bluuebunny/crossref_metadata_2025_split huggingface dataset:
Human epidermal growth factor receptor 2 status of breast cancer patients in Asia: Results from a large, multicountry study
Authors: Pathmanathan Nirmala , Geng Jing‐shu , Li Wencai , Nie Xiu , Veloso Januario , Hill Julie , McCloud Philip , Bilous Michael 
Published: June 2016

AbstractAimCurrent estimates of the human epidermal growth factor receptor 2 (HER2)‐positivity rate in breast cancer are largely based on studies from the United States, Europe and Australia, and might not reflect the rate among breast cancer patients in Asia. The primary aim of this study was to conduct a clinical audit of laboratories across eight countries in Asia to determine the incidence of HER2‐positive breast cancer in this region.MethodsPathology laboratories submitted data on breast cancers consecutively tested for HER2 over a two‐year period. The proportion of HER2‐positive, ‐equivocal and ‐negative tumors was determined for each country and overall. HER2‐positivity rate by age and histological grade was also determined.ResultsHER2 results from 30 179 breast cancers were submitted by 96 laboratories. The overall HER2‐positivity rate was 23.5%; the rate between countries ranged from 19.7% to 44.2%, and from 4.4% to 51.6% between laboratories. An equivocal HER2 result was recorded in 18.2% of cases. Discrepancies between laboratories suggest that testing expertise contributes to variations seen in HER2 status across laboratories, as well as the generally higher rate of HER2‐positivity that was recorded.ConclusionIn this study, the incidence of HER2‐positive breast cancer diagnosed in Asian women was higher than published studies on women from Western countries. In addition, the study found that women in Asian countries presented with breast cancer at an earlier age, with a higher histological grade. This study serves to highlight the challenges with HER2 testing and data collection in a large multicenter Asian cohort.
Metabolic syndrome is associated with increased seminal inflammatory cytokines and reproductive dysfunction in a case‐controlled male cohort
Authors: Leisegang Kristian , Bouic Patrick J. D. , Henkel Ralf R. 
Published: June 2016

ProblemThe impact of metabolic syndrome (MetS) associated systemic inflammation on the male reproductive tract requires further investigation.Method of studyA cross‐sectional case‐controlled study design consisting of a control group (n=32) and a MetS (n=42) group was used. Variables include MetS diagnostic criterion, serum C‐Reactive Protein (CRP), routine semen analysis, spermatozoa mitochondrial membrane potential (MMP) and DNA fragmentation (DF), as well as TNF‐α, IL‐1β, IL6 and IL8 concentrations in serum and semen.ResultsSerum and seminal levels of TNF‐α, IL‐1β, IL6 and IL8 were all significantly increased in the MetS group. Ejaculation volume, sperm concentration, total sperm count, progressive and total motility and vitality were significantly decreased and sperm with abnormal MMP and DF were increased in the MetS group.ConclusionThe results suggest that MetS is associated with decreased fertility parameters in males, as well as local reproductive tract inflammation, in the absence of leukocytospermia.
Outcomes of breech birth by mode of delivery: a population linkage study
Authors: Bin Yu Sun , Roberts Christine L. , Ford Jane B. , Nicholl Michael C. 
Published: June 2016

BackgroundTrial evidence supports a policy of caesarean section for singleton breech presentations at term, but vaginal breech birth is considered a safe option for selected women.AimsTo provide recent Australian data on outcomes associated with intended mode of delivery for term breech singletons in women who meet conservative eligibility criteria for vaginal breech birth.Materials and MethodsBirth and hospital records from 2009 to 2012 in New South Wales were used to identify women with nonanomalous pregnancies who would be considered eligible for vaginal breech birth. Intended mode of delivery was inferred from labour onset and management.ResultsOf 10 133 women with term breech singleton pregnancies, 5197 (51.3%) were classified as eligible for vaginal breech delivery. Of these, 6.8% intended vaginal breech birth, 76.4% planned caesarean section and intention could not be determined for 16.8%. Women intending vaginal delivery had higher rates of neonatal morbidity (6.0% vs 2.1%), neonatal birth trauma (7.4% vs 0.9%), Apgar <4 at one minute (10.5% vs 1.1%), Apgar <7 at five minutes (4.3% vs 0.5%) and neonatal intensive care unit/special care nursery admissions (16.2% vs 6.6%) than those planning caesarean section. Increased perinatal risks remained after adjustment for maternal characteristics. Severe maternal morbidity (1.4% vs 0.7%) and post‐partum readmission (4.6% vs 4.0%) were higher in the intended vaginal compared to planned caesarean births, but these differences were not statistically significant.ConclusionsIn a population of women classified as being eligible for vaginal breech birth, intended vaginal delivery was associated with higher rates of neonatal morbidity than planned caesarean section.
Rethinking placental pathology in the PSANZ classification of unexplained stillbirth at term
Authors: Bartlett Kate , Zuccollo Jane , Sadler Lynn , Masson Vicki 
Published: June 2016

