundance of pallid sturgeon ≥3 years old in the study area had a 1%, 5%, or 25% chance of being <4,600, 7,000, or 15,000, respectively. When we assumed fish were distributed in proportion to survey catch per unit effort, the farthest downstream reach in the survey hosted at least 4.5–15 fish per river kilometer (rkm), whereas the remainder of the reaches in the lower and middle Mississippi River hosted at least 2.6–8.5 fish/rkm for all model variations examined. The lower Mississippi River had an average density of pallid sturgeon ≥3 years old of at least 3.0–9.8 fish/rkm. The choice of Bayesian prior was the largest source of uncertainty we considered but did not alter the order of magnitude of lower bounds. Nil‐recapture estimates of abundance are highly uncertain and require careful communication but can deliver insights from experiments that might otherwise be considered a failure.
How does age affect the outcome of kidney transplantation in elderly recipients?
Authors: Neri Flavia , Furian Lucrezia , Cavallin Francesco , Ravaioli Matteo , Silvestre Cristina , Donato Paola , La Manna Gaetano , Pinna Antonio Daniele , Rigotti Paolo 
Published: June 2017

AbstractThe aging of the on‐dialysis population raises the issue of whether to propose elderly patients for kidney transplantation and how to manage their immunosuppression. This study aimed to analyze the outcome of kidney transplantation on an Italian series of elderly recipients. We included in this retrospective study all patients over 60 years, receiving a deceased‐donor kidney transplantation from January 2004 to December 2014 in two north Italian Centers. We analyzed the correlation of recipient age with graft's and patient's survival, delayed graft function, acute cellular rejection (ACR), surgical complications, infections, and glomerular filtration rate. Four hundred and fifty‐two patients with a median age of 65 years were included in the study. One‐, 3‐, and 5‐year patient's and graft's survival were, respectively, of 98.7%, 93%, 89% and 94.4%, 87.9%, 81.4%. The increasing recipient age was an independent risk factor only for the patient's (P=.008) and graft's survival (P=.002). ACR and neoplasia were also associated to a worse graft survival. The reduced graft survival in elderly kidney recipients seems to be related more to the increasing recipient's age than to the donor's features. In this population, the optimization of organ allocation and immunosuppression may be the key factors to endorse improvements.
Long‐term graft survival in patients with chronic antibody‐mediated rejection with persistent peritubular capillaritis treated with intravenous immunoglobulin and rituximab
Authors: Mulley William R. , Huang Louis L. , Ramessur Chandran Sharmila , Longano Anthony , Amos Liv A. R. , Polkinghorne Kevan R. , Nikolic‐Paterson David J. , Kanellis John 
Published: June 2017

AbstractChronic antibody‐mediated rejection (cAMR) is the major cause of premature renal allograft loss and is resistant to therapy with 12‐month graft failure of up to 50% reported. We examined the duration of graft survival and associates of graft failure in patients with donor‐specific antibody‐positive cAMR and treatment‐resistant peritubular capillaritis between June 2007 and October 2010. Those with advanced interstitial fibrosis (n=5) were excluded. Included patients (n=24) received treatment with high‐dose intravenous immunoglobulin and fixed‐dose rituximab (500 mg). Compared with previous reports, the study group experienced prolonged graft survival (median 82.1 months). Graft loss was predicted by eGFR and degree of proteinuria at diagnosis but not by donor‐specific HLA antibody class or intensity, nor individual or summed Banff scores. Allograft biopsies were further examined for infiltrating leukocyte subtypes and location with high numbers of glomerular leukocytes, particularly macrophages, independently associated with an increased risk of graft failure. This study suggests that patients with cAMR and persistent microcirculatory inflammation, excluding those with advanced histological damage, can expect prolonged graft survival when treated with IVIg and rituximab. Trial level evidence is required to validate this observation. Further examination of the role of macrophages in cAMR is warranted.
Effect of everolimus vs calcineurin inhibitors on quality of life in heart transplant recipients during a 3‐year follow‐up: Results of a randomized controlled trial (SCHEDULE)
Authors: Relbo Authen Anne , Grov Ingelin , Karason Kristjan , Gustafsson Finn , Eiskjær Hans , Rådegran Göran , Gude Einar , Jansson Kjell , Dellgren Göran , Solbu Dag , Arora Satish , Andreassen Arne K. , Gullestad Lars 
Published: June 2017

