bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment considerations in actinic keratosis
Authors: Goldenberg G. 
Published: March 2017

AbstractThe chronic skin condition actinic keratosis (AK) is characterized by the formation of keratotic lesions of variable thickness that are poorly delimited. AK occurs on areas of the skin that have had long‐term exposure to the sun or UV radiation. Although AKs may regress, they usually persist and can progress to squamous cell carcinoma (SCC). Clinicians are unable to predict which AKs will progress; therefore, both clinically visible lesions and subclinical, non‐visible (i.e. the entire area affected by AK/field cancerization) should be treated. AK treatment options include lesion‐directed therapies that target specific AK lesions and field‐directed therapies that target multiple clinical lesions and the underlying field damage. This article reviews currently available treatment options in AK, with a focus on patient‐applied field therapies, and their suitability according to specific disease characteristics and patient needs. Choice of treatment in AK depends on lesion‐, patient‐ and treatment‐related factors and should be individualized. Considerations when choosing a therapy include site of application, treatment duration, surface area of application, tolerability profiles and implications on adherence. Field‐directed therapies treat clinical and subclinical damage (i.e. the entire area affected by AK), achieve high rates of sustained clearance of AKs and may reduce the risk of progression to SCC. There is a clear need for field therapies with short duration of treatment and predictable, short‐lived, mild local skin reactions that can be used over a large surface area. Therapies with shorter and simpler treatment courses are often associated with better adherence than treatments with longer courses. These may, therefore, represent more appropriate choices in patients for whom convenience and/or adherence are an issue.
Falls and Frailty in Prostate Cancer Survivors: Current, Past, and Never Users of Androgen Deprivation Therapy
Authors: Winters‐Stone Kerri M. , Moe Esther , Graff Julie N. , Dieckmann Nathan F. , Stoyles Sydnee , Borsch Carolyn , Alumkal Joshi J. , Amling Christopher L. , Beer Tomasz M. 
Published: March 2017

ObjectivesTo compare the prevalence of and association between falls and frailty of prostate cancer survivors (PCSs) who were current, past or never users of androgen deprivation therapy (ADT).DesignCross‐sectional.SettingMail and electronic survey.ParticipantsPCSs (N = 280; mean age 72 ± 8).MeasurementsCancer history, falls, and frailty status (robust, prefrail, frail) using traditionally defined and obese phenotypes.ResultsCurrent (37%) or past (34%) ADT users were more than twice as likely to have fallen in the previous year as never users (15%) (P = .002). ADT users had twice as many recurrent falls (P < .001) and more fall‐related injuries than unexposed men (P = .01). Current (43%) or past (40%) ADT users were more likely to be classified as prefrail or frail than never users (15%) (P < .001), and the prevalence of combined obese frailty + prefrailty was even greater in current (59%) or past (62%) ADT users than never users (25%) (P < .001). Traditional and obese frailty significantly increased the likelihood of reporting falls in the previous year (odds ratio (OR) = 2.15, 95% CI = 1.18–3.94 and OR = 2.97, 95% CI = 1.62–5.58, respectively) and was also associated with greater risk of recurrent falls (OR = 3.10, 95% CI = 1.48–6.5 and OR = 3.99, 95% CI = 1.79–8.89, respectively).ConclusionsCurrent and past exposure to ADT is linked to higher risk of falls and frailty than no treatment. PCSs should be appropriately counseled on fall prevention strategies, and approaches to reduce frailty should be considered.
Delirium in the Emergency Department and Its Extension into Hospitalization (DELINEATE) Study: Effect on 6‐month Function and Cognition
Authors: Han Jin H. , Vasilevskis Eduard E. , Chandrasekhar Rameela , Liu Xulei , Schnelle John F. , Dittus Robert S. , Ely E. Wesley 
Published: March 2017