BackgroundApproximately 30 per cent of stillbirths are currently classified ‘unexplained’ using the Perinatal Society of Australia and New Zealand (PSANZ) classification system in New Zealand. This unexplained category includes deaths with placental pathology even though the importance of placental pathology and its causal relationship to stillbirth is well described.AimsTo determine whether unexplained stillbirths in New Zealand classified using PSANZ criteria can be more usefully classified based on placental pathology.MethodsAudit of the classification of cause of death among ‘unexplained antepartum death’ at term by perinatal pathologist review of postmortem and/or placental pathology reports using the current PSANZ Perinatal Death Classification (PDC)10 classification and a proposed ‘significant placental pathology’ subclassification. The main outcome measure was a change in cause of death from unexplained term stillbirth to an alternative PSANZ classification or to significant placental pathology subcategory.ResultsIn total, 177 unexplained stillbirths with a postmortem and/or placental pathology report in New Zealand between 2007 and 2013 inclusive were reviewed. Twenty‐three cases (13%) had significant placental pathology that could have been a direct cause of the stillbirth. A further seven cases (4%) were misclassified and could be better classified within another PDC category.ConclusionsA classification system incorporating placental pathologies which are recognised by the current literature to be causative of stillbirth would better describe stillbirths at term in New Zealand. This would benefit parental counselling and follow‐up in subsequent pregnancies. A standard approach to reporting placental pathology would benefit clinicians. Education on placental pathology for clinicians working with parents experiencing stillbirth and multidisciplinary approach to classification is also recommended.
Loving‐Kindness Meditation Effects on Well‐Being and Altruism: A Mixed‐Methods Online RCT
Authors: Galante Julieta , Bekkers Marie‐Jet , Mitchell Clive , Gallacher John 
Published: June 2016

BackgroundEvidence suggests that facilitating empathy could improve individuals' well‐being. Loving‐kindness meditation (LKM) could be a facilitator, and online delivery a cost‐effective format.MethodsWe conducted an internet‐based randomised controlled trial recruiting 809 adults to test whether an LKM course improves well‐being through evoking pleasant emotions, psychological resources, and altruism compared to a light physical exercise course (LE). Participants in both arms followed video‐based instructions, completed post‐intervention questionnaires, and used online diaries and forums. To measure altruism £10/$10 were offered to participants with a choice of donating all/half to charity. Thematic analysis was applied to diary/forum entries.ResultsBoth courses increased well‐being without significant differences. LKM participants were less anxious than LE participants (ß = −0.22, 95% confidence interval (CI) [−0.43, −0.02], p = .03), and more likely to donate £5/$5 (Relative Risk = 3.57, 95%CI [0.82, 15.50], p = .09). Attrition was high (82%). Participants engaged in diary/forum usage. LKM was an emotionally intense experience, generating deep reflections and increased connectedness but difficult for some to process. LE led to gentle increases in relaxation, generating a sense of achievement.ConclusionsFuture research needs to confirm findings and devise ways of delivering online LKM effectively to diverse populations.
Estimating the immunogenicity of blood group antigens: a modified calculation that corrects for transfusion exposures
Authors: Stack Gary , Tormey Christopher A. 
Published: June 2016

