bluuebunny/crossref_metadata_2025_split huggingface dataset:
A histopathological study of melanocytic and pigmented skin lesions in patients with albinism
Authors: van der Westhuizen Gerhard , Beukes Catherine A. , Green Brent , Sinclair Werner , Goedhals Jacqueline 
Published: August 2015

AbstractBackgroundOculocutaneous albinism (OCA) is a group of genetic disorders characterized by diminished pigmentation of the skin, hair and eyes. Individuals with OCA are at increased risk to develop sun‐induced skin malignancies. The incidence of malignant melanoma in OCA individuals is, however, very low. The aim of this study was to document pigmented and melanocytic skin lesions occurring in patients with OCA.MethodsA prospective study was performed. Sixteen patients with OCA presenting at the Oncology and Dermatology Departments at Universitas Academic Hospital Annex in Bloemfontein, South Africa, were included. Selected clinically pigmented and/or melanocytic lesions were biopsied and studied by light microscopy.ResultsTwenty‐four punch biopsies were taken. Ten dendritic freckles and 10 melanocytic nevi were confirmed histologically. The nevi, which occurred in eight patients, were found on sun‐protected skin. All the freckles occurred on sun‐exposed skin. Twelve patients had current or previous skin malignancies. No melanomas were present in the study population. Other skin lesions ranged from solar keratoses to squamous cell carcinomas.ConclusionThe majority of pigmented lesions were dendritic freckles that occurred on sun‐exposed skin. None of the patients had a current or previous diagnosis of malignant melanoma.
Laparoscopic splenectomy for hereditary spherocytosis—preliminary report
Authors: Rogulski Robert , Adamowicz‐Salach Anna , Matysiak Michał , Piotrowski Dariusz , Gogolewski Michał , Piotrowska Anna , Roik Danuta , Kamiński Andrzej 
Published: August 2015

AbstractSplenectomy is considered standard surgical therapy in hereditary spherocytosis. The procedure is indicated in patients with severe anemia, recurrent hemolytic, and aplastic crises. The aim of the study was to assess treatment outcomes in patients with hereditary spherocytosis who underwent total or partial laparoscopic splenectomy. Fifteen patients aged 4–17 yr underwent laparoscopic splenectomy from 2009 to 2012. Partial and total splenectomies were performed (five and 10 children, respectively). Hematologic parameters, liver function tests, and splenic volume before and after the surgery were analyzed retrospectively. Total follow‐up was 1–30 months. Hospitalization and operating time were similar in both groups. In partial splenectomy group, branches of splenic arteries gave better blood supply than short gastric vessels. In both groups, hematologic parameters were improved. Postoperative markedly elevated platelet count was maintained up to 6 months, and after that, platelet count gradually decreased to normal values. Bilirubin level was decreased in early postoperative period; however, it increased later to achieve levels lower than in preoperative period. No severe general infections were observed in both groups. Laboratory parameters (hemoglobin and bilirubin concentrations and RBC) after the surgery improved in all patients, and the effect was maintained during 12 months of follow‐up. Platelet count increased significantly after the surgery and was maintained at high levels during the next 6 months. However, it returned to preoperative levels within a year after the surgery. Our study showed that partial splenectomy was not inferior to total splenectomy. However, full assessment requires longer follow‐up and larger group of patients.
Practical recommendations for the process of proposing, planning and writing a neurological management guideline by EAN task forces
Authors: Leone M. A. , Keindl M. , Schapira A. H. , Deuschl G. , Federico A. 
Published: August 2015

The European Academy of Neurology (EAN), founded in 2014 after the merging of the two previously active European Neurological Societies, considers the production of neurological guidelines a major obligation, as this is a major tool to improve clinical practice in neurology. This paper updates practical suggestions to develop guidelines about the treatment and diagnosis of neurological diseases within the framework of the EAN. Its aim is to make uniform, traceable and explicit the path from the decision to write an EAN guideline to its publication. We explain the protocol structure, handling of conflicts of interest, format, timeline and process of revision and acceptance.It provides the view of the Scientific Committee and the Board of the EAN. We hope to make easier a larger involvement of the EAN scientific community in producing guidelines.
Predominance of caudate nucleus lesions in acute ischaemic stroke patients with impairment in language and speech
Authors: Grönholm E. O. , Roll M. C. , Horne M. A. , Sundgren P. C. , Lindgren A. G. 
Published: August 2015