BackgroundThe natural course and clinical significance of delirium in the emergency department (ED) is unclear.ObjectivesWe sought to (1) describe the extent to which delirium in the ED persists into hospitalization (ED delirium duration) and (2) determine how ED delirium duration is associated with 6‐month functional status and cognition.DesignProspective cohort study.SettingTertiary care, academic medical center.ParticipantsED patients ≥65 years old who were admitted to the hospital.MeasurementsThe modified Brief Confusion Assessment Method was used to ascertain delirium in the ED and hospital. Premorbid and 6‐month function were determined using the Older American Resources and Services Activities of Daily Living (OARS ADL) questionnaire which ranged from 0 (completely dependent) to 28 (completely dependent). Premorbid and 6‐month cognition were determined using the short form Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) which ranged from 1 to 5 (severe dementia). Multiple linear regression was performed to determine if ED delirium duration was associated with 6‐month function and cognition adjusted for baseline OARS ADL and IQCODE, and other confounders.ResultsA total of 228 older ED patients were enrolled. Of the 105 patients who were delirious in the ED, 81 (77.1%) patients’ delirium persisted into hospitalization. For every ED delirium duration day, the 6‐month OARS ADL decreased by 0.63 points (95% CI: −1.01 to −0.24), indicating poorer function. For every ED delirium duration day, the 6‐month IQCODE increased 0.06 points (95% CI: 0.01–0.10) indicating poorer cognition.ConclusionsDelirium in the ED is not a transient event and frequently persists into hospitalization. Longer ED delirium duration is associated with an incremental worsening of 6‐month functional and cognitive outcomes.
Determinants of Dropout and Nonadherence in a Dementia Prevention Randomized Controlled Trial: The Prevention of Dementia by Intensive Vascular Care Trial
Authors: Beishuizen Cathrien R. L. , Coley Nicola , Moll van Charante Eric P. , van Gool Willem A. , Richard Edo , Andrieu Sandrine 
Published: March 2017

ObjectivesTo explore and compare sociodemographic, clinical, and neuropsychiatric determinants of dropout and nonadherence in older people participating in an open‐label cluster‐randomized controlled trial—the Prevention of Dementia by Intensive Vascular care (preDIVA) trial—over 6 years.DesignSecondary analysis.SettingOne hundred sixteen general practices in the Netherlands.ParticipantsCommunity‐dwelling individuals aged 70 to 78 (N = 2,994).InterventionNurse‐led multidomain intervention targeting cardiovascular risk factors to prevent dementia.MeasurementsThe associations between participant baseline sociodemographic (age, sex, education), clinical (medical history, disability, cardiovascular risk), neuropsychiatric (depressive symptoms (Geriatric Depression Scale‐15), and cognitive (Mini‐Mental State Examination)) characteristics and dropout from the trial and nonadherence to the trial intervention were explored using multilevel logistic regression models.ResultsOlder age, poorer cognitive function, more symptoms of depression, and greater disability were the most important determinants of dropout of older people. The presence of cardiovascular risk factors was not associated with dropout but was associated with nonadherence. Being overweight was a risk factor for nonadherence, whereas people with high blood pressure or a low level of physical exercise adhered better to the intervention. The association between poorer cognitive function and symptoms of depression and dropout was stronger in the control group than in the intervention group, and vice versa for increased disability.ConclusionIn a large dementia prevention trial with 6‐year follow‐up, dropout was associated with older age, poorer cognitive function, symptoms of depression, and disability at baseline. These findings can help to guide the design of future dementia prevention trials in older adults. The associations found between cardiovascular risk factors and nonadherence need to be confirmed in other older populations receiving cardiovascular prevention interventions.
Characterizing Clinical and MRI Dissociation in Patients with Multiple Sclerosis
Authors: Healy Brian C. , Buckle Guy J. , Ali Eman N. , Egorova Svetlana , Khalid Fariha , Tauhid Shahamat , Glanz Bonnie I. , Chitnis Tanuja , Guttmann Charles R.G. , Weiner Howard L. , Bakshi Rohit 
Published: March 2017