SummaryCalculations of blood group antigen immunogenicity have been based on antigen and antibody frequencies in transfused populations, with the assumption of a single red blood cell (RBC) unit exposure per patient. Given that patients are usually transfused >1 RBC unit, antigen exposures will be greater than assumed, resulting in inaccurate immunogenicity calculations. As such, the goal of this study was to modify the calculation to correct for RBC exposures. To further improve accuracy, we used an empirically‐derived immunogenicity for the reference antigen, K, in calculations of absolute immunogencity and eliminated anamnestic and pre‐existing antibodies (i.e., antibodies induced outside the study site) from the calculation. Alloantibody numbers for the top 12 specificities and mean RBCs (MRBC) transfused per patient were obtained from the records of a hospital transfusion service. A revised immunogenicity calculation, incorporating a correction for MRBC, was developed. This correction resulted in up to a 4‐fold increase in the immunogenicity of relatively high frequency antigens, with smaller increases for lower frequency antigens, yielding the following revised immunogenicity ranking: K>Jka>Lua>E>P1>c>M>Leb>C>Lea>Fya>S. Use of an empirical value for K immunogenicity resulted in a 1·9‐fold increase in absolute immunogenicities for all antigens. In summary, the calculation of blood group antigen immunogenicity has been further refined.
Treatment of graft failure with TNI‐based reconditioning and haploidentical stem cells in paediatric patients
Authors: Teltschik Heiko‐Manuel , Heinzelmann Frank , Gruhn Bernd , Feuchtinger Tobias , Schlegel Patrick , Schumm Michael , Kremens Bernhard , Müller Ingo , Ebinger Martin , Schwarze Carl Philipp , Ottinger Hellmut , Zips Daniel , Handgretinger Rupert , Lang Peter 
Published: June 2016

SummaryGraft failure is a life‐threatening complication after allogeneic haematopoietic stem cell transplantation (HSCT). We report a cohort of 19 consecutive patients (median age: 8·5 years) with acute leukaemias (n = 14) and non‐malignant diseases (n = 5) who experienced graft failure after previous HSCT from matched (n = 3) or haploidentical donors (n = 16) between 2003 and 2012. After total nodal irradiation (TNI)‐based reconditioning combined with fludarabine, thiotepa and anti‐T cell serotherapy, all patients received T cell‐depleted peripheral blood stem cell grafts from a second, haploidentical donor. Median time between graft failure and retransplantation was 14 d (range 7–40). Sustained engraftment (median: 10 d, range 9–32) and complete donor chimerism was observed in all evaluable patients. 5 patients additionally received donor lymphocyte infusions. Graft‐versus‐host disease (GvHD) grade II and III occurred in 1 patient each (22%); no GvHD grade IV was observed. 2 patients had transient chronic GvHD. The regimen was well tolerated with transient interstitial pneumonitis in one patient. Treatment‐related mortality after one year was 11%. Event‐free survival and overall survival 3 years after retransplantation were 63% and 68%. Thus, a TNI‐based reconditioning regimen followed by transplantation of haploidentical stem cells is an option to rescue patients with graft failure within a short time span and with low toxicity.
Adipsic hypernatremia without hypothalamic lesions accompanied by autoantibodies to subfornical organ
Authors: Hiyama Takeshi Y. , Utsunomiya Akari N. , Matsumoto Masahito , Fujikawa Akihiro , Lin Chia‐Hao , Hara Keiichi , Kagawa Reiko , Okada Satoshi , Kobayashi Masao , Ishikawa Mayumi , Anzo Makoto , Cho Hideo , Takayasu Shinobu , Nigawara Takeshi , Daimon Makoto , Sato Tomohiko , Terui Kiminori , Ito Etsuro , Noda Masaharu 
Published: June 2016

AbstractAdipsic (or essential) hypernatremia is a rare hypernatremia caused by a deficiency in thirst regulation and vasopressin release. In 2010, we reported a case in which autoantibodies targeting the sensory circumventricular organs (sCVOs) caused adipsic hypernatremia without hypothalamic structural lesions demonstrable by magnetic resonance imaging (MRI); sCVOs include the subfornical organ (SFO) and organum vasculosum of the lamina terminalis (OVLT), which are centers for the monitoring of body‐fluid conditions and the control of water and salt intakes, and harbor neurons innervating hypothalamic nuclei for vasopressin release. We herein report three newly identified patients (3‐ to 8‐year‐old girls on the first visit) with similar symptoms. The common features of the patients were extensive hypernatremia without any sensation of thirst and defects in vasopressin response to serum hypertonicity. Despite these features, we could not detect any hypothalamic structural lesions by MRI. Immunohistochemical analyses using the sera of the three patients revealed that antibodies specifically reactive to the mouse SFO were present in the sera of all cases; in one case, the antibodies also reacted with the mouse OVLT. The immunoglobulin (Ig) fraction of serum obtained from one patient was intravenously injected into wild‐type mice to determine whether the mice developed similar symptoms. Mice injected with a patient's Ig showed abnormalities in water/salt intake, vasopressin release, and diuresis, which resultantly developed hypernatremia. Prominent cell death and infiltration of reactive microglia was observed in the SFO of these mice. Thus, autoimmune destruction of the SFO may be the cause of the adipsic hypernatremia. This study provides a possible explanation for the pathogenesis of adipsic hypernatremia without demonstrable hypothalamus‐pituitary lesions.
A novel plasminogen activator inhibitor‐1 inhibitor, TM5441, protects against high‐fat diet‐induced obesity and adipocyte injury in mice
Authors: Piao Lingjuan , Jung Inji , Huh Joo Young , Miyata Toshio , Ha Hunjoo 
Published: June 2016