Background and purposeWhereas traditional views of language processing in the brain have assumed that the language function is concentrated to a limited number of cortical areas (Broca's and Wernicke's areas), current knowledge points at a much more complex system of language and speech processing involving many brain areas, both cortical and subcortical. The purpose of the current study was to make an unbiased assessment of which cerebral areas are affected in first‐ever acute ischaemic stroke patients identified as having language and speech impairments according to the National Institutes of Health Stroke Scale (NIHSS).MethodsData from 34 patients with language and speech impairment, with a score of 1–3 on item 9 of the NIHSS, following ischaemic stroke were collected from the Lund Stroke Register. Magnetic resonance images acquired up to 20 days after stroke onset were used to create an overlap lesion image using MRIcron software.ResultsThe classical language areas, Wernicke's and Broca's areas, were affected in less than one‐fourth of the patients. The most frequently affected region was a subcortical region – the left caudate nucleus and the adjacent corona radiata.ConclusionsThese findings contribute to the growing body of evidence that the basal ganglia have a crucial role in the control over language and speech processing.
Ecological sensitivity of marl lakes to nutrient enrichment: evidence from Hawes Water, UK
Authors: Wiik Emma , Bennion Helen , Sayer Carl D. , Davidson Thomas A. , McGowan Suzanne , Patmore Ian R. , Clarke Stewart J. 
Published: August 2015

Summary

Highly calcareous (marl) lakes are infrequent but important freshwater ecosystems, protected under the EU Habitats and Species Directive. Chara lakes have been considered resistant to eutrophication owing to the self‐stabilising properties of charophyte meadows. However, the opposite is suggested by the large‐scale biodiversity declines in marl lake taxa in Europe, and evidence of charophyte sensitivity to eutrophication. We combined contemporary, palaeolimnological and archival methods to investigate the eutrophication of Hawes Water, a shallow marl lake in north‐west England (U.K.).

Changes in aquatic macrophyte and invertebrate communities were reconstructed through the analysis of historical macrophyte surveys and sedimentary plant and animal macrofossils in two dated sediment cores from the littoral and deep zones of the lake. In addition, chlorophyll and carotenoid pigments were analysed to track changes in primary production from benthic and pelagic areas. Substantial changes in macrophyte communities were detected over centennial timescales, suggesting high ecosystem sensitivity considering the presently moderate phosphorus concentrations in Hawes Water (mean annual total phosphorus 20 μg L−1).

Two apparent periods of threshold‐like change were identified from the sediment record: (i) changes in cyanobacteria (aphanizophyll + myxoxanthophyll to canthaxanthin + zeaxanthin) and potentially in nutrient stoichiometry, reductions in the maximum macrophyte colonisation depth and water clarity, reduced charophyte and Potamogeton diversity, and increases in Nymphaeaceae; and (ii) severe reductions in light availability inferred from subdecadal doubling in phytoplankton abundance, substantial increases in Daphnia abundance and the extinction of charophytes from higher water depths.

Further, change in both the littoral and deeper water has confined key marl lake taxa to smaller niches. In the littoral, increasing siltation and reed and Nymphaeaceae densities caused extinction of Littorella uniflora in the early 1900s and have reduced the evenness of Characeae with suspected imminent extinction of two highly localised Chara spp. In the deeper water, upslope creep of maximum colonisation depth has reduced habitat for intermediate‐depth marl lake taxa leading to the loss of four Potamogeton and one Chara species, and replacement of these taxa by Nuphar lutea.

The large changes in macrophyte community composition and increased incidences of turbid water have reduced the distinctive and valued marl lake features of Hawes Water, indicating that marl lakes can, as a habitat type, be highly sensitive to eutrophication. The persistence of abundant generalist macrophyte species at considerable water depth may be a feature of high‐alkalinity lakes in clearwater, macrophyte‐dominated states, but is a distinct eutrophication response in marl lakes rather than an indication of resistance to eutrophication.
Interactive multiple‐stressor effects of the antibiotic monensin, cattle effluent and light on stream periphyton
Authors: Winkworth Cynthia L. , Salis Romana K. , Matthaei Christoph D. 
Published: August 2015

Summary

Streams draining agricultural land are simultaneously exposed to multiple stressors including agricultural antibiotics and effluent from surface water run‐off. The potential interactive effects of these contaminants on stream benthic communities are poorly understood.

