bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health professional students' rural placement satisfaction and rural practice intentions: A national cross‐sectional survey
Authors: Smith Tony , Sutton Keith , Pit Sabrina , Muyambi Kuda , Terry Daniel , Farthing Annie , Courtney Claire , Cross Merylin 
Published: August 2017

AbstractObjectiveThe aim of this study was to profile students undertaking placements at University Departments of Rural Health (UDRHs) and investigate factors affecting students' satisfaction and intention to enter rural practice.DesignCross‐sectional survey comprising 21 core questions used by all UDRHs.SettingEleven UDRHs across Australia that support students' placements in regional, rural and remote locations.ParticipantsMedical, nursing and allied health students who participated in UDRH placements between July 2014 and November 2015 and completed the questionnaire.Main outcome measuresKey dependent variables were placement satisfaction and rural practice intention. Descriptive variables were age, gender, Aboriginal or Torres Strait Islander (ATSI) background, location of placement, healthcare discipline, year of study and type and length of placement.ResultsA total of 3328 students responded. The sample was predominantly female (79%), the mean age was 26.0 years and 1.8% identified as ATSI. Most placements (69%) were >2 but ≤12 weeks, 80% were in Modified Monash 3, 4 or 5 geographical locations. Public hospitals and community health made up 63% of placements. Students satisfied with their placement had 2.33 higher odds of rural practice intention. Those satisfied with Indigenous cultural training, workplace supervision, access to education resources and accommodation had higher odds of overall satisfaction and post‐placement rural practice intention.ConclusionsThe majority of students were highly satisfied with their placement and the support provided by rural clinicians and the UDRHs. UDRHs are well placed to provide health professional students with highly satisfactory placements that foster rural practice intention.
Fertility preservation in women with borderline ovarian tumors – how does it impact disease outcome? A cohort study
Authors: Helpman Limor , Yaniv Assaf , Beiner Mario E. , Aviel‐Ronen Sarit , Perri Tamar , Ben‐Baruch Gilad , Hogen Ben‐David Liat , Jakobson‐Setton Ariella , Korach Jacob 
Published: August 2017

AbstractIntroductionBorderline ovarian tumors are typically indolent neoplasms. Since many are diagnosed in younger women, fertility conservation is an important consideration and has been advocated based on retrospective data. The objective of this study was to identify features impacting on recurrence and survival in a series of borderline ovarian tumors, and to assess the safety of a fertility‐sparing approach.Material and methodsA historical cohort study of consecutive borderline ovarian tumors cases treated at a single institution over 30 years (1981–2011). Data on surgical approach (fertility‐sparing or otherwise), disease stage, CA125 levels, histological features, adjuvant treatment and follow‐up data were collected. Recurrence and survival were assessed using the Kaplan–Meier method and associations with the variables of interest were evaluated using a multivariate Cox proportional hazards model.Results213 patients were included. Of 132 women age 40 years and below at diagnosis, 112 (85%) had a fertility‐sparing procedure and 60 (46%) had conservation of an involved ovary. Fifty patients (24%) developed recurrences; fertility preservation (hazard ratio = 2.57; 95% confidence interval 1.1–6; p = 0.029) and advanced stage (hazard ratio = 4.15; 95% confidence interval 2.3–7.6; p < 0.001) were independently associated with recurrence on multivariate analysis. Eleven (5%) patients died of their disease. Fertility preservation was not associated with compromised survival.ConclusionsBorderline ovarian tumors carry a good prognosis overall. Fertility preservation is associated with a higher risk of disease relapse; however, as most relapses are localized and may be salvaged with surgical treatment, overall survival is not compromised.
Clusters of week‐specific maternal gestational weight gain pattern and their association with birthweight: an observational cohort study
Authors: Liang Huan , Yin Chuanmin , Dong Xinran , Acharya Ganesh , Li Xiaotian 
Published: August 2017

