bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mucin‐rich variant of traditional serrated adenoma: a distinct morphological variant
Authors: N Kalimuthu Sangeetha , Serra Stefano , Hafezi‐Bakhtiari Sara , Colling Richard , Wang Lai Mun , Chetty Runjan 
Published: March 2017

AimsTraditional serrated adenomas (TSAs) account for 5% of serrated polyps, and have a villiform architecture, eosinophilic cells with a brush border, and indented, flat‐topped luminal serrations. However, some are composed of mucin‐filled goblet cells (GCs): mucin‐rich TSA (MrTSA). The aim of this study was to determine whether this variant has unique features as compared with classic TSA (cTSA).Methods and resultsOne hundred and fifty‐six TSAs were retrieved from the period 2010–2016. Patient demographics, site of polyps and 16 microscopic variables were evaluated. TSAs containing ≥50% GCs were classified as MrTSAs. Ectopic crypt foci (ECFs) were quantified as low (1–10) or high (>10), counted at ×200 magnification, and the average was taken for 10 fields. Twenty‐four fulfilled the criteria for MrTSA. In males, MrTSAs (65%) were more prevalent than cTSAs (55%). There was no age difference, and both variants had a predilection for the left colon, although, in the right colon, MrTSAs were more frequent (39%) than cTSAs (10%) (P = 0.012). Adenomatous dysplasia was present in four of 24 MrTSAs (low grade, 3; high grade, 1). The most distinctive features of MrTSAs were: a variable growth pattern [endophytic (9%), mixed (30%), or villiform/exophytic (61%)], and a lower frequency of ECFs (P = 0.001) and more intraepithelial lymphocytes (P < 0.05) than in cTSAs. MrTSAs retain characteristic luminal serrations, at least focally. Inflamed MrTSAs can mimic inflammatory polyps and hamartomatous polyps (when there are >95% GCs).ConclusionsMrTSA is characterized by >50% GCs, and fewer ECFs than cTSA, but with preservation of archetypal luminal serrations. Awareness of this variant will prevent misdiagnosis, given the association of TSA with the accelerated pathway to colorectal cancer.
High prevalence of willingness to use direct‐acting antiviral‐based regimens for hepatitis C virus (HCV) infection among HIV/HCV coinfected people who use drugs
Authors: Socías ME , Ti L , Dong H , Shoveller J , Kerr T , Montaner J , Milloy M‐J 
Published: March 2017

ObjectivesDespite the high burden of hepatitis C virus (HCV)‐related morbidity and mortality among HIV‐positive people who use illicit drugs (PWUD), uptake of interferon‐based treatments for HCV infection has been negligible among this group. Direct‐acting antiviral (DAA) therapies offer an opportunity to expand treatment access among this population. The aim of this study was to explore willingness to use DAA‐based regimens among HIV/HCV‐coinfected PWUD in Vancouver, Canada.MethodsData were drawn from the AIDS Care Cohort to evaluate Exposure to Survival Services (ACCESS), a prospective cohort of HIV‐positive PWUD. Using logistic regression analyses, we investigated factors associated with willingness to use DAA‐based regimens among HIV/HCV‐coinfected participants.ResultsOf 418 HIV/HCV‐coinfected PWUD surveyed between June 2014 and May 2015, 295 (71%) were willing to use DAA‐based regimens. In multivariable analysis, participants enrolled in methadone maintenance therapy [adjusted odds ratio (AOR) 1.61; 95% confidence interval (CI) 1.04–2.51], those with a recent assessment by an HCV specialist (AOR 2.02; 95% CI 1.28–3.19) and those who perceived that HCV infection was affecting their health (AOR 2.49; 95% CI 1.41–4.37) were more likely to be willing to use DAA‐based regimens.ConclusionsOverall, this study found a high prevalence of willingness to use DAA‐based regimens among HIV/HCV‐coinfected PWUD in Vancouver. Importantly, enrolment in methadone maintenance therapy was positively associated with willingness, suggesting that integrated models of HIV, HCV and addiction care should be explored as a way to address HCV‐related morbidity and mortality among HIV/HCV‐coinfected PWUD.
T regulatory cells are critical for the maintenance, anamnestic expansion and protection elicited by vaccine‐induced CD8 T cells
Authors: Bhattacharyya Mitra , Penaloza‐MacMaster Pablo 
Published: March 2017