ABSTRACTBACKGROUND AND PURPOSETwo common approaches for measuring disease severity in multiple sclerosis (MS) are the clinical exam and brain magnetic resonance imaging (MRI) scan. Although most patients show similar disease severity on both measures, some patients have clinical/MRI dissociation.METHODSSubjects from a comprehensive care MS center who had a concurrent brain MRI, spinal cord MRI, clinical examination, and patient reported outcomes were classified into three groups based on the Expanded Disability Status Scale (EDSS) and cerebral T2 hyperintense lesion volume (T2LV). The first group was the low lesion load/high disability group (LL/HD) with T2LV < 2 ml and EDSS ≥ 3. The second group was the high lesion load/low disability group (HL/LD) with T2LV > 6 ml and EDSS ≤ 1.5. All remaining subjects were classified as not dissociated. The three groups were compared using regression techniques for unadjusted analyses and to adjust for age, disease duration, and gender.RESULTSTwenty‐two subjects were classified as LL/HD (4.1%; 95% CI: 2.6%, 6.2%), and 50 subjects were classified as HL/LD (9.4%; 95% CI: 7.0%, 12.2%). Subjects in the LL/HD group were more likely to have a progressive form of MS and had significantly lower physical quality of life in adjusted and unadjusted analysis. Subjects in HL/LD had significantly more gadolinium‐enhancing lesions, and subjects in the LL/HD group had significantly more cervical spinal cord lesions.CONCLUSIONSOur results indicate that dissociation may occur between physical disability and cerebral lesion volume in either direction in patients with MS. Type of MS, brain atrophy, and spinal cord lesions may help to bridge this dissociation.
Arginine for gestating sows and foetal development: A systematic review
Authors: Palencia J. Y. P. , Lemes M. A. G. , Garbossa C. A. P. , Abreu M. L. T. , Pereira L. J. , Zangeronimo M. G. 
Published: March 2017

SummaryThe use of functional amino acids during pregnancy has been linked to improved reproduction in mammals. In this context, arginine is a precursor in the synthesis of numerous molecules, such as nitric oxide and polyamines, which play an important role during reproduction. However, contradictory studies are found in the literature, particularly regarding the amount of supplementation and the period of pregnancy in which it is used. The objective of this study was to evaluate the effects of dietary arginine supplementation for pregnant sows on foetal development via a systematic review. The search for papers was performed during the month of December 2015, in the databases ISI Web of Science, Science Direct, Scopus, and SciELO. From a total of 5675 returned studies, only 13 papers were selected after applying selection criteria. Most (47%) of the studies that evaluated the effects of dietary arginine supplementation on foetal development in pigs used 1% arginine. Supplementation was initiated in the first third of pregnancy in 47% of tests, including in both primiparous and multiparous sows. These studies showed positive results for embryo survival and foetal development, evidenced by the increase in placental weight and the number and weight of piglets born alive. Of all evaluated studies, 53% showed benefits on foetal development. It is concluded that supplementing dietary arginine in gestating sows can benefit embryo survival and foetal development. However, to establish a supplementation plan with this amino acid, aspects related to the period of pregnancy, supplementation levels, and source of arginine must be well defined.
Effects of restricted vs. step up dietary adaptation for 6 or 9 days on feedlot performance, feeding behaviour, ruminal and blood variables of Nellore cattle
Authors: Perdigão A. , Millen D. D. , Brichi A. L. C. , Vicari D. V. F. , Franzói M. C. S. , Barducci R. S. , Martins C. L. , Estevam D. D. , Cesar M. T. , Arrigoni M. D. B. 
Published: March 2017

SummaryThis study was designed to determine effects of quantitatively restricted intake of the final finishing diet as a means of dietary adaptation compared with diets increasing in concentrate (step up) over periods of 6 and 9 days on feedlot performance, carcass characteristics, feeding behaviour, blood gas profile and rumen morphometrics of Nellore cattle. One hundred twenty 22‐month‐old Nellore bulls (352 ± 20 kg) were randomly allocated in 24 pens and fed for 84 days. The experimental design was a completely randomized block with 2 × 2 factorial arrangement of treatments: adaptation using either step up protocol for 6 days or 9 days or restriction protocol for 6 days or 9 days, where the pen (five bullocks/pen; six pens/treatment) was considered the experimental unit. Cattle adapted by step up protocol had significantly greater average daily gain throughout the study when compared to those adapted by restriction protocol, regardless of adaptation length. During the adaptation period, a greater dry matter intake fluctuation was observed for animals maintained on restriction programme when compared to those adapted to the finishing diets using step up protocol. In addition, a protocol × length interaction for rumenitis scores was observed, where the level of injuries to the ruminal wall was significantly higher for the cattle adapted by restriction protocol for 9 days and lower for animals submitted for 9 days to the step up programme. Likewise, a protocol × length interaction for mitotic index was observed, in which cattle adapted by step up protocol for 9 days had lower numbers of cells in mitosis. Thus, the step up protocol led to better feedlot performance, and based on this fact, the length of 9 days promoted better rumen epithelium adaptation of Nellore cattle to high‐concentrate diets.
Dietary effects of soy and citrus flavonoid on antioxidation and microbial quality of meat in broilers
Authors: Kamboh A. A. , Memon A. M. , Mughal M. J. , Memon J. , Bakhetgul M. 
Published: March 2017

