bluuebunny/crossref_metadata_2025_split huggingface dataset:
Routine guidewire application facilitates cholangioscopy in the management of postoperative residual hepatolithiasis
Authors: Wen Xu‐dong , Xiao Le , Wang Tao , Navarro‐Alvarez Nalu , Liu Wei‐hui 
Published: November 2017

Background and AimAlthough postoperative cholangioscopy (POC) is considered to be an effective treatment for residual hepatolithiasis after surgery, its security and validity still need to be improved. This study compared wire‐guided POC (WG‐POC) versus traditional POC (T‐POC) in the management of patients with residual hepatolithiasis.MethodsThis retrospective study included a total of 203 patients who suffered from hepatolithiasis and underwent hepatectomy as initial intervention from 1 January 2016 to 1 January 2017. After surgery, 110 patients were subjected to T‐POC and 93 to WG‐POC for eliminating residual hepatolithiasis. Perioperative course and follow‐up outcomes were retrospectively analyzed.ResultsNo significant differences in clinical characteristics or distribution of residual hepatolithiasis between the WG‐POC and T‐POC groups were observed (P > 0.05). However, overall POC interventional sessions (2.9 ± 0.85 vs 4.0 ± 1.21 times), average operating time (264.8 ± 103.61 vs 389.4 ± 136.26 min), overall complications rate (18.28% vs 32.73%), and overall T‐tube retaining time (21.8 ± 6.20 vs 28.8 ± 8.09 days) were lower in the WG‐POC group than in the T‐POC group (P < 0.05). In addition, there were no significant differences between the two groups (WG‐POC vs T‐POC) in recurrence (4.30% vs 4.55%) and residual calculi (8.60% vs 6.36%) at half‐a‐year follow up (P > 0.05).ConclusionsRoutine wire guidance may improve the outcome of cholangioscopy in managing complicated residual hepatolithiasis, being associated with clear advantages such as shorter operating time and number of POC interventions, reduced T‐tube retaining time, and fewer postoperative complications.
A new hybrid anchoring balloon for direct peroral cholangioscopy using an ultraslim upper endoscope
Authors: Li Jian , Guo Shao‐Ju , Zhang Jing‐Chao , Wang Hong‐Yan , Li Kai , Niu She‐Hui 
Published: November 2017

Background and AimLarge impacted or residual invisible common bile duct (CBD) stones after mechanical lithotripsy are challenging. We aimed to evaluate the feasibility and success rate of a new hybrid anchoring balloon‐guided direct peroral cholangioscopy (POC) for these conditions using an ultraslim endoscope.MethodsSixty‐five patients with large or residual invisible CBD stones for direct POC from July 2012 to July 2016 were identified, including six cases in whom an additional interventional procedure was required. There were altogether 55 cases undergoing a procedure with our new device, with a 0.021‐inch guidewire tied to a balloon catheter at its distal end in this single‐center retrospective study. Technical success, procedure time, diagnostic and therapeutic efficacy of direct POC, and procedure‐related complications were studied.ResultsThe hybrid anchoring balloon‐guided direct POC was successful in 51/55 (92.7%) procedures, including 18 cases in whom the conventional wire‐guided method failed within 25 min. Mean time for technical success by our method was 12.4 ± 3.4 min. In total, of the 43 cases with previous removal of CBD stones, seven (16.3%) were found to have residual stones ≥4 mm, excluding three cases in whom direct POC failed. In another 25 cases for difficult stones, 24 lithotripsies were carried out, resulting in 23 complete fragmentations. No significant procedure‐related complications were observed.ConclusionThe new hybrid anchoring balloon device performs well in facilitating direct POC using an ultraslim endoscope for evaluation and extraction of residual or large impacted CBD stones.
Response to clobazam in continuous spike‐wave during sleep
Authors: Vega Clemente , Sánchez Fernández Ivan , Peters Jurriaan , Thome‐Souza Maria S , Jackson Michele , Takeoka Masanori , Wilkening Greta N , Pearl Phillip L , Chapman Kevin , Loddenkemper Tobias 
Published: November 2017

