bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of timing and duration of thiopurine treatment on colectomy in ulcerative colitis: a national population‐based study of incident cases between 1989–2009
Authors: Chhaya V. , Saxena S. , Cecil E. , Chatu S. , Subramanian V. , Curcin V. , Majeed A. , Pollok R. C. 
Published: November 2014

SummaryBackgroundThe role of thiopurines in altering the risk of colectomy in ulcerative colitis (UC) remains unclear.AimsTo examine predictors of colectomy in UC and determine the impact of thiopurines on the risk of colectomy.MethodsWe constructed a population‐based cohort of incident cases of UC in the United Kingdom between 1989 and 2009. We determined trends in thiopurine usage and colectomy for three defined cohorts: era 1 (1989–1995), era 2 (1996–2002), era 3 (2003–2009). We used Cox regression to determine predictors of colectomy and quantified the impact of duration and timing of thiopurine use on the risk of colectomy.ResultsWe identified 8673 incident cases of UC. 5‐year colectomy rates increased from 4.2%, 5.1% to 6.9% (P = 0.001) for era 1, era 2 and era 3, respectively, despite increasing thiopurine use. This was not significant after adjustment for predictors of colectomy (P = 0.06). There was a higher risk of colectomy in men (HR 1.44, 95% CI: 1.19–1.73), those diagnosed at an early age (HR 1.35, 95% CI: 1.04–1.75; 16–24 vs. 25–64) and early steroid users (HR 1.94, 95% CI: 1.59–2.37). 5‐ASA users were less likely to require a colectomy (HR 0.35, 95% CI: 0.28–0.44). Amongst thiopurine users, those treated for greater than 12 months had a 71% reduction in risk of colectomy (HR 0.29, 95% CI: 0.21–0.40). Early thiopurines offered no additional benefit.ConclusionsThiopurine exposure for greater than 12 months reduces the likelihood of colectomy by 71%. Young men and those requiring steroids within 3 months of diagnosis are at greatest risk of colectomy, and most likely to benefit from sustained thiopurine use.
Histomorphological studies of the testis and male genital ducts of Supachai's caecilian, Ichthyophis supachaii Taylor, 1960 (Amphibia: Gymnophiona)
Authors: Pewhom Akkanee , Chumnanpuen Pramote , Muikham Itsares , Chatchavalvanich Kannika , Srakaew Nopparat 
Published: November 2014

We investigated the structure of the male reproductive system in Ichthyophis supachaii. The testis comprises a series of mulberry‐like lobes, each of which contains testis lobules occupied by germ cysts. A single cyst consists of synchronously developing germ cells. Six spermatogenic cell types, viz. primary spermatogonia, secondary spermatogonia, primary spermatocytes, secondary spermatocytes, spermatids and spermatozoa, have been identified and described. Notably, the testis of I. supachaii encompasses specific organization patterns of spermatids and spermatozoa during spermiogenesis. Spermiating cysts rupture and release spermatozoa to the collecting ducts, which are subsequently transported to the sperm duct, Wolffian duct and cloaca. We report for the first time ciliated cells in the epithelium of the caecilian Wolffian duct. The cloaca is divided into the urodeum and phallodeum. The urodeum has ciliated and glandular epithelia at its dorsolateral and ventral regions, respectively, as the lining of its internal surface. The muscular phallodeum is lined by ciliated epithelium. Paired Mullerian ducts lie parallel to the intestine and join the cloaca. The posterior portion of the duct is modified as the Mullerian gland. The most posterior region is non‐glandular and lined by ciliated epithelium. Our findings contribute further to information on the reproductive biology of caecilians in Thailand.
Current status of antibody therapy in ALL
Authors: Ai Jing , Advani Anjali 
Published: November 2014

