bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic concordance of breast pathologists: lessons from the National Health Service Breast Screening Programme Pathology External Quality Assurance Scheme
Authors: Rakha Emad A , Ahmed Mohamed A , Aleskandarany Mohammed A , Hodi Zsolt , Lee Andrew H S , Pinder Sarah E , Ellis Ian O 
Published: November 2016

AimsPrevious concordance studies examining accuracy of breast diagnosis by pathologists, typically targeting difficult, histologically challenging breast lesions using artificial and restrictive environments, have reported aberrantly high levels of diagnostic discordance. The results of these studies may be misinterpreted by non‐pathologists and raise concerns relating to routine practice. This study aims to assess the diagnostic agreement among UK breast pathologists.MethodsTwo hundred and forty consecutive breast lesions, submitted by participants from their routine practice, included in the UK National Health Service Breast Screening Programme (NHSBSP) breast pathology EQA scheme during the last 10 years were reviewed. An average of approximately 600 participants viewed each case. Data on diagnostic categories (benign, atypical, in‐situ malignant and invasive malignant) were collected. In this study, benign and atypical diagnoses were grouped together.ResultsThe overall diagnostic agreement level was in the almost perfect range. Thirty‐five cases (14.6%) showed diagnostic concordance of ≤95%. Reasons for discordance included one or more of: (1) scheme methodology limitations such as: (i) miscoding of certain lesions (e.g. phyllodes tumours and lobular neoplasia) (n = 7) and (ii) variable representation of the index lesion on glass slides (n = 18); and (2) diagnostically challenging cases that may be interpreted more easily using immunohistochemistry (n = 28). These latter included benign and malignant papillary lesions (n = 12), complex sclerosing lesions (n = 7), intraductal epithelial proliferative lesions (n = 6) and an unusual special tumour type (n = 1). Further review identified pathologists’ misinterpretation in 13 cases (5.4%), with an average discordance rate of only 4.2%.ConclusionsThe performance of breast pathologists is high. Exclusion of the effect of the scheme methodology limitations highlights further the high performance rate and identifies true diagnostically challenging entities. These difficult cases may benefit from additional diagnostic work‐up and second opinions.
Climate hindcasts: exploring the disjunct distribution of Diopatra biscayensis
Authors: Wethey David S. , Woodin Sarah A. , Berke Sarah K. , Dubois Stanislas F. 
Published: November 2016

AbstractThe ecosystem engineer onuphid polychaete Diopatra biscayensis has a continuous population in the Bay of Biscay from the Cantabria coast in Spain to southern Brittany in France. A group of disjunct populations also are found in the English Channel, separated from the Biscay population by more than 400 coastal kilometers. It remains unclear whether D. biscayensis is native to the Bay of Biscay; it is also debated whether the disjunct populations in the English Channel are relics of a formerly continuous population, or the product of recent introductions through aquaculture. Here, we use climate hindcasts to explore hypotheses about the D. biscayensis historical distribution in Europe. If D. biscayensis is native, its range would have been restricted to southern Iberia and the Mediterranean during the Last Glacial Maximum (21,000 BP). However, the species is completely absent from both regions today, further supporting its interpretation as a non‐native species. If it was historically present in Europe, the climate hindcasts are congruent with range contraction in the Last Glacial Maximum (21,000 BP), expansion in the Mid‐Holocene Warm Period (6000 BP), and contraction again in the past 1000 years (850–1850), prior to the first reports of D. biscayensis on the Spanish and French Atlantic coasts. However, the simulations do not support there being climatic refugia along the English Channel coast that would account for the existence of relic populations. Taken together, the evidence suggests that D. biscayensis has been introduced to the Bay of Biscay, and that disjunct populations in the English Channel are the result of recent transport through human activities, perhaps aquaculture.
Population and reproductive dynamics of the polychaete Pygospio elegans in a boreal estuary complex
Authors: Thonig Anne , Knott K. Emily , Kesäniemi Jenni Emilia , Winding Hansen Benni , Banta Gary Thomas 
Published: November 2016

