bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using cadaveric simulation to introduce the concept and skills required to start performing transanal total mesorectal excision
Authors: Wynn G. R. , Austin R. C. T. , Motson R. W. 
Published: January 2018

AbstractAimThe aim was to document the outcomes of surgeons attending a cadaveric simulation course designed to provide an introduction to transanal total mesorectal excision (TaTME).MethodThis was a prospective observational study documenting the outcomes from classroom and wet lab activities. Follow‐up questionnaires were used to monitor clinical activity after the course.ResultsOutcomes of 65 delegates from 12 different countries attending seven cadaveric simulation courses are described. Median time to insert and close the rectal purse‐string was 15 min (range 7–50 min) and median time to complete the transanal mesorectal dissection was 105 min (range 60–260 min). Objective assessment of specimen quality showed that 42% of specimens were complete, 47% nearly complete and 11% were incomplete. Failure of the intraluminal rectal purse‐string was the most common difficulty encountered. Within 6 months of attending the course, nearly half (26/55; 47%) of the surgeons who responded had performed between 1 and 13 TaTMEs. Only 8/26 (31%) of the surgeons had arranged mentoring for their first case.ConclusionThis training model provides high levels of trainee satisfaction and the knowledge and technical skills to enable them to start performing TaTME. There is still work to do to provide adequate supervision and mentorship for surgeons early on their learning curve that is essential for the safe introduction of this new technique.
Real‐life adaptations in walking patterns in patients with established peripheral arterial disease assessed using a global positioning system in the community: a cohort study
Authors: Klonizakis Markos , Bianchi Stephen M. , Gernigon Marie , Abraham Pierre , Nawaz Shah 
Published: January 2018

SummaryObjectiveLower extremity peripheral arterial disease (PAD) is a chronic condition most commonly presenting with intermittent claudication (IC). Intermittent claudication limits walking ability and may negatively affect health‐related quality of life. Treadmill assessment of maximal walking distance (MWD) is the gold standard to assess PAD symptom severity. Despite being a well‐established and reproducible tool, it may be inappropriate (due to frailty or fear) for some patients and only describes maximal abilities for a single walk test. Global positioning systems (GPS) have been proposed as reliable and reproducible tool to measure total, mean and maximal walking distances in patients with PAD, in the community setting. Using GPS, our study attempted to explore what happens to the walking ability of patients with IC following no intervention under ‘real‐life’ conditions.Design and methodsUsing the GlobalSat DG100 GPS, forty‐three patients (69 ± 9 years; nine female; no invasive interventions or rehabilitation) undertook two 60‐min walking assessments, 6 months apart. Assessments took place in community spaces that had even terrain, no tall trees or buildings and were free from motorized vehicles. Global positioning systems‐measured maximum walking distance was the main study outcome measure.ResultsOver the 6‐month period, patients demonstrated significantly shorter GPS‐measured, mean (552 m versus 334 m; P = 0·02) and maximum (714 m versus 545 m; P = 0·04) walking distances, stopping also more frequently (nine versus five times; P = 0·03).ConclusionsGiven the reported symptom progression, we advocate early intervention (e.g. exercise interventions) combined with frequent patient monitoring in attempts to maintain or improve walking ability.
Utility of single versus multiple breath washout in adult asthma
Authors: Kjellberg S. , Viklund E. , Robinson P. D. , Zetterström O. , Olin A.‐C. , Gustafsson P. 
Published: January 2018

SummaryNitrogen multiple breath washout (N2 MBW) is a sensitive method to identify peripheral airway involvement in asthma, but is a time‐consuming test. The N2 vital capacity single breath (VC SBW) test offers greater time efficiency, but concordance with N2 MBW is poorly understood. The prevalence of peripheral airway abnormality was determined by N2 MBW and N2 SBW tests in 194 asthmatic subjects aged 18–1 years. N2 MBW data were related to findings in 400 healthy controls, aged 17–71 years, while N2 SBW data were compared to findings in 224 healthy controls, aged 15–65 years, to derive equipment‐specific reference values. Amongst asthmatic subjects, relationships between N2 SBW and N2 MBW outcomes were studied. N2 SBW relationship with clinical history, spirometry, blood eosinophils and fraction exhaled nitric oxide (FENO) data was also explored. The prevalence of peripheral airway involvement (i.e. abnormal ventilation distribution) determined by N2 SBW‐derived phase III slope (N2 SIII) was 24·7%, compared to 44% determined by N2 MBW‐derived lung clearance index (LCI) (P<0·001). Predictors of abnormal N2 SIII were older age, smoking history and lower FEV1. N2 SBW offers lower sensitivity than N2 MBW to detect small airway dysfunction in adult asthma, but may be a marker of more severe disease.
Lichen planopilaris and frontal fibrosing alopecia cannot be differentiated by histopathology
Authors: Gálvez‐Canseco Aldo , Sperling Leonard 
Published: January 2018

BackgroundLichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) represent 2 entities that cause primary cicatricial alopecia. These entities are clinically different; nevertheless, the literature suggests that FFA represents a form of LPP. The main argument in support of this hypothesis is that previous studies comparing the histologic findings have not found obvious differences between these diseases.MethodsOur objective was to more critically compare and contrast 20 histologic findings of these diseases in a large number of patients in order to determine any significant histologic differences between LPP and FFA.ResultsWe found 3 parameters that were statistically different, namely the presence of terminal catagen‐telogen hairs (50% FFA vs 23.5% LPP; P = .020); a severe perifollicular inflammatory infiltrate (29.4% LPP vs 4.6% FFA; P = .010) and a zone of concentric lamellar fibroplasia (85.3% LPP vs 63.6% FFA; P = .041).ConclusionsAlthough a few histologic features differ between FFA and LPP, we believe that these differences are too subtle or non‐specific to distinguish between them with confidence. Therefore, clinical correlation is essential to establish the diagnosis.
CDX2 and LEF‐1 expression in pilomatrical tumors and their utility in the diagnosis of pilomatrical carcinoma
Authors: Tumminello Katherine , Hosler Gregory A. 
Published: January 2018

BackgroundThe Wnt signaling pathway has been implicated in the pathogenesis of pilomatrical tumors. Lymphoid enhancer‐binding factor 1 (LEF‐1) is a downstream component of this pathway, and Caudal‐related homeobox transcription factor 2 (CDX2) has been postulated to regulate it, but little is known about expression of these transcription factors in pilomatrical tumors.MethodsImmunohistochemistry for CDX2, β‐catenin, LEF‐1, CK19, CK5, Special AT‐rich sequence‐ binding protein 2 (SATB2), cadherin 17 and androgen receptor was performed on pilomatricomas (PMs) (N = 12), pilomatrical carcinomas (PMCAs) (N = 12) and non‐pilomatrical cutaneous tumors (N = 18).ResultsPMs and PMCAs were positive for CDX2 (9/12 PMs, sensitivity = 75%, specificity = 100%; 11/12 PMCAs, sensitivity = 92%, specificity = 100%; P < 0.01), β‐catenin (12/12 PMs, sensitivity = 100%, specificity = 94%; 10/12 PMCAs, sensitivity = 83%, specificity = 94%; P < 0.01) and LEF‐1 (12/12 PMs, sensitivity = 100%, specificity = 56%; 12/12 PMCAs, sensitivity = 100%, specificity = 56%; P < 0.01). CDX2 expression was commonly focal, within a discrete subpopulation of squamoid cells. The LEF‐1 expression pattern was different and discernable between pilomatrical tumors (strong, diffuse) and non‐pilomatrical tumors (weak, patchy).ConclusionThis study reaffirms the importance of the Wnt signaling pathway in the tumorigenesis of pilomatrical tumors, and this introduces CDX2 as a possible regulator and marker of pilomatrical tumorigenesis. LEF‐1 and CDX2 performed at least as well as β‐catenin, if not better when taking into account expression pattern, as a diagnostic marker for PMCA, and should be considered in the workup of ambiguous primitive‐appearing cutaneous tumors.
Efficacy of glucagon‐like peptide‐1 receptor agonists compared to dipeptidyl peptidase‐4 inhibitors for the management of type 2 diabetes: A meta‐analysis of randomized clinical trials
Authors: Tran Susan , Retnakaran Ravi , Zinman Bernard , Kramer Caroline K. 
Published: January 2018