AbstractThe Scandinavian heart transplant everolimus de novo study with early calcineurin inhibitors avoidance (SCHEDULE) trial was a 12 month, randomized, open‐label, parallel‐group trial that compared everolimus (EVR; n=56) to conventional CsA (n=59) immunosuppression. Previously, we reported that EVR outperformed CsA in improving renal function and coronary artery vasculopathy, despite a higher rejection rate with EVR. This study aimed to compare the effects of these treatments on quality of life (QoL). Within five post‐operative days, patients (mean age 50±13 years, 27% women) were randomized to EVR or a standard CsA dosage (CsA group). This study assessed quality of life (QoL), based on the Short Form‐36, EuroQol‐5D, and Beck Depression Inventory (BDI). Assessments were performed pre‐HTx and 12 and 36 months post‐HTx. At 12 and 36 months, the groups showed similar improvements in Short Form‐36 measures (at pre‐HTx, 12 and 36 months the values were as follows: Physical component summary: EVR: 31.5±110.9, 49.1±9.7, and 47.9±10.6; P<.01; CsA: 32.5±8.2, 48.4±8.5, and 46.5±11.5; P<.01; mental component summary: EVR: 46.0±12.0, 51.7±11.9, and 52.1±13.0; P<.01; CsA: 38.2±12.5, 53.4±7.1, and 54.3±13.0; P<.01); similar decrease in mean BDI (EVR: 10.9±10.2, 5.4±4.7, and 8.1±9.0; P<.01; CsA: 11.8±7.1, 6.3±5.4, and 6.2±6.5; P<.01); and similar Euro Qol‐improvements. Thus, in this small‐sized study, EVR‐based and conventional CsA immunosuppressive strategies produced similar QoL improvements.
Favourable changes in mortality in people with diabetes: US NHANES 1999–2010
Authors: Tsujimoto Tetsuro , Kajio Hiroshi , Sugiyama Takehiro 
Published: June 2017

AimsDiabetes‐related complications have declined during the past two decades. We aimed to examine whether mortality in people with diabetes improved over time in the 1999 to 2010 National Health and Nutrition Examination Survey (NHANES).MethodsWe conducted a prospective cohort study using 1999 to 2004 and 2005 to 2010 data from the NHANES. For primary analyses, we compared the unadjusted, age‐adjusted and multivariable‐adjusted hazard ratios (HR) for mortality outcomes (total, cardiovascular, cardiac and cancer deaths) of the participants with diabetes with those without diabetes using Cox proportional hazard models.ResultsFor each mortality outcome, HR (95% confidence interval) in diabetic participants during the period 2005 to 2010 was lower than that during the period 1999 to 2004 (all‐cause death, 2.76 [1.87‐4.08] vs 4.23 [2.57‐6.98]; cardiovascular death, 2.70 [1.20‐6.04] vs 8.82 [3.28‐23.70]; cardiac death, 2.45 [0.98‐6.09] vs 15.55 [7.01‐34.50]; cancer death, 2.33 [0.87‐6.23] vs 3.03 [1.20‐7.65]). Compared with mortality outcome during the period 1999 to 2004, greater declines in mortality during the period 2005 to 2010 were observed for cardiovascular (−54.0%) and cardiac deaths (−64.8%). In age‐adjusted and multivariable‐adjusted models, the cumulative event rates for total, cardiovascular and cardiac deaths were not significantly different between participants with and without diabetes during the period 2005–2010; this was not the case during the period 1999–2004. The leading cause of death was malignant neoplasm during the period 2005–2010.ConclusionConsiderably improved outcomes for total, cardiovascular and cardiac deaths were observed in people with diabetes during the 2005 to 2010 NHANES compared to the 1999 to 2004 NHANES.
The effects of ethanol on diverse components of choice in the rat: reward discrimination, preference and relative valuation
Authors: McGraw Justin J. , Zona Luke C. , Cromwell Howard C. 
Published: June 2017

AbstractAlcohol consumption impairs judgment and choice. How alcohol alters these crucial processes is primarily unknown. Choice can be fractionated into different components including reward discrimination, preference and relative valuation that can function together or in isolation depending upon diverse factors including choice context. We examined the diverse components and contextual effects by analyzing the effects of alcohol drinking on choice behavior in a task with a reduced level of temporal and spatial constraints. Rats were trained to drink 10% ethanol during 6 weeks of behavior testing using a combined sucrose‐fade and two‐bottle free‐choice procedure. Two different sucrose pellet outcomes (e.g., constant vs. variable) were presented each week to examine the impact of voluntary drinking on reward‐based decision‐making. Behavioral contexts of single option, free choice and extinction were examined for each outcome set. Comparisons were made between alcohol and control groups and within the alcohol group over time to inspect choice profiles. Between‐group results showed alcohol drinking animals expressed altered place preference and modified sucrose reward approach latencies. The within‐group profile showed that alcohol drinking animals can express adequate reward discrimination, preference and incentive contrast during free choice. All of these components were significantly reduced during the context of extinction. Control animals were also impacted by extinction but not as severely. The findings point to a need for a greater focus on the context and the diverse components of choice when examining external and internal factors influencing decision‐making during alcohol or other substance of abuse exposure.
Functional traits explain ecosystem function through opposing mechanisms
Authors: Cadotte Marc W. 
Published: June 2017

AbstractThe ability to explain why multispecies assemblages produce greater biomass compared to monocultures, has been a central goal in the quest to understand biodiversity effects on ecosystem function. Species contributions to ecosystem function can be driven by two processes: niche complementarity and a selection effect that is influenced by fitness (competitive) differences, and both can be approximated with measures of species’ traits. It has been hypothesised that fitness differences are associated with few, singular traits while complementarity requires multidimensional trait measures. Here, using experimental data from plant assemblages, I show that the selection effect was strongest when trait dissimilarity was low, while complementarity was greatest with high trait dissimilarity. Selection effects were best explained by a single trait, plant height. Complementarity was correlated with dissimilarity across multiple traits, representing above and below ground processes. By identifying the relevant traits linked to ecosystem function, we obtain the ability to predict combinations of species that will maximise ecosystem function.
Acute flaccid myelitis in childhood: a retrospective cohort study
Authors: Andersen E. W. , Kornberg A. J. , Freeman J. L. , Leventer R. J. , Ryan M. M. 
Published: June 2017