SummaryT regulatory (Treg) cells are critical for preventing autoimmunity and suppressing immune responses during cancer and chronic infection. However, the role of Treg cells in the generation of vaccine‐induced immune memory remains ill‐defined. Using the mouse model of lymphocytic choriomeningitis virus (LCMV) infection, we demonstrate that transient absence of Treg cells during effector to memory CD8 T‐cell transition results in a permanent impairment in the maintenance, function and recall capacity of CD8 T cells. Memory CD8 T cells in mice that were transiently depleted of Treg cells exhibited defective up‐regulation of memory markers with a significant decrease in polyfunctionality. However, Treg‐depleted mice showed no significant change in CD4 T‐cell responses, and antibody levels relative to control. Altogether, this study evaluates the role of Treg cells in the formation of immune memory and demonstrates an important role for Treg cells in promoting memory CD8 T‐cell differentiation and vaccine‐induced immune protection against intracellular pathogens.
Nursing clinical practice changes to improve self‐management in chronic obstructive pulmonary disease
Authors: Padilha J.M. , Sousa P.A.F. , Pereira F.M.S. 
Published: March 2017

AimTo propose nursing clinical practice changes to improve the development of patient self‐management.BackgroundChronic obstructive pulmonary disease is one of the main causes of chronic morbidity, loss of quality of life and high mortality rates.IntroductionControl of the disease's progression, the preservation of autonomy in self‐care and maintenance of quality of life are extremely challenging for patients to execute in their daily living. However, there is still little evidence to support nursing clinical practice changes to improve the development of self‐management.MethodsA participatory action research study was performed in a medicine inpatient department and the outpatient unit of a Portuguese hospital. The sample comprised 52 nurses and 99 patients. For data collection, we used interviews, participant observation and content analysis.ResultsThe main elements of nursing clinical practice that were identified as a focus for improvement measures were the healthcare model, the organization of healthcare and the documentation of a support decision‐making process.The specific guidelines, the provision of material to support decision‐making and the optimization of information sharing between professionals positively influenced the change process.This change improved the development of self‐management skills related to the awareness of the need for ‘change’, hope, involvement, knowledge and abilities.DiscussionThe implemented changes have improved health‐related behaviours and clinical outcomes.ConclusionTo support self‐management development skills, an effective nursing clinical practice change is needed. This study has demonstrated the relevance of a portfolio of techniques and tools to help patients adopt healthy behaviours.Implications for nursing and/or health policyThe involvement and participation of nurses and patients in the conceptualization, implementation and evaluation of policy change are fundamental issues to improve the quality of nursing care and clinical outcomes.
Rethinking thresholds for serological evidence of influenza virus infection
Authors: Zhao Xiahong , Siegel Karen , Chen Mark I‐Cheng , Cook Alex R. 
Published: March 2017

IntroductionFor pathogens such as influenza that cause many subclinical cases, serologic data can be used to estimate attack rates and the severity of an epidemic in near real time. Current methods for analysing serologic data tend to rely on use of a simple threshold or comparison of titres between pre‐ and post‐epidemic, which may not accurately reflect actual infection rates.MethodsWe propose a method for quantifying infection rates using paired sera and bivariate probit models to evaluate the accuracy of thresholds currently used for influenza epidemics with low and high existing herd immunity levels, and a subsequent non‐influenza period. Pre‐ and post‐epidemic sera were taken from a cohort of adults in Singapore (n=838). Bivariate probit models with latent titre levels were fit to the joint distribution of haemagglutination‐inhibition assay‐determined antibody titres using Markov chain Monte Carlo simulation.ResultsEstimated attack rates were 15% (95% credible interval: 12%‐19%) for the first H1N1 pandemic wave. For a large outbreak due to a new strain, a threshold of 1:20 and a twofold rise (if pared sera is available) would result in a more accurate estimate of incidence.ConclusionThe approach presented here offers the basis for a reconsideration of methods used to assess diagnostic tests by both reconsidering the thresholds used and by analysing serological data with a novel statistical model.
The effects of development, vegetation‐type conversion, and fire on low‐elevation Southern California spider assemblages
Authors: Spear Dakota M. , Adams Tessa A. , Boyd Elise S. , Dipman Madison M. , Staubus Weston J. , Meyer Wallace M. 
Published: March 2017

