bluuebunny/crossref_metadata_2025_split huggingface dataset:
Methods of analyzing regional dermatological care as exemplified by the city of Hamburg
Authors: Augustin Jobst , Erasmi Stefan , Reusch Michael , Augustin Matthias 
Published: June 2015

SummaryBackgroundThe rural‐urban divide is often linked to regional inequalities in healthcare. However, studies have also shown regional healthcare disparities within urban areas. To evaluate these studies, further parameters such as accessibility must be added to the standard criteria. The objective of this study was to present methodic tools for evaluating dermatological healthcare provision in Hamburg, primarily focusing on accessibility.MethodsAnalyzing data from 97 districts, the geographical distribution of 101 dermatologists and the physician‐patient ratio were determined. In a second step, network analysis regarding accessibility was performed.ResultsThere are regional inequalities in Hamburg with respect to dermatological care. Depending on the district, the physician‐patient ratio ranges from 44.9 % (undersupply) to > 500 % (oversupply). Similar differences exist regarding accessibility. Although 94.5 % of the population of Hamburg is able to reach the nearest dermatologist within ten minutes (by car), it may take more than 30 minutes depending on district and mode of transportation.ConclusionsAnalysis of the physician‐patient ratio reveals differences regarding dermatological care in Hamburg. However, results of the network analysis show that these differences do not significantly affect access to dermatological care. Therefore, network analysis should be used as an additional tool to evaluate regional healthcare provision.
Methoden zur Analyse der regionalen dermatologischen Versorgung am Beispiel Hamburgs
Authors: Augustin Jobst , Erasmi Stefan , Reusch Michael , Augustin Matthias 
Published: June 2015

ZusammenfassungHintergrund:Regionale Ungleichheiten in der Gesundheitsversorgung werden häufig mit dem Stadt‐Land‐Unterschied in Verbindung gebracht. Untersuchungen haben aber gezeigt, dass sich bei einer kleinräumigen Betrachtung auch in Städten regionale Versorgungsdisparitäten ausmachen lassen. Für deren Bewertung sind neben Versorgungsgrad noch weitere Größen wie die Erreichbarkeit hinzuzuziehen. Zielsetzung der vorliegenden Arbeit war das Aufzeigen methodischer Werkzeuge zur Bewertung der dermatologischen Versorgung am Beispiel Hamburgs. Besonderer Fokus wurde auf die Erreichbarkeit gelegt.Methoden:Auf Basis der 97 Hamburger Stadtteile wurde zunächst die Verteilung der 101 berücksichtigten Dermatologen sowie der Versorgungsgrad ermittelt. Anschließend wurde eine Netzwerkanalyse zur Erreichbarkeit durchgeführt.Ergebnisse:In Hamburg bestehen regionale Unterschiede im Versorgungsgrad und in der Erreichbarkeit von Dermatologen. Je nach Stadtteil liegt der Versorgungsgrad zwischen 44,9 % (unterversorgt) und > 500 % (überversorgt). Ähnliche Unterschiede zeigen sich bei der Erreichbarkeit. 94,5 % der Einwohner Hamburgs erreichen den nächsten Dermatologen innerhalb von zehn Minuten (PKW). Entsprechend dem Stadtteil und Verkehrsmittel kann der Zeitaufwand auf über 30 Minuten ansteigen.Schlussfolgerungen:Mittels des Versorgungsgrades können Unterschiede in der dermatologischen Versorgung Hamburgs aufgezeigt werden. Anhand der Netzwerkanalyse wurde jedoch ersichtlich, dass es trotz dieser Unterschiede nur wenige Defizite in der Erreichbarkeit des nächsten Dermatologen gibt. Netzwerkanalysen können damit als wertvolle und ergänzende Methode dienen, um das regionale Versorgungsgeschehen zu bewerten.
Prospective assessment of consensus criteria for evaluation of patients with suspected choledocholithiasis
Authors: Sethi Saurabh , Wang Fen , Korson Andrew S. , Krishnan Sandeep , Berzin Tyler M. , Chuttani Ram , Pleskow Douglas K. , Sawhney Mandeep S. 
Published: June 2015

