bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perineal stapled prolapse resection for full‐thickness external rectal prolapse: a multicentre prospective study
Authors: Mistrangelo M. , Tonello P. , Brachet Contul R. , Arnone G. , Passera R. , Grasso L. , Rapetti L. , Borroni R. , Pozzo M. , Roveroni M. , Morino M. , Perinotti R. 
Published: March 2016

AbstractAimMany different surgical techniques have been reported for the surgical treatment of full‐thickness external rectal prolapse. Perianal stapled prolapse resection (PSP) is a relatively newly reported technique for full thickness external rectal prolapse. The aim of this prospective multicentre study was to evaluate the results of this procedure.MethodConsecutive patients who underwent a PSP resection for full‐thickness external rectal prolapse at five centres were recruited to the study. Median operating time, hospital stay, complications, recurrence and functional results according to the Wexner Incontinence Scale and obstructive defaecation syndrome score were recorded.ResultsThere were 27 patients treated by PSP. The median Wexner incontinence score improved from 10 presurgery to 5 after surgery (P < 0.001); the median obstructed defaecation syndrome score improved from 12 presurgery to 5 (range 4–10) after surgery (P < 0.001). A laparoscopically assisted procedure was performed in three patients (11.1%). The median number of cartridges used was six (range four to nine). The median operating time was 48 min. Early complications occurred in six patients (22.2%) and late complications in two (7.4%). The median length of hospital stay was 5 days. The recurrence rate at a median follow‐up of 30.3 months was 14.8%.ConclusionPSP appears to be an easy, fast and safe procedure. Early functional results are good. The recurrence rate compares favourably with other perineal procedures like the Delorme or the Altemeier operations. Long‐term functional results need to be investigated further.
The Role of Lexical Frequency in the Acceptability of Syntactic Variants: Evidence Fromthat‐Clauses in Polish
Authors: Divjak Dagmar 
Published: March 2016

AbstractA number of studies report that frequency is a poor predictor of acceptability, in particular at the lower end of the frequency spectrum. Because acceptability judgments provide a substantial part of the empirical foundation of dominant linguistic traditions, understanding how acceptability relates to frequency, one of the most robust predictors of human performance, is crucial. The relation between low frequency and acceptability is investigated using corpus‐ and behavioral data on the distribution of infinitival and finitethat‐complements in Polish. Polish verbs exhibit substantial subordination variation and for the majority of verbs taking an infinitival complement, thethat‐complement occurs with low frequency (<0.66 ipm). These low‐frequencythat‐clauses, in turn, exhibit large differences in how acceptable they are to native speakers. It is argued that acceptability judgments are based on configurations of internally structured exemplars, the acceptability of which cannot reliably be assessed until sufficient evidence about the core component has accumulated.
Uphill and Downhill in a Flat World: The Conceptual Topography of the Yupno House
Authors: Cooperrider Kensy , Slotta James , Núñez Rafael 
Published: March 2016

AbstractSpeakers of many languages around the world rely on body‐based contrasts (e.g.,left/right) for spatial communication and cognition. Speakers of Yupno, a language of Papua New Guinea's mountainous interior, rely instead on an environment‐baseduphill/downhillcontrast. Body‐based contrasts are as easy to use indoors as outdoors, but environment‐based contrasts may not be. Do Yupno speakers still useuphill/downhillcontrasts indoors and, if so, how? We report three studies on spatial communication within the Yupno house. Even in this flat world,uphill/downhillcontrasts are pervasive. However, the terms are not used according to the slopes beyond the house's walls, as reported in other groups. Instead, the house is treated as a microworld, with a “conceptual topography” that is strikingly reminiscent of the physical topography of the Yupno valley. The phenomenon illustrates some of the distinctive properties of environment‐based reference systems, as well as the universal power and plasticity of spatial contrasts.
Reflectance confocal microscopy features of mycosis fungoides and Sézary syndrome: correlation with histopathologic and T‐cell receptor rearrangement studies
Authors: Mancebo Silvia E. , Cordova Miguel , Myskowski Patricia L. , Flores Eileen S. , Busam Klaus , Jawed Sarah I. , Skripnik Anna , Rajadhyaksha Milind , Querfeld Christiane 
Published: March 2016