AbstractPygospio elegans is an opportunistic, wide‐spread spionid polychaete that reproduces asexually via fragmentation and can produce benthic and pelagic larvae, hence combining different developmental modes in one species. We documented the density, size distribution, and reproductive activity of P. elegans at four sites in the Danish Isefjord‐Roskilde Fjord estuary complex, where all modes of reproduction were reported. We compared population dynamics of this species to environmental parameters such as salinity, temperature, and sediment characteristics (grain size, sorting, porosity, water content, organic content, C/N). We observed that new cohorts—resulting either from sexual or asexual reproduction—appeared in spring and fall, and old ones disappeared in late summer and winter. Sexual reproduction occurred from September until May, and although their timing was variable, there were two reproductive peaks at three sites. At those sites, we also observed a switch in larval developmental mode. Asexual reproduction peaked in April. While the seasonal dynamics can be related to temperature to a large extent, the differences in population dynamics among sites also correlated with sediment structure and salinity. Populations from sites with coarse and heterogeneous sediment had high levels of sexual reproduction. At the site with lower salinity, intermediate and benthic larvae were present during winter in contrast to pelagic larvae found at the other sites. However, we could not identify one clear environmental factor determining the mode of development. At present, it remains unclear to what degree genetic background contributes to mode of development. Hence, whether the differences in developmental mode are the result of genetically different cohorts will be further investigated.
When does speech sound disorder matter for literacy? The role of disordered speech errors, co‐occurring language impairment and family risk of dyslexia
Authors: Hayiou‐Thomas Marianna E. , Carroll Julia M. , Leavett Ruth , Hulme Charles , Snowling Margaret J. 
Published: November 2016

BackgroundThis study considers the role of early speech difficulties in literacy development, in the context of additional risk factors.MethodChildren were identified with speech sound disorder (SSD) at the age of 3½ years, on the basis of performance on the Diagnostic Evaluation of Articulation and Phonology. Their literacy skills were assessed at the start of formal reading instruction (age 5½), using measures of phoneme awareness, word‐level reading and spelling; and 3 years later (age 8), using measures of word‐level reading, spelling and reading comprehension.ResultsThe presence of early SSD conferred a small but significant risk of poor phonemic skills and spelling at the age of 5½ and of poor word reading at the age of 8. Furthermore, within the group with SSD, the persistence of speech difficulties to the point of school entry was associated with poorer emergent literacy skills, and children with ‘disordered’ speech errors had poorer word reading skills than children whose speech errors indicated ‘delay’. In contrast, the initial severity of SSD was not a significant predictor of reading development. Beyond the domain of speech, the presence of a co‐occurring language impairment was strongly predictive of literacy skills and having a family risk of dyslexia predicted additional variance in literacy at both time‐points.ConclusionsEarly SSD alone has only modest effects on literacy development but when additional risk factors are present, these can have serious negative consequences, consistent with the view that multiple risks accumulate to predict reading disorders.
Ixekizumab treatment improves fingernail psoriasis in patients with moderate‐to‐severe psoriasis: results from the randomized, controlled and open‐label phases of UNCOVER‐3
Authors: van de Kerkhof P. , Guenther L. , Gottlieb A.B. , Sebastian M. , Wu J.J. , Foley P. , Morita A. , Goldblum O. , Zhang L. , Erickson J. , Ball S. , Rich P. 
Published: November 2016

AbstractBackgroundFingernail psoriasis is difficult to treat.ObjectiveThe objective was to evaluate the effect of ixekizumab, a monoclonal antibody selectively targeting IL‐17A, on fingernail psoriasis.MethodsThis Phase 3, double‐blind trial (UNCOVER‐3) randomized patients to placebo, etanercept (50‐mg twice weekly), or 80 mg ixekizumab as one injection every 4 (IXE Q4W) or 2 weeks (IXE Q2W) after a 160‐mg starting dose. At Week 12, ixekizumab patients received open‐label IXE Q4W through Week 60; placebo patients received a 160‐mg starting ixekizumab dose and etanercept patients a 4‐week placebo washout before starting IXE Q4W. Efficacy was assessed by mean per cent Nail Psoriasis Severity Index (NAPSI) improvement at Weeks 12 and 60.ResultsOf 1346 patients in the UNCOVER‐3 trial, this subgroup analysis included only patients with baseline fingernail psoriasis: 116 (60.1%) placebo, 236 (61.8%) etanercept, 228 (59.1%) IXE Q4W and 229 (59.5%) IXE Q2W. At Week 12, greater mean per cent NAPSI improvements were achieved in IXE Q4W (36.7%) and IXE Q2W (35.2%) vs. placebo (−34.3%, P < 0.001 each comparison) and etanercept (20.0%, P = 0.048 vs. Q4W, P = 0.072 vs. Q2W). At Week 60, mean per cent NAPSI improvement was >80% regardless of initial treatment. At Week 12 (nonresponder imputation), complete resolution (NAPSI = 0) was achieved in 19.7% (IXE Q4W), 17.5% (IXE Q2W), 4.3% (placebo, P < 0.001 each comparison) and 10.2% (etanercept, P < 0.05 each comparison) of patients. By Week 60, >50% of patients achieved complete resolution.ConclusionsAt Week 12, significant improvements in fingernail psoriasis were achieved with ixekizumab therapy. With IXE Q4W maintenance dosing, additional improvement was demonstrated through 60 weeks, and >50% of patients achieved complete resolution.Registered at clinicaltrials.gov: NCT01646177
Molecular Phylogeny and Taxonomy of a New Freshwater Hymenostomatid from Northeastern China, with the Establishment of a New Genus Anteglaucoma gen. n. (Protista, Ciliophora, Oligohymenophorea)
Authors: Pan Xuming , Shi Zihan , Wang Chundi , Bourland William A. , Chen Ying , Song Weibo 
Published: November 2016

