bluuebunny/crossref_metadata_2025_split huggingface dataset:
Establishment and evaluation of a novel biomarker‐based nomogram for malignant phaeochromocytomas and paragangliomas
Authors: Zhong Xu , Ye Lei , Su TingWei , Xie Jing , Zhou Weiwei , Jiang Yiran , Jiang Lei , Ning Guang , Wang Weiqing 
Published: April 2017

SummaryObjectiveNo single histological or molecular marker is diagnostic for malignant phaeochromocytomas and paragangliomas (PPGLs). This study aimed to establish and evaluate a prognostic nomogram to improve the prediction of metastatic probability in individual PPGL patients.MethodsThree hundred and 47 consecutive PPGL patients from January 2002 through December 2014 were randomly divided into a training set (n=208) and a validation set (n=139). A multivariate logistic regression analysis of selected prognostic features was performed, and a nomogram to predict metastasis was constructed. Discrimination and calibration were employed to evaluate the performance of the nomogram. Clinical usefulness was calculated using decision curve analysis.ResultsThe overall metastatic rate was 10.6%. Primary tumour size, primary tumour location, vascular invasion, ERBB‐2 overexpression, SDHB mutation and catecholamine type were associated with malignancy in the logistic analysis and were included in the nomogram. The nomogram showed an area under the receiver operating characteristic curve (AUC) of 0.872 (95% confidence interval [CI], 0.819‐0.914) in the training set. The validation set showed good discrimination, with an AUC of 0.870 (95% CI, 0.803‐0.921). The nomogram was well calibrated, with no significant difference between the predicted and the observed probabilities (Hosmer‐Lemeshow test: P=.510 for the training set; .314 for the validation set). Decision curve analysis revealed that molecular markers (ERBB‐2 overexpression and SDHB mutation) could increase the clinical benefit of the nomogram.ConclusionOur results support the use of the present biomarker‐based nomogram, which has good discriminative ability, to predict the metastatic probability of PPGLs.
A qualitative study of the role of Australian general practitioners in the surgical management of obesity
Authors: Jose K. , Venn A. , Nelson M. , Howes F. , Wilkinson S. , Ezzy D. 
Published: April 2017

SummaryGeneral practitioners (GPs) are increasingly managing patients with class 2 and 3 obesity (body mass index [BMI] > 35 and 40 kg/m2, respectively). Bariatric surgery is considered for patients with class 2 obesity and comorbidities or class 3 obesity where sustained weight loss using non‐surgical interventions has not been achieved. In Australia, GPs facilitate access to surgery through referral processes, but the nature of GP involvement in bariatric pre‐ and post‐surgery care is currently unclear. This qualitative study involved 10 in‐depth interviews with GPs and 20 interviews with adults who had all undergone laparoscopic adjustable gastric banding (LAGB) for weight management in Tasmania, Australia. Interviews were transcribed and analysed thematically. Referrals for bariatric surgery commonly occurred at the patient's request or to manage comorbidity. Consistent with previous studies, for GPs, referral patterns were influenced by previous case experience and patients’ financial considerations. Accessibility of surgery was also a consideration. Post‐surgery, there was a lack of clarity about the role of GPs, with patients generally preferring the surgical team to manage the LAGB. In bariatric surgery, patient preference for surgery, access and comorbidity are key drivers for referral and post‐surgical monitoring and support. Greater role clarity and enhanced collaboration between surgeons, GPs and patients following surgery is likely to enhance the experience and outcomes for patients.
Inflammatory features of frontal fibrosing alopecia
Authors: Ma Sophia A. , Imadojemu Sotonye , Beer Kenneth , Seykora John T. 
Published: April 2017