BackgroundMycosis fungoides/Sézary syndrome (MF/SS) often requires multiple skin biopsies for definitive diagnosis. In vivo reflectance confocal microscopy (RCM) visualizes high‐resolution cellular detail of the skin. The objective of this study is to evaluate the morphologic features of MF/SS using RCM and to correlate RCM features with histopathology and T‐cell receptor (TCR) gene rearrangement studies.MethodsA cohort of patients with active/recurrent or suspicious MF/SS disease was prospectively recruited for RCM imaging and histopathologic/RCM images were evaluated. Statistical analyses were performed to identify unique RCM features and to correlate RCM features with histopathologic findings and TCR rearrangement studies.ResultsEighty‐three lesions were evaluated. Correlation between RCM and histopathology was moderate for all relatable features (κ = 0.41, p<0.001), almost perfect for intraepidermal atypical lymphocytes [prevalence and bias‐adjusted kappa (PABAK) = 0.90], and fair for Pautrier collections (κ = 0.32, p = 0.03). Lesions with Pautrier collections identified by RCM were significantly more likely to show TCR clonality (p = 0.04) and diagnostic features of MF/SS on histopathology (p = 0.03).ConclusionsOur study captures morphologic RCM criteria for a variety of skin lesions. Pautrier collections visualized by RCM are associated with improved histopathologic diagnosis and detection of TCR gene clonality. Although further studies are needed to validate the diagnostic implications of RCM for MF/SS, our study highlights the potential utility of RCM.
CC chemokine receptor 5 Δ32 polymorphism: association analysis and allele distribution among cutaneous leishmaniasis patients from Pakistan
Authors: Sophie Mariam , Hameed Abdul , Muneer Akhtar , Samdani Azam J. , Saleem Saima , Azhar Abid 
Published: March 2016

BackgroundHuman immunodeficiency virus (HIV)/leishmaniasis coinfection is a matter of deep concern worldwide. CC chemokine receptor 5 (CCR5) functions as a co‐receptor for HIV entry into host immune cells with an elevated expression observed during leishmaniasis, promoting parasite persistence. A 32 bp deletion (Δ32) in the CCR5 gene provides protection against HIV infection and increased resistance to Leishmania infection.MethodsIn this study, CCR5‐Δ32 distribution within Pakistani population with cutaneous leishmaniasis was investigated to evaluate genetic susceptibility to HIV infection. CCR5‐Δ32 polymorphism was analyzed in 276 leishmaniasis patients and 119 uninfected healthy controls. Genotypic and allelic frequencies were evaluated and tested for Hardy–Weinberg equilibrium (HWE).ResultsThe overall Δ32 allele frequency was 6.58% of the population (n = 395). There was a significant difference (p < 0.05) in the geographical distribution of Δ32 allele which was higher in the northern region of the country when compared with the south. Five individuals were identified to be homozygous for the Δ32 allele which has not been reported before from Pakistan. However, no significant association was observed between CCR5‐Δ32 and cutaneous leishmaniasis.ConclusionThe higher frequency of CCR5 wild‐type allele among leishmaniasis patients may suggest an increased risk of HIV infection and also support its facilitative role in Leishmania infection.
New endoscopic classification of the cardiac orifice in esophageal achalasia: Champagne glass sign
Authors: Gomi Kuniyo , Inoue Haruhiro , Ikeda Haruo , Bechara Robert , Sato Chiaki , Ito Hiroaki , Onimaru Manabu , Kitamura Yohei , Suzuki Michitaka , Nakamura Jun , Hata Yoshitaka , Maruyama Shota , Sumi Kazuya , Takahashi Hiroshi 
Published: March 2016