AbstractIntroductionGestational weight gain varies widely among different populations, and an inappropriate gestational weight gain is associated with adverse pregnancy outcomes. We aimed to investigate week‐specific serial changes in gestational weight gain in an urban Chinese population to derive clusters of gestational weight gain patterns and explore the impact of gestational weight gain patterns on birthweight.Material and methodsThis was an observational cohort study of 6130 women delivered at a university hospital in Shanghai, China. Pre‐pregnancy bodyweight, height, week‐specific and total gestational weight gain, pregnancy outcome and birthweight were extracted using electronic medical records. The association between gestational weight gain and gestational age was tested using linear regression, and week‐specific reference percentiles for gestational weight gain were calculated. Hierarchical clustering was used to derive gestational weight gain clusters. Mean birthweight among the clusters was compared using Dunnet's test.ResultsWe found a significant linear association between gestational weight gain and gestational age (r = 0.56; p < 0.00001). Seven distinct clusters of gestational weight gain pattern were identified. The birthweight significantly correlated with gestational weight gain (r = 0.28; p < 0.00001). Compared with the cluster that had normal gestational weight gain throughout the pregnancy, the mean birthweight among the clusters that had abnormal gestational weight gain (inadequate or excessive) in the third trimester was significantly different (p < 0.001), but those who achieved normal gestational weight gain (between 5 and 95 percentile) in the third‐trimester had similar mean birthweight.ConclusionWomen with abnormal gestational weight gain before the third‐trimester still had a fair chance of delivering a normal birthweight baby if their gestational weight gain was normal in the third‐trimester, suggesting that interventions started even late in pregnancy may have a positive effect on fetal growth.
Systematic review with meta‐analysis: enteral nutrition therapy for the induction of remission in paediatric Crohn's disease
Authors: Swaminath A. , Feathers A. , Ananthakrishnan A. N. , Falzon L. , Li Ferry S. 
Published: August 2017

AbstractBackgroundDespite potential adverse‐events in a paediatric population, corticosteroids are used to induce remission in paediatric Crohn's disease. Exclusive enteral nutrition also induces remission, but is infrequently used in the USA because corticosteroids are considered the superior therapy. New data have become available since the publication of the most recent meta‐analysis in 2007.AimTo see if current literature supports the use of EEN versus CS in paediatric populations.MethodsAll studies with comparator arms of exclusive enteral nutrition and an exclusive corticosteroids, with remission clearly defined were identified by searching eight online databases.ResultsOf 2795 identified sources, nine studies met our inclusion criteria. Eight of these (n = 451), had data that could be abstracted into our meta‐analysis. Exclusive enteral nutrition was as effective as corticosteroids in inducing remission (OR = 1.26 [95% CI 0.77, 2.05]) in paediatric Crohn's disease. There was no difference between Exclusive enteral nutrition and corticosteroids efficacy when comparing newly diagnosed Crohn's (OR = 1.61 [95% CI .87, 2.98]) or relapsed (OR = 0.76 [95% CI .29‐1.98]). Intestinal healing was significantly more likely among patients receiving Exclusive enteral nutrition compared to corticosteroids (OR = 4.5 [95% CI 1.64, 12.32]). There was no difference in the frequency of biomarker normalisation including CRP (OR = 0.85 [95% CI .44, 1.67]) and faecal calprotectin (OR 2.79 [95% CI .79‐10.90]).ConclusionsThere is no difference in efficacy between exclusive enteral nutrition and corticosteroids in induction of remission in Crohn's disease in a paediatric population. Exploratory analyses suggest that a greater proportion of patients treated with exclusive enteral nutrition achieved mucosal healing.
Lenalidomide as second‐line therapy for advanced hepatocellular carcinoma: exploration of biomarkers for treatment efficacy
Authors: Shao Y.‐Y. , Chen B.‐B. , Ou D.‐L. , Lin Z.‐Z. , Hsu C.‐H. , Wang M.‐J. , Cheng A.‐L. , Hsu C. 
Published: August 2017