AbstractThe morphology, infraciliature and SSU rDNA sequence of a new freshwater hymenostomatid ciliate, Anteglaucoma harbinensis gen. nov., spec. nov., collected from a farmland pond in Harbin, China, were investigated. The new genus Anteglaucoma is characterized as follows: small to medium‐sized Glaucomidae with oral apparatus in anterior one‐third of cell; paroral membrane composed of almost longitudinally arranged dikinetids; three adoral membranelles nearly equal in length and arranged almost longitudinally in parallel; silverline pattern tetrahymenid. The improved diagnosis of family Glaucomidae Corliss 1971 is provided based on the previous and present work. The type species Anteglaucoma harbinensis spec. nov. is defined by having 32–35 somatic kineties; four or five postoral kineties; membranelle 1 and membranelle 2 having five or six kinetosomal rows, membranelle 3 having three kinetosomal rows; single macronuclear nodule; contractile vacuole on average 15% from posterior body end; locomotion characterized by crawling with a rather hectic jerking motion; freshwater habitat. Phylogenetic analyses show that Anteglaucoma clusters in the family Glaucomidae and groups with the genera Glaucoma. The molecular and morphological data indicate that Glaucomidae is related to the family Bromeliophryidae in the phylogenetic trees.
Oxidative and Microbial Stability of Pomegranate Peel Extracts and Bagasse Supplemented Cookies
Authors: Ismail Tariq , Akhtar Saeed , Riaz Muhammad , Hameed Aneela , Afzal Khurram , Sattar Sheikh Ahsan 
Published: November 2016

AbstractThis study aimed at exploring pomegranate peel (PoP) for its potential as an ingredient of choice in baked products primarily to stabilize lipids and inhibit microbiological spoilage. Pomegranate peel extracts (PoPx) and pomegranate peel bagasse (Pbg) were supplemented to wheat flour cookies at 0.25–1.0% and 1.5–7.5%, respectively. Cookies supplemented with 7.5% Pbg reduced caloric contents and significantly (P < 0.05) enhanced dietary fiber and inorganic residues of the product. Positive correlation was observed for cookies phenolics contents with 2,2‐diphenyl‐1‐picrylhydrazyl (DPPH) and ferric reducing antioxidant power assay. Total phenolics recovery from Pbg and PoPx was shown to range from 78.35 to 315.7 mg GAE/100g), respectively. PoPx supplemented cookies, holding significant antioxidant properties, inhibited thiobarbituric acid number by 67% and reduced growth of aerobic counts (2.04–1.30 log10 cfu/g) and yeasts/molds (1.70–1.05 log10 cfu/g). Sensory evaluation of Pbg supplemented cookies indicated relatively lower score for texture and crispiness while other treatment combinations were ranked acceptable at 9‐point hedonic scale for all sensory parameters.Practical ApplicationsSynthetic antioxidants and antimicrobials being injudiciously exploited as food preservatives are hampering quality of food and life. Programmed replacement of preservative cum intoxicating agents with relatively least to nontoxic natural phytochemicals is referred to be the sustainable and safe approach in food preservation. On account of its tremendous food quality enhancement features, PoP vide its ethnobotanical extracts deliver significant antioxidant, antimicrobial and nutraceuticals properties. As witnessed in current study, PoPx supplementation in bakery products has a prospective role in inhibiting lipid oxidation and microbiological spoilage and, hence can be considered as viable substitute of synthetic preservatives. Nutritional enhancement features of peel bagasse further endeavors underutilized fruit waste as ingredient of choice in formulating virtually balanced therapeutic formulation against certain critical ailments.
Nurse and Medical Provider Perspectives on Antibiotic Stewardship in Nursing Homes
Authors: Scales Kezia , Zimmerman Sheryl , Reed David , Beeber Anna Song , Kistler Christine E. , Preisser John S. , Weiner Bryan J. , Ward Kimberly , Fann Amy , Sloane Philip D. 
Published: November 2016