Background and AimEndoscopy, barium esophagram and manometry are used in the diagnosis of achalasia. In the case of early achalasia, characteristic endoscopic findings are difficult to recognize. As a result, the diagnosis of achalasia is often made several years after symptom onset. Therefore, we examined the endoscopic findings of the cardiac orifice in achalasia and propose a new classification.MethodsA total of 400 patients with spastic esophageal motility disorders who underwent peroral endoscopic myotomy (POEM) at our hospital between March 2014 and August 2015 were screened for this study. Champagne glass sign (CG) was defined as when the distal end of the lower esophageal sphincter relaxation failure (LESRF) was proximal to the squamocolumnar junction (SCJ) and the SCJ was dilated in the retroflex view. Specifically, CG‐1 was defined as a distance from the SCJ to the lower end of LESRF of <1 cm, and CG‐2 was defined as a distance ≥1 cm.ResultsCG‐0 was seen in 73 patients (28.0%), whereas the CG sign was seen in 186 patients (71.3%), of whom 170 (65.1%) were CG‐1 and 16 (6.1%) were CG‐2.ConclusionsThe CG sign is often observed in esophageal achalasia patients. CG‐0 (equal to Maki‐tsuki) was observed in 28.0% of achalasia patients only. Its absence with dilated SCJ cannot be used to rule out achalasia. Barium esophagram and manometry should be done if esophageal achalasia is strongly suspected.
Direct and indirect effects of weather variability in a specialist butterfly
Authors: CERRATO CRISTIANA , LAI VALENTINA , BALLETTO EMILIO , BONELLI SIMONA 
Published: March 2016

1. Climate change poses serious threats to the long‐term persistence of many animal and plant populations. Species having specific niche requirements, or characterised by highly co‐evolved interactions, will face the greatest challenges. An example is represented byMaculinea alcon(Denis &Schiffermüller), a monophagous and univoltine butterfly species, which lays eggs only on larval host plants which occur inparticular phenological conditions.2. The present 2‐year study focused on twoM.alconpopulations, both located at the southern boundaries of the species, but facing different climatic conditions (360 m,low altitudeversus 860 m,high altitude). Population vulnerability with respect to direct and indirect effects of climate change was analysed, focusing on two important aspects of butterfly biology, i.e. the flight activity of adults and the degree of synchrony in the larval plant–insect interactions.3. It was observed that, when positive temperature anomalies are reached, the temperature can exert detrimental effects on adults' activity. At a low altitude, in a hotter than usual year, a temperature threshold was recorded (around 32 °C), above which the activity of butterflies is inhibited. In contrast, at a high altitude, temperature increases maintain the opportunity to enhance butterfly activity. Altitudinal differences were also observed in the phenology of the two interacting species, which generate stronger asynchrony at low altitudes.4. High‐ and low‐altitude populations represent different conservation units: a global increase in temperature would pose a serious threat to the lowland populations, whereas high‐altitude populations would gain a greater role in assuring the persistence ofM.alconat its southern boundaries.
What's the meaning of local? Using molecular markers to define seed transfer zones for ecological restoration in Norway
Authors: Jørgensen Marte Holten , Elameen Abdelhameed , Hofman Nadine , Klemsdal Sonja , Malaval Sandra , Fjellheim Siri 
Published: March 2016

AbstractAccording to the Norwegian Diversity Act, practitioners of restoration in Norway are instructed to use seed mixtures of local provenance. However, there are no guidelines for how local seed should be selected. In this study, we use genetic variation in a set of alpine species (Agrostis mertensii, Avenella flexuosa, Carex bigelowii, Festuca ovina, Poa alpina and Scorzoneroides autumnalis) to define seed transfer zones to reduce confusion about the definition of ‘local seeds’. The species selected for the study are common in all parts of Norway and suitable for commercial seed production. The sampling covered the entire alpine region (7–20 populations per species, 3–15 individuals per population). We characterised genetic diversity using amplified fragment length polymorphisms. We identified different spatial genetic diversity structures in the species, most likely related to differences in reproductive strategies, phylogeographic factors and geographic distribution. Based on results from all species, we suggest four general seed transfer zones for alpine Norway. This is likely more conservative than needed for all species, given that no species show more than two genetic groups. Even so, the approach is practical as four seed mixtures will serve the need for restoration of vegetation in alpine regions in Norway.
End‐of‐life care decisions for haemodialysis patients – ‘We only tend to have that discussion with them when they start deteriorating’
Authors: Lazenby Sophia , Edwards Adrian , Samuriwo Raymond , Riley Stephen , Murray Mary Ann , Carson‐Stevens Andrew 
Published: March 2016

