bluuebunny/crossref_metadata_2025 huggingface dataset:
The Prognostic Value of High-Sensitive Troponin I in Stable Coronary Artery Disease Depends on Age and Other Clinical Variables
Authors: Carda Rocío , Aceña Álvaro , Pello Ana , Cristóbal Carmen , Tarín Nieves , Huelmos Ana , Alonso Joaquín , Asensio Dolores , Lorenzo Óscar , Martín-Ventura José Luis , Blanco-Colio Luis , Farré Jerónimo , López Bescós Lorenzo , Egido Jesús , Tuñón José
Published: June 2015

Objectives: To study the prognostic value of high-sensitive troponin (hs-cTn) I in stable coronary artery disease. Methods: In total, we studied 705 patients. Secondary outcomes were the incidence of: (1) acute ischemic events and (2) heart failure or death. The primary outcome was the composite of them. Results: Patients with hs-cTnI >0 ng/ml (62.1%) were older, had a lower estimated glomerular filtration rate, more frequent a history of hypertension, atrial fibrillation, ejection fraction <40%, and therapy with angiotensin-converting enzyme inhibitors, diuretics and acenocumarol. The follow-up period was 2.2 ± 0.99 years. Fifty-three patients suffered an acute ischemic event, 33 died or suffered heart failure and 78 developed the primary outcome. By univariate Cox's regression analysis, hs-cTnI >0 was associated with a higher risk of developing the primary outcome [relative risk = 2.360 (1.359-4.099); p = 0.001] and heart failure or death [relative risk = 5.932 (1.806-19.482); p < 0.001], but not with acute ischemic events. Statistical significance was lost after controlling for age. By logistic regression analysis, age [relative risk = 1.026 (1.009-1.044); p = 0.003], ejection fraction <40% [relative risk = 4.099 (2.043-8.224); p < 0.001], use of anticoagulants [relative risk = 2.785 (1.049-7.395); p = 0.040] and therapy with angiotensin-converting enzyme inhibitors [relative risk = 1.471 (1.064-2.034); p = 0.020], and estimated glomerular filtration rate [relative risk = 0.988 (0.977-0.999); p = 0.027] were associated with hs-cTnI >0. Conclusions: In stable coronary disease, hs-cTnI is associated with the incidence of heart failure or death, but this relationship depends on other variables.
Primary Vulvo-Vaginal Cancers: Trends in Incidence and Mortality in Poland (1999-2012)
Authors: Banas Tomasz , Pitynski Kzimierz , Jach Robert , Knafel Anna , Ludwin Artur , Juszczyk Grzegorz , Nieweglowska Dorota
Published: June 2015

Background: The aim of this study was to determine the incidence, mortality rates and trends of vulvar and vaginal cancers in Poland. Methods: Data were retrieved from the Polish National Cancer Registry. Age-standardised rates (ASRs) of cancer incidence and mortality were calculated by direct standardisation, and joinpoint regression was performed to describe the trends using the average annual percent change (AAPC). Results: From 1999 to 2012, the number of diagnosed cases of vulvar cancer was 5,958, and the ASRs of incidence varied from 0.99 to 1.18, with a significant trend towards a decrease (AAPC -0.78; p < 0.05). The ASR of mortality varied from 0.39 to 0.62, with a slight but insignificant increase in trend (AAPC 0.72; p > 0.05). The ASR of vaginal cancer incidence varied from 0.21 to 0.31, while the ASR of mortality ranged from 0.09 to 0.22. This study also proved a significantly falling trend in vaginal cancer mortality (AAPC -4.69; p < 0.05) and a decreasing trend in vaginal cancer incidence (AAPC -1.67; p > 0.05). Conclusion: The rarity of vulvar and vaginal cancers as well as the decline in their incidence rates should not discourage further research on the epidemiology and treatment of these conditions.
The Effects of Oxygen Therapy on Myocardial Salvage in ST Elevation Myocardial Infarction Treated with Acute Percutaneous Coronary Intervention: The Supplemental Oxygen in Catheterized Coronary Emergency Reperfusion (SOCCER) Study
Authors: Khoshnood Ardavan , Carlsson Marcus , Akbarzadeh Mahin , Bhiladvala Pallonji , Roijer Anders , Bodetoft Stefan , Höglund Peter , Zughaft David , Todorova Lizbet , Erlinge David , Ekelund Ulf
Published: June 2015