AimTo evaluate the efficacy of clobazam treatment in reducing epileptiform discharges and modifying neuropsychological function in continuous spike‐wave during slow wave sleep.MethodWe performed a prospective clinical trial in patients with continuous spike‐wave during sleep aged 4 to 10 years. Patients underwent neuropsychological assessment and overnight electroencephalographic monitoring before treatment, and subsequent repeat assessment and overnight electroencephalographic monitoring 3 months after treatment. Treatment consisted of 1mg/kg clobazam up to a maximum dose of 30mg during the first night, followed by 0.5mg/kg nightly for 3 months.ResultsNine patients completed the study and had pre‐ and post‐neuropsychological evaluation. There was a qualitative reduction in median (p25–p75) spike percentage after 3 months (72.2 [68.0–75.8] vs 32.7 [4.7–81.7]). There were no marked changes in median (p25–p75) IQ comparing pre‐ and post‐clobazam treatment (80.0 [74.0–88.0] vs 80.0 [67.0–89.0]). There was a qualitative increase in Verbal IQ (83.0 [69.0–92.0] vs 95.0 [83.0–99.0]) and a qualitative decrease in Non‐verbal IQ (84.0 [74.0–87.0] vs 71.0 [60.0–84.0]).InterpretationQualitative improvements in epileptiform activity and cognition occurred in patients treated with clobazam for 3 months and the relationship between epileptiform activity and cognitive outcome should be studied in larger studies.What this paper adds

Verbal IQ in patients with continuous spike‐wave during sleep improved following short‐term treatment with clobazam.

Other neuropsychological improvements were observed, but varied by patient.

Cognitive improvement was observed despite some worsening of epileptiform discharges.
Impact of comorbidities constituting the hematopoietic cell transplant (HCT)‐comorbidity index on the outcome of patients undergoing allogeneic HCT for acute myeloid leukemia
Authors: Khalil Manar M. I. , Lipton Jeffrey H. , Atenafu Eshetu G. , Gupta Vikas , Kim Dennis D. , Kuruvilla John , Viswabandya Auro , Messner Hans A. , Michelis Fotios V. 
Published: November 2017

AbstractObjectiveTo investigate the prognostic impact of the individual component comorbidities of the hematopoietic cell transplant comorbidity index (HCT‐CI) in patients with acute myeloid leukemia (AML) that underwent allogeneic hematopoietic cell transplant (HCT).MethodThis single‐center study retrospectively investigated the individual comorbidities of the HCT‐CI on the outcome of 418 patients that underwent HCT for AML, in CR1 (n = 303, 72%) or CR2 (n = 115, 28%) at our center between 1999 and 2014.ResultsMedian age at HCT was 50 years (range 18‐71). Univariate analysis of the HCT‐CI, grouped as score 0 (n = 109), 1‐2 (n = 157) and ≥3 (n = 152), demonstrated significant influence on overall survival (OS) (P = .004) and non‐relapse mortality (NRM) (P = .02). For individual comorbidities constituting the HCT‐CI, variables with a P‐value ≤ .2 on univariate analysis were included in the multivariable analysis. For OS, none of the comorbidities of the HCT‐CI demonstrated independent prognostic relevance. However, for NRM, multivariable analysis demonstrated pretransplant diabetes (HR = 2.17, 95% CI = 1.31‐3.60, P = .003) and cardiovascular comorbidity (HR = 1.78, 95% CI = 1.15‐2.76, P = .01) to be independent predictors of NRM post‐transplant.ConclusionAmong the comorbidities that compose the HCT‐CI, diabetes and cardiovascular comorbidity independently predict NRM in patients undergoing allogeneic HCT for AML. This information should be taken into consideration regarding post‐transplant monitoring and care.
A review of urban impacts on avian life‐history evolution: Does city living lead to slower pace of life?
Authors: Sepp Tuul , McGraw Kevin J. , Kaasik Ants , Giraudeau Mathieu 
Published: November 2017