ObjectivesTo examine perspectives on antibiotic use and antibiotic stewardship of nurses and medical providers in nursing homes (NHs).DesignCross‐sectional survey.SettingNHs in North Carolina (N = 31).ParticipantsNursing staff (n = 182) and medical providers (n = 50).MeasurementsRespondents completed a self‐administered questionnaire about their perspectives on antibiotic use in their NH, the influence of residents and families on antibiotic prescribing decisions, and readiness to improve antibiotic stewardship. Open‐ended questions on barriers to antibiotic stewardship were also asked. Linear mixed modeling was used to analyze differences between respondent groups and to test for associations with individual and organizational characteristics.ResultsAll respondents supported reducing antibiotic use, although medical providers’ support was significantly stronger (P = .005). When asked about their perception of residents’ and family members’ preference for antibiotic use in the case of suspected infection and the influence of that preference on antibiotic‐prescribing decisions, respondents indicated that residents and families favor antibiotic use and influence prescribing decisions. Nurses reported a stronger perception than medical providers that families prefer antibiotics (P = .04) and influence prescribing decisions (P = .02). All respondents reported commitment and efficacy to change practices (mean 4.0–4.1 for nurses and 3.6–3.9 for medical providers on a 5‐point scale). Four significant associations related to organizational and individual characteristics were found: directors of nursing and specialist nurses reported greater self‐efficacy for changing practice than other nurses (P = .003), medical providers with a subspecialty (e.g., geriatrics) reported greater self‐efficacy (P = .007) and commitment to change (P = .001) than those without a subspecialty, and medical providers specializing in hospice and palliative care rated family influence (P = .006) higher than those with other subspecialties.ConclusionNursing staff and medical providers share a commitment to reducing unnecessary antibiotic use. Antibiotic stewardship interventions should foster cooperation and build competency to implement alternative management approaches and to educate residents and families. Nurse leaders and medical providers with long‐term care training may be especially effective champions for antibiotic stewardship.
Reliability and Validity of a Simplified Comprehensive Assessment Tool for Feeding Support: Kuchi‐Kara Taberu Index
Authors: Maeda Keisuke , Shamoto Hiroshi , Wakabayashi Hidetaka , Enomoto Junko , Takeichi Mika , Koyama Tamami 
Published: November 2016

ObjectivesTo verify the reliability and validity and develop an English version of an instrument (Kuchi‐Kara Taberu Index (KT Index)) to comprehensively assess and intervene in problems with eating and swallowing.DesignMulticenter cross‐sectional study.SettingNursing homes.ParticipantsIndividuals aged 65 and older (mean age 88.3 ± 6.8; 80.0% female) who had lived in a nursing home for longer than 1 month (N = 115).MeasurementsThe KT index consisted of 13 items: desire to eat, overall condition, respiratory condition, oral condition, cognitive function while eating, oral preparatory and propulsive phases, dysphagia severity, position and endurance while eating, eating, daily life, food intake level, food modification, and nutrition. Weighted kappa coefficients, Cronbach alpha, and Spearman rank correlation coefficients were determined.ResultsWeighted kappa values in the inter‐ and intrarater reliability tests ranged from 0.54 to 0.96 and 0.68 to 0.98, respectively. Cronbach alpha was 0.892. Spearman rank correlation coefficients (r) between the total KT index and external criteria were determined (Functional Oral Intake Scale, r = 0.790; Barthel Index, r = 0.830; Mini Nutritional Assessment Short Form, r = 0.582; Cognitive Performance Scale, r = −0.673; all P < .001). Similar correlations were observed when some items related to each external criterion were removed from the total KT index. Translation‐retranslation procedures were conducted to develop an English version of the KT index.ConclusionThe study provided evidence of the reliability and validity of the KT index and developed an English version. Future studies regarding validation of health‐related quality of life indices and their effect on clinical courses of eating and swallowing conditions are needed.
Nursing Home Use After Implantable Cardioverter‐Defibrillator Implantation in Older Adults: Results from the National Cardiovascular Data Registry
Authors: Kramer Daniel B. , Reynolds Matthew R. , Normand Sharon‐Lise , Parzynski Craig S. , Spertus John A. , Mor Vincent , Mitchell Susan L. 
Published: November 2016

