bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distribution of lymph node metastases on FDG‐PET/CT in inoperable or unresectable oesophageal cancer patients and the impact on target volume definition in radiation therapy
Authors: Machiels Melanie , Wouterse Sanne J , Geijsen Elisabeth D , van Os Rob M , Bennink Roel J , van Laarhoven Hanneke WM , Hulshof Maarten CCM 
Published: May 2016

AbstractIntroductionDefinitive chemoradiotherapy (dCRT) is standard care for localised inoperable/unresectable oesophageal tumours. Many surgical series have reported on distribution of lymph node metastases (LNM) in resected patients. However, no data is available on the distribution of at‐risk LN regions in this more unfavourable patient group. This study aimed to determine the spread of LNM using FDG‐PET/CT, to compare it with the distribution in surgical series and to define its impact on the definition of elective LN irradiation (ENI).MethodsFDG‐PET/CT images of patients with oesophageal cancer treated with dCRT (from 2003 to 2013) were reviewed to identify the anatomic distribution of FDG‐avid LNs. Tumours were divided according to proximal, mid‐thoracic or distal localisation.ResultsAbout 105 consecutive patients entered analysis. The highest numbers of FDG‐avid LNs in proximal tumours were at LN station 101R (45%) and 106recL (35%). For mid‐thoracic tumours at 104R (30%) and 105 (30%). For tumours located in the distal oesophagus, the most common sites were along the lesser curvature of the stomach (21%) and the left gastric artery (21%). Except for the supraclavicular and pretracheal nodes, there were no positive locoregional LNM found outside the standard surgical resection area.ConclusionOur results show a good correlation between the distribution of nodal volumes at risk in surgical series and on FDG‐PET/CT. The results can be used to determine target definition in dCRT for oesophageal cancer. For mid‐thoracic tumours, the current target delineation guidelines may be extended based on the risk of node involvement, but more clinical studies are needed to determine if the potential harm of expanding the CTV outweighs the potential benefit.
What Is the Optimal Setting for a Continuous‐Flow Left Ventricular Assist Device in Severe Mitral Regurgitation?
Authors: Naito Noritsugu , Nishimura Takashi , Takewa Yoshiaki , Kishimoto Satoru , Date Kazuma , Umeki Akihide , Ando Masahiko , Ono Minoru , Tatsumi Eisuke 
Published: May 2016

AbstractExcessive left ventricular (LV) volume unloading can affect right ventricular (RV) function by causing a leftward shift of the interventricular septum in patients with mitral regurgitation (MR) receiving left ventricular assist device (LVAD) support. Optimal settings for the LVAD should be chosen to appropriately control the MR without causing RV dysfunction. In this study, we assessed the utility of our electrocardiogram‐synchronized rotational speed (RS) modulation system along with a continuous‐flow LVAD in a goat model of MR. We implanted EVAHEART devices after left thoracotomy in six adult goats weighing 66.4 ± 10.7 kg. Severe MR was induced through inflation of a temporary inferior vena cava filter placed within the mitral valve. We evaluated total flow (TF; the sum of aortic flow and pump flow [PF]), RV fractional area change (RVFAC) calculated by echocardiography, left atrial pressure (LAP), LV end‐diastolic pressure (LVEDP), LV end‐diastolic volume (LVEDV), and LV stroke work (LVSW) with a bypass rate (PF divided by TF) of 100% under four conditions: circuit‐clamp, continuous mode, co‐pulse mode (increased RS during systole), and counter‐pulse mode (increased RS during diastole). TF tended to be higher in the counter‐pulse mode. Moreover, RVFAC was significantly higher in the counter‐pulse mode than in the co‐pulse mode, whereas LAP was significantly lower in all driving modes than in the circuit‐clamp condition. Furthermore, LVEDP, LVEDV, and LVSW were significantly lower in the counter‐pulse mode than in the circuit‐clamp condition. The counter‐pulse mode of our RS modulation system used with a continuous‐flow LVAD may offer favorable control of MR while minimizing RV dysfunction.
Reduction of dietary lysine increases free glutamate content in chicken meat and improves its taste
Authors: Watanabe Genya , Kobayashi Hiroyuki , Shibata Masahiro , Kubota Masatoshi , Kadowaki Motoni , Fujimura Shinobu 
Published: May 2016