IntroductionFrontal fibrosing alopecia (FFA) is a cicatricial alopecia typically occurring in postmenopausal women. The etiology and pathophysiology of FFA is poorly understood but thought to be immune mediated. This study aims to further explore the extent of fibrosis and the inflammatory microenvironment by characterizing Langerhans cells (LCs), helper T cells, cytotoxic T cells and B cells near hair follicles in FFA.MethodsEleven paraffin‐embedded tissues from patients with a clinical and histopathologic diagnosis of FFA were selected for immunohistochemical studies using CD3, CD4, CD8, CD1a and CD20. The lymphocytes and LCs were counted around involved follicles. The CD4/CD8 T‐lymphocyte ratios were calculated and compared to the CD4/CD8 T‐lymphocyte ratios in uninvolved areas.ResultsOn histopathologic review, at least 35% of follicles in each case were affected by the disease with concentric perifollicular fibrosis and a perifollicular lichenoid lymphocytic infiltrate around the infundibuloisthmic portion of the hair follicle. There was an increase of perifollicular LCs (mean of 18, SD of 5.5) and intrafollicular LCs (mean of 14, SD of 4.3) in involved follicles compared to uninvolved follicles (P < .0001). The involved follicles also showed a relative decrease in the CD4/CD8 ratio indicating increased numbers of CD8+ T cells; a finding distinct from the CD4‐predominant population in uninvolved follicles (P < .0001).ConclusionThe inflammatory features of FFA show a CD8‐biased T‐cell infiltrate with increased numbers of LCs in the infundibuloisthmic region. The increased LCs may represent an aberrant immune reaction promoting a CD8+ T‐cell response.
Fire exclusion and climate change interact to affect long‐term changes in the functional composition of plant communities
Authors: Li Daijiang , Waller Donald M. 
Published: April 2017

AbstractAimPlant functional traits allow us to mechanistically link changes in species composition to changes in ecosystem functions. Understanding how and why changes occur in functional composition of plant communities can thus help us better conserve and restore biodiversity. We aim to examine long‐term effects of fire exclusion and climate change on the functional composition of fire‐maintained pine barrens in central Wisconsin.LocationCentral Wisconsin, USA.MethodsUsing a database that included vegetation data of surveys (1958) and resurveys (2012) of 30 sites, we quantified functional composition (α and β functional diversity, community‐weighted means) of each site at both time periods. We then applied linear regression and linear mixed models to study effects of fire exclusion and climate change on changes in functional composition.ResultsWe observed shifts towards larger specific leaf area, greater seed mass and other traits related to shade tolerance. These communities thus appear to be undergoing ecological succession, favouring plant adaptions to better harvest light and carbon in darker, warmer and wetter habitats. Functional alpha diversity increased, while functional beta diversity decreased even after controlling for changes in taxonomic diversity. Fire exclusion and climate change both contributed to these increases in local functional diversity but neither is related to the functional homogenization observed. Fire exclusion and climate change also interacted negatively to affect local functional diversity, suggesting that future climate change and succession may soon reduce alpha functional diversity.Main conclusionsOur study provides a rare record of long‐term functional dynamics and demonstrates that fire exclusion and climate change can interact to affect the functional composition of plant communities. Thus, we should consider changes in local ecological conditions as we seek to predict how climate change will affect the functional composition of plant communities.
Including environmental niche information to improve IUCN Red List assessments
Authors: Breiner Frank T. , Guisan Antoine , Nobis Michael P. , Bergamini Ariel 
Published: April 2017

AbstractAimInformation on change in species’ environmental preferences (i.e., niche) is currently not included in IUCN Red List criteria, although such information is key for assessing whether species not only lose geographic range but also lose part of their realized niche. Here, using niche size quantification and niche‐based species distribution models (SDMs), we test whether realized niche size and predicted potential range size provide additional information compared with the standard IUCN scores.LocationSwitzerland, national scale.MethodsWe simulated randomly, spatially directed, and ecologically directed local extinction events of varying magnitudes (10%, 30%, and 50% of occurrences). For a set of 148 representative vascular plant species, we tested how accurately the geographic versus niche measures pictured these extinction scenarios respectively.ResultsWe found that changes in niche size often corresponded to changes in geographic space. However, there was considerable variation and, for many species, changes in geographic and in niche space delivered complementary information. IUCN criteria based on spatial projections of SDMs did not capture extinction events in most cases and often increased the modelled range size, even when up to 50% of the occurrences were removed by simulated extinction events.Main conclusionOur findings demonstrate that changes in niche size can provide valuable additional information and could be used more systematically to complement changes in range size for Red List assessments. In turn, change in SDM‐predicted range size was not a good surrogate for classical extent of occurrence and area of occupancy criteria and should be used with caution. Further research is needed to assess whether and how spatial predictions of SDMs may be used to appropriately complement current IUCN criteria and to test whether our findings apply to other organisms and other spatial extents.
Bringing the human pancreas into focus: new paradigms for the understanding of Type 1 diabetes
Authors: Morgan N. G. 
Published: April 2017