Objectives: Despite a lack of scientific evidence, oxygen has long been a part of standard treatment for patients with acute myocardial infarction (AMI). However, several studies suggest that oxygen therapy may have negative cardiovascular effects. We here describe a randomized controlled trial, i.e. Supplemental Oxygen in Catheterized Coronary Emergency Reperfusion (SOCCER), aiming to evaluate the effect of oxygen therapy on myocardial salvage and infarct size in patients with ST elevation myocardial infarction (STEMI) treated with a primary percutaneous coronary intervention (PCI). Methods: One hundred normoxic STEMI patients accepted for a primary PCI are randomized in the ambulance to either standard oxygen therapy or no supplemental oxygen. All patients undergo cardiovascular magnetic resonance imaging (CMR) 2-6 days after the primary PCI, and a subgroup of 50 patients undergo an extended echocardiography during admission and at 6 months. All patients are followed for 6 months for hospital admission for heart failure and subjective perception of health. The primary endpoint is the myocardial salvage index on CMR. Discussion: Even though oxygen therapy is a part of standard care, oxygen may not be beneficial for patients with AMI and is possibly even harmful. The results of the present and concurrent oxygen trials may change international treatment guidelines for patients with AMI or ischemia.
Optical Coherence Tomographic Features and Visual Prognosis after Treatment for Idiopathic Choroidal Neovascularization
Authors: Cao Xu-Sheng , Peng Xiao-Yan , You Qi-Sheng , Zhang Yong-Peng , Jonas Jost B.
Published: June 2015

Background: The aim of this study was to determine whether pretreatment spectral-domain optical coherence tomographic (SD-OCT) features are associated with visual prognosis after treatment for idiopathic subfoveal choroidal neovascularization (ISCNV) with intravitreal ranibizumab. Methods: We retrospectively evaluated SD-OCT images of eyes with ISCNV undergoing treatment with intravitreal ranibizumab with a mean follow-up of 7 months. Results: This study included 22 patients (22 eyes) with a mean age of 32.7 ± 8.1 years. In univariate analysis, better final visual acuity expressed in logMAR units was significantly associated with a lower amount of pretreatment ellipsoid zone defects (p = 0.03; standardized correlation coefficient β = 0.46) and a lower amount of pretreatment external limiting membrane (ELM) damage (p = 0.007; β = 0.56). All other SD-OCT parameters were not significantly associated with final visual acuity. A higher improvement in visual acuity was marginally significantly associated with larger pretreatment ellipsoid zone defects (p = 0.049; β = -0.43). Conclusions: The integrity of the outer retinal layers at baseline, in particular of the ELM, is of importance in predicting the final visual outcome in patients undergoing intravitreal medical therapy for ISCNV.
Burden of Common Complex Disease Variants in the Exomes of Two Healthy Centenarian Brothers
Authors: Tindale Lauren C. , Zeng Andy , Bretherick Karla L. , Leach Stephen , Thiessen Nina , Brooks-Wilson Angela R.
Published: June 2015

Background: It is not understood whether long-term good health is promoted by the absence of disease risk variants, the presence of protective variants, or both. We characterized the exomes of two exceptionally healthy centenarian brothers aged 106 and 109 years who had never been diagnosed with cancer, cardiovascular disease, diabetes, Alzheimer's disease, or major pulmonary disease. Objective: The aim of this study was to gain insight into whether exceptional health and longevity are a result of carrying fewer disease-associated variants than typical individuals. Methods: We compared the number of disease-associated alleles, and the proportion of alleles predicted to be functionally damaging, between the centenarian brothers and published population data. Mitochondrial sequence reads were extracted from the exome data in order to analyze mitochondrial variants. Results: The brothers carry a similar number of common disease-associated variants and predicted damaging variants compared to reference groups. They did not carry any high-penetrance clinically actionable variants. They carry mitochondrial haplogroup T, and one brother has a single heteroplasmic variant. Conclusion: Although our small sample size does not allow for definitive conclusions, a healthy aging and longevity phenotype is not necessarily due to a decreased burden of common disease-associated variants. Instead, it may be rare ‘positive' variants that play a role in this desirable phenotype.
Fingerprint of Lung Fluid Ultrafine Particles, a Novel Marker of Acute Lung Inflammation
Authors: Bar-Shai Amir , Alcalay Yifat , Sagiv Adi , Rotem Michal , Feigelson Sara W. , Alon Ronen , Fireman Elizabeth
Published: June 2015