Background and AimAmerican Society for Gastrointestinal Endoscopy (ASGE) guidelines have proposed criteria to stratify patients into low, intermediate and high risk of choledocholithiasis. The criteria include variables that are readily available in clinical practice. The objective of the present study was to prospectively assess the accuracy of these criteria.MethodsA prospective observational cohort study was conducted at Beth Israel Deaconess Medical Center. All adult patients referred for endoscopic retrograde cholangiopancreatography (ERCP) with suspected choledocholithiasis were considered for inclusion. ASGE criteria were applied, and each patient was categorized as high, intermediate or low risk for choledocholithiasis. Presence of stone at ERCP served as criteria standard.ResultsDuring the study period, 402 patients met study inclusion criteria and 336 were reported in the final analysis. Of the 244 patients in the high risk for choledocholithiasis group, 185 were found to have stones at ERCP (75.8%, 95% CI 70.2–80.1%). Of the 92 patients in the intermediate risk for choledocholithiasis group, 45 had stones at ERCP (48.9%, 95% CI 38.8–59.1%); P‐value for difference between groups = 0.001. Diagnostic accuracy for choledocholithiasis in the high‐risk group was 69.05%, and for the intermediate group was 39.95%. Presence of choledocholithiasis on pre‐ERCP imaging (OR: 3.6; 95% CI 2.2–6.0; P < 0.01), and bilirubin >1.8 but <4 mg/dL (OR: 1.69; 95% CI 1.0–2.8; P < 0.04) were the strongest predictors of choledocholithiasis. No additional variable that improved accuracy of ASGE criteria was identified.ConclusionASGE criteria stratify patients by risk for choledocholithiasis and can be used in routine clinical practice.
Comparison of early outcomes and quality of life after laparoscopic Heller's cardiomyotomy to peroral endoscopic myotomy for treatment of achalasia
Authors: Chan Shannon Melissa , Wu Justin Che Yuen , Teoh Anthony Yuen Bun , Yip Hon Chi , Ng Enders Kwok Wai , Lau James Yun Wong , Chiu Philip Wai Yan 
Published: June 2015

Background and AimThis retrospective cohort study compared clinical outcomes and quality of life after peroral endoscopic myotomy (POEM) against laparoscopic Heller myotomy (LHM) for treatment of achalasia.MethodsPatient demographics, operation time, intraoperative blood loss, hospital stay, time to resume diet and analgesic requirement were recorded. Clinical outcomes including recurrence of dysphagia, need for reintervention, and occurrence of gastroesophageal reflux disease (GERD) were recorded.ResultsFrom 2001 to 2014, 33 patients underwent POEM whereas 23 patients received LHM. Patients LHM had with longer mean operative time (P = 0.02), more blood loss (P = 0.001) and higher requirement for analgesics (P = 0.009) than those treated by POEM. Hospital stay and time to resume diet were similar. Both POEM and LHM achieved similar dysphagia scores at postoperative 4 weeks, 3 months and 6 months. Twenty‐six percent of LHM patients and 15.2% of POEM patients sustained gastroesophageal reflux disease (GERD) after treatment (P = 0.311). Six patients required regular proton pump inhibitor three after POEM and three after LHM (P = 0.639). Thirteen percent of LHM patients sustained recurrent dysphagia and one required reintervention. There was no recurrence in the POEM group. Follow‐up duration (mean [SD]) for the LHM group was significantly longer (60 [42] months vs 6 [4] months; P = 0.001). There was also no difference in all four aspects of GERD‐related quality of life outcomes.ConclusionCompared to LHM, POEM achieved shorter operative time, less blood loss and pain. POEM is comparable to LHM for treatment of achalasia with similar incidence of GERD after the procedure.
Anti‐CD19 chimeric antigen receptor‐modified T cells for B‐cell malignancies: a systematic review of efficacy and safety in clinical trials
Authors: Zhu Yangmin , Tan Youping , Ou Ruiming , Zhong Qi , Zheng Liling , Du Yuanyuan , Zhang Qing , Huang Jing 
Published: June 2015