SummaryDespite the significant advances in modern chemotherapy, it remains challenging to treat adult patients with acute lymphoblastic leukaemia (ALL). The relapse rate remains high, and the outcome at the time of relapse is dismal. Antibody‐based therapies have demonstrated promising results in this patient group. Variable mechanisms have been applied to target surface antigens (CD20 [also termed MS4A1], CD22, CD52 and CD19) that are commonly expressed on malignant leukaemia cells. In this review, we will focus on the clinical application of such therapies in adult ALL, including the naked antibodies: Rituximab, Ofatumumab, Epratuzumab and Alemtuzumab; the immunotoxins: BL22 and Combotox; the immunoconjugates: inotuzumab and SAR 3419; as well as the Bi‐specific T cell engaging (BiTE)‐specific antibody, Blinatumomab.
The role of FDG‐PET/CT in the evaluation of residual disease in paediatric non‐Hodgkin lymphoma
Authors: Bhojwani Deepa , McCarville Mary B. , Choi John K. , Sawyer Jennifer , Metzger Monika L. , Inaba Hiroto , Davidoff Andrew M. , Gold Robert , Shulkin Barry L. , Sandlund John T. 
Published: November 2014

Summary18F‐labelled–fluorodeoxyglucose positron emission tomography (FDG‐PET) findings are challenging to interpret for residual disease versus complete response in paediatric patients with non‐Hodgkin lymphoma (NHL). A biopsy is often warranted to confirm the presence or absence of viable tumour if there is clinical or radiographic evidence of residual disease. In this study, we compared conventional imaging and FDG‐PET/computerized tomography (CT) findings with biopsy results in 18 children with NHL. Our goal was to provide additional data to establish more reliable criteria for response evaluation. Residual disease was suspected after conventional imaging alone in eight patients, after FDG‐PET/CT alone in three and after both modalities in seven patients. Biopsy confirmed the presence of viable tumour in two patients. Two additional patients experienced progressive disease or relapse. The sensitivity and negative predictive value of FDG‐PET/CT using the London criteria to indicate residual tumour detectable by biopsy were 100%, but specificity was low (60%), as was the positive predictive value (25%). Thus, in this study, a negative FDG‐PET/CT finding was a good indicator of complete remission. However, because false‐positive FDG‐PET/CT findings are common, biopsy and close monitoring are required for accurate determination of residual disease in individual patients.
What Sort of Collective Bargaining Is Emerging in China?
Authors: Lee Chang‐Hee , Brown William , Wen Xiaoyi 
Published: November 2014

AbstractChina is experiencing a rapid expansion of what is termed ‘collective bargaining’. The article draws on workplace and sectoral examples to assess what underlies this. Recent changes in labour policy are outlined. Four studies at establishment level describe the use of hybrid representation in response to growing worker activism and internal union reform. Two studies of sectoral bargaining shed light on decentralized decision‐making on pay. Attention is drawn to the growth of employer organizations and increased articulation within the trade union. A form of collective bargaining is emerging where the union draws on state power to improve conditions of employment.
Patterns of surveillance imaging after nephrectomy in the Medicare population
Authors: Feuerstein Michael A. , Atoria Coral L. , Pinheiro Laura C. , Huang William C. , Russo Paul , Elkin Elena B. 
Published: November 2014

ObjectivesTo characterize patterns of imaging surveillance after nephrectomy in a population‐based cohort of older patients with kidney cancer.Patients and MethodsUsing the Surveillance, Epidemiology and End Results (SEER)‐Medicare database, we identified patients aged ≥66 years who underwent partial or radical nephrectomy for localized kidney cancer diagnosed between 2000 and 2009. Primary outcomes were chest imaging (X‐ray or computed tomography [CT]) and abdominal imaging (CT, MRI or ultrasonography) in Medicare claims from 4 to 36 months after surgery. We estimated the frequency of imaging in three time periods (postoperative months 4–12, 13–24, 25–36), stratified by tumour stage. Repeated‐measures logistic regression was used to identify the patient and disease characteristics associated with imaging.ResultsRates of chest imaging were 65–80%, with chest X‐ray surpassing CT in each time period. Rates of abdominal imaging were 58–76%, and cross‐sectional imaging was more common than ultrasonography in each time period. Use of cross‐sectional chest and abdominal imaging increased over time, while the use of chest X‐ray decreased (P < 0.01). Ultrasonography use remained stable for patients with T1 and T2 disease, but the rate of use decreased in patients with T3 disease (P < 0.05). Rates of chest and abdominal imaging increased with tumour stage (P < 0.001).ConclusionsPatterns of imaging suggest possible overuse in patients at low risk of recurrence and underuse in those at greater risk. New surveillance imaging guidelines may reduce unwarranted variability and promote risk‐based, cost‐effective management after nephrectomy.
The wingless-related integration site-5a/secreted frizzled-related protein-5 system is dysregulated in human sepsis
Authors: Schulte D M , Kragelund D , Müller N , Hagen I , Elke G , Titz A , Schädler D , Schumacher J , Weiler N , Bewig B , Schreiber S , Laudes M 
Published: November 2014