Background: Acute lung inflammation can be monitored by various biochemical readouts of bronchoalveolar lavage fluid (BALF). Objective: To analyze the BALF content of ultrafine particles (UFP; <100 nm) as an inflammatory biomarker in early diagnosis of acute and chronic lung diseases. Methods: Mice were exposed to different stress conditions and inflammatory insults (acute lipopolysaccharide inhalation, tobacco smoke and lethal dose of total body irradiation, i.e. 950 rad). After centrifugation, the cellular pellet was assessed while cytokines and ultrafine particles were measured in the soluble fraction of the BALF. Results: A characteristic UFP distribution with a D50 (i.e. the dimension of the 50th UFP percentile) was shared by all tested mouse strains in the BALF of resting lungs. All tested inflammatory insults similarly shifted this size distribution, resulting in a unique UFP fingerprint with an averaged D50 of 58.6 nm, compared with the mean UFP D50 of 23.7 nm for resting BALF (p < 0.0001). This UFP profile was highly reproducible and independent of the intensity or duration of the inflammatory trigger. It returned to baseline after resolution of the inflammation. Neither total body irradiation nor induction of acute cough induced this fingerprint. Conclusions: The UFP fingerprint in the BALF of resting and inflamed lungs can serve as a binary biomarker of healthy and acutely inflamed lungs. This marker can be used as a novel readout for the onset of inflammatory lung diseases and for complete lung recovery from different insults.
Longitudinal Measurement of Serum Vascular Endothelial Growth Factor in Patients with Chronic Obstructive Pulmonary Disease
Authors: Boeck Lucas , Mandal Jyotshna , Costa Luigi , Roth Michael , Tamm Michael , Stolz Daiana
Published: June 2015

Background: Impaired vascular endothelial growth factor (VEGF) signaling causes emphysema in animal models. In chronic obstructive pulmonary disease (COPD) patients, alterations in VEGF tissue expression have been observed. We hypothesize that circulating VEGF may be a biomarker to phenotype COPD patients. Objective: The aim of this study was to investigate VEGF serum levels in stable and exacerbated COPD. Methods: VEGF serum levels as well as parameters of short- and long-term outcome were assessed and analyzed in two COPD cohorts [PROMISE, n = 117; ProCOLD (PC), n = 191]. Results: VEGF serum levels at stable COPD were neither related to forced expiratory volume in 1 s nor to the Modified Medical Research Council dyspnea score, 6-min walking distance or BODE index. There was no association between single VEGF levels and COPD exacerbation frequency or mortality at 1 and 2 years of follow-up. In PC an increase in VEGF over time (ΔVEGF) was associated with the exacerbation frequency as well as the 1- and 2-year hospitalization rate (p = 0.046, 0.009 and 0.006, respectively). Furthermore, in PC ΔVEGF was associated with 1- and 2-year survival (p = 0.009 and 0.041, respectively). Conclusions: Single serum VEGF levels, at stable and exacerbated COPD, were not associated with clinically significant outcomes in COPD. Conversely, the VEGF course seems related to COPD prognosis.
Is Mechanical Bowel Preparation Necessary for Gynecologic Surgery? A Systematic Review and Meta-Analysis
Authors: Zhang Jing , Xu Liangzhi , Shi Gang
Published: June 2015

Objective: To clarify the efficacy and side effects of mechanical bowel preparation (MBP) before gynecologic surgery. Methods: A systematic review was conducted. Embase, PubMed, the Cochrane Central Register of Controlled Trials in the Cochrane Library and China National Knowledge Infrastructure were searched. Randomized controlled trials on MBP prior to gynecologic surgery were included. The software package Revman 5.3 was used for statistical analysis. Odds ratio (OR) and standard mean deviation were calculated for dichotomous and continuous variable, respectively. Results: The quality of the included studies was moderate to good. MBP prior to laparoscopic gynecologic benign surgery or vaginal prolapse surgery has not been proven to be valuable for surgical performance, mainly involving visualization of the surgical field (OR 1.52, 95% confidence interval [CI] 1 to 2.32; Z = 1.95, p = 0.05), bowel handling (OR 2.21, 95% CI 0.83 to 5.84; Z = 1.59, p = 0.11), surgical complications (OR 1.3, 95% CI 0.46 to 3.67; Z = 0.5, p = 0.62) and bowel preparation. The discomfort due to oral catharsis is severer than no bowel preparation and enema, however without any difference between enema and no bowel preparation. Conclusion: The routine practice of MBP before gynecologic surgery needs to be reconsidered. This traditional clinical behavior has to be abandoned before