AbstractTaste is a crucial factor of meat quality, and amino acids are important taste‐active components in meat. Here, the effects of dietary lysine (Lys) content on taste‐active components in meat, especially free glutamate (Glu), were investigated. Twenty‐eight‐day‐old broilers (Gallus gallus) were fed diets with graded Lys content of 90% or 100% of the recommended Lys requirement, (according to the National Research Council, ) for 10 days. Free amino acid content in meat and sensory scores of meat soup were estimated. Free Glu content, the main taste‐active component of meat, was significantly increased by a reduction of dietary Lys. Compared with the Lys 100% group (control), free Glu concentrations of meat were increased by 35.7% in the Lys 90% group (P < 0.05). In addition, free glycine, valine, isoleucine, leucine, histidine and threonine concentrations of meat were significantly increased in the Lys 90% group (P < 0.05). Sensory evaluation of meat soup made from the Lys 100% and 90% groups indicated different meat tastes. Sensory scores of taste intensity, umami and kokumi tastes were significantly higher in the Lys 90% group. These results suggest that a reduction of dietary lysine increased free glutamate content in meat and improved its taste.
Parent and child psychopathological symptoms: the mediating role of parental emotion dysregulation
Authors: Han Zhuo Rachel , Lei Xuemei , Qian Jing , Li Peipei , Wang Hui , Zhang Xutong 
Published: May 2016

BackgroundParental psychopathological symptoms have been associated with a number of child psychological problems, yet little research has examined the role of parental emotion dysregulation on the intergenerational transmission of psychopathological symptoms. This study aims to examine the relationship between parents' and children's psychopathological symptoms with a focus on the mediating mechanism of parental emotion dysregulation on these relationships.MethodsEighty‐nine Chinese parents and their school‐age children between the ages of 7 and 12 (49 males,Mage = 8.79,SD = 1.81) participated in the study. In the initial phase of the study, parents filled out a series of questionnaires reporting their own psychopathological symptoms viaSCL‐90 and difficulties with emotion regulation via Difficulties in Emotion Regulation Scale. After 9 months, the parents reported their children's internalizing and externalizing problems via Child Behavior Checklist, and the children self‐reported anxiety symptoms via Screen for Child Anxiety Related Emotional Disorders in the second phase of the study.ResultsThe results showed that parental emotion dysregulation played an important role as a mediator of the relationship between parental psychopathological symptoms and child internalizing problems and separation anxiety, which indicates that parents' mental health problems were significantly associated with their difficulties with emotion regulation, which in turn led to more internalizing problems and separation anxiety in their children. However, we did not find a mediating effect of parental emotion dysregulation on the links between parent psychopathology and child externalizing problems or other types of self‐reported anxiety symptoms.ConclusionsOur findings highlighted the importance of implementing more psycho‐education programs that specifically target parents' emotion regulation abilities in both community and clinical settings to ameliorate the intergenerational transmission of psychopathological symptoms between generations.
Treatment with botulinum toxin in children with cerebral palsy: a qualitative study of parents' experiences
Authors: Lorin K. , Forsberg A. 
Published: May 2016

AbstractBackgroundIn children with cerebral palsy everyday movements such as walking, standing and using one's hands can be difficult to perform because of spasticity. Botulinum neurotoxin type A (BoNT‐A) are often used to reduce spasticity. The aim of this study was to describe how parents of children with cerebral palsy experienced the child's treatment with BoNT‐A, how the child was affected by the treatment and how spasticity affected the child.MethodsA qualitative study in which 15 parents of children (6–13 years old) with cerebral palsy were interviewed about their experiences of the BoNT‐A treatment. The children had received several BoNT‐A treatments. An interview guide was used with topics: the child's functions before and after the treatment, the outcomes of the treatment and how they valued the BoNT‐A treatment. Content analysis was used to analyse the interviews.ResultsThe analyses resulted in two themes: ‘When softness comes and goes’ and ‘Both want and do not want’. The reduction of spasticity – softness – was described to promote motor functions, and facilitate the next step in motor development. The children were described as being more active out of their own initiative and having a happier mood. Spasticity, described as stiffness, was described to make walking more strenuous as well as interfering with activities. The BoNT‐A injection procedure was perceived as troublesome and painful for the child, and sometimes traumatic for both children and parents.ConclusionsTreatment with BoNT‐A was described as facilitating motor development and activity. The children's and the parents' negative experiences of the injection procedure should be addressed.
Informal help from family support workers for families in France
Authors: Tillard Bernadette 
Published: May 2016