AimsGlucagon‐like peptide‐1 (GLP‐1) agonists and dipeptidyl peptidase‐4 (DPP‐4) inhibitors are both incretin‐based therapies for type 2 diabetes (T2DM) but have distinct efficacy and side effect profiles. We thus performed a systematic review and meta‐analysis to compare the effects of GLP‐1 agonists to DPP‐4 inhibitors on glycaemic control, weight and incidence of adverse events in adults with T2DM. We also sought to determine whether there was any additional effect in switching from DPP‐4 inhibitor to GLP‐1 agonist.Materials and methodsWe systematically searched PubMed, Embase and ClinicalTrials.gov for (1) randomized controlled trials (RCTs) comparing any GLP‐1 agonist to any DPP‐4 inhibitor and (2) interventional studies where a DPP‐4 inhibitor was switched to a GLP‐1 agonist. We assessed pooled data using random‐effects model (CRD42017057115).ResultsThe pooled analysis of 13 RCTs (n = 4330) showed that, compared to DPP‐4 inhibitors, GLP‐1 agonists yielded a greater mean reduction in glycated haemoglobin (HbA1c) of −0.41% (95% CI −0.53 to −0.30) and in weight of −2.15 kg (−3.04 to −1.27). GLP‐1 agonists were associated with greater likelihood of gastrointestinal side effects with no increased risk of hypoglycaemia. In 5 interventional studies (n = 433), switching from DPP‐4 inhibitor to GLP‐1 agonist yielded further mean reduction in HbA1c of −0.69% (−1.03 to −0.35) and in weight of −2.25 kg (−3.12 to −1.38).ConclusionsGLP‐1 agonists yield greater reduction in HbA1c and weight as compared to DPP‐4 inhibitors, with increased incidence of gastrointestinal symptoms but not hypoglycaemia. Replacing a DPP‐4 inhibitor with GLP‐1 agonist provides additional benefits in glycaemic control and weight loss.
Comparisons of diabetic retinopathy events associated with glucose‐lowering drugs in patients with type 2 diabetes mellitus: A network meta‐analysis
Authors: Tang Huilin , Li Guangyao , Zhao Ying , Wang Fei , Gower Emily W. , Shi Luwen , Wang Tiansheng 
Published: January 2018

AimTo assess the comparative effects of glucose‐lowering drugs (GLDs) on the risk of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM).MethodsWe systematically searched Cochrane Central Register of Controlled Trials, PUBMED and EMBASE from inception to January 17, 2017 to identify randomized controlled trials (RCTs) that reported DR events among T2DM patients receiving any GLD. Random‐effects pairwise and network meta‐analyses were performed to calculate odds ratios (ORs) with 95% confidence intervals (CIs).ResultsA total of 37 independent RCTs with 1806 DR events among 100 928 patients with T2DM were included. The mean duration of diabetes was 8.7 years and mean baseline HbA1c was 8.2% (SD, 0.5%). Our network meta‐analysis found that DPP‐4i (OR, 1.20; 95% CI, 0.87‐1.65), GLP‐1RA (OR, 1.19; 95% CI, 0.94‐1.52) and SGLT2 inhibitors (OR, 0.79; 95% CI, 0.49‐1.28) were not associated with a higher risk of DR than placebo; however, a significantly increased risk of DR was associated with DPP‐4i in the pairwise meta‐analysis (OR, 1.27; 95% CI, 1.05‐1.53). Sulfonylureas, on the other hand, were associated with a significantly increased risk of DR compared to placebo (OR, 1.67; 95% CI, 1.01‐2.76).ConclusionsCurrent evidence indicates that the association between DPP‐4i, GLP‐1RA or SGLT2 inhibitors and risk of DR remains uncertain in patients with T2DM. Some evidence suggests that sulfonylureas may be associated with increased risk of DR. However, given that DR events were not systematically assessed, these effects should be explored further in large‐scale, well‐designed studies.
Seed‐dispersal interactions in fragmented landscapes – a metanetwork approach
Authors: Emer Carine , Galetti Mauro , Pizo Marco A. , Guimarães Paulo R. , Moraes Suelen , Piratelli Augusto , Jordano Pedro 
Published: January 2018

AbstractMutualistic interactions repeatedly preserved across fragmented landscapes can scale‐up to form a spatial metanetwork describing the distribution of interactions across patches. We explored the structure of a bird seed‐dispersal (BSD) metanetwork in 16 Neotropical forest fragments to test whether a distinct subset ofBSD‐interactions may mediate landscape functional connectivity. The metanetwork is interaction‐rich, modular and poorly connected, showing high beta‐diversity and turnover of species and interactions. Interactions involving large‐sized species were lost in fragments < 10 000 ha, indicating a strong filtering by habitat fragmentation on the functional diversity ofBSD‐interactions. Persistent interactions were performed by small‐seeded, fast growing plant species and by generalist, small‐bodied bird species able to cross the fragmented landscape. This reduced subset of interactions forms the metanetwork components persisting to defaunation and fragmentation, and may generate long‐term deficits of carbon storage while delaying forest regeneration at the landscape level.
The new therapeutic herbal drug HM0601 and its bioactive compound rutin exert potent antiproliferative activities in mast cells
Authors: Jeong Hyun‐Ja , Yoou Myoung‐Schook , Han Na‐Ra , Hwang Sung Yeoun , Yoon Kyoung Wan , Kim Hyung‐Min 
Published: January 2018