AbstractObjectivesAdministration of anti‐CD19 chimeric antigen receptor (CAR)‐modified T cells for B‐cell malignancies has been remarkably effective in recent clinical trials. To investigate the critical parameters affecting efficacy and evaluated the safety of using CAR T cells targeting CD19 in B‐lineage malignancies. We performed a systematic review of reported phase I clinical trials using CAR T cells targeting CD19 in B‐lineage malignancies.MethodsWe searched Medline and Embase for studies on anti‐CD19 CAR‐modified T cells in patients with B‐cell malignancies in October 2014. Univariate analyses were performed using the Kaplan–Meier method, and a Cox regression model was used to determine the independent prognostic factors of progression‐free survival (PFS).ResultsSix trials involving 50 patients were included in this review. After CAR T‐cell infusion, the overall response rate was 48% (complete responses in 24%). The 6‐month PFS and 1‐year PFS were 43% and 27%, respectively. Statistically significant factors favorably influencing PFS were conditioning chemotherapy (P < 0.001), B‐cell aplasia (P = 0.040), and durable persistence of CAR T cells (P = 0.013) in univariate analyses. After multivariate analysis, conditioning chemotherapy remained as an independent prognostic factor for PFS. The most common adverse events were fever, hypotension, rigor, fatigue, bacteremia, chill, dyspnea, and headache, but all were temporary and resolved.ConclusionAnti‐CD19 CAR‐modified T cells have shown therapeutic efficacy in patients with B‐lineage malignancies and were well tolerated in most patients. Conditioning chemotherapy is a prerequisite to improve the clinical outcome.
Leukemia diagnosis: today and tomorrow
Authors: Béné Marie C. , Grimwade David , Haferlach Claudia , Haferlach Torsten , Zini Gina ,   the European LeukemiaNet
Published: June 2015

AbstractThe European LeukemiaNet (ELN) is composed of several work packages, four of them being directly involved in the various aspects of diagnosis. On the occasion of the annual ELN meeting of 2015 in Mannheim, these four work packages collectively examined the current situation and future prospects of cytomorphology, flow cytometry, cytogenetics, next‐generation sequencing, and minimal residual disease detection in the context of leukemia diagnosis and follow‐up. This document summarizes the outcome of this compendium.
Management of intermediate‐risk pulmonary embolism: uncertainties and challenges
Authors: Klok Frederikus Albertus , Meyer Guy , Konstantinides Stavros 
Published: June 2015

AbstractCurrent guidelines on the treatment of acute pulmonary embolism (PE) recommend stratification of hemodynamically stable patients in ‘low risk’ and ‘intermediate risk’. Validated risk scores, cardiac biomarkers, and imaging of the right ventricle all help in distinguishing both patient categories. The relevance of this risk stratification lies in the determination of the most optimal treatment for the individual patient. In this clinical review, we will discuss how patients with ‘intermediate‐risk’ PE can be identified as well as recent advances in their therapeutic management. Based on a clinical case, we will highlight the indications for reperfusion therapy and the current experience with non‐vitamin K‐dependent oral anticoagulant (NOACs) in this specific patient's category.
Threat modulates neural responses to looming visual stimuli
Authors: Vagnoni Eleonora , Lourenco Stella F. , Longo Matthew R. 
Published: June 2015

AbstractObjects on a collision course with an observer produce a specific pattern of optical expansion on the retina known as looming, which in theory exactly specifies the time‐to‐collision (TTC) of approaching objects. It was recently demonstrated that the affective content of looming stimuli influences perceived TTC, with threatening objects judged as approaching sooner than non‐threatening objects. Here, the neural mechanisms by which perceived threat modulates spatiotemporal perception were investigated. Participants judged the TTC of threatening (snakes, spiders) or non‐threatening (butterflies, rabbits) stimuli, which expanded in size at a rate indicating one of five TTCs. Visual‐evoked potentials (VEPs) and oscillatory neural responses measured with electroencephalography were analysed. The arrival time of threatening stimuli was underestimated compared with non‐threatening stimuli, though an interaction suggested that this underestimation was not constant across TTCs. Further, both speed of approach and threat modulated both VEPs and oscillatory responses. Speed of approach modulated the N1 parietal and oscillations in the beta band. Threat modulated several VEP components (P1, N1 frontal, N1 occipital, early posterior negativity and late positive potential) and oscillations in the alpha and high gamma band. The results for the high gamma band suggest an interaction between these two factors. Previous evidence suggests that looming stimuli activate sensorimotor areas, even in the absence of an intended action. The current results show that threat disrupts the synchronization over the sensorimotor areas that are likely activated by the presentation of a looming stimulus.
Mouse pups lacking collapsin response mediator protein 4 manifest impaired olfactory function and hyperactivity in the olfactory bulb
Authors: Tsutiya Atsuhiro , Nishihara Masugi , Goshima Yoshio , Ohtani‐Kaneko Ritsuko 
Published: June 2015