ObjectivesTo evaluate the incidence and characteristics of nursing home (NH) use after implantable cardioverter‐defibrillator (ICD) implantation.DesignCohort study.SettingMedicare beneficiaries in the National Cardiovascular Data Registry—ICD Registry.ParticipantsIndividuals aged 65 and older receiving ICDs between January 1, 2006, and March 31, 2010 (N = 192,483).MeasurementsProportion of ICD recipients discharged to NHs directly after device placement, cumulative incidence of long‐term NH admission, and factors associated with immediate discharge to a NH and time to long‐term NH admission.ResultsOver 4 years, 40.6% of the cohort died, and 35,939 (18.7%) experienced at least one NH admission, including 4.0% directly discharged to a NH after ICD implantation and 2.8% admitted to long‐term NH care during follow‐up. The cumulative incidence of long‐term NH admission, accounting for the competing risk of death, was 1.7% at 1 year, 3.8% at 3 years, and 4.6% at 4 years; 20.1% of individuals admitted to a NH died there. Factors most strongly associated with direct NH discharge and time to long‐term NH care were older age (adjusted odds ratio (AOR) = 2.09, 95% confidence interval (CI) = 2.01–2.17 per 10‐year increment; adjusted hazard ratio (AHR) = 1.88, 95% CI = 1.80–1.97, respectively), dementia (AOR = 2.60, 95% CI = 2.25–3.01; AHR = 2.50, 95% CI = 2.14–2.93, respectively), and Medicare Part A claim for NH stay in prior 6 months (AOR = 3.96, 95% CI = 3.70–4.25; AHR = 2.88, 95% CI = 2.65–3.14, respectively).ConclusionNearly one in five individuals are admitted to NHs over a median of 1.6 years of follow‐up after ICD implantation. Understanding these outcomes may help inform the clinical care of these individuals.
Osteoporosis Treatment Efficacy for Men: A Systematic Review and Meta‐Analysis
Authors: Nayak Smita , Greenspan Susan L. 
Published: November 2016

ObjectivesTo evaluate the efficacy of treatment options to reduce osteoporotic fracture risk in men.DesignSystematic review and meta‐analysis.SettingRandomized clinical trials that evaluated the efficacy of a treatment for osteoporosis or low bone mineral density for adult men and reported fracture outcomes.ParticipantsMen.MeasurementsPubMed, Embase, and the Cochrane Library databases were searched for relevant studies. Information was extracted from included studies on participant sociodemographic characteristics, number of male participants, treatment evaluated, comparator for evaluated treatment, study duration, and fracture outcomes. Risk of bias of individual studies was assessed using measures recommended by the Cochrane Collaboration.ResultsTwenty‐four articles reporting results for 22 studies (including 4,868 male participants) met strict inclusion criteria. Fixed‐effects meta‐analyses using the Mantel‐Haenszel method demonstrated significantly lower risk of vertebral fractures with alendronate (relative risk (RR) = 0.328, 95% confidence interval (CI) = 0.155–0.692) and risedronate (RR = 0.428, 95% CI = 0.245–0.746) but not with calcitonin (RR = 0.272, 95% CI = 0.046–1.608) or denosumab (RR = 0.256, 95% CI = 0.029–2.238) than in controls. For bisphosphonates as a treatment category, meta‐analyses demonstrated significantly lower risk of vertebral fractures (RR = 0.368, 95% CI = 0.252–0.537) and nonvertebral fractures (RR = 0.604, 95% CI = 0.404–0.904) than in controls. The meta‐analysis finding that bisphosphonates significantly reduce nonvertebral fracture risk was not robust to sensitivity analysis.ConclusionBisphosphonates reduce the risk of vertebral and possibly nonvertebral fractures for men with osteoporosis. Further studies are needed to evaluate the efficacy of bisphosphonates for reducing nonvertebral fracture risk and the efficacy of nonbisphosphonates for reducing vertebral and nonvertebral fracture risk in men with osteoporosis.