AbstractThe concept of a pace‐of‐life syndrome describes inter‐ and intraspecific variation in several life‐history traits along a slow‐to‐fast pace‐of‐life continuum, with long lifespans, low reproductive and metabolic rates, and elevated somatic defences at the slow end of the continuum and the opposite traits at the fast end. Pace‐of‐life can vary in relation to local environmental conditions (e.g. latitude, altitude), and here we propose that this variation may also occur along an anthropogenically modified environmental gradient. Based on a body of literature supporting the idea that city birds have longer lifespans, we predict that urban birds have a slower pace‐of‐life compared to rural birds and thus invest more in self maintenance and less in annual reproduction. Our statistical meta‐analysis of two key traits related to pace‐of‐life, survival and breeding investment (clutch size), indicated that urban birds generally have higher survival, but smaller clutch sizes. The latter finding (smaller clutches in urban habitats) seemed to be mainly a characteristic of smaller passerines. We also reviewed urbanization studies on other traits that can be associated with pace‐of‐life and are related to either reproductive investment or self‐maintenance. Though sample sizes were generally too small to conduct formal meta‐analyses, published literature suggests that urban birds tend to produce lower‐quality sexual signals and invest more in offspring care. The latter finding is in agreement with the adult survival hypothesis, proposing that higher adult survival prospects favour investment in fewer offspring per year. According to our hypothesis, differences in age structure should arise between urban and rural populations, providing a novel alternative explanation for physiological differences and earlier breeding. We encourage more research investigating how telomere dynamics, immune defences, antioxidants and oxidative damage in different tissues vary along the urbanization gradient, and suggest that applying pace‐of‐life framework to studies of variation in physiological traits along the urbanization gradient might be the next direction to improve our understanding of urbanization as an evolutionary process.
Land use and life history limit migration capacity of eastern tree species
Authors: Miller Kathryn M. , McGill Brian J. 
Published: November 2017

AbstractAimTemperate tree species overwhelmingly responded to past climate change by migrating rather than adapting. However, past climate change did not have the modern human‐driven patterns of land use and fragmentation, raising questions of whether tree migration will still be able to keep pace with climate. Previous studies using coarse‐grained or randomized landscapes suggest that dispersal may be delayed but have not identified outright barriers to migration. Here, we use real‐world fragmented landscapes at the scale of forest stands to assess the migration capacity of eastern tree species.LocationEastern U.S.A.Time periodPresent day to 2100.Major taxa studiedEastern U.S. trees.MethodsWe simulated dispersal over 100 years for 15 species common to the mid‐Atlantic region and that are predicted to gain suitable habitat in the northeast. In contrast to previous studies, we incorporated greater realism with species‐specific life histories and real‐world spatial configurations of anthropogenic land use. We used simulation results to calculate dispersal rates for each species and related these to predicted rates of species habitat shift.ResultsOur simulations suggest that land use in the human‐dominated east‐coast corridor slows species dispersal rates by 12–40% and may prevent keeping pace with climate. Species most impacted by anthropogenic land use were often those with the highest predicted species habitat shifts. We identified two major dispersal barriers, the Washington DC metropolitan area and central NY, that severely impeded tree migration.Main conclusionsPatterns of anthropogenic land use not only slowed migration but also resulted in effective barriers to dispersal. These impacts were exacerbated by tree life histories, such as long ages to maturity and narrow dispersal kernels. Without intervention, the migration lags predicted here may lead to loss in biodiversity and ecosystem functions as current forest species decline, and may contribute to formation of novel communities.
Extreme homogenization: The past, present and future of mammal assemblages on islands
Authors: Longman Emily K. , Rosenblad Kyle , Sax Dov F. 
Published: November 2017

AbstractAimWe documented how the similarity of mammal assemblages on continental and oceanic islands has changed since initial human colonization, since European arrival and overall. We investigated how levels of similarity might change in the future.LocationContinental and oceanic islands worldwide.Time periodHuman settlement of islands to the present, as well as projections for the future.Major taxa studiedMammals.MethodsWe used mammal occurrence data on islands to calculate the change in similarity using a pairwise approach based on Jaccard's index and a multisite approach based on Jaccard's and Sørensen's measures. We divided the mammal assemblages into two time periods, before and after island colonization or trade began with Europeans. We unpacked the mechanisms driving changes in similarity, exploring how initial similarity interacts with seven types of species turnover events to determine overall change. Finally, we calculated how future similarity levels will change if past trends in introductions and extinctions continue.ResultsMammals, on both continental and oceanic islands, show one of the most pronounced cases of homogenization ever observed, and on oceanic islands mammals show the largest increase in homogenization ever observed for a terrestrial group. Most of the homogenization observed to date has been driven by recent historical changes, not by changes that occurred before European arrival. If current patterns of species introductions and extinctions continue, then oceanic islands will experience little additional homogenization, whereas continental islands will homogenize greatly beyond current levels.Main conclusionsMammal assemblages on oceanic islands show nearly an order of magnitude greater change in similarity than plant and bird assemblages. Projections of future similarity indicate that continental and oceanic islands are on different trajectories of change. These trajectories could be altered by management actions, but in some cases those actions that would be impactful run counter to current conservation norms.
Personal finance blogs: Helpful tool for consumers with low financial literacy or preaching to the choir?
Authors: Hoffmann Arvid , Otteby Katarina 
Published: November 2017

