bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of pars plana vitrectomy and nuclear cataract on oxygen saturation in retinal vessels, diabetic and non‐diabetic patients compared
Authors: Šín Martin , Chrapek Oldřich , Karhanová Marta , Šínová Irena , Špačková Kareřina , Langová Kateřina , Řehák Jiří 
Published: August 2015

AbstractPurposeTo determine the effect of pars plana vitrectomy (PPV) on oxygen saturation in retinal vessels in patients with diabetes and non‐diabetes after a 1‐year follow‐up.MethodsThis was a prospective consecutive interventional case series in 82 eyes in 82 patients. The sample consisted of 25 patients with non‐proliferative diabetic retinopathy with macular oedema based on vitreoretinal traction or epiretinal membrane (ERM) and 57 non‐diabetic patients with macular hole and ERM. Automatic retinal oximetry (Oxymap Inc.) was used on all patients 24 hr prior to PPV, and it was also used 7 and 52 weeks after PPV (classic 20G or sutureless 23G). We analysed the data according to subgroup diagnosis and lens status.ResultsArterial saturation increased significantly from 96.4 ± 2.9% at baseline to 96.6 ± 3.4% at week 7 and 97.3 ± 3.4% at week 52 (p < 0.0001; Friedman test). Vein saturation also increased significantly from 63.5 ± 7.9% at baseline to 66.1 ± 7.7% and 67.0 ± 7.2% at weeks 7 and 52 (p < 0.0001; Friedman test). The value of the arteriovenous (A‐V) difference decreased significantly after vitrectomy from 32.8 ± 7.5% at baseline to 30.5 ± 7.5% and 30.3 ± 7.0% at weeks 7 and 52 (p < 0.0001; Friedman test). The subgroup analysis revealed that in patients with diabetes, there were no statistically significant changes in oxygen saturation in blood vessels or in the A‐V difference after PPV. After vitrectomy, retinal vessel diameter reduced by about 3.5% in both groups of patients. Further, the analysis revealed that opacification of the lens leads to a decrease in oxygen saturation in contrast to a clear lens and pseudophakic IOLs.ConclusionOxygen saturation is higher in the retinal veins and arteries after PPV in patients with non‐diabetes, and this lasts for at least 52 weeks. In contrast, in patients with diabetes, there is no increase in oxygen saturation in the retinal vessels after vitrectomy. After vitrectomy, retinal vessel diameter reduced in both groups of patients. Further, the nuclear cataract progression has substantial effect on oximetry results. Patients with nuclear cataract exhibited an increase in saturation in both arteries and veins, but the A‐V difference remained the same.
Long‐Term Pharmacotherapy of Adults With Attention Deficit Hyperactivity Disorder: A Literature Review and Clinical Study
Authors: Fredriksen Mats , Peleikis Dawn E. 
Published: August 2015

AbstractThis MiniReview reports and discusses the main findings of the author's thesis including a literature study of long‐term pharmacological treatment of adults with attention deficit hyperactivity disorder (ADHD), and a clinical study of 1‐year medication. Electronic databases were systematically reviewed for original studies on pharmacotherapy of the defined duration, 24 weeks or more. Although few trials were found with limitations such as excluding comorbidities, treatment with stimulants and atomoxetine was reported tolerated and effective compared to non‐treatment. The clinical study of the thesis was conducted on 250 medication‐naïve patients with ADHD referred to a specialized outpatient clinic. Comorbid psychiatric disorders were diagnosed among 75% of the patients. About 56% had not completed secondary school, and 51% had been unable to work the preceding year. Persisting inattentive symptoms and comorbid mental disorders in adulthood were related to long‐term work disability. In the prospective observational study of the thesis, patients were treated with methylphenidate as first‐line drug and atomoxetine or dexamphetamine as second‐line drugs, according to current treatment guidelines. At 12‐month follow‐up, 232 patients completed evaluation and 70% persisted on medication. About 80% of these used methylphenidate. Sustained improvement of symptoms and functioning was related to continued medication. Comorbid mental disorders and side effects were related to lower effectiveness and adherence, and 12% stopped medication due to side effects. Summing up the MiniReview, treatment with stimulants and atomoxetine of adults with ADHD has long‐term beneficial effects and is tolerated but more longitudinal studies should be performed. With stated limitations, the findings of the thesis should contribute to a relevant guidance for clinical practice.
Effects of 22 Novel CYP2D6 Variants Found in the Chinese Population on the Bufuralol and Dextromethorphan Metabolisms In Vitro
Authors: Cai Jie , Dai Da‐Peng , Geng Pei‐Wu , Wang Shuang‐Hu , Wang Hao , Zhan Yun‐Yun , Huang Xiang‐Xin , Hu Guo‐Xin , Cai Jian‐Ping 
Published: August 2015