AbstractProviding educative help at home means that professionals have to enter into the intimacy of families and share daily tasks often for a long time. Family support workers spend many hours alongside parents, helping them with their domestic and parenting tasks. This paper reports findings from an ethnographic study in which the researcher notes and gathers personal accounts relating to material and non‐material exchanges between professionals and parents. It analyses the various forms of exchanges between families and family support workers that are permitted, tolerated or excluded by employers. It shows the informal side of professionals working with parents at home.
The role of interventional sialendoscopy and intraductal steroid therapy in patients with recurrent sine causa sialadenitis: a prospective cross‐sectional study
Authors: Capaccio P. , Torretta S. , Di Pasquale D. , Rossi V. , Pignataro L. 
Published: May 2016

ObjectivesTo verify the role of interventional sialendoscopy and steroidal ductal irrigation in patients with recurrent sialadenitis.DesignA prospective, cross‐sectional pilot study.SettingUniversity of Milan.ParticipantsFifty‐four patients with sine causa recurrent sialadenitis who underwent interventional sialendoscopy (group A, 36 patients) or interventional sialendoscopy followed by a intraductal steroidal irrigations (group B, 18 patients).Main outcomes measuresThe number of episodes of sialadenitis three and 6 months before and after sialendoscopy, and their severity assessed by means of a 0–10 pain visual analogue scale.ResultsIn the population as a whole, a significant post‐treatment reduction in the number of episodes of 30.7 ± 5.5 after 3 months and 34.6 ± 10.2 after 6 months (P < 0.001) and a significant reduction in pain visual analogue scale values of 4.7 ± 0.4 after 6 months (P < 0.001) occurred. There was a statistically significant reduction in both parameters at the same time points in both treatment groups (P ≥ 0.001), with no significant between‐group difference in pain visual analogue scale values, an albeit non‐significant trend in favour of group B in terms of the number of episodes 3 months after therapy that became significant after 6 months (11.0 ± 9.9 versus 20.5 ± 9.5; P = 0.05).ConclusionsInterventional sialendoscopy is effective for the treatment of recurrent sialadenitis; the addition of intraductal steroidal irrigations seems to increase its value in the medium term. Further studies of larger case series with longer follow‐up are needed to establish the possibly primary role of steroid therapy in blocking inflammation.
Effectiveness of percutaneous tibial nerve stimulation in managing refractory constipation
Authors: Kumar L. , Liwanag J. , Athanasakos E. , Raeburn A. , Zarate‐Lopez N. , Emmanuel A. V. 
Published: May 2016

AbstractAimChronic constipation can be aetiopathogenically classified into slow transit constipation (STC), rectal evacuation difficulty (RED) or a combination (BOTH). Although the efficacy of percutaneous tibial nerve stimulation (PTNS) in faecal incontinence has been well proved, a current literature search identifies only one study which assessed its effect on constipation. We aimed to evaluate the effectiveness of PTNS in patients with different causes of constipation.MethodThirty‐four patients [30 women, median age 50 (20−79) years] with constipation who had previously failed maximal laxative and biofeedback therapy participated in the study. All patients underwent a baseline radio‐opaque marker transit study and anorectal physiology examination. All had 12 sessions of PTNS of 30 min per session. A fall in the Wexner constipation score to ≤15 or by ≥5 points was taken as the primary outcome. Secondary outcomes included the results of pre‐ and post‐ PTNS transit and anorectal physiology studies.ResultsEleven patients had STC, 14 had RED and nine had BOTH. A response was seen in four patients (1/11 STC, 2/14 RED and 1/9 BOTH). Comparing pre‐ and post‐ PTNS, there was no significant change in the mean Wexner score (P = 0.10). There was no change in colonic transit time among the whole population (P = 0.56) or among those with STC (P = 0.47). There was no improvement in balloon expulsion in the whole group (P = 0.73) or in patients with RED (P = 0.69).ConclusionPTNS is of no benefit to patients with constipation, whatever aetiopathogenic mechanism is responsible for the symptoms.
The role of learning in social development: Illustrations from neglected children
Authors: Wismer Fries Alison B. , Pollak Seth D. 
Published: May 2016