Summary
Sepsis and type 2 diabetes exhibit insulin resistance as a common phenotype. In type 2 diabetes we and others have recently provided evidence that alterations of the proinflammatory wingless-related integration site (wnt)-5a/anti-inflammatory secreted frizzled-related protein (sFRP)-5 system are involved in the pathogenesis of insulin resistance. The aim of the present study was to investigate whether this novel cytokine system is dysregulated in human sepsis, which may indicate a potential mechanism linking inflammation to metabolism. In this single-centre prospective observational study, critically ill adult septic patients were examined and proinflammatory wnt5a and wnt5a inhibitor sFRP5 were measured in serum samples by enzyme-linked immunosorbent assay (ELISA) at admission to the intensive care unit (ICU) and 5 days later. Sixty sepsis patients were included, and 30 healthy individuals served as controls. Wnt5a levels were found to be increased significantly in septic patients compared to healthy controls (2·21 ± 0·33 versus 0·32 ± 0·03 ng/ml, P &lt; 0·0001). In contrast, sFRP5 was not altered significantly in septic patients (19·72 ± 3·06 versus 17·48 ± 6·38 ng/ml, P = 0·07). On admission to the ICU, wnt5a levels exhibited a significant positive correlation with the leucocyte count (rs = 0·3797, P = 0·004). Interestingly, in patients recovering from sepsis, wnt5a levels declined significantly within 5 days (2·17 ± 0·38–1·03 ± 0·28 ng/ml, P &lt; 0·01). In contrast, if sepsis was worsening, wnt5a levels increased in the same time-period by trend (2·34 ± 0·59–3·25 ± 1·02 ng/ml, P &gt; 0·05). sFRP5 levels did not change significantly throughout the study period. The wnt5a/sFRP5 system is altered in human sepsis and might therefore be of interest for future studies on molecular pathophysiology of this common human disease.
Wildlife Harvest and Consumption in Amazonia's Urbanized Wilderness
Authors: Parry Luke , Barlow Jos , Pereira Heloisa 
Published: November 2014

AbstractUrbanization of forested wilderness could threaten biodiversity if expanding cities drive demand for wildlife as food. We examined the scale and drivers of urban wildlife consumption in the forested prefrontier of Brazilian Amazonia, defined as municipalities (n = 73) with over 90% of their original forest cover still intact. A representative survey of two prefrontier cities indicated that virtually all urban households consume wildlife, including fish (99%), bushmeat (mammals and birds; 79%), chelonians (48%) and caimans (28%)—alarming evidence of an underreported wild‐meat crisis in the heart of Amazonia. We also report rapid growth of cities and inadequate resources to deter illegal consumption in this urbanized wilderness covering 1.86 million km2. We evaluate relevant policy levers and conclude that poverty‐alleviation programs may accelerate a long‐term transition from consumption of wildlife as an economical source of protein for the poor to luxury food for the wealthy. We argue that innovative environmental governance could limit wildlife consumption to only harvest‐tolerant species. Researchers and policy‐makers should engage with policies and ideas that promote poverty alleviation and supply poor city‐dwellers with affordable alternatives to eating wildlife.
Community gastroenterologists can learn diminutive colon polyp histology characterization with narrow band imaging by a computer‐based teaching module
Authors: Sinh Preetika , Gupta Neil , Rao Deepthi S. , Wani Sachin , Sharma Prateek , Bansal Ajay , Allen John , Ketover Scott R. , Rastogi Amit 
Published: November 2014