AbstractBackgroundLenalidomide has immunomodulatory and anti‐angiogenic effects and showed moderate anti‐tumour efficacy in patients with. advanced hepatocellular carcinoma (HCC)AimTo explore potential biomarkers of lenalidomide efficacy as second‐line therapy for HCC.MethodsEligible patients were diagnosed with advanced HCC, documented progression on sorafenib, and Child‐Pugh class A liver function. Patients received 25 mg/day lenalidomide orally on days 1‐21 every 4 weeks. The primary endpoint was 6 month progression‐free survival rate. Early α‐fetoprotein response was defined as a > 20% decline of α‐fetoprotein levels from baseline within the first 4 weeks of treatment. Vascular response, evaluated using dynamic contrast‐enhanced magnetic resonance imaging, was defined as a > 40% decline in Ktrans after 2 weeks of treatment. The percentage of peripheral blood lymphocyte subsets were also analysed.ResultsFifty‐five patients were enrolled. The response rate was 13%, and the disease‐control rate was 53%. The 6 month progression‐free survival rate was 9.1%. The median progression‐free and overall survival was 1.8 months and 8.9 months respectively. Early α‐fetoprotein response was significantly associated with higher disease‐control rate (76% vs 22%, P = .001) and longer progression‐free survival (P = .020). Vascular response was not associated with any treatment outcomes. Patients with a high pre‐treatment B cell percentage were more likely to have disease control (70% vs 36%, P = .010) and exhibited longer progression‐free survival (P < .001) and overall survival (P = .042).ConclusionsLenalidomide exhibited moderate activity as second‐line therapy for advanced HCC. Its immunomodulatory effects should be further explored (www.clinicaltrials.gov NCT01545804).
Thinning affects understorey tree community assembly in monoculture plantations by facilitating stochastic immigration from the landscape
Authors: Kitagawa Ryo , Ueno Mitsuru , Masaki Takashi 
Published: August 2017

AbstractAimTo maintain biodiversity in plantation forest ecosystems it is important to understand the community assembly process. Canopy thinning effectively increases understorey diversity in plantation forests. However, the process of understorey community assembly after canopy thinning remains unclear. We compared the relative importance of two mechanisms that could affect the assembly of understorey woody communities after thinning: (1) environmental filtering due to competition from canopy trees, and (2) stochastic immigration. If the latter is dominant, the effectiveness of local treatment might be unpredictable because of the variable probability of immigration at each location.LocationYamagata Prefecture, Japan.MethodsWe censused the understorey tree communities in 18 quadrats (each 1 m × 1 m) in each of 49 stands of Japanese cedar plantations. The mean species richness of the 18 quadrats (alpha‐diversity), variation in community composition among them (beta‐diversity), deviation of beta‐diversity from that of a random community (beta‐deviation) and total species richness of the plots (gamma‐diversity) were compared among censuses (before thinning, 2 and 5 yr after thinning). The relative contributions of two explanatory variables to the various diversities were examined: (1) basal area of canopy trees (overstorey BA, an index of environmental filtering), and (2) available seed source in the surrounding landscape (landscape effect; an index of the probability of immigration).ResultsAlthough neither beta‐diversity nor gamma‐diversity changed throughout the censuses, the alpha‐diversity, stem abundance and beta‐deviation were affected by thinning. beta‐deviation increased after thinning. Overstorey BA limited alpha‐ and gamma‐diversity throughout the censuses. The landscape effect was more significant in terms of beta‐deviation after than before thinning. In addition, the effective scale of the landscape effect increased after thinning.ConclusionOur results indicate that both processes are important: thinning brought about an increase in the relative importance of stochastic immigration as well as a reduction in competitive pressure from canopy trees. These results suggest that while local treatment can increase understorey diversity, stochastic immigration from seed sources is the direct driver after thinning. Although local treatment is effective, its efficiency depends on the seed source availability in the surrounding landscape.
Medication adherence in patients with apparent resistant hypertension: findings from the SYMPATHY trial
Authors: de Jager Rosa L. , van Maarseveen Erik M. , Bots Michiel L. , Blankestijn Peter J. ,   on behalf of the SYMPATHY investigators
Published: August 2017