AbstractCytochrome P450 2D6 (CYP2D6) is a highly polymorphic enzyme that metabolizes a large number of therapeutic drugs. To date, more than 100 CYP2D6 allelic variants have been reported. Among these variants, we recently identified 22 novel variants in the Chinese population. The aim of this study was to functionally characterize the enzymatic activity of these variants in vitro. A baculovirus‐mediated expression system was used to express wild‐type CYP2D6.1 and other variants (CYP2D6.2, CYP2D6.10 and 22 novel CYP2D6 variants) at high levels. Then, the insect microsomes containing expressed CYP2D6 proteins were incubated with bufuralol or dextromethorphan at 37°C for 20 or 25 min., respectively. After termination, the metabolites were extracted and used for the detection with high‐performance liquid chromatography. Among the 24 CYP2D6 variants tested, two variants (CYP2D6.92 and CYP2D6.96) were found to be catalytically inactive. The remaining 22 variants exhibited significantly decreased intrinsic clearance values for bufuralol 1′‐hydroxylation and 20 variants showed significantly lower intrinsic clearance values for dextromethorphan O‐demethylation than those of the wild‐type CYP2D6.1. Our in vitro results suggest that most of the variants exhibit significantly reduced catalytic activities compared with the wild‐type, and these data provide valuable information for personalized medicine in Chinese and other Asian populations.
Impact of centralized diagnostic review on quality of initial staging in Hodgkin lymphoma: experience of the German Hodgkin Study Group
Authors: Bröckelmann Paul J. , Goergen Helen , Fuchs Michael , Kriz Jan , Semrau Robert , Baues Christian , Kobe Carsten , Behringer Karolin , Eichenauer Dennis A. , von Tresckow Bastian , Klimm Beate , Halbsguth Teresa , Wongso Diana , Plütschow Annette , Haverkamp Heinz , Dietlein Markus , Eich Hans T. , Stein Harald , Diehl Volker , Borchmann Peter , Engert Andreas 
Published: August 2015

SummaryAccurate clinical staging is crucial for adequate risk‐adapted treatment in Hodgkin lymphoma (HL) to prevent patients from under‐ or over‐treatment. Within the latest German Hodgkin Study Group trial generation, diagnostic findings such as histopathology, computerized tomography imaging and clinical risk factors were re‐evaluated by expert panels. Here, we retrospectively analysed 5965 patients and identified 399 in who major discordant findings changed their first‐line treatment allocation. Histopathology review did not confirm the initial diagnosis of HL in 87 patients. Treatment allocation was revised in 312 of the remaining 5878 patients: 176 were assigned to a higher and 128 to a lower risk group, respectively; the correct treatment group remained unclear in 8 patients. Cases of revised treatment allocation accounted for 9·8%, 6·0%, 0·8%, and 14·8% of patients initially assigned to the HD13, HD14, HD15 trials and stage IA lymphocyte‐predominant HL project, respectively. Most revisions were due to wrong application of clinical stage (20·5% of 312 patients with revised treatment group), histological subtype (9·0%) or the risk factors ≥3 involved areas (46·8%) or large mediastinal mass (9·3%). In conclusion, centralized review by experienced experts changed risk‐adapted first‐line treatment in a relevant proportion of HL patients. Quality control measures clearly improve the accuracy of treatment and should be implemented in clinical practice.
The case for an autoimmune aetiology of type 1 diabetes
Authors: Mannering S I , Pathiraja V , Kay T W H 
Published: August 2015