Background and AimThe aim of the present study was to evaluate the impact of a computer‐based teaching module on the performance of community gastroenterologists for characterization of diminutive polyps (≤5 mm) using narrow band imaging video clips.MethodsEighty videos were distributed in pre‐ and post‐test DVD along with a 20‐min audiovisual teaching presentation detailing endoscopic features differentiating adenomas from hyperplastic polyps using narrow band imaging. Each participant first reviewed pretest video clips and entered their responses for polyp histology and their confidence in diagnosis: high: ≥90% or low: <90%. Following this, they reviewed the teaching module and assessed the post‐test videos. Performance characteristics were calculated for pre‐ and post‐test videos by comparing predicted histology with actual histology. Fisher's exact test was used for analysis and the kappa statistic was calculated for interobserver agreement.ResultsFifteen gastroenterologists in community practice completed the study. Sensitivity, specificity, accuracy and negative predictive value in characterization of polyp histology improved significantly post‐test compared to pretest. In post‐test, accuracy was 92% for high‐confidence diagnoses and the proportion of these increased with training from 46% (pretest) to 64% (post‐test); P < 0.001. Interobserver agreement for diagnosis improved from fair (kappa = 0.23) in pretest to moderate (kappa = 0.56) in post‐test.ConclusionsA teaching module using video clips can be used to teach community gastroenterologists polyp histology characterization by narrow band imaging. Whether this translates into real‐time high accuracy in polyp detection needs to be further evaluated.
Does trauma in the primary dentition cause sequelae in permanent successors? A systematic review
Authors: Lenzi Michele Machado , Alexandria Adílis Kalina , Ferreira Daniele Masterson T. P. , Maia Lucianne Cople 
Published: November 2014

AbstractThis systematic review sought scientific evidence (in the literature) that trauma in the primary incisors cause sequelae in permanent successors. Also this work verified whether there was a relation between the presence and type of sequelae in permanent teeth with the child's age at the time of injury and type of trauma. Electronic databases, including the PubMed, Scopus, The Cochrane Library, LILACS, and Web of Science were used to search for original articles up to June 2013. Prospective and retrospective studies that assessed the association of trauma in deciduous incisors and developmental disturbances in permanent successors were selected. Two authors independently reviewed and extracted the data from the included studies. A methodological quality assessment evaluation of the selected studies was performed. The search retrieved 258 citations. Initially, 19 studies fulfilled the selection criteria; however, one (1) was excluded, leaving 18 for the final selection. Despite some limitations in the study designs were observed, especially the lack of a control group in most studies, the evidence found suggests that individuals with trauma in their primary incisors have more developmental disorders in the permanent successors than individuals without a previous trauma. Furthermore, the younger the child is at the time of injury, the more frequent and more severe are the sequelae to the permanent successor incisors. More severe traumas such as intrusion and avulsion are associated to more serious developmental disorders. These results should be analyzed carefully because very few studies evaluated had a control group.
Genotype distribution of Raffaelea quercivora in the oak galleries and its composition in the mycangia of Platypus quercivorus
Authors: Takahashi Y. S. , Matsushita N. , Hogetsu T. 
Published: November 2014

SummaryRaffaelea quercivora is the pathogenic fungus that causes Japanese oak wilt. The female monogynous ambrosia beetle, Platypus quercivorus, carries this fungus in mycangia on the pronotum. These beetles bore galleries in oak trees with their partners to produce offspring, and they deposit fungus on the gallery walls from their mycangia. The offspring mature in the gallery, before loading the fungal pathogen and flying from the gallery to other healthy trees. To investigate the unloading and loading modes of the fungus within the gallery, we developed four polymorphic microsatellite markers for R. quercivora and identified the fungal genotypes in the galleries and mycangia of the beetles. Small wood chips were sampled at 5–10‐mm intervals from the walls of five galleries in a dead Quercus serrata tree. The pronota were also sampled from five female adult beetles. The genotypes of the R. quercivora isolates from the wood chips and pronota were identified using the microsatellite makers. The genotypic analysis showed that each gallery was inhabited patchily by 5–10 genotypes of R. quercivora, and the mycangia of each beetle contained 3–6 genotypes. These results indicate that diverse R. quercivora genotypes are unloaded repeatedly from the mycangia of female beetles onto the gallery wall, which results in their patchy distribution on the walls. When the offspring leave the host tree, the fungal clones that proliferate in the walls are also loaded repeatedly into the mycangia of the mature beetles.
The impact of caregivers on the effectiveness of an early community mental health detection and intervention programme in Hong Kong
Authors: Pan Jia‐Yan , Ng Yat‐Nam Petrus , Young Kim‐Wan Daniel 
Published: November 2014