AbstractChildren who experience early caregiving neglect are very likely to have problems developing and maintaining relationships and regulating their social behavior. One of the earliest manifestations of this problem is reflected in indiscriminate behavior, a phenomenon where young children do not show normative wariness of strangers or use familiar adults as sources of security. To better understand the developmental mechanisms underlying the emergence of these problems, this study examined whether institutionally reared children, who experienced early social neglect, had difficulty associating motivational significance to visual stimuli. Pairing stimuli with motivational significance is presumably one of the associative learning processes involved in establishing discriminate or selective relationships with others. We found that early experiences of neglectful caregiving were associated with difficulties in acquiring such associations, and that delays in this developmental skill were related to children's social difficulties. These data suggest a way in which early social learning experiences may impact the development of processes underlying emotional development.
Five‐year extended follow‐up status of 10 patients with Dravet syndrome treated with fenfluramine
Authors: Ceulemans Berten , Schoonjans An‐Sofie , Marchau Fabienne , Paelinck Bernard P. , Lagae Lieven 
Published: May 2016

SummaryDravet syndrome (DS) is a rare and therapy‐resistant epilepsy syndrome. A retrospective analysis of add‐on fenfluramine treatment in 12 patients with DS was published in 2012 and provided evidence of a meaningful long‐term response. Herein we present the results of a subsequent 5‐year prospective observation of this original cohort. Ten patients with a mean current age of 24 years were followed prospectively from 2010 until 2014. The mean current dose of fenfluramine was 0.27 mg/kg/day, with a mean treatment duration of 16.1 years. Seizure frequency was derived from a seizure diary. Cardiac examinations and assessments of clinical effectiveness and adverse events were performed at least annually. Three patients were seizure‐free for the entire 5 years, and an additional four patients experienced seizure‐free intervals of at least 2 years. Fenfluramine was generally well‐tolerated. Two patients had mild (stable) valve thickening on the last echocardiography that was deemed clinically insignificant. No patient had any clinical or echocardiographic signs of pulmonary hypertension. These findings support the long‐term control of convulsive seizures by low‐dose fenfluramine while being well tolerated in this cohort of patients with DS. After up to 27 years of treatment, no patient has developed any clinical signs or symptoms of cardiac valvulopathy or pulmonary hypertension.
Frontal fibrosing alopecia: reflections and hypotheses on aetiology and pathogenesis
Authors: Tziotzios Christos , Stefanato Catherine M. , Fenton David A. , Simpson Michael A. , McGrath John A. 
Published: May 2016

AbstractSince first described by Kossard in 1994, frontal fibrosing alopecia (FFA) has been something of an enigma. The clinical heterogeneity of FFA, its apparent rarity and investigators' suboptimal access to phenotypically consistent patient cohorts may all have had a negative impact on delineating disease pathogenesis. Moreover, there is a relative paucity of epidemiological, interventional and basic research studies, and there have been no advances in translational therapeutics, unlike for other inflammatory dermatoses, such as alopecia areata (AA). Dermatologists anecdotally describe an increasing incidence in FFA over the last decade, which has led to the notion that the disorder may be induced by unknown environmental triggers. On the other hand, segregation of FFA in some families lends support to an unexplored genetic element implicated in disease pathogenesis. We herein review what is known about the pathobiology of FFA and formulate working hypotheses to advance insight into this intriguing hair disorder.
A fracture mechanics based model for the analysis of seal effectiveness
Authors: Brighenti R. , Artoni F. 
Published: May 2016