AimsHypertension is only controlled in approximately 35% of the patients, which could be partially due to nonadherence. Recently, bioanalytical assessment of adherence to blood pressure (BP) lowering drugs has gaining interest. Our aim was to explore possible determinants of nonadherence in treatment resistant hypertension, assessed by objective screening for antihypertensive agents in serum. The secondary aim was to study the effect of adherence on the change in BP.MethodsThis project was a substudy of SYMPATHY; an open‐label randomized‐controlled trial to assess the effect of renal denervation on BP 6 months after treatment compared to usual care in patients with resistant hypertension. Stored serum samples were screened for antihypertensive agents to assess adherence at baseline and 6 months after intervention, using liquid chromatography–tandem mass spectrometry. Office and 24‐h BP were measured on the same day as blood was sampled. Patients and physicians were unaware of adherence measurements.ResultsNinety‐eight baseline and 83 6‐month samples were available for analysis. Sixty‐eight percent [95% confidence interval (CI) 59–78%] of the patients was nonadherent (n = 67). For every onw pill more prescribed, 0.785 [95%CI 0.529–0.891] prescribed pill was less detected in blood. A decrease of one pill in adherence between baseline and 6 months was associated with a significant rise in office systolic BP of 4 (95%CI 0.230–8.932) mmHg.ConclusionObjective measurement of BP lowering drugs in serum, as a tool to assess adherence, showed that nonadherence was very common in patients with apparent resistant hypertension. Furthermore, the assessment results were related to (changes in) blood pressure. Our findings provide direct and objective methodology to help the physician to understand and to improve the condition of apparent resistant hypertension.
Protective Effect of Atazanavir Sulphate Against Pulmonary FibrosisIn VivoandIn Vitro
Authors: Song Shina , Ji Yunxia , Zhang Guanghua , Zhang Xue , Li Bin , Li Defang , Jiang Wanglin 
Published: August 2017

AbstractAtazanavir sulphate, an antiretroviral protease inhibitor, has been used to treatHIV/AIDS, but its ability to serve as an antipulmonary fibrosis (PF) agent remains unknown. In this study, the effects of atazanavir sulphate on various aspects ofPFwere examined and CoCl2was used to induce the hypoxia‐mimicking conditionin vitro, including epithelial–mesenchymal transition (EMT) in A549 cells, endothelial–mesenchymal transition (EndMT) in human pulmonary microvascular endothelial cells (HPMECs), proliferation in human lung fibroblasts (HLF‐1) and potential protective effects in human type I alveolar epithelial cells (ATI). Additionally, the effects of atazanavir sulphate were examined using a bleomycin (BLM)‐induced pulmonary fibrosis model. After atazanavir sulphate treatment, in A549 cells andHPMECs, the expression of vimentin,HMGB1, Toll‐like receptor 4 (TLR‐4) and p‐NF‐κB decreased, while the expression of E‐cadherin andVE‐cadherin increased. InATI cells, the expression of aquaporin 5 andRAGEwere increased after atazanavir treatment. Proliferation ofHLF‐1 was reduced after atazanavir treatment, meanwhile the expression of hypoxia‐inducible factor‐1α (HIF‐1α), prolyl hydroxylase domain protein 2 (PHD‐2),HMGB1,TLR‐9, p‐NF‐κB, collagen I and collagenIIIwas decreased. In theBLM‐induced pulmonary fibrosis rat model, atazanavir sulphate amelioratedPFby reducing pathological score, collagen deposition and the expression of α‐SMA,HIF‐1α,PHD‐2,HMGB1,TLR‐4,TLR‐9 and p‐NF‐κB. In summary, our study supports the proposal that atazanavir sulphate may have a therapeutic potential in reducing the progression of pulmonary fibrosis by suppressingHMGB1/TLRsignalling.
Discovery of naphthyl‐N‐acylhydrazone p38α MAPK inhibitors with in vivo anti‐inflammatory and anti‐TNF‐α activity
Authors: Freitas Rosana H. C. N. , Cordeiro Natália M. , Carvalho Patrícia R. , Alves Marina A. , Guedes Isabella A. , Valerio Tayna S. , Dardenne Laurent E. , Lima Lídia M. , Barreiro Eliezer J. , Fernandes Patrícia D. , Fraga Carlos A. M. 
Published: August 2017

Protein kinases constitute attractive therapeutic targets for development of new prototypes to treat different chronic diseases. Several available drugs, like tinibs, are tyrosine kinase inhibitors; meanwhile, inhibitors of serine/threonine kinases, such as mitogen‐activated protein kinase (MAPK), are still trying to overcome some problems in one of the steps of clinical development to become drugs. So, here we reported the synthesis, the in vitro kinase inhibitory profile, docking studies, and the evaluation of anti‐inflammatory profile of new naphthyl‐N‐acylhydrazone derivatives using animal models. Although all tested compounds (3a–d) have been characterized as p38α MAPK inhibitors and have showed in vivo anti‐inflammatory action, LASSBio‐1824 (3b) presented the best performance as p38α MAPK inhibitor, with IC50 = 4.45 μm, and also demonstrated to be the most promising anti‐inflammatory prototype, with good in vivo anti‐TNF‐α profile after oral administration.
Effectiveness of oral health education on oral hygiene and dental caries in schoolchildren: Systematic review and meta‐analysis
Authors: Stein Caroline , Santos Nathália Maria Lopes , Hilgert Juliana Balbinot , Hugo Fernando Neves 
Published: August 2017