AbstractCalifornia sage scrub (CSS), a native ecosystem type of low‐elevation areas of Southern California, is increasingly threatened by urban development, altered fire regimes, and vegetation‐type conversion to non‐native grasslands. Using pitfall traps, we examined how suburbanization, type conversion, and fire influence ground‐dwelling spider assemblages in eastern Los Angeles County, CA, by surveying spiders in three habitats (CSS, non‐native grasslands, and suburban areas) before and after a fire that occurred in a small portion of our study site. Spider assemblages in the suburban habitat differed from those in CSS and non‐native grassland habitats, but CSS and grassland assemblages did not significantly differ. This suggests that the urban development, but not vegetation‐type conversion to non‐native grasslands, has significant effects on ground‐dwelling spider assemblages. Fire had no observable effect on assemblages. Because ground‐dwelling spiders were not impacted by fire and type conversion, increased fire frequencies, which often result in the establishment of non‐native grasses, may not deleteriously influence this animal group, a differing pattern from other taxonomic groups. However, the rapid urban development occurring in low‐elevation areas of Southern California means that species requiring non‐suburban sites for their survival (15 species, 24.1%) may be threatened and require conservation assessment.
Circulating long non‐coding RNAs NRON and MHRT as novel predictive biomarkers of heart failure
Authors: Xuan Lina , Sun Lihua , Zhang Ying , Huang Yuechao , Hou Yan , Li Qingqi , Guo Ying , Feng Bingbing , Cui Lina , Wang Xiaoxue , Wang Zhiguo , Tian Ye , Yu Bo , Wang Shu , Xu Chaoqian , Zhang Mingyu , Du Zhimin , Lu Yanjie , Yang Bao Feng 
Published: March 2017

AbstractThis study sought to evaluate the potential of circulating long non‐coding RNAs (lncRNAs) as biomarkers for heart failure (HF). We measured the circulating levels of 13 individual lncRNAs which are known to be relevant to cardiovascular disease in the plasma samples from 72 HF patients and 60 non‐HF control participants using real‐time reverse transcription‐polymerase chain reaction (real‐time RT‐PCR) methods. We found that out of the 13 lncRNAs tested, non‐coding repressor of NFAT (NRON) and myosin heavy‐chain‐associated RNA transcripts (MHRT) had significantly higher plasma levels in HF than in non‐HF subjects: 3.17 ± 0.30 versus 1.0 ± 0.07 for NRON (P < 0.0001) and 1.66 ± 0.14 versus 1.0 ± 0.12 for MHRT (P < 0.0001). The area under the ROC curve was 0.865 for NRON and 0.702 for MHRT. Univariate and multivariate analyses identified NRON and MHRT as independent predictors for HF. Spearman's rank correlation analysis showed that NRON was negatively correlated with HDL and positively correlated with LDH, whereas MHRT was positively correlated with AST and LDH. Hence, elevation of circulating NRON and MHRT predicts HF and may be considered as novel biomarkers of HF.
Annual Research Review: Childhood maltreatment, latent vulnerability and the shift to preventative psychiatry – the contribution of functional brain imaging
Authors: McCrory Eamon J. , Gerin Mattia I. , Viding Essi 
Published: March 2017

BackgroundChildhood maltreatment is a potent predictor of poor mental health across the life span. We argue that there is a need to improve the understanding of the mechanisms that confer psychiatric vulnerability following maltreatment, if we are to progress from simply treating those with a manifest disorder, to developing effective preventative approaches that can help offset the likelihood that such disorders will emerge in the first place.MethodsWe review extant functional neuroimaging studies of children and adolescents exposed to early neglect and/or maltreatment, including physical, sexual and emotional abuse across four neurocognitive domains: threat processing, reward processing, emotion regulation and executive control. Findings are discussed in the context of ‘latent vulnerability’, where alterations in neurocognitive function are considered to carry adaptive value in early adverse caregiving environments but confer long‐term risk.ResultsStudies on threat processing indicate heightened as well as depressed neural responsiveness in maltreated samples, particularly in the amygdala, thought to reflect threat hypervigilance and avoidance respectively. Studies on reward processing generally report blunted neural response to anticipation and receipt of rewards, particularly in the striatum, patterns associated with depressive symptomatology. Studies on emotion regulation report increased activation of the anterior cingulate cortex (ACC) during active emotion regulation, possibly reflecting greater effortful processing. Finally, studies of executive control report increased dorsal ACC activity during error monitoring and inhibition.ConclusionsAn emerging body of work indicates that altered neurocognitive functioning following maltreatment: (a) is evident even in the absence of overt psychopathology; (b) is consistent with perturbations seen in individuals presenting with psychiatric disorder; (c) can predict future psychiatric symptomatology. These findings suggest that maltreatment leads to neurocognitive alterations that embed latent vulnerability to psychiatric disorder, establishing a compelling case for identifying those children at most risk and developing mechanistically informed models of preventative intervention. Such interventions should aim to offset the likelihood of any future psychiatric disorder.
Acquired perforating dermatosis: clinicopathological study of 31 cases, emphasizing pathogenesis and treatment
Authors: García‐Malinis A.J. , del Valle Sánchez E. , Sánchez‐Salas M.P. , del Prado E. , Coscojuela C. , Gilaberte Y. 
Published: March 2017