SummaryType 1 diabetes (T1D) develops when there are insufficient insulin-producing beta cells to maintain glucose homeostasis. The prevailing view has been that T1D is caused by immune-mediated destruction of the pancreatic beta cells. However, several recent papers have challenged the long-standing paradigm describing T1D as a tissue-specific autoimmune disease. These authors have highlighted the gaps in our knowledge and understanding of the aetiology of T1D in humans. Here we review the evidence and argue the case for the autoimmune basis of human T1D. In particular, recent analysis of human islet-infiltrating T cells brings important new evidence to this question. Further data in support of the autoimmune basis of T1D from many fields, including genetics, experimental therapies and immunology, is discussed. Finally, we highlight some of the persistent questions relating to the pathogenesis of human type 1 diabetes that remain to be answered.
Reframing the concept of alternative livelihoods
Authors: Wright Juliet H. , Hill Nicholas A. O. , Roe Dilys , Rowcliffe J. Marcus , Kümpel Noëlle F. , Day Mike , Booker Francesca , Milner‐Gulland E. J. 
Published: August 2015

AbstractAlternative livelihood project (ALP) is a widely used term for interventions that aim to reduce the prevalence of activities deemed to be environmentally damaging by substituting them with lower impact livelihood activities that provide at least equivalent benefits. ALPs are widely implemented in conservation, but in 2012, an International Union for Conservation of Nature resolution called for a critical review of such projects based on concern that their effectiveness was unproven. We focused on the conceptual design of ALPs by considering their underlying assumptions. We placed ALPs within a broad category of livelihood‐focused interventions to better understand their role in conservation and their intended impacts. We dissected 3 flawed assumptions about ALPs based on the notions of substitution, the homogenous community, and impact scalability. Interventions based on flawed assumptions about people's needs, aspirations, and the factors that influence livelihood choice are unlikely to achieve conservation objectives. We therefore recommend use of a sustainable livelihoods approach to understand the role and function of environmentally damaging behaviors within livelihood strategies; differentiate between households in a community that have the greatest environmental impact and those most vulnerable to resource access restrictions to improve intervention targeting; and learn more about the social–ecological system within which household livelihood strategies are embedded. Rather than using livelihood‐focused interventions as a direct behavior‐change tool, it may be more appropriate to focus on either enhancing the existing livelihood strategies of those most vulnerable to conservation‐imposed resource access restrictions or on use of livelihood‐focused interventions that establish a clear link to conservation as a means of building good community relations. However, we recommend that the term ALP be replaced by the broader term livelihood‐focused intervention. This avoids the implicit assumption that alternatives can fully substitute for natural resource‐based livelihood activities.
Custom‐Fitted EVA Mouthguards: what is the ideal thickness? a dynamic finite element impact study
Authors: Verissimo Crisnicaw , Costa Paulo Victor Moura , Santos‐Filho Paulo Cesar Freitas , Tantbirojn Daranee , Versluis Antheunis , Soares Carlos José 
Published: August 2015

AbstractBackground/AimThe aim of this study was to evaluate the tooth stresses and strains, shock absorption, and displacement during impact of custom‐fitted mouthguards with different thicknesses.MethodsSix bar‐shaped specimens of the EVA were made and subjected to tensile test for elastic modulus assessment. Two‐dimensional plane‐strain models of a human maxillary central incisor, periodontal ligament, bone support, soft tissue, and mouthguard (MTG) were created. The mouthguards were modeled in five different thicknesses (2, 3, 4, 5, and 6 mm). One model was created without mouthguard. A nonlinear dynamic impact analysis was performed in which a rigid object hit the model at 1 m s−1. Strain and stress (von Mises and Critical modified von Mises) distributions were evaluated, and the displacement of the mouthguard with respect to the tooth was calculated.ResultsThe mean [SD] for the EVA elastic modulus was 18.075 [0.457] MPa. The model without mouthguard showed the highest stress values at the enamel and dentin structures in the tooth crown during the impact. For the MTG models, the location of the stress concentrations changed to the root, regardless of the MTG thickness, but maximum stresses in the enamel and dentin were lower compared with the model without MTG. Increasing the mouthguard thickness did not notably decrease the stress‐strain values.ConclusionIt was concluded that the use of a mouthguard promoted lower stresses and strains in teeth during an impact with a rigid object. There was no substantial difference in peak stresses and strains and in shock absorption among the different mouthguard thicknesses.
Young adults' experiences of their parents caring for a relative with dementia
Authors: Hou Pik Yi , Lai Claudia Kam Yuk , Chung Ching Sum , Sham Amy Kin Kwan , Yeung Ching Lai 
Published: August 2015