Background and PurposeObesity is one of the most prevalent chronic diseases worldwide, and dysregulated adipocyte function plays an important role in obesity‐associated metabolic disorder. The level of plasma plasminogen activator inhibitor‐1 (PAI‐1) is increased in obese subjects, and PAI‐1 null mice show improved insulin sensitivity when subjected to high‐fat and high‐sucrose diet‐induced metabolic stress, suggesting that a best‐in‐class PAI‐1 inhibitor may become a novel therapeutic agent for obesity‐associated metabolic syndrome. TM5441 is a novel orally active PAI‐1 inhibitor that does not cause bleeding episodes. Hence, in the present study we examined the preventive effect of TM5441 on high‐fat diet (HFD)‐induced adipocyte dysfunction.Experimental ApproachTen‐week‐old C57BL/6J mice were fed a normal diet (18% of total calories from fat) or HFD (60% of total calories from fat) for 10 weeks, and TM5441 (20 mg·kg−1 oral gavage) was administered daily with the initiation of HFD.Key ResultsTM5441 prevented HFD‐induced body weight gain and systemic insulin resistance. TM5441 normalized HFD‐induced dysregulated JNK and Akt phosphorylation, suggesting that it prevents the insulin resistance of adipocytes. TM5441 also attenuated the macrophage infiltration and increased expression of pro‐inflammatory cytokines, such as inducible nitric oxide synthase, induced by the HFD. In addition, TM5441 prevented the HFD‐induced down‐regulation of genes involved in mitochondrial biogenesis and function, suggesting that it may prevent adipocyte inflammation and dysregulation by maintaining mitochondrial fitness.Conclusion and ImplicationsOur data suggest that TM5441 may become a novel therapeutic agent for obesity and obesity‐related metabolic disorders.
Early Cretaceous origin of pollen‐feeding beetles (Insecta: Coleoptera: Oedemeridae)
Authors: Peris David 
Published: June 2016

AbstractThe taxonomic position of a new pollen‐feeding fossil beetle from Spanish amber (late Albian, 105 Ma) is analysed. A phylogenetic analysis allows me to accommodateDarwinylus marcosigen. et sp. nov. in the Polyphaga: Oedemeridae within current limits for the family, which clearly belongs in the subfamily Oedemerinae. It corresponds to the oldest definitive record for the family. Some autapomorphies, mainly in antennae, are observable in the fossil compared with extant members of the family. A discussion about these problematic characters and the evolution of the family is proposed.
Radiographic and histological evaluation of deproteinized bovine bone mineral vs. deproteinized bovine bone mineral with 10% collagen in ridge preservation. A randomized controlled clinical trial
Authors: Nart Jose , Barallat Lucía , Jimenez Daniel , Mestres Jaume , Gómez Alberto , Carrasco Miguel Angel , Violant Deborah , Ruíz‐Magaz Vanessa 
Published: June 2016

AbstractObjectivesThe aims of this randomized clinical trial were to compare the dimensional changes and the histological composition after using deproteinized bovine bone mineral (DBBM) or deproteinized bovine bone mineral with 10% collagen (DBBM‐C) and a collagen membrane in ridge preservation procedures.Material and methodsPatients who required an extraction and a subsequent implant‐supported rehabilitation at a non‐molar site were recruited. After extraction, a cone beam computed tomography (CBCT) was performed and sites were randomly treated either with DBBM or DBBM‐C plus a collagen membrane. At 5 months, before implant placement, a second CBCT was performed and a biopsy of the area was obtained. A blinded investigator superimposed the CBCTs and performed measurements to determine bone volume changes between the two time points. Additionally, a histomorphometric analysis of the biopsies was performed in a blinded manner.ResultsEleven sites belonged to the DBBM group and eleven to the DBBM‐C group. All together, a significant reduction in height and width was observed at 5 months of healing, but no statistically significant differences were observed between the DBBM and the DBBM‐C group. The histomorphometric analysis revealed a similar composition in terms of newly formed bone, connective tissue and residual graft particles in both groups.ConclusionsDeproteinized bovine bone mineral with 10% collagen showed a similar behaviour as DBBM not only in its capacity to minimize ridge contraction but also from a histological point of view. Thus, both graft materials seem to be suitable for ridge preservation procedures.
Embolization of the superior rectal arteries for chronic bleeding due to haemorrhoidal disease
Authors: Moussa N. , Sielezneff I. , Sapoval M. , Tradi F. , Del Giudice C. , Fathallah N. , Pellerin O. , Amouyal G. , Pereira H. , de Parades V. , Vidal V. 
Published: June 2016