AbstractType 1 diabetes affects increasingly large numbers of people globally (including at least half a million children under the age of 14 years) and it remains an illness with life‐long and often devastating consequences. It is surprising, therefore, that the underlying aetiology of Type 1 diabetes remains poorly understood. This is largely because the cellular and molecular processes leading to the loss of β cells in the pancreas have rarely been studied at, or soon after, the onset of disease. Where such studies have been undertaken, a number of surprises have emerged which serve to challenge conventional wisdom. In particular, it is increasingly understood that the process of islet inflammation (insulitis) is much less florid in humans than in certain animal models. Moreover, the profile of immune cells involved in the inflammatory attack on β cells is variable and this variation occurs at the level of individual patients. As a result, two distinct profiles of insulitis have now been defined that are differentially aggressive and that might, therefore, require specifically tailored therapeutic approaches to slow the progression of disease. In addition, the outcomes are also different in that the more aggressive form (termed ‘CD20Hi’) is associated with extensive β‐cell loss and an early age of disease onset (<7 years), while the less aggressive profile (known as ‘CD20Lo’) is associated with later onset (>13 years) and the retention of a higher proportion of residual β cells. In the present review, these new findings are explained and their implications evaluated in terms of future therapies.
Continuous subcutaneous insulin infusion (CSII) therapy at Derby Teaching Hospitals: sustained benefits in glucose control
Authors: Anyanwagu U. , Olaoye H. , Jennings P. , Ashton‐Cleary S. , Sugunendran S. , Hughes D. , Idris I. , Wilmot E. G. 
Published: April 2017

AbstractAimIn the short term, continuous subcutaneous insulin infusion (CSII) has been associated with improved glycaemic control, reduced hypoglycaemia and improved quality of life (QOL). However, limited data are available on its long‐term benefits, particularly in the UK. We aimed to assess the impact of CSII on longer term outcomes.MethodPatient‐level data were obtained for CSII users at Derby Teaching Hospitals, UK. Patient confidence and satisfaction questionnaires using the Likert scale were used to assess confidence in self‐management. Comparative statistics were conducted using Pearson's chi‐square and Student's t‐tests.ResultsSome 258 CSII users were identified (60.1% female, mean age 43.9 ± 13.4 years). Overall, there was significant decrease in HbA1c from 78 mmol/mol (9.3 ± 2.0%) at baseline, to 69 mmol/mol (8.5 ± 1.3%) at 6 months [mean difference (md): –0.64; 95% confidence interval (95% CI): –0.91 to –0.37; P < 0.0001]; which was sustained at 6 years of follow‐up (HbA1c: 66 mmol/mol, 8.2 ± 1.3%; md: –1.07%; 95% CI: –1.45 to –0.69; P < 0.0001). One hundred and twenty‐one patients (47%) responded to the survey, of whom 95 (78.5%) reported a reduction in the frequency of hypoglycaemia; 102 (84.3%) were satisfied with the quality of care received in the insulin pump service.ConclusionCSII therapy led to a sustained long‐term improvement in glycaemic control in addition to a reduction in self‐reported hypoglycaemia.
Retinal nerve fibre layer thickness is reduced in metabolic syndrome
Authors: Zarei R. , Anvari P. , Eslami Y. , Fakhraie G. , Mohammadi M. , Jamali A. , Afarideh M. , Ghajar A. , Heydarzade S. , Esteghamati A. , Moghimi S. 
Published: April 2017