Using a streamside channel experiment with a full factorial, repeated‐measures design, we assessed the individual and combined effects of the veterinary antibiotic monensin (four concentrations versus control), dairy cattle effluent (added versus control) and differing light levels (reduced versus ambient) on benthic stream periphyton (biomass accrual, community composition and ecological algal guilds). Antibiotic and effluent treatments were applied during a 24‐hour pulse to simulate run‐off from farmland, while light was manipulated throughout the experiment, to mimic the presence or absence of riparian shading.

Periphyton taxon richness was decreased by the two highest antibiotic levels 8 days after the pulse. Multivariate community composition (relative abundances of the 15 most common periphyton taxa) was also affected by all three stressors 8 days post‐pulse. However, the periphyton community recovered within 16 days post‐pulse.

Interactions among stressors were fairly common, occurring for two of three ecological algal guilds and six of the 15 common taxa. Nevertheless, interactions were generally subtle, without any strong synergistic or antagonistic patterns.

Our study shows that the antibiotic monensin can negatively affect stream periphyton communities, but also implies short pulses may not have lasting impacts. The lack of strong synergistic or antagonistic interactions between monensin and light or effluent indicates monensin effects on stream periphyton may be predicted reasonably well based on single‐stressor studies.
Cancer incidence among HIV‐positive women in British Columbia, Canada: Heightened risk of virus‐related malignancies
Authors: Salters KA , Cescon A , Zhang W , Ogilvie G , Murray MCM , Coldman A , Hamm J , Chiu CG , Montaner JSG , Wiseman SM , Money D , Pick N , Hogg RS 
Published: August 2015

ObjectivesWe used population‐based data to identify incident cancer cases and correlates of cancer among women living with HIV/AIDS in British Columbia (BC), Canada between 1994 and 2008.MethodsData were obtained from a retrospective population‐based cohort created from linkage of two province‐wide databases: (1) the database of the BC Cancer Agency, a province‐wide population‐based cancer registry, and (2) a database managed by the BC Centre for Excellence in HIV/AIDS, which contains data on all persons treated with antiretroviral therapy in BC. This analysis included women (≥ 19 years old) living with HIV in BC, Canada. Incident cancer diagnoses that occurred after highly active antiretroviral therapy (HAART) initiation were included. We obtained a general population comparison of cancer incidence among women from the BC Cancer Agency. Bivariate analysis (Pearson χ2, Fisher's exact or Wilcoxon rank‐sum test) compared women with and without incident cancer across relevant clinical and sociodemographic variables. Standardized incidence ratios (SIRs) were calculated for selected cancers compared with the general population sample.ResultsWe identified 2211 women with 12 529 person‐years (PY) of follow‐up who were at risk of developing cancer after HAART initiation. A total of 77 incident cancers (615/100 000 PY) were identified between 1994 and 2008. HIV‐positive women with cancer, in comparison to the general population sample, were more likely to be diagnosed with invasive cervical cancer, Hodgkin's lymphoma, non‐Hodgkin's lymphoma and Kaposi's sarcoma and less likely to be diagnosed with cancers of the digestive system.ConclusionsThis study observed elevated rates of cancer among HIV‐positive women compared to a general population sample. HIV‐positive women may have an increased risk for cancers of viral‐related pathogenesis.
Postnatal retention in HIV care: insight from the Swiss HIV Cohort Study over a 15‐year observational period
Authors: Aebi‐Popp K , Kouyos R , Bertisch B , Staehelin C , Rudin C , Hoesli I , Stoeckle M , Bernasconi E , Cavassini M , Grawe C , Lecompte TD , Rickenbach M , Thorne C , Martinez de Tejada B , Fehr J ,   the Swiss Mother and Child HIV Cohort Study and the Swiss HIV Cohort Study
Published: August 2015