AimThe aim of the present study was to explore the experiences and perceptions young adults had of family members who are caring for a relative with dementia.MethodsAn exploratory qualitative study with semi‐structured interviews was carried out and data were collected from 24 young adults recruited through purposive sampling. The participants had to have a close relative who was caring for an elderly family member with dementia. A content analysis approach was used for the verbatim transcription.ResultsThe findings showed that caring for a relative with dementia was perceived as a time‐consuming, exhausting and long‐term task. The participants experienced stress and strain, although they were not the primary caregivers. Despite their negative perceptions of the task, they were willing to take on the responsibility of becoming a primary caregiver in the future. However, they intended to seek assistance in meeting their caregiving roles and responsibilities. Seeing how their close relative cared for a dependent older adult led them to reflect on what they would become in the future. Interestingly, although the participants expected their future offspring to take care of them when they became old, they did not want to be a burden to their children.ConclusionYoung adults are the caregivers of tomorrow. Knowing their perspective on caregiving is important if health professionals are to help them evolve into a caregiving role. It has implications for realizing the goal of aging in place. Geriatr Gerontol Int 2016; 16: 873–879.
Impact of board‐certificated physiatrists on rehabilitation outcomes in elderly patients after hip fracture: An observational study using the Japan Rehabilitation Database
Authors: Momosaki Ryo , Kakuda Wataru , Yamada Naoki , Abo Masahiro 
Published: August 2015

AimTo clarify the impact on rehabilitation outcomes of board‐certificated physiatrists (BCP) as the physicians with primary responsibility for elderly patients in convalescent rehabilitation wards after hip fracture.MethodsThe present retrospective observational study used 2005–2013 data from the Japan Rehabilitation Database. We identified in‐hospital patients with hip fracture admitted to rehabilitation wards. After applying exclusion criteria, 824 patients were eligible. The primary outcome was functional independence measure instrument efficiency.ResultsBCP were responsible for the care of 46% of patients with hip fracture. Patients who were managed by a BCP had significantly higher mean functional independence measure efficiency than patients who were not, both before and after adjustment by inverse propensity‐score weighting (0.37 vs 0.26; P = 0.04 and 0.39 vs 0.26; P < 0.01, respectively). Additionally, the mean length of stay was significantly shorter in patients who were managed by BCP than in those who were not, both before and after inverse propensity‐score weighting (65 vs 71 days, P = 0.04 and 64 vs 69 days, P < 0.01, respectively).ConclusionsOur data suggest that the participation of BCP is associated with good rehabilitation outcomes in patients with hip fracture at convalescent rehabilitation wards. Geriatr Gerontol Int 2016; 16: 963–968.
Frequency, nature and outcomes of hospital admissions in centenarians in an area of North‐East England
Authors: Dotchin Catherine L , Gray William K , Gaskin Elizabeth , Hartley Samantha , Walker Richard W 
Published: August 2015