AbstractAimsTo investigate retinal nerve fibre layer (RNFL) thickness in people with metabolic syndrome (MetS) and healthy controls.MethodsA cross‐sectional study was performed from March 2014 to January 2016. All participants underwent anthropometric and serological biochemical measurements, ophthalmological examination, and spectral‐domain optical coherence tomography (SD‐OCT). Individuals with elevated intraocular pressure, glaucoma, diabetic retinopathy and other ocular disorders were excluded. T‐test, Chi square and general linear models were used to analyse the data.ResultsIn total, 278 eyes from 139 participants were investigated [median (interquartile range) age: 37 (32−43) years]. RNFL thickness was lower in the nasal superior (107.8 ± 19.5μm) and temporal superior (135.7 ± 18.9μm) sectors in MetS group compared with the control group (114.6 ± 22.4 μm, P = 0.013 and 140.7 ± 18.2 μm, P = 0.027, respectively). After multiple adjustments for age, gender and the side of the examined [right (OD)/left (OS)] eye, MetS was independently associated with a lower RFNL thickness in the nasal superior (β = 0.20, P = 0.009) and temporal superior (β = 0.14, P = 0.048) sectors. RNFL thickness was significantly reduced in participants with higher numbers of metabolic abnormalities, independent of age, gender and the side of the examined eye (P = 0.043).ConclusionOur findings demonstrate that MetS is independently associated with reduced RNFL thickness, suggesting that neurodegeneration is implicated in pathogenesis of MetS.
Coincidence of mandibular fractures with isolated posterior maxillary sinus fractures
Authors: Blatt Sebastian , Rahimi‐Nedjat Roman , Sagheb Keyvan , Piechowiak Lisa , Walter Christian , Brüllmann Dan 
Published: April 2017

AbstractBackground/AimThere are no data available to show whether there is a relationship between mandibular fractures and isolated fractures of the posterior and/or lateral walls of the maxillary sinus. The aim of this study was to determine whether there is a coincidence between these fracture patterns.MethodsFour hundred large volume cone beam computed tomography scans (CBCT) of patients with a fracture of the mandible between 2008 and 2013 were analyzed retrospectively. Patients with multiple midfacial fractures were excluded. The radiographic findings were correlated with epidemiological and clinical data of the patients such as gender, age, treatment methods, or complications.ResultsThe most frequent fracture sites of the mandible were the jaw angle, the parasymphysis region, and the condyle. Nineteen of the 400 patients (4.75%) had an isolated fracture of the lateral and/or posterior maxillary sinus. Odds‐ratio analysis revealed a high tendency for significant correlation of condylar process fractures with isolated maxillary sinus fractures. Chi‐square test demonstrated a P‐value near statistical significance (P=.054). No other fracture site of the mandible could be associated with an isolated fracture of the maxillary sinus.ConclusionA condylar process fracture of the mandible after trauma without any further injury of the midface may be associated with an isolated fracture of the lateral and/or posterior maxillary sinus.
Linking macroecology and community ecology: refining predictions of species distributions using biotic interaction networks
Authors: Staniczenko Phillip P.A. , Sivasubramaniam Prabu , Suttle K. Blake , Pearson Richard G. 
Published: April 2017

AbstractMacroecological models for predicting species distributions usually only include abiotic environmental conditions as explanatory variables, despite knowledge from community ecology that all species are linked to other species through biotic interactions. This disconnect is largely due to the different spatial scales considered by the two sub‐disciplines: macroecologists study patterns at large extents and coarse resolutions, while community ecologists focus on small extents and fine resolutions. A general framework for including biotic interactions in macroecological models would help bridge this divide, as it would allow for rigorous testing of the role that biotic interactions play in determining species ranges. Here, we present an approach that combines species distribution models with Bayesian networks, which enables the direct and indirect effects of biotic interactions to be modelled as propagating conditional dependencies among species’ presences. We show that including biotic interactions in distribution models for species from a California grassland community results in better range predictions across the western USA. This new approach will be important for improving estimates of species distributions and their dynamics under environmental change.
Disenfranchisement and Ambiguity in the Face of Loss: The Suffocated Grief of Sexual Assault Survivors
Authors: Bordere Tashel 
Published: April 2017

AbstractGrief, loss, and social injustice are vital elements in the distinct yet intersecting stories of sexual assault and post‐assault survivorship. Yet survivors must frequently cope in isolation or in programs and therapeutic settings informed by literature that does not consistently account for grief and loss as central to their experiences. Utilizing a feminist framework, I review and critique literature on sexual assault survivorship and loss with focus on factors related to disenfranchisement and suffocated grief among young adult females. I also explore how these factors further complicate grief and mourning processes. Implications for socially just and culturally appropriate research and practice with bereaved sexual assault survivors are provided.
Sugar enrichment provides evidence for a role of nitrogen fixation in coral bleaching
Authors: Pogoreutz Claudia , Rädecker Nils , Cárdenas Anny , Gärdes Astrid , Voolstra Christian R. , Wild Christian 
Published: April 2017