AbstractRecent transitions from defined benefit to defined contribution plans assign greater individual responsibility to consumers to prepare for retirement and make consequential financial choices. However, many consumers are ill‐equipped to do so, considering overall low levels of financial literacy. At the same time, there is increasing controversy about the effectiveness of traditional financial education, such as high school financial education, counselling and seminars or workshops. Alternative sources of (just‐in‐time) financial training or advice may be needed to financially empower consumers and help them make important financial decisions. In the light of these developments, this study investigates if consumers perceive personal finance blogs as a helpful alternative in acquiring financial knowledge, and which factors influence perceived helpfulness of and intention to use personal finance blogs. Using Structural Equation Modelling to analyse data from a sample of U.S. consumers, the results of this study uncover that financial literacy and susceptibility to informational influence have a significant positive association with perceived helpfulness. Perceived financial uncertainty, which refers to uncertainty in terms of consumers’ perceived ability to accurately predict their future financial needs, has a significant negative association with perceived helpfulness of and intention to use personal finance blogs. Finally, perceived helpfulness of a personal finance blog is a significant positive predictor of consumers’ intention to use it. Overall, the findings suggest that personal finance blogs are preaching to the choir, since the consumers who are most likely to use personal finance blogs seem to need them the least given their higher levels of financial literacy and lower levels of perceived financial uncertainty. Taken together, the findings shed light on the potential users of personal finance blogs and underline the challenges of a ‘one‐size‐fits‐all’ financial education. This study aids in assessing personal finance blogs as an online resource which is scarcely researched, but which has the potential to provide just‐in‐time financial education to consumers across the world.
Associative role of HLA‐DRB1 SNP genotypes as risk factors for susceptibility and severity of rheumatoid arthritis: A North‐east Indian population‐based study
Authors: Das S. , Baruah C. , Saikia A. K. , Bose S. 
Published: November 2017

SummaryRheumatoid arthritis (RA) is a complex, multifactorial, systemic autoimmune disease. Reports are suggestive of the role of HLA especially HLA‐DRB1 alterations in RA pathogenesis. Existing data involving different geographical populations on the role of alterations in specific locus of HLA‐DRB1 in RA susceptibility and severity are equivocal, with no data available from ethnically distinct North‐east Indian population, where RA cases are alarmingly increasing. This study aimed to evaluate the association of HLA‐DRB1 gene SNPs (rs13192471, rs660895 and rs6457617) with susceptibility and severity of RA in an ethnically distinct North‐east Indian population. Whole blood was collected from clinically characterized RA cases (satisfying the American College of Rheumatology 1987 criteria) (n = 123) and community‐based age and sex‐matched healthy controls (n = 156) with informed consent. The HLA‐DRB1 SNP analysis was performed for all the RA and control cases using ARMS‐PCR using case and control genomic DNA as template. Statistical analysis was performed by SPSSv13.0 software. The HLA‐DRB1 rs660895 showed both wild (AA) and heterozygote (AG) genotype but the heterozygote allele was found to be associated with reduced risk of RA compared to controls [OR = 0.531, p = .024]. The difference in distribution of rs6457617 polymorphism between RA and control cases was comparable [OR = 0.525, p = .079]. Significantly higher distribution of variant rs13192471 genotype was observed in RA cases (69.92%) compared to controls (46.75%) (p < .001) and was associated with increased risk of susceptibility to RA [OR = 2.576, p < .001] compared to controls, as well as progression to severity in RA cases [OR = 2.404, p = .048]. Combinatorially also, the presence of rs13192471 variant genotype was associated with increased risk of RA susceptibility [OR = 8.267, p = .026] and RA severity [OR = 3.647, p = .280]. Alterations in HLA‐DRB1 are associated with RA susceptibility. HLA‐DRB1 rs13192471 SNP plays a critical role in RA susceptibility and severity in North‐east Indian cases and has prognostic significance in RA.
Constipation management in people with intellectual disability: A systematic review
Authors: Robertson Janet , Baines Susannah , Emerson Eric , Hatton Chris 
Published: November 2017