SummaryThe current study investigated dietary effects of soy genistein (SG) and citrus hesperidin (CH) on microbial spoilage and antioxidant quality of chicken meat. Broilers were divided to six treatment groups: control (C), SG and CH, supplemented with 5 mg of SG and 20 mg of CH per kg of feed, respectively, and SGCH1, SGCH2 and SGCH3, supplemented with 5, 10 or 20 mg of SG + CH (1:4) per kg of feed respectively. Both SG and CH reduced (p < .01) the microbial load of spoilage organisms in breast meat at 0 and 15 days of refrigeration. Hepatic and muscle total antioxidant and superoxide dismutase activities, and crude protein contents were generally improved (p < .05), whereas hepatic malondialdehyde concentration and muscle fat was decreased (p < .01) by the dietary treatments. In conclusion, soy genistein and CH supplementation could improve meat composition, antioxidant and microbial quality of broilers meat.
Relationships between body temperatures and inflammation indicators under physiological and pathophysiological conditions in pigs exposed to systemic lipopolysaccharide and dietary deoxynivalenol
Authors: Tesch T. , Bannert E. , Kluess J. , Frahm J. , Hüther L. , Kersten S. , Breves G. , Renner L. , Kahlert S. , Rothkötter H.‐J. , Dänicke S. 
Published: March 2017

SummaryWe studied the constancy of the relationship between rectal and intraabdominal temperature as well as their linkage to inflammatory markers (leucocyte counts, kynurenine‐to‐tryptophan ratio (Kyn–Trp ratio), tumour necrosis factor alpha (TNF‐α) in healthy and in pigs exposed to lipopolysaccharide (LPS) and/or deoxynivalenol (DON). Barrows (n = 44) were fed 4 weeks either a DON‐contaminated (4.59 mg DON/kg feed) or a control (CON) diet and equipped with an intraabdominal temperature logger and a multicatheter system (V.portae hepatis, V.lienalis, Vv.jugulares) facilitating infusion of 0.9% NaCl (CON) or LPS (7.5 μg/kg BW) and simultaneous blood sampling. Body temperatures were measured and blood samples taken every 15 min for leucocyte counts, TNF‐α and Kyn–Trp ratio. Combination of diet and infusion created six groups: CON_CONjug.‐CONpor., CON_CONjug.‐LPSpor., CON_LPSjug.‐CONpor., DON_CONjug.‐CONpor., DON_CONjug.‐LPSpor., DON_LPSjug.‐CONpor.. The relationship between both temperatures was not uniform for all conditions. Linear regression revealed that an intraabdominal increase per 1°C increase in rectal temperature was ~25% higher in all LPS‐infused pigs compared to NaCl‐infusion, albeit diet and site of LPS infusion modified the magnitude of this difference. Inflammatory markers were only strongly present under LPS influence and showed a significant relationship with body temperatures. For example, leucocyte counts in clinically inconspicuous animals were only significantly correlated to core temperature in DON‐fed pigs, but in all LPS‐infused groups, irrespective of diet and temperature method. In conclusion, the gradient between body core and rectal temperature is constant in clinically inconspicuous pigs, but not under various pathophysiological conditions. In the latter, measurement of inflammatory markers seems to be a useful completion.
Qualitative profile of degummed guar (Cyamopsis tetragonoloba L.) seeds grown in a Mediterranean area for use as animal feed
Authors: Chiofalo B. , Lo Presti V. , D'Agata A. , Rao R. , Ceravolo G. , Gresta F. 
Published: March 2017