AbstractHM0601 consists of Allium hookeri and Lycium chinense fruit and contains a lot of rutin. Here, we ascertained whether HM0601 and its major compound rutin reduce proliferation of human mast cell line, HMC‐1, under thymic stromal lymphopoietin (TSLP) stimulation. Therapeutic rutin or HM0601 treatment considerably reduced proliferation of mast cells without exposing activated HMC‐1 cells to any cytotoxicity. Reduced levels of mouse double minute 2 and phosphorylated signal transducers and activators of transcription 6 were accompanied by treatment with rutin or HM0601. In TSLP‐stimulated cells, rutin or HM0601 treatment significantly impaired levels of interleukin (IL)‐13 and Bcl2 expression. Notably, rutin or HM0601 treatment returned Bax and phosphorylated p53 protein levels and caspase‐3 activities impaired by TSLP. In addition, levels of inflammatory cytokine were considerably reduced by treatment with rutin or HM0601 on TSLP‐stimulated cells. In conclusion, these results indicate that HM0601 can be used as a new therapeutic herbal drug for prevention and therapeutic intervention of allergic inflammatory diseases.
Early life history connectivity of Antarctic silverfish (Pleuragramma antarctica) in the Ross Sea
Authors: Brooks Cassandra M. , Caccavo Jilda Alicia , Ashford Julian , Dunbar Robert , Goetz Kimberly , La Mesa Mario , Zane Lorenzo 
Published: January 2018

AbstractA recent population hypothesis for Antarctic silverfish (Pleuragramma antarctica), a critical forage species, argued that interactions between life history and circulation associated with glacial trough systems drive circumpolar distributions over the continental shelf. In the Ross Sea, aggregations of eggs and larvae occur under fast ice in Terra Nova Bay, and the hypothesis predicted that dispersing larvae encounter outflow along the western side of Drygalski Trough. The outflow advects larvae towards the shelf‐break, and mixing with trough inflow facilitates return toward the inner shelf. To examine the hypothesis, we compared samples of P. antarctica collected near Coulman Island in the outflow, along Crary Bank in the inflow, and a third set taken over the rest of the Ross Sea. We ruled out misidentification using an innovative genetic validation. Silverfish larvae comprised 99.5% of the catch, and the highest population densities were found in Drygalski Trough. The results provided no evidence to reject the population hypothesis. Abundance indices, back‐calculated hatching dates, length distributions and growth were congruent with a unified early life history in the western Ross Sea, constrained by cryopelagic early stages in Terra Nova Bay. By contrast, a sample in the Bay of Whales revealed much smaller larvae, suggesting either a geographically separate population in the eastern Ross Sea, or westward connectivity with larvae spawned nearby by fish sourced from troughs upstream in the Amundsen Sea. These results illustrate how hypotheses that integrate population structure with life history can provide precise spatial predictions for subsequent testing.
Breeding implications of drought stress under future climate for upland rice in Brazil
Authors: Ramirez‐Villegas Julian , Heinemann Alexandre B. , Pereira de Castro Adriano , Breseghello Flávio , Navarro‐Racines Carlos , Li Tao , Rebolledo Maria C. , Challinor Andrew J. 
Published: January 2018