AbstractAimThe prevalence rate of mental illness in Chinese communities is high, but Chinese clients tend to underutilize mental health services. Caregivers may play an important role in mental health early detection and intervention, but few studies have investigated their roles in community mental health services. This study compared the effectiveness of an early detection and intervention programme, the Community Mental Health Intervention Project, for two groups in the context of Hong Kong – clients with and without caregivers.MethodA comparison group pre–post‐test design was adopted. A total of 170 service users joined this study, including 100 with caregivers and 70 without caregivers.ResultsBoth groups showed a significant decrease in psychiatric symptoms and increase in community living skills; the group without caregivers indicated a greater reduction in psychiatric symptoms. Different social work intervention components had different predictive effects on these changes.ConclusionThe Community Mental Health Intervention Project is an effective early detection and intervention programme in working with Hong Kong Chinese people who are suspected of having mental health problems, especially for those without caregivers.
Venepuncture during head‐up tilt testing in patients with suspected vasovagal syncope – implications for the test protocol
Authors: Humm A. M. , Z'Graggen W. J. 
Published: November 2014

Background and purposeHead‐up tilt (HUT) testing is a widely used diagnostic tool in patients with suspected vasovagal syncope (VVS). However, no gold standard exists for this examination and the various protocols used have a limited sensitivity and specificity. Our aim was to determine the sensitivity of a sequential HUT testing protocol including venepuncture (VP) and sublingual nitroglycerin application.MethodsThis was a retrospective analysis of the diagnostic gain of a sequential HUT testing protocol including VP applied 10 min after the start of HUT testing and sublingual application of nitroglycerin 20 min after the start of the test protocol in 106 patients with a final diagnosis of VVS. The sensitivity of the test protocol was compared between patients with positive and negative history for VP induced VVS.ResultsOverall, pre‐syncope or syncope occurred in 68 patients (64.2%). Only 17% of all patients fainted spontaneously within 10 min of passive HUT. Another 39.6% fainted within 20 min. Application of nitroglycerin after 20 min of HUT evoked syncope in another 7.5% until the end of 45 min of HUT. The sensitivity of the test protocol for evoking (pre‐)syncope was 94.4% in patients with a positive history for VP associated VVS and 58% in patients with a negative history (P < 0.01**); 85.7% of patients with a positive history and 42.9% of patients with a negative history fainted within 20 min of HUT testing (P < 0.01**).ConclusionsImplementation of VP in sequential HUT testing protocols allows the sensitivity of HUT testing to be increased, especially in patients with a positive history for VP associated VVS.
Pallidal stimulation for acquired dystonia due to cerebral palsy: beyond 5 years
Authors: Romito L. M. , Zorzi G. , Marras C. E. , Franzini A. , Nardocci N. , Albanese A. 
Published: November 2014

Background and purposeThere is increasing evidence that deep brain stimulation (DBS) of the globus pallidus internus (GPi) is effective in patients with idiopathic or inherited generalized dystonia. There is comparatively less experience about the effects of GPi DBS on acquired dystonia, particularly dystonia due to cerebral palsy (DCP). Clinical and demographic outcome predictors for DBS in dystonia syndromes are also poorly defined. Our aim was to examine the efficacy and safety of GPi DBS for the treatment of generalized DCP.MethodsFifteen patients with DCP up to 6.2 years after DBS surgery were studied. Only mild limb spasticity or mild static brain magnetic resonance imaging abnormalities were acceptable for inclusion. Dystonia severity and disability were assessed by the Burke−Fahn−Marsden dystonia rating scale (BFMDRS), and health‐related quality of life was assessed by the Short Form General Health Survey (SF‐36) scale. The amount of energy delivered was calculated, and adverse events and side effects were collected.ResultsAt last follow‐up, BFMDRS motor score improved on average by 49.5%, and the disability score improved by 30%. Health‐related quality of life improved in most patients. Age at implant, age at onset and disease duration did not correlate to outcome, whilst higher pre‐operative dystonia severity and occurrence of spasticity were associated with poorer outcome. The patients received a stable amount of energy after the first 2 years post‐implant and throughout all the observation period. There were few serious adverse events or side effects.ConclusionsThe outcome was encouraging in the majority of DCP patients, with a stable outlook and a good safety profile.