ObjectivesThe aim of this study was to quantify loss to follow‐up (LTFU) in HIV care after delivery and to identify risk factors for LTFU, and implications for HIV disease progression and subsequent pregnancies.MethodsWe used data on pregnancies within the Swiss HIV Cohort Study from 1996 to 2011. A delayed clinical visit was defined as > 180 days and LTFU as no visit for > 365 days after delivery. Logistic regression analysis was used to identify risk factors for LTFU.ResultsA total of 695 pregnancies in 580 women were included in the study, of which 115 (17%) were subsequent pregnancies. Median maternal age was 32 years (IQR 28–36 years) and 104 (15%) women reported any history of injecting drug use (IDU). Overall, 233 of 695 (34%) women had a delayed visit in the year after delivery and 84 (12%) women were lost to follow‐up. Being lost to follow‐up was significantly associated with a history of IDU [adjusted odds ratio (aOR) 2.79; 95% confidence interval (CI) 1.32–5.88; P = 0.007] and not achieving an undetectable HIV viral load (VL) at delivery (aOR 2.42; 95% CI 1.21–4.85; P = 0.017) after adjusting for maternal age, ethnicity and being on antiretroviral therapy (ART) at conception. Forty‐three of 84 (55%) women returned to care after LTFU. Half of them (20 of 41) with available CD4 had a CD4 count < 350 cells/μL and 15% (six of 41) a CD4 count < 200 cells/μL at their return.ConclusionsA history of IDU and detectable HIV VL at delivery were associated with LTFU. Effective strategies are warranted to retain women in care beyond pregnancy and to avoid CD4 cell count decline. ART continuation should be advised especially if a subsequent pregnancy is planned.
Feasibility, Acceptability, and Preliminary Effects of the COPE Online Cognitive‐Behavioral Skill‐Building Program on Mental Health Outcomes and Academic Performance in Freshmen College Students: A Randomized Controlled Pilot Study
Authors: Melnyk Bernadette Mazurek , Amaya Megan , Szalacha Laura A. , Hoying Jacqueline , Taylor Tiffany , Bowersox Kristen 
Published: August 2015

ProblemDespite the increasing prevalence of mental health disorders in university students, few receive needed evidence‐based treatment.ObjectiveThe purpose of this study was to assess the feasibility and preliminary effects of a seven‐session online cognitive‐behavioral skill‐building intervention (i.e., COPE, Creating Opportunities for Personal Empowerment) versus a comparison group on their anxiety, depressive symptoms, and grade performance.MethodsA randomized controlled pilot study was conducted from September 2012 to May 2013 with 121 college freshmen enrolled in a required one credit survey course.FindingsAlthough there were no significant differences in anxiety and depressive symptoms between the groups, only COPE students with an elevated level of anxiety at baseline had a significant decline in symptoms. Grade point average was higher in COPE versus comparison students. Evaluations indicated that COPE was a positive experience for students.ConclusionsCOPE is a promising brief intervention that can be integrated effectively into a required freshman course.
Percent Time With a Supratherapeutic INR in Atrial Fibrillation Patients Also Using an Antiplatelet Agent Is Associated With Long‐Term Risk of Dementia
Authors: JACOBS VICTORIA , WOLLER SCOTT C. , STEVENS SCOTT M. , MAY HEIDI T. , BAIR TAMI L. , CRANDALL BRIAN G. , CUTLER MICHAEL , DAY JOHN D. , WEISS J. PETER , OSBORN JEFFREY S. , MALLENDER CHARLES , ANDERSON JEFFREY L. , BUNCH T. JARED 
Published: August 2015

Antiplatelet and Warfarin Use and Risk of Dementia in Atrial Fibrillation PatientsBackgroundPatients with atrial fibrillation (AF) are at higher risk of developing dementia. AF patients treated with warfarin with poor time in therapeutic ranges are significantly more likely to develop dementia. AF patients are also frequently treated with antiplatelet agents due to coexistent vascular disease. We hypothesize that AF patients with anticoagulation and antiplatelet therapies will be at higher risk of dementia, particularly with chronic exposure to over‐anticoagulation.MethodsChronically anticoagulated patients receiving warfarin (target INR 2–3) for AF and managed by the Intermountain Healthcare Clinical Pharmacist Anticoagulation Service (CPAS) on concurrent antiplatelet agents with no history of dementia or stroke/TIA were included. The primary outcome was the presence of dementia defined by neurologist determined ICD‐9 codes. Percent time with an INR>3.0 was determined and then compared by 3 strata <10% (n = 340), 10–24% (n = 417), ≥25% (n = 235). Multivariable Cox hazard regression was utilized to determine dementia incidence by percent time.ResultsA total of 992 patients were studied. Patients with an INR>3 more than 25% of the time were 2.40 times more likely to develop dementia (P = 0.04). A comparison between < 10% group and 10–24.9% group with INR>3 indicated no difference in risk for the development of dementia (P = 0.74). The risk was significantly increased in patients using triple antithrombotic therapy, although the number of patients within this group was small.ConclusionIn AF patients receiving antiplatelet and anticoagulant therapies, the percent of time exposed to over‐anticoagulation increased dementia risk. These data support the possibility of chronic cerebral injury from microbleeds as a mechanism underlying the association of AF and dementia.
Lessons Learned from Asymptomatic Acute Coronary Occlusion Complicating Radiofrequency Ablation of Right Ventricular Outflow Tract Tachycardia
Authors: DILLING‐BOER DAGMARA , VANDUYNHOVEN PHILIPPE 
Published: August 2015