BackgroundConstipation can lead to serious health issues and death. This systematic review summarizes international research pertaining to the management of constipation in people with intellectual disability.MethodStudies published from 1990 to 2017 were identified using Medline, Cinahl, PsycINFO, Web of Science, email requests and cross‐citations. Studies were reviewed narratively in relation to identified themes.ResultsEighteen studies were reviewed in relation to three themes: laxative receipt; interventions (dietary fibre, abdominal massage and macrogol); and staff issues (knowledge and training). Laxative polypharmacy was common. Studies report positive results for dietary fibre and abdominal massage although study quality was limited.ConclusionThe main management response to constipation in people with intellectual disability is laxative use despite limited effectiveness. An improved evidence base is required to support the suggestion that an individualized, integrated bowel management programme may reduce constipation and associated health conditions in people with intellectual disability.
Capacity, Willingness, and Sovereign Default Risk: Reassuring the Market in Times of Crisis
Authors: Bølstad Jørgen , Elhardt Christoph 
Published: November 2017

AbstractPreserving the trust of bond markets is crucial for the world's many indebted countries, but it is still unclear when and how national or international actors can contribute to this goal. We present a set of arguments addressing this question and test them on the case of the eurozone debt crisis. Distinguishing between actors' capacity and willingness to avoid defaults, we argue that the crisis was marked by a lack of capacity at the national level, and limited or uncertain willingness at the European level. Accordingly, we find that European‐level efforts to reassure markets had considerably stronger effects than similar efforts at the national level. Furthermore, national efforts appear to have mattered the least in countries with the least capacity. These findings are based on a comprehensive new dataset of political events and relevant news, and they hold across a number of robustness checks and placebo tests.
Gating the holes in the Swiss cheese (part I): Expanding professor Reason's model for patient safety
Authors: Seshia Shashi S. , Bryan Young G. , Makhinson Michael , Smith Preston A. , Stobart Kent , Croskerry Pat 
Published: November 2017

AbstractIntroductionAlthough patient safety has improved steadily, harm remains a substantial global challenge. Additionally, safety needs to be ensured not only in hospitals but also across the continuum of care. Better understanding of the complex cognitive factors influencing health care–related decisions and organizational cultures could lead to more rational approaches, and thereby to further improvement.HypothesisA model integrating the concepts underlying Reason's Swiss cheese theory and the cognitive‐affective biases plus cascade could advance the understanding of cognitive‐affective processes that underlie decisions and organizational cultures across the continuum of care.MethodsThematic analysis, qualitative information from several sources being used to support argumentation.DiscussionComplex covert cognitive phenomena underlie decisions influencing health care. In the integrated model, the Swiss cheese slices represent dynamic cognitive‐affective (mental) gates: Reason's successive layers of defence. Like firewalls and antivirus programs, cognitive‐affective gates normally allow the passage of rational decisions but block or counter unsounds ones. Gates can be breached (ie, holes created) at one or more levels of organizations, teams, and individuals, by (1) any element of cognitive‐affective biases plus (conflicts of interest and cognitive biases being the best studied) and (2) other potential error‐provoking factors. Conversely, flawed decisions can be blocked and consequences minimized; for example, by addressing cognitive biases plus and error‐provoking factors, and being constantly mindful. Informed shared decision making is a neglected but critical layer of defence (cognitive‐affective gate). The integrated model can be custom tailored to specific situations, and the underlying principles applied to all methods for improving safety. The model may also provide a framework for developing and evaluating strategies to optimize organizational cultures and decisions.LimitationsThe concept is abstract, the model is virtual, and the best supportive evidence is qualitative and indirect.ConclusionsThe proposed model may help enhance rational decision making across the continuum of care, thereby improving patient safety globally.