AbstractThe fluid containment in vessels, pipes, containers, etc. often requires the use of seals in order to assure the absence of leak in the junction zones. Sealing mechanism is typically achieved through the use of elastomeric elements that form contact with the surrounding rigid materials the containers are made of. A proper design and safety evaluation of the containment capacity of seals requires the careful evaluation of the contact pressure distribution between the soft (seal) and hard (vessel) elements. In the present paper such a problem is considered and solved through contact stress and strain evaluation based on fracture mechanics; numerical and experimental analyses on elastomeric elements are considered in order to verify the proposed modeling procedure. It is shown that the desired safety level against leakage can be ensured on the basis of the classical fracture mechanics parameters when the seal crack tip exists, or through contact strain assessment when the stress singularity vanishes. Such results can be useful in the design of seal shapes and for estimating the pressure to be applied to the sealed bodies in order to guarantee no leaks. Finally, some final relevant conclusions on the present study on leak containment are drawn.
An extrapolation method to determine the effective notch stress in circular hollow section X‐joints
Authors: Pradana M. R. , Qian X. , Swaddiwudhipong S. , Shen W. 
Published: May 2016

AbstractThis paper presents an extrapolation method to determine the effective notch stress (ENS) on the weld toes of welded circular hollow section (CHS) X‐joints in‐line with the extrapolation method to determine the structural hot‐spot stress in existing design guidelines. This investigation verifies and extends the recently proposed ENS extrapolation scheme to CHS X‐joints, which elevates significantly the difficulty in generating a weld toe radius along the brace‐to‐chord intersection as required in existing guidelines. An extensive numerical study then investigates the ENS extrapolation for CHS X‐joints under three loading conditions, namely, the brace axial load, the brace in‐plane bending load, and the brace out‐of‐plane bending load. The numerical study derives a set of recommended extrapolation parameters that ensures accurate ENS estimation for each loading condition. This paper demonstrates that the proposed extrapolation method for the CHS X‐joints yields good agreement with the standard ENS calculation procedure described in the International Institute of Welding (IIW) guideline.
Association of low back and knee pain with falls in Japanese community‐dwelling older adults: A 3‐year prospective cohort study
Authors: Kitayuguchi Jun , Kamada Masamitsu , Inoue Shigeru , Kamioka Hiroharu , Abe Takafumi , Okada Shimpei , Mutoh Yoshiteru 
Published: May 2016

AbstractAimTo examine whether the chronicity and intensity of low back pain (LBP) or knee pain (KP) was associated with the occurrence of falls among a community‐dwelling older population.MethodsThis was a community‐based 3‐year prospective cohort study. In 2009, baseline questionnaires were mailed to 3080 randomly selected residents aged 60–79 years; 2534 residents (82.3%) responded to the baseline survey, and 1‐ and 3‐year follow‐up surveys were subsequently mailed to them. The data for 1890 respondents who had no falls in the past year at baseline were analyzed. Associations between pain status (chronicity, intensity and persistence) and the occurrence of falls were analyzed by multivariable‐adjusted logistic regression.ResultsA total of 197 (13.6%) participants had at least one fall during 12 months at 3‐year follow up; of those, 68 (4.8%) had multiple falls, and 65 (4.5%) resulted in an injury. Chronicity and intensity of LBP were associated with injurious falls (P for trend = 0.033 and P for linearity = 0.041, respectively), and KP was associated with at least one fall (P for trend = 0.021 and P for linearity = 0.040, respectively). In addition, participants who had chronic pain persistently at both baseline and 1‐year follow up had a higher risk of falls (LBP for injurious falls; adjusted odd ratio 2.46, 95% confidence interval 1.08–5.63, KP for at least one fall; adjusted odd ratio 2.39, 95% confidence interval 1.29–4.44), compared with those who had no pain at both time‐points.ConclusionsLBP and KP chronicity, intensity and persistence of chronic pain were associated with a greater risk of falls in older adults. Geriatr Gerontol Int 2017; 17: 875–884.