AbstractBackgroundAcquired perforating dermatosis (APD) is a rare group of skin disorders of unknown aetiology and pathogenesis and is associated with several systemic diseases.ObjectiveWe review the clinicopathological features, associated systemic diseases and treatment response in a series of APD patients.MethodsWe conducted a retrospective observational study of all patients histologically diagnosed with APD in Hospital San Jorge (Huesca, Spain) between 2002 and 2014. Demographic and clinical features were collected from medical records. Statistical analyses were carried out using SPSS software (version 20.0; IBM Corp, Armonk, NY, USA).ResultsThe study population consisted of 31 patients (19 women and 12 men), with a mean age of 54 years. Reactive perforating collagenosis (n = 15, 45%) was the most common histopathologic type. The most frequently affected area was the lower limbs (66.6%, n = 22), and pruritus was present in 19 patients (61.3%, P = 0.005). Arterial hypertension (30.3%) was the most common associated condition. Five patients were receiving treatment with infliximab when diagnosed with APD. Most patients responded to topical steroids and oral antihistamines (n = 15).LimitationsThis study is retrospective, and the sample size is limited.ConclusionAcquired perforating dermatosis is an underdiagnosed dermatosis frequently associated with systemic disorders. Its pathogenesis may involve vascular damage, not only in patients with diabetes, but also in those with arterial hypertension and chronic venous insufficiency. Control of pruritus and underlying extracutaneous disorders, as well as discontinuation of the treatment with biologics, are important aspects of the management of this dermatosis.
Formation and development of Staphylococcus biofilm: With focus on food safety
Authors: Miao Jian , Liang Yanrui , Chen Lequn , Wang Wenxin , Wang Jingwen , Li Bing , Li Lin , Chen Dingqiang , Xu Zhenbo 
Published: March 2017

AbstractStaphylococcus is a common gram‐positive pathogen, which has been considered to be a leading concern to public health and food safety due to the multi‐drag resistance and virulence. As is known, most Staphylococcus tend to form biofilm both during various food processing procedures and in environment, and the bacteria in biofilms show a number of specific advantages over planktonic bacteria due to strong resistance ability. As a consequence, inhibition and removal of Staphylococcus biofilm is difficult for food safety during processing. The present review aims to discuss and demonstrate the formation and development of Staphylococcus biofilm based on food safety account under the background of both phenotype and genetic regulation, providing scientific reference for control strategy.Practical applicationAs a common foodborne pathogen, Staphylococcus aureus in food industry is a potential harm to the health of both customer and stuff. Biofilm plays a significant role in bacterial survival, tolerant to environmental stresses. Thus, a comprehensive understanding of biofilm is of essential and urgent need. This review of biofilm of Staphylococcus aureus illustrated the biofilm in food industry and its formation, influential factor, quantification, genetic regulation mechanism, and control strategies, which provided a background of Staphylococcus aureus biofilm prevention in food industry.
Novel strategies for the treatment of acute pancreatitis based on the determinants of severity
Authors: Windsor John A , Escott Alistair , Brown Lisa , Phillips Anthony RJ 
Published: March 2017