Asymptomatic Coronary Occlusion and Right Ventricular Outflow Tract Tachycardia AblationIntroductionRadiofrequency ablation has become a standard procedure in the treatment of ventricular arrhythmias. The success rate varies according to the etiology and the presence or absence of underlying structural heart disease, while complication rates are relatively low.MethodsTo describe the damage in neighboring structures during the ablation in certain locations.ResultsWe present a patient who underwent a radiofrequency ablation of sustained monomorphic ventricular tachycadia at the inferior and anterior part of the right ventricular outflow tract, at the insertion of the right ventricle to the left ventricle. Extensive ablation resulted in an asymptomatic occlusion of the mid segment of the left descending coronary artery.ConclusionCreation of deeper and broader lesions with current catheter technologies can result in damage of the adjacent endo‐ and epicardial structures. Careful evaluation of the area of interest prior to and after the ablation should therefore be mandatory.
The Mechanism of Reflection Type Reentry: A Simulation Study
Authors: KANDEL SUNIL M. , ROTH BRADLEY J. 
Published: August 2015

The Mechanism of Reflection Type ReentryIntroductionReflection is a special type of reentry in which an electrical wave front travels in a forward direction through tissue that is then re‐excited by a wave front that propagates backward. This type of reentry has been studied computationally in 1‐dimensional fibers and verified experimentally. Different hypotheses explaining reflected reentry have been proposed based on the structure and heterogeneity of the tissue properties, but the mechanism remains uncertain.Methods and ResultsWe used the bidomain model to represent cardiac tissue and the Luo–Rudy model to describe the active membrane properties. We consider an ischemic region in a volume of ventricular myocardium. Our results show that a slow depolarization in the ischemic border zone caused by electrotonic coupling to depolarized tissue in the normal region creates a delay between proximal and distal regions that produces enough electrotonic current in the distal region to re‐excite the proximal region.ConclusionOur simulation shows that an early afterdepolarization (EAD) is not the source of the reflection. It depends on the pacing interval and stimulus strength necessary to maintain enough time delay between proximal and distal regions.
The role of evidence analysts in creating nutrition management guidelines for inherited metabolic disorders
Authors: Osara Yetsa , Coakley Kathryn , Aisthorpe Alana , Stembridge Adrya , Quirk Meghan , Splett Patricia L , Rohr Fran , Singh Rani H. 
Published: August 2015

AbstractRationale, aims and objectivesEvidence and consensus‐based guidelines for nutrition management of maple syrup urine disease (MSUD) were developed as part of a project to create nutrition guidelines for inherited metabolic disorders identified through newborn screening. The objective of this study was to describe and evaluate the role of evidence analysts in the systematic review phase of guideline development to improve quality of process and output and inform future guideline development projects.MethodsRecruitment, training and output of evidence analysts were documented throughout the MSUD project. The role of analysts was to critically review and rate the scientific quality of published literature and abstract pertinent information using quality checklists and abstraction worksheets. A secure, web‐based application was developed to standardize the process and establish permanent documentation. Analysts completed a post‐project survey on perceptions of their role, training and the evidence analysis process.ResultsOf 23 recruits, 65% (15) completed evidence analyst training; 73% of those (11) participated in the analysis of 98 literature articles. Analysts reviewed a median of four articles (range 1–16) with median productivity of 1.1 articles per month. All analysts surveyed (n = 9) understood their role and agreed that training was adequate; 100% agreed that analyst involvement was critical in developing guidelines for MSUD.ConclusionEvidence analysts played a key role in appraising and abstracting evidence to develop nutrition guidelines for MSUD. With critical improvements to the process, particularly more stringent and systematic evaluation and documentation of analyst performance related to productivity and quality, we will continue to recruit, train and support evidence analysts in evidence‐based guideline development projects.