AbstractBackgroundHaemodialysis patients receive very little involvement in their end‐of‐life care decisions. Issues relating to death and dying are commonly avoided until late in their illness. This study aimed to explore the experiences and perceptions of doctors and nurses in nephrology for involving haemodialysis patients in end‐of‐life care decisions.MethodsA semi‐structured qualitative interview study with 15 doctors and five nurses and thematic analysis of their accounts was conducted. The setting was a large teaching hospital in Wales, UK.ResultsPrognosis is not routinely discussed with patients, in part due to a difficulty in estimation and the belief that patients do not want or need this information. Advance care planning is rarely carried out, and end‐of‐life care discussions are seldom initiated prior to patient deterioration. There is variability in end‐of‐life practices amongst nephrologists; some patients are felt to be withdrawn from dialysis too late. Furthermore, the possibility and implications of withdrawal are not commonly discussed with well patients. Critical barriers hindering better end‐of‐life care involvement for these patients are outlined.ConclusionsThe study provides insights into the complexity of end‐of‐life conversations and the barriers to achieving better end‐of‐life communication practices. The results identify opportunities for improving the lives and deaths of haemodialysis patients.
Phospholamban p.Arg14del cardiomyopathy is characterized by phospholamban aggregates, aggresomes, and autophagic degradation
Authors: te Rijdt Wouter P , van Tintelen J Peter , Vink Aryan , van der Wal Allard C , de Boer Rudolf A , van den Berg Maarten P , Suurmeijer Albert J H 
Published: March 2016

AimsThe non‐desmosomal phospholamban PLN p.Arg14del mutation was identified in patients diagnosed with dilated cardiomyopathy (DCM) and/or arrhythmogenic cardiomyopathy (ACM). We aimed to investigate whether this mutation leads to aggregation, aggresome formation and autophagy of mutant PLN protein.Methods and resultsWe studied 20 complete heart specimens of PLN p.Arg14del mutation carriers [mean age 48 ± 15 years; 55% males], either from autopsies or from explants. Gross and microscopic examination showed biventricular cardiomyopathy with histopathological features of both ACM and DCM, i.e. a combination of fibrofatty replacement and interstitial fibrosis. Immunohistochemistry for PLN showed large perinuclear PLN protein aggregates in cardiomyocytes in both ventricles in all examined hearts. The median numbers of PLN‐containing aggregates were 12 per 5 mm2 range 3–48 mm2 in right ventricular myocardium and 13 per 5 mm2 (range 5–89 mm2) in left ventricular myocardium. Double immunohistochemical staining showed colocalization of autophagy markers p62 (sequestosome‐1) and microtubule‐associated protein light chain 3 with PLN in all aggregates, suggestive of degradation by selective autophagy. On electron microscopy, the ultrastructural appearance of these PLN‐containing aggregates was typical of aggresomes; they were not surrounded by a membrane, and were located adjacent to the microtubular organizing centre. PLN‐containing aggregates were not found in 10 PLN‐negative cases of idiopathic and genetic DCM or in seven cases of desmosomal ACM.ConclusionsPLN p.Arg14del cardiomyopathy is a biventricular cardiomyopathy characterized by large perinuclear PLN protein aggregates with a typical ultrastructural appearance of aggresomes. PLN detected by immunohistochemistry appears to be a sensitive and specific marker for this disease.
A randomised crossover trial of minimising medical terminology in secondary care correspondence in patients with chronic health conditions: impact on understanding and patient reported outcomes
Authors: Wernick M. , Hale P. , Anticich N. , Busch S. , Merriman L. , King B. , Pegg T. 
Published: March 2016

BackgroundThere is little existing research on the role that secondary care letters have in ensuring patient understanding of chronic health conditions.AimTo determine whether minimising the use of medical terminology in medical correspondence improved patient understanding and anxiety/depression scores.MethodsA single‐centre, non‐blinded, randomised crossover design assessed health literacy, EQ‐5D scores and the impact of the ‘translated’ letter on the doctor's professionalism, the patient's relationship with their general practitioner (GP) and their perceived impact on chronic disease management. Patients were crossed over between their ‘translated’ and original letter.ResultsSixty patients were recruited. Use of a ‘translated’ letter reduced mean terms not understood from 7.78 to 1.76 (t(58) = 4.706, P < 0.001). Most patients (78.0%) preferred the ‘translated’ letter, with 69.5% patients perceiving an enhancement in their doctor's professionalism (z = 2.864, P = 0.004), 69.0% reporting a positive influence on relationship with their GP (z = 2.943, P = 0.003) and 79.7% reporting an increase in perceived ability to manage their chronic health condition with the ‘translated’ letter (z = 4.601, P < 0.001). There was no effect on EQ‐5D depression/anxiety scores.ConclusionMinimising the use of medical terminology in medical correspondence significantly improved patient understanding and perception of their ability to manage their chronic health condition. Although there was no impact on EQ‐5D depression/anxiety scores, overwhelming patient preference for the ‘translated’ letter indicates a need for minimisation of medical terminology in medical correspondence for patients with chronic health conditions.
Barriers to and facilitators of diabetes self‐management with elderly Korean‐American immigrants
Authors: Joo J.Y. , Lee H. 
Published: March 2016