AimsThere are few data on the use of hospital services by centenarians living in the UK. In the present study, we recorded the frequency, nature and outcomes of hospital admissions in centenarians in an area of North‐East England.MethodsData regarding hospital attendance in centenarians in Northumberland and North Tyneside, covered by one National Health Service Trust, were collected. For the years 2010–2013, demographics, frequency of admission and length of hospital stay data were collected. Medical notes for those admitted in 2011 were reviewed, and data extracted relating to diagnosis, medications and past medical history.ResultsAcross the 4 years of the study, there were 349 hospital attendances of centenarians. A total of 264 of these attendances resulted in admission with an overnight stay. In 2011, there were 107 attendances, 75 of which (in 54 unique patents) resulted in admission and an overnight stay. The unique patients admitted represented 41.5% of the centenarians living in the catchment area. The most common primary reason for admission in centenarians was respiratory tract infection, though falls were a primary or secondary reason for admission in 41.3% of centenarians. There were 11 in‐hospital deaths in 2011, and a further seven deaths within 30 days of discharge. The median number of medications taken on admission and discharge was six.ConclusionsAlmost half of the centenarians living in the catchment area were admitted to hospital during 2011. Over 25% of admissions either died in hospital or within 30 days of discharge. Geriatr Gerontol Int 2016; 16: 969–975.
Comprehensive Geriatric Assessment is a useful predictive tool for postoperative delirium after gastrointestinal surgery in old‐old adults
Authors: Maekawa Yoshihiro , Sugimoto Ken , Yamasaki Makoto , Takeya Yasushi , Yamamoto Koichi , Ohishi Mitsuru , Ogihara Toshio , Shintani Ayumi , Doki Yuichiro , Mori Masaki , Rakugi Hiromi 
Published: August 2015

AimTo determine whether carrying out the Comprehensive Geriatric Assessment before operations would be useful for predicting complications, particularly postoperative delirium (POD), in old‐old patients.MethodsA total of 517 patients aged 75 years and older, who underwent radical surgery for gastrointestinal cancer at Osaka University Hospital, were recruited for this observational study. The Comprehensive Geriatric Assessment components and assessment of performance status were carried out before surgery, and a record of postoperative complications including POD was made prospectively until discharge from hospital. The following morphological and clinical measurements were also obtained from the medical records: age, sex, disease type, previous history, comorbid lifestyle‐related diseases, POD, postoperative complications, operative method, duration of operation, hemorrhage volume, blood transfusion volume, method of anesthesia, body mass index and blood tests.ResultsPOD appeared in 24.0% of the 517 patients who underwent surgery. Barthel Index, Mini‐Mental State Examination, instrumental activities of daily living and Geriatric Depression Scale results were associated with the incidence of POD, and the Barthel Index, Mini‐Mental State Examination and Instrumental Activities of Daily Living results were extracted as independent factors associated with the development of POD after adjusting for traditional risk factors for postoperative complications and performance status.ConclusionsThe Comprehensive Geriatric Assessment before gastrointestinal surgery can be a useful tool for predicting the development of POD in old‐old patients. Geriatr Gerontol Int 2016; 16: 1036–1042.
Field Investigation of a New Recharge Approach for ASR Projects in Near‐Surface Aquifers
Authors: Liu Gaisheng , Knobbe Steven , Reboulet Edward C. , Whittemore Donald O. , Händel Falk , Butler James J. 
Published: August 2015

AbstractAquifer storage and recovery (ASR) is the artificial recharge and temporary storage of water in an aquifer when water is abundant, and recovery of all or a portion of that water when it is needed. One key limiting factor that still hinders the effectiveness of ASR is the high costs of constructing, maintaining, and operating the artificial recharge systems. Here we investigate a new recharge method for ASR in near‐surface unconsolidated aquifers that uses small‐diameter, low‐cost wells installed with direct‐push (DP) technology. The effectiveness of a DP well for ASR recharge is compared with that of a surface infiltration basin at a field site in north‐central Kansas. The performance of the surface basin was poor at the site due to the presence of a shallow continuous clay layer, identified with DP profiling methods, that constrained the downward movement of infiltrated water and significantly reduced the basin recharge capacity. The DP well penetrated through this clay layer and was able to recharge water by gravity alone at a much higher rate. Most importantly, the costs of the DP well, including both the construction and land costs, were only a small fraction of those for the infiltration basin. This low‐cost approach could significantly expand the applicability of ASR as a water resources management tool to entities with limited fiscal resources, such as many small municipalities and rural communities. The results of this investigation demonstrate the great potential of DP wells as a new recharge option for ASR projects in near‐surface unconsolidated aquifers.