SummaryGuar (Cyamopsis tetragonoloba L.) is an interesting summer legume multipurpose crop used for the extraction of seed gum, due to its galactomannan content, and the high‐protein by‐product, (germ and hull) used for animal feed. The aim of this study was to assess qualitative traits of degummed seeds, named guar meal, of six guar varieties from India, South Africa and USA, grown in a Mediterranean environment (Sicily, Southern Italy), in order to explore their suitability for livestock, and comparing them with the marketed Indian products of guar meals, Churi and Korma. After harvest, seeds were manually degummed and proximate composition was analysed using the official method of analyses, total phenols and tannins by UV spectrophotometry and fatty acids by GC‐FID. Qualitative profile of degummed guar seeds (DGS) was significantly (p < .05) influenced by the genotype. Among DGS, Matador showed a high (p < .05) content of protein (518 g/kg), lipids (59.4 g/kg) and the lowest (p < .05) NDF level (181 g/kg) compared to the other varieties. Total phenol content of DGS showed similar values among varieties (2.57 mg gallic acid/g, on average) and with those of guar meal Korma 50%–53% (2.89 mg gallic acid/g) and Korma 56%–58% (2.94 mg gallic acid/g). Tannins were below the instrumental limit of quantification (1.5 mg/g of catechin equivalents) in DGS, as well as in the marketed products. Fatty acid composition was significantly influenced (p < .05) by the genotype. Matador showed the significant highest content of polyunsaturated fatty acids (PUFA) of the n6 series (45.2 g/100 g), whereas India showed the significant (p < .05) highest content of PUFA of the n3 series (3.55 g/100 g), and the significant (p < .05) highest level of n3/n6 PUFA ratio (0.08), and the best (p < .05) Atherogenic Index (0.19) and Thrombogenic Index (0.46). This study shows the interesting nutritional characteristics of degummed guar seeds, underlining that, if the future of the guar gum industries depends largely on the utilization of guar seed meal, this product can be considered a valuable feed resource and a way to increase the income of guar production.
Significant change events in psychodynamic psychotherapy: Is cognition or emotion more important?
Authors: McCarthy Kye L. , Caputi Peter , Grenyer Brin F.S. 
Published: March 2017

ObjectiveSignificant change events are helpful moments within a psychotherapy session that have been shown in previous research to relate strongly to outcome. They are special moments and therefore provide rich data for research into understanding therapeutic process. This study investigated clinical and linguistic features of these helpful moments using and comparing both human ratings and computerized text analysis strategies.MethodSignificant change events versus non‐event passages were studied within 1195 word blocks of transcribed psychotherapy for 20 participants with diagnoses of comorbid depression and personality disorder. Significant events were determined manually by independent raters using the Helpful Aspects of Therapy (HAT) form linked to the Helpful Aspects of Experiential Therapy Content Analysis System (HAETCAS). Mergenthaler's Therapeutic Cycles Model (TCM)‐computerized text analysis, identified significant events via linguistic markers. The Linguistic Inquiry and Word Count (LIWC) differentiated emotional and cognitive components.ResultsSignificant events included statements reflecting emotional and cognitive awareness and insight, and moments of alliance strengthening. These events were saturated with both positive and negative emotion words, particularly anger and sadness, and more cognitive insight words.ConclusionsSignificant moments of psychotherapeutic movement featured high therapeutic alliance. There was evidence of the integration or working through of positive and negative emotional content with cognitive insight – meaning both emotion and cognition were important in these interchanges.Practitioner points

This study found that significant events in therapy were characterized by high levels of both emotional and cognitive language, and alliance strengthening.

Linguistic analysis methods provide important data on psychotherapeutic processes which can be useful in guiding clinicians and improving treatment outcomes.
Bilateral native nephrectomy reduces systemic oxalate level after combined liver‐kidney transplant: A case report
Authors: Villani Vincenzo , Gupta Neena , Elias Nahel , Vagefi Parsia A. , Markmann James F. , Paul Elahna , Traum Avram Z. , Yeh Heidi 
Published: March 2017

AbstractPrimary hyperoxaluria type 1 (PH1) is a rare liver enzymatic defect that causes overproduction of plasma oxalate. Accumulation of oxalate in the kidney and subsequent renal failure are fatal to PH1 patients often in pediatric age. Combined liver and kidney transplantation is the therapy of choice for end‐stage renal disease due to PH1. Levels of plasma oxalate remain elevated for several months after liver transplantation, as the residual body oxalate is slowly excreted. Patients with persistent hyperoxaluria after transplant often require hemodialysis, and accumulation of residual oxalate in the kidney can induce graft dysfunction. As the native kidneys are the main target of calcium oxalate accumulation, we postulated that removal of native kidneys could drastically decrease total body oxalate levels after transplantation. Here, we report a case of bilateral nephrectomy at the time of combined liver‐kidney transplantation in a pediatric PH1 patient. Bilateral nephrectomy induced a rapid decrease in plasma oxalate to normal levels in less than 20 days, compared to the several months reported in the literature. Our results suggest that removal of native kidneys could be an effective strategy to decrease the need for hemodialysis and the risk of renal dysfunction after combined liver‐kidney transplantation in patients with PH1.