AbstractObjectivesThe objective of this study was to evaluate the effectiveness of oral health educational actions in the school context in improving oral hygiene and dental caries in schoolchildren through systematic review and meta‐analysis.MethodsClinical trials with schoolchildren between 5 and 18 years old were included. Eligible studies were those which had as outcomes caries, plaque accumulation, gingivitis, toothache or tooth loss and which had been published from 1995 to 2015, in any language. The risk of bias was assessed in specific domains according to the Cochrane Handbook. A meta‐analysis was carried out using fixed‐effects models.ResultsA total of 4417 references were found, from which 93 full texts were evaluated and 12 included in this meta‐analysis. Five studies showed a reduction in plaque levels, and two studies with gingivitis as the outcome found no effect. There was not enough evidence on the effectiveness of the interventions in reducing dental caries.ConclusionsTraditional oral health educational actions were effective in reducing plaque, but not gingivitis. There is no long‐term evidence in respect of the effectiveness of these interventions in preventing plaque accumulation, gingivitis and dental caries in the school environment.
Tree Growth Modelling Constrained by Growth Equations
Authors: Yi Lei , Li Hongjun , Guo Jianwei , Deussen Oliver , Zhang Xiaopeng 
Published: August 2017

AbstractModelling and simulation of tree growth that is faithful to the living environment and numerically consistent to botanic knowledge are important topics for realistic modelling in computer graphics. The realism factors concerned include the effects of complex environment on tree growth and the reliability of the simulation in botanical research, such as horticulture and agriculture. This paper proposes a new approach, namely, integrated growth modelling, to model virtual trees and simulate their growth by enforcing constraints of environmental resources and tree morphological properties. Morphological properties are integrated into a growth equation with different parameters specified in the simulation, including its sensitivity to light, allocation and usage of received resources and effects on its environment. The growth equation guarantees that the simulation procedure numerically matches the natural growth phenomenon of trees. With this technique, the growth procedures of diverse and realistic trees can also be modelled in different environments, such as resource competition among multiple trees.
Traps and transformations influencing the financial viability of tourism on private‐land conservation areas
Authors: Clements Hayley S. , Cumming Graeme S. 
Published: August 2017

AbstractThe ability of private conservation organizations to remain financially viable is a key factor influencing their effectiveness. One‐third of financially motivated private‐land conservation areas (PLCAs) surveyed in South Africa are unprofitable, raising questions about landowners’ abilities to effectively adapt their business models to the socioeconomic environment. In any complex system, options for later adaptation can be constrained by starting conditions (path dependence). We tested 3 hypothesized drivers of path dependence in PLCA ecotourism and hunting business models: (H1) the initial size of a PLCA limits the number of mammalian game and thereby predators that can be sustained; (H2) initial investments in infrastructure limit the ability to introduce predators; and (H3) rainfall limits game and predator abundance. We further assessed how managing for financial stability (optimized game stocking) or ecological sustainability (allowing game to fluctuate with environmental conditions) influenced the ability to overcome path dependence. A mechanistic PLCA model based on simple ecological and financial rules was run for different initial conditions and management strategies, simulating landowner options for adapting their business model annually. Despite attempts by simulated landowners to increase profits, adopted business models after 13 years were differentiated by initial land and infrastructural assets, supporting H1 and H2. A conservation organization's initial assets can cause it to become locked into a financially vulnerable business model. In our 50‐year simulation, path dependence was overcome by fewer of the landowners who facilitated natural ecological variability than those who maintained constant hunting rates and predator numbers, but the latter experienced unsustainably high game densities in low rainfall years. Management for natural variability supported long‐term ecological sustainability but not shorter term socioeconomic sustainability for PLCAs. Our findings highlight trade‐offs between ecological and economic sustainability and suggest a role for governmental support of the private conservation industry.