AbstractMembers of the collapsin response mediator protein (CRMP) family are reported to be involved in the pathogenesis of various neuronal disorders, including schizophrenia and autism. One of them, CRMP4, is reported to participate in aspects of neuronal development, such as axonal guidance and dendritic development. However, no physiological or behavioral phenotypes in Crmp4 knockout (Crmp4‐KO) mice have been identified, making it difficult to elucidate the in vivo roles of CRMP4. Focusing on the olfaction process because of the previous study showing strong expression of Crmp4 mRNA in the olfactory bulb (OB) during the early postnatal period, it was aimed to test the hypothesis that Crmp4‐KO pups would exhibit abnormal olfaction. Based on measurements of their ultrasonic vocalizations, impaired olfactory ability in Crmp4‐KO pups was found. In addition, c‐Fos expression, a marker of neuron activity, revealed hyperactivity in the OB of Crmp4‐KO pups compared with wild‐types following exposure to an odorant. Moreover, the mRNA and protein expression levels of glutamate receptor 1 (GluR1) and 2 (GluR2) were exaggerated in Crmp4‐KO pups relative to other excitatory and inhibitory receptors and transporters, raising the possibility that enhanced expression of these excitatory receptors contributes to the hyperactivity phenotype and impairs olfactory ability. This study provides evidence for an animal model for elucidating the roles of CRMP4 in the development of higher brain functions as well as for elucidating the developmental regulatory mechanisms controlling the activity of the neural circuitry.
Importance of gene dosage in controlling dendritic arbor formation during development
Authors: Copf Tijana 
Published: June 2015

AbstractProper dendrite morphology is crucial for normal nervous system functioning. While a number of genes have been implicated in dendrite morphogenesis in both invertebrates and mammals, it remains unclear how developing dendrites respond to changes in gene dosage and what type of patterns their responses may follow. To understand this, I review here evidence from the recent literature, focusing on the genetic studies performed in the Drosophila larval dendritic arborization class IV neuron, an excellent cell type to understand dendrite morphogenesis. I summarize how class IV arbors change morphology in response to developmental fluctuations in the expression levels of 47 genes, studied by means of genetic manipulations such as loss‐of‐function and gain‐of‐function, and for which sufficient information is available. I find that arbors can respond to changing gene dosage in several distinct ways, each characterized by a singular dose–response curve. Interestingly, in 72% of cases arbors are sensitive, and thus adjust their morphology, in response to both decreases and increases in the expression of a given gene, indicating that dendrite morphogenesis is a process particularly sensitive to gene dosage. By summarizing the parallels between Drosophila and mammals, I show that many Drosophila dendrite morphogenesis genes have orthologs in mammals, and that some of these are associated with mammalian dendrite outgrowth and human neurodevelopmental disorders. One notable disease‐related molecule is kinase Dyrk1A, thought to be a causative factor in Down syndrome. Both increases and decreases in Dyrk1A gene dosage lead to impaired dendrite morphogenesis, which may contribute to Down syndrome pathoetiology.
Decomposition kinetics and organic geochemistry of woody debris in a ferralsol in a humid tropical climate
Authors: Fujisaki K. , Perrin A.‐S. , Boussafir M. , Gogo S. , Sarrazin M. , Brossard M. 
Published: June 2015