AbstractAimThe aim of this study was to assess the safety and efficacy of the emborrhoid technique (embolization of the superior haemorrhoidal arteries) in patients ineligible for surgery.MethodsBetween January 2014 and April 2015, 30 consecutive patients (average age 58 years) suffering from disabling chronic bleeding due to haemorrhoidal disease and with a contraindication for surgery (n = 23) or with a failure of instrumental or surgical treatment (n = 7) underwent embolization. All cases were discussed at multidisciplinary meetings including a proctology specialist or a surgeon and an interventional radiologist. We performed super selective micro coil embolization (pushable 2–3 mm fibre coils) of the distal branches of the superior rectal arteries with a microcatheter, via a right femoral approach, under local anaesthesia. We assessed clinical outcome by evaluating bleeding and specific clinical scores relating to bleeding and changes in quality of life.ResultsImmediate technical success, with no complication, was achieved in 93% of cases. A mean of 3.1 arteries per patient was embolized, with a mean of 7.6 coils per patient. Median follow‐up was 5 months. Clinical score improvement was observed in 72%, in 17 patients after a single embolization session, and in four additional patients after a second embolization session. No improvement in bleeding was observed in eight patients (28%).ConclusionDistal coil embolization of the superior rectal arteries for disabling chronic bleeding due to haemorrhoidal disease is safe and effective in patients untreatable by surgery.
The role of the defaecating pouchogram in the assessment of evacuation difficulty after restorative proctocolectomy and pouch–anal anastomosis
Authors: Stellingwerf M. E. , Maeda Y. , Patel U. , Vaizey C. J. , Warusavitarne J. , Bemelman W. A. , Clark S. K. 
Published: June 2016

AbstractAimRestorative proctocolectomy (RPC) with ileal pouch–anal anastomosis (IPAA) is the most frequently performed operation for intractable ulcerative colitis (UC) and for many patients with familial adenomatous polyposis (FAP). It can be complicated by a functional evacuation difficulty, which is not well understood. We aimed to evaluate the role of defaecating pouchography in an attempt to assess the mechanism of evacuation difficulty in pouch patients.MethodAll RPC patients who had had a defaecating pouchogram for evacuation difficulty at one hospital between 2006 and 2014 were retrospectively reviewed. The findings and features were correlated with the symptoms. Demographic, clinical and radiological variables were analysed.ResultsEighty‐seven [55 (63%) female] patients aged 47.6 ± 12.5 years (mean standard ± SD) were identified. Thirty‐five had a mechanical outlet obstruction and 52 had no identified mechanical cause to explain the evacuation difficulty. The mean age of these 52 [33 (63%) female] patients was 48.2 ± 13 years. Of these 52 patients, significantly more used anti‐diarrhoeal medication (P = 0.029), complained of a high frequency of defaecation (P = 0.005), experienced a longer time to the initiation of defaecation (P = 0.049) and underwent pouchoscopy (P = 0.003). Biofeedback appeared to improve the symptoms in 7 of 16 patients with a nonmechanical defaecatory difficulty. The most common findings on defaecating pouchography included residual barium of more than 33% after an attempted evacuation (46%, n = 24), slow evacuation (35%, n = 18) and mucosal irregularity (33%, n = 17). Correlation between radiological features and symptoms showed a statistically significant relationship between straining, anal pain, incontinence and urgency with patterns of anismus or pelvic floor descent or weakness seen on the defaecating pouchogram. Symptoms of incomplete evacuation, difficulty in the initiation of defaecation, high defaecatory frequency and abdominal pain were not correlated with the radiological features of the pouchogram.ConclusionDefaecating pouchography may be useful for identifying anismus and pelvic floor disorders in pouch patients who have symptoms of straining, anal pain or incontinence. In patients with a high frequency of defaecation and abdominal pain it does not provide clinically meaningful information. Patients who complain of straining, incontinence, anal pain or urgency and have anismus or pelvic floor disorders may benefit from behavioural therapy.