AbstractAimThe aim of this study was to explore barriers to and facilitators of diabetes self‐management among first‐generation Korean‐American elderly immigrants with type 2 diabetes in the United States Midwest.BackgroundThe number of Korean‐American elderly immigrants with type 2 diabetes in the United States is expected to increase because they are at risk of adopting a Western lifestyle.MethodsThree focus groups (N = 18) and five individual interviews were conducted with Korean‐American elderly immigrants with type 2 diabetes. Demographic characteristics and diabetes‐related medical history information were obtained with a questionnaire. All data were digitally recorded, transcribed verbatim and translated from Korean into English. Transcripts were analysed using standard content‐based analysis.ResultsFive perceived barriers were identified: the high cost of type 2 diabetes care, language issues, loss of self‐control, memory loss and limited access to healthcare resources. Three perceived facilitators were time, seeking information, and family and peer supports.LimitationsThe convenience samples and small sample size may limit the study.ConclusionsThe barriers to and facilitators of diabetes self‐management identified in this study can be used in the development of more age‐ and culturally sensitive diabetes interventions and resources.Implication for nursing and health policyNurses and healthcare providers can use this study's findings to develop patient‐centred, age‐appropriate and culturally appropriate diabetes interventions. There are urgent needs to train bilingual healthcare providers and staff and to provide translation services for Korean‐American elderly immigrants. Finally, communities and social supports within public health policy are urgently needed for this ethnic minority group.
An Exploration of Costs of Community‐Based Specialist Health Service Provision for the Management of Aggressive Behaviour in Adults with Intellectual Disabilities
Authors: Unwin Gemma , Deb Shoumitro , Deb Tanya 
Published: March 2016

BackgroundIn the UK, people with intellectual disabilities who exhibit aggressive behaviour often receive community‐based specialist health services from a community learning disability team (CLDT). Our aim was to estimate costs associated with this provision and to identify predictors of higher costs.MethodCosts were estimated for 60 adults with intellectual disabilities and aggressive behaviour who attended specialist psychiatric outpatient clinics in the West Midlands region of the UK, including contact time with members of the CLDT and use of psychotropic medication over a 12‐month period.ResultsMean total cost of 12‐month service provision was £418 (95% confidence interval [CI] £299–557). Mean total cost of 12‐month psychotropic medication was £369 (95% CI £256–492). Amongst individual members of the CLDT, mean costs were highest for psychiatrists (£181) and relatively lower for community nurses (£70) and clinical psychologists (£30), and lowest for physiotherapists (£13). Male sex, presence of expressive verbal communication and presence of epilepsy were independently associated with 12‐month medication and service use costs, accounting for 23% of the variance in cost.ConclusionsIt seems that in terms of costs, there is an overreliance on medication and psychiatrists and a relatively lesser reliance on other CLDT members such as community nurses and clinical psychologists for the management of aggressive behaviour in adults with intellectual disabilities within community settings. Health commissioners may wish to explore this relative cost discrepancy further and try to redress the balance where appropriate.
Remote Magnetic Navigation for Catheter Ablation in Patients With Congenital Heart Disease: A Review
Authors: ROY KARINE , GOMEZ‐PULIDO FEDERICO , ERNST SABINE 
Published: March 2016

Review on Remote Magnetic Navigation in Congenital Heart DiseaseIn patients with congenital heart disease, challenges to catheter‐based arrhythmia interventions are unique and numerous given the complexity of the underlying defects, anatomic and surgical intervention variants including baffles, conduits, patches, and/or shunts. Remote magnetic navigation offers significant advantages in these cases that may present with limited vascular access or difficult access to the target cardiac chambers implicated by the previous surgical interventions. We reviewed the data available on the safety, feasibility, and effectiveness of magnetic navigation for the treatment of arrhythmia in congenital heart disease and discussed the specific challenges related to various congenital defects and repair with the potential advantages offered by magnetic navigation in these circumstances.