AbstractAcute pancreatitis (AP) is a common disease for which a specific treatment remains elusive. The key determinants of the outcome from AP are persistent organ failure and infected pancreatic necrosis. The prevention and treatment of these determinants provides a framework for the development of specific treatment strategies. The gut‐lymph concept provides a common mechanism for systemic inflammation and organ dysfunction. Acute and critical illness, including AP, is associated with intestinal ischemia and drastic changes in the composition of gut lymph, which bypasses the liver to drain into the systemic circulation immediately proximal to the major organ systems which fail. The external diversion of gut lymph and the targeting of treatments to counter the toxic elements in gut lymph offers novel approaches to the prevention and treatment of persistent organ failure. Infected pancreatic necrosis is increasingly treated with less invasive techniques, the mainstay of which is drainage, both endoscopic and percutaneous. Further improvements will occur with the strategies to accelerate liquefaction and through a fundamental re‐design of drains, both of which will increase drainage efficacy. The determinants of severity and outcome in patients admitted with AP provide the basis for innovative treatment strategies. The priorities are to translate the gut‐lymph concept to clinical practice and to improve the design and active use of drains for infected complications of AP.
Oral and Maxillofacial Lesions Diagnosed in Older People of a Brazilian Population: A Multicentric Study
Authors: Silva Leorik P. , Leite Rafaella B. , Sobral Ana P. V. , Arruda José A. , Oliveira Leni V. , Noronha Mariana S. , Kato Camila O. , Mesquita Ricardo A. , Schuch Lauren F. , Gomes Ana P. N. , Vasconcelos Ana C. U. , Souza Lélia B. 
Published: March 2017

ObjectivesThe aim of this study was to investigate the prevalence of oral and maxillofacial lesions among older adults (≥60 years) from representative regions in Brazil.DesignRetrospective descriptive cross‐sectional study.SettingBiopsy records were obtained from the archives of four Brazilian referral centers of oral diagnosis between 2000 and 2016.ParticipantsA total of 45,506 biopsy records of all patients were analyzed, of these 7,259 persons aged 60 and older were selected.MeasurementsData such as gender, age, race, anatomical location, and histopathological diagnosis were collected and categorized. Pearson's chi‐square test (P < .005) was used to evaluate differences in the frequency of the several groups of oral lesions.ResultsOral and maxillofacial lesions were diagnosed in 7,259 older people, including 59.4% women (P < .001) and 61.3% white patients (P = .07). The most commonly affected sites were the cheek mucosa (20.3%) and mandible (8.9%) (P < .001). Reactive and inflammatory lesions were the most common lesions, followed by neoplasms. Oral squamous cell carcinoma was the most prevalent neoplasm (83.4%) (P < .001).ConclusionKnowledge of oral diseases obtained from biopsy records provides more accurate data about the diagnosis and oral health of elderly patients. These indicators thus support the development of specific health policies for the prevention and treatment of oral and maxillofacial lesions that affect this population.
Variation in Hospice Services by Location of Care: Nursing Home Versus Assisted Living Facility Versus Home
Authors: Unroe Kathleen T. , Bernard Brittany , Stump Timothy E. , Tu Wanzhu , Callahan Christopher M. 
Published: March 2017

ObjectivesTo describe differences in hospice services for patients living at home, in nursing homes or in assisted living facilities, including the overall number and duration of visits by different hospice care providers across varying lengths of stay.DesignRetrospective cohort study using hospice patient electronic medical record data.SettingLarge, national hospice provider.ParticipantsData from 32,605 hospice patients who received routine hospice care from 2009 to 2014 were analyzed.MeasurementsDescriptive statistics were calculated for utilization measures for each type of provider and by location of care. Frequency and duration of service contacts were standardized to a 1 week period and pairwise comparisons were used to detect differences in care provided between the three settings.ResultsMinimal differences were found in overall intensity of service contacts across settings, however, the mix of services were different for patients living at home versus nursing home versus assisted living facility. Overall, more nurse care was provided at the beginning and end of the hospice episode; intensity of aide care services was higher in the middle portion of the hospice episode. Nearly 43% of the sample had hospice stays less than 2 weeks and up to 20% had stays greater than 6 months.ConclusionThere are significant differences between characteristics of hospice patients in different settings, as well as the mix of services they receive. Medicare hospice payment methodology was revised starting in 2016. While the new payment structure is in greater alignment with the U shape distribution of services, it will be important to evaluate the impact of the new payment methodology on length of stay and mix of services by different providers across settings of care.