AbstractRice is the most important food crop in the developing world. For rice production systems to address the challenges of increasing demand and climate change, potential and on‐farm yield increases must be increased. Breeding is one of the main strategies toward such aim. Here, we hypothesize that climatic and atmospheric changes for the upland rice growing period in central Brazil are likely to alter environment groupings and drought stress patterns by 2050, leading to changing breeding targets during the 21st century. As a result of changes in drought stress frequency and intensity, we found reductions in productivity in the range of 200–600 kg/ha (up to 20%) and reductions in yield stability throughout virtually the entire upland rice growing area (except for the southeast). In the face of these changes, our crop simulation analysis suggests that the current strategy of the breeding program, which aims at achieving wide adaptation, should be adjusted. Based on the results for current and future climates, a weighted selection strategy for the three environmental groups that characterize the region is suggested. For the highly favorable environment (HFE, 36%–41% growing area, depending on RCP), selection should be done under both stress‐free and terminal stress conditions; for the favorable environment (FE, 27%–40%), selection should aim at testing under reproductive and terminal stress, and for the least favorable environment (LFE, 23%–27%), selection should be conducted for response to reproductive stress only and for the joint occurrence of reproductive and terminal stress. Even though there are differences in timing, it is noteworthy that stress levels are similar across environments, with 40%–60% of crop water demand unsatisfied. Efficient crop improvement targeted toward adaptive traits for drought tolerance will enhance upland rice crop system resilience under climate change.
‘Get an early check – Chrysanthemum tea’: An outcome evaluation of a multimedia campaign promoting HIV testing among men who have sex with men in Hong Kong
Authors: Kwan NNM , Wong AMH , Fang Y , Wang Z 
Published: January 2018

Objectives‘Get an early check – chrysanthemum tea’ was a multimedia campaign promoting HIV testing targeting Chinese‐speaking men who have sex with men (MSM) in Hong Kong, China. It ran from October to December 2015. This study was carried out to investigate the level of campaign exposure among Chinese‐speaking MSM in Hong Kong and the association between uptake of HIV testing in the last 6 months and campaign exposure.MethodsA cross‐sectional survey was conducted 6 months after the campaign was launched. Participants were Hong Kong Chinese‐speaking men aged ≥18 years who had had anal or oral sex with at least one man in their lifetime. A total of 153 eligible participants completed the anonymous self‐administered questionnaire.ResultsAmong the participants, 45.8% had been exposed to the campaign and 43.1% had taken up HIV testing in the last 6 months. In multivariate logistic regression analysis, exposure to the campaign [multivariate odds ratio (ORm) 2.55; 95% confidence interval (CI) 1.25, 5.19] and having had anal intercourse with a nonregular sex partner (ORm 2.36; 95% CI 1.05, 5.31) in the last 6 months were significantly associated with uptake of HIV testing in the last 6 months.ConclusionsThe campaign had relatively good reach in the target population and may have been useful to encourage them to take up HIV testing. Future campaigns promoting HIV testing among MSM in Hong Kong are still needed. Such programmes should consider making use of viral videos, having a longer project duration and developing culturally sensitive materials for non‐Chinese‐speaking MSM.
The world‐wide incidence of Kaposi's sarcoma in the HIV/AIDS era
Authors: Liu Z , Fang Q , Zuo J , Minhas V , Wood C , Zhang T 
Published: January 2018

ObjectivesKaposi's sarcoma (KS) is a multicentric angioproliferative cancer of endothelial origin typically occurring in the context of immunosuppression or immunodeficiency. Consequently, KS is one of the most common cancers in HIV‐infected individuals and frequently occurs among transplant recipients. Nevertheless, its incidence in different populations is not well understood.MethodsWe searched online databases for publications on KS incidence. A random‐effect meta‐analysis was performed to combine the KS incidences and incidence rate ratios (IRRs) for associated risk factors.ResultsSeventy‐six eligible studies representing 71 time periods were included. For HIV‐infected people, the overall KS incidence was 481.54 per 100 000 person‐years with a 95% confidential interval (CI) of 342.36–677.32 per 100 000 person‐years. HIV‐infected men who have sex with men (MSM) had the highest incidence of KS (1397.11 per 100 000 person‐years; 95% CI 870.55–2242.18 per 100 000 person‐years). The incidence of KS was significantly lower in female than in male individuals (IRR 3.09; 95% CI 1.70–5.62). People receiving highly active antiretroviral therapy (HAART) had a lower incidence compared with people who had never received HAART (IRR 6.57; 95% CI 1.91–24.69). The incidence of KS was 68.59 (95% CI 31.39–149.86) per 100 000 person‐years in transplant recipients, 52.94 (95% CI 39.90–70.20) per 100 000 person‐years in children with HIV infection, and 1.53 (95% CI 0.33–7.08) per 100 000 person‐years in the general population.ConclusionsGlobally, a relatively high incidence of KS was found among HIV‐seropositive people and, in particular, in HIV‐infected MSM. The introduction of HAART has largely prevented the development of KS, but it has not entirely removed the challenge of KS. In Africa, in particular, KS imposes a very heavy disease burden, which can mainly be attributed to the high prevalence of KS‐associated herpesvirus and poor access to HAART.