Background and purposeClusters of acute limb weakness in paediatric patients have been linked to outbreaks of non‐polio enteroviruses, termed acute flaccid myelitis (AFM). Outside these clusters, in countries where polio is not endemic, this poliomyelitic‐like illness is rare in childhood and its natural history is not well defined. We describe presenting features, investigation findings and long‐term outcome of a series of children with AFM.MethodsThis was a retrospective cohort study.ResultsEight children (six females) aged 3 months to 8 years (median age 5 years) met case criteria. Initial symptoms were pain (n = 7) followed by limb weakness with hypotonia (n = 8). Flaccid paralysis occurred in only three patients. Two had cranial nerve dysfunction. Magnetic resonance imaging of the spinal cord demonstrated grey matter involvement particularly affecting the anterior cord, with longitudinally extensive changes in three children. Cerebrospinal fluid examination showed pleocytosis in six children with raised cerebrospinal fluid protein in five. Nerve conduction and electromyography findings were consistent with a motor neuronopathy. Residual deficits were common, with moderate to severe weakness seen in five patients. Median follow‐up was 28 months (range 17–108 months, 30.4 patient years in total).ConclusionsAcute flaccid myelitis is an uncommon condition in childhood with a high rate of significant long‐term morbidity. AFM should be considered in children presenting with acute limb pain and weakness.
Improving the quality of prison research: A qualitative study of ex‐offender service user involvement in prison suicide prevention research
Authors: Awenat Yvonne F. , Moore Currie , Gooding Patricia A. , Ulph Fiona , Mirza Aisha , Pratt Daniel 
Published: June 2017

AbstractBackgroundSuicide is the leading cause of avoidable death in prisons worldwide and suicide prevention is an international priority. Consequently, there is an urgent need to develop evidence‐based treatments. We conducted a randomized controlled trial of a novel suicide prevention psychological therapy for male prisoners. To promote ecological validity by addressing the “real‐world” situation of suicidal prisoners, we involved a consultant group of ex‐offenders with past experience of being suicidal during imprisonment. Service user involvement in prison research is challenging and underdeveloped.ObjectiveWe aimed to investigate the ex‐offender service user consultants’ experiences of being involved in the research.DesignIndividual qualitative interviews were conducted and analysed using an Interpretative Phenomenology Analysis (IPA) framework.Setting/participantsThe study was conducted at a university in North England, UK, comprising four ex‐offenders with experience of being suicidal during past imprisonments.ResultsTwo superordinate themes were identified: “Working Together” depicted participants’ perceptions of the pivotal role of good relationships with researchers, and “Journey of Change” outlined how participants’ involvement in the research impacted on their personal lives.DiscussionLittle is known about how to successfully involve ex‐offender service users in research. Our results indicate the conditions necessary for successfully engaging ex‐offender service users in research and have important implications for improving the quality of prison research.ConclusionsInvolving forensic service users in research is feasible and should be encouraged, as despite certain challenges, it is highly rewarding both for the research and the ex‐offender service users.
MYC protein dysregulation is driven by BCR‐PI3K signalling in diffuse large B‐cell lymphoma
Authors: Wang Wei‐Ge , Liu Ze‐Bing , Jiang Xiang‐Nan , Lee Jimmy , Zhou Xiao‐Yan , Li Xiao‐Qiu 
Published: June 2017

AimsMYC overexpression is a common feature of diffuse large B‐cell lymphoma (DLBCL) and is associated with poor prognosis in patients with this neoplasm. We aimed to investigate the underlying mechanisms of MYC dysregulation, as they have not been fully determined.Methods and resultsWe immunohistochemically evaluated the correlation between B‐cell receptor (BCR)–phosphoinositide 3‐kinase (PI3K) pathway activity and MYC level in 108 cases of de‐novo DLBCL, 25 of which featured loss of BCR, and investigated the effects of BCR–PI3K signalling on MYC level and phosphorylation in DLBCL cell lines. The expression levels of phospho‐SYK and phospho‐AKT correlated with MYC expression in BCR‐positive DLBCL. MYC expression was significantly lower in BCR‐negative tumour tissues than in BCR‐positive tumour tissues. Upon BCR stimulation, the BCR‐positive cell lines showed active BCR–PI3K signalling and decreased MYC phosphorylation at T58, leading to an increased overall level of MYC. Conversely, inhibition of BCR–PI3K signalling increased MYC phosphorylation and thus resulted in a decreased overall level of MYC. No effects were observed in the BCR‐negative cell lines.ConclusionsOverexpression of MYC in DLBCL can be driven by the BCR–PI3K signalling pathway via dephosphorylation at T58, and BCR inhibitors may exert their functions by down‐regulation of MYC.