SummaryLarge inputs of woody debris to soil can improve the soil. We examined the fate of woody debris buried in soil after fire‐free forest conversion to cropland inFrenchGuiana. We measured the mass loss of woody debris > 4 mm on five sampling dates for 4 years after deforestation. Composition of the organic matter of woody debris was analysed withRock‐Eval pyrolysis, which enabled us to distinguish a labile carbon pool (Clab) and a resistant carbon pool (Cres). Decomposition of woody debris followed a first‐order function with a half‐life of 17.6 months. During the decomposition of woody debris > 4 mm, theC:Nratio, hydrogen index (HI) and pyrolysed carbon below 400°C (R400) decreased, suggesting that decarboxylation and dehydrogenation of woody debris occurred. BothClabandCresstocks decreased with time, but the decrease inClabwas faster. There was little humification of the debris and no long‐term biogeochemical preservation of a woody debris fraction, which accords with the first‐order decay observed. We conclude that the benefits of ligno‐cellulosic inputs for soil organic carbon contents in a tropical humid climate occur during the first year following deforestation.RésuméLes apports massifs de débris de bois au sol peuvent améliorer le sol. Nous avons examiné sur un site enGuyane le devenir de débris de bois enfouis dans le sol, suite à la conversion sans brûlis de forêt en cultures. Nous avons mesuré le stock des débris de bois > 4 mm jusqu'à 4 années après déforestation. Les transformations de la matière organique des débris ont bois ont été analysées par la pyrolyseRock‐Eval, nous permettant de distinguer un compartiment de carbone labile (Clab) et un compartiment de carbone résistant (Cres) dans ces débris. La décomposition des débris de bois suit une décroissance exponentielle de premier ordre, avec une demi‐vie de 17,6 mois. Durant la décomposition des débris, le rapportC/N, l'indice d'hydrogène (HI) et le carbone pyrolysé avant 400°C (R400) diminuent, suggérant des processus de décarboxylation et déshydrogénation qui se mettent en place rapidement après l'enfouissement des débris. Les stocks deClabetCresdiminuent tous deux au cours du temps, avec une cinétique plus rapide pourClab. Ces résultats indiquent une faible polymérisation de la matière organique des débris, et une absence de préservation biogéochimique d'une partie des débris, en accord avec la décroissance exponentielle observée. Cette étude suggère que les bénéfices des amendements ligno‐cellulosiques pour la matière organique des sols sont de courte durée en milieu tropical humide.
Leaf economics and hydraulic traits are decoupled in five species‐rich tropical‐subtropical forests
Authors: Li Le , McCormack M. Luke , Ma Chengen , Kong Deliang , Zhang Qian , Chen Xiaoyong , Zeng Hui , Niinemets Ülo , Guo Dali 
Published: June 2015

AbstractLeaf economics and hydraulic traits are critical to leaf photosynthesis, yet it is debated whether these two sets of traits vary in a fully coordinated manner or there is room for independent variation. Here, we tested the relationship between leaf economics traits, including leaf nitrogen concentration and leaf dry mass per area, and leaf hydraulic traits including stomatal density and vein density in five tropical‐subtropical forests. Surprisingly, these two suites of traits were statistically decoupled. This decoupling suggests that independent trait dimensions exist within a leaf, with leaf economics dimension corresponding to light capture and tissue longevity, and the hydraulic dimension to water‐use and leaf temperature maintenance. Clearly, leaf economics and hydraulic traits can vary independently, thus allowing for more possible plant trait combinations. Compared with a single trait dimension, multiple trait dimensions may better enable species adaptations to multifarious niche dimensions, promote diverse plant strategies and facilitate species coexistence.
Agreement between two inertial sensor gait analysis systems for lameness examinations in horses
Authors: Pfau T. , Boultbee H. , Davis H. , Walker A. , Rhodin M. 
Published: June 2015

SummaryGait analysis is gaining popularity for quantification of lameness and 2 commonly used inertial sensor systems assess trunk movement symmetry: can these be used interchangeably in multi‐centre studies? We compared head and pelvic movement symmetry between 2 inertial sensor gait analysis systems in 13 horses equipped simultaneously with the 2 systems. The first system quantified dorsoventral movement in the local reference frame (System A) and the second system global vertical movement (System B). Widths of limits of agreement were calculated employing a well established regression method dealing with systematically changing differences over the range of measured values. Widths of limits of agreement between Systems A and B were narrower for pelvic movement than head movement. For head movement, they ranged from 6.4 to 6.9 mm for in‐hand trot and from 7.3 to 9.7 mm on the lunge and for pelvic movement from 2.5 to 4.4 mm in‐hand and from 3.6 to 5.3 mm on the lunge. Widths of limits of agreement between the 2 investigated inertial sensor gait analysis systems are of comparable magnitude (some equivalent, some marginally higher) to the currently proposed thresholds of 6 mm for head and 3 mm for pelvic movement used in lameness investigations. Differences in measurements with 2 different systems (A and B) obtained from the same horse falling within the reported values should not be seen as a sign of a change in lameness.