AbstractThe disruption of the coral–algae symbiosis (coral bleaching) due to rising sea surface temperatures has become an unprecedented global threat to coral reefs. Despite decades of research, our ability to manage mass bleaching events remains hampered by an incomplete mechanistic understanding of the processes involved. In this study, we induced a coral bleaching phenotype in the absence of heat and light stress by adding sugars. The sugar addition resulted in coral symbiotic breakdown accompanied by a fourfold increase of coral‐associated microbial nitrogen fixation. Concomitantly, increased N:P ratios by the coral host and algal symbionts suggest excess availability of nitrogen and a disruption of the nitrogen limitation within the coral holobiont. As nitrogen fixation is similarly stimulated in ocean warming scenarios, here we propose a refined coral bleaching model integrating the cascading effects of stimulated microbial nitrogen fixation. This model highlights the putative role of nitrogen‐fixing microbes in coral holobiont functioning and breakdown.
Predictors of the health‐related quality of life of Chinese people with major neurocognitive disorders and their caregivers: The roles of self‐esteem and caregiver's burden
Authors: Young Daniel Kim‐wan , Ng Petrus Yat‐nam , Kwok Timothy 
Published: April 2017

AbstractAimThe present research study aimed to identify and compare the clinical and non‐clinical factors that predict the self‐reported and proxy‐reported health‐related quality of life (HRQoL) of people with major neurocognitive disorder (PwND) who are living at home in a Chinese society.MethodsA total of 57 Chinese PwND‐family caregiver dyads that were using the services of local senior centers were recruited through a cross‐sectional survey with convenience sampling. Each PwND and caregiver rated the PwND's HRQoL independently by using the Quality of Life‐Alzheimer's disease measure. Additional measures included the Rosenberg Self‐Esteem Scale (RSES), Index for Managing Memory Loss, Geriatric Depression Scale, Cornell Scale for Depression in Dementia and Zarit Burden Inventory.ResultsThe results of hierarchical multiple linear regression analyses showed that the PwND's self‐rated HRQoL and caregiver‐rated HRQoL were found to be predicted by different clinical and non‐clinical variables. In particular, the self‐esteem of PwND had the highest predictive power for the self‐rated HRQoL, whereas the caregiver burden is the only significant predictor for the caregiver‐rated HRQoL.ConclusionsIn the present study, the self‐esteem of PwND and the caregiver's burden were found to be important factors predicting self‐rated HRQoL and caregiver‐rated HRQoL respectively, which is probably because of the influence of traditional Chinese cultural values. Thus, it is important for non‐pharmacological interventions to address these special needs to promote HRQoL for this population. Geriatr Gerontol Int 2017; 17: 2319–2328.
Structure of massai grass pasture grazed on by sheep supplemented in the dry season
Authors: Fernandes Leonardo Santana , Difante Gelson dos Santos , Montagner Denise Baptaglin , Emerenciano Neto João Virgínio , de Araújo Itânia Maria Medeiros , Campos Nathália Rafaela Fidelis 
Published: April 2017

AbstractThis study aimed to evaluate the agronomic and structural characteristics of massai grass under grazing by sheep supplemented in the dry season. The treatments were supplements offered to sheep in massai grass pastures: multiple mixture, leucaena hay, gliricidia hay and soybean meal. The pastures were evaluated regarding: canopy height; forage accumulation and mass; accumulation, mass and percentage of morphological constituents; leaf:stem and green mass:dead material ratio; and pre‐ and post‐grazing forage bulk density. Higher pre‐grazing heights were observed (27.4 cm) in pasture occupied by animals supplemented with multiple mixture. No effects of supplement types for forage mass (average of 4426.6 kg ha−1 of dry matter) or of morphological constituents in pre‐grazing were observed; however, a grazing cycle effect was observed for these variables, with decreased forage mass in the order of 20% between the first and fourth pasture cycle. Involvement of dead material in forage mass increased by 45 and 23% in the pre and post‐grazing, respectively, from the first to the third grazing cycle. Using protein supplements in sheep's diet was not able to modify massai grass structure in the dry season. Massai grass is alternative forage for supplemented sheep production systems in pastures during the dry season, supporting grazing in 150 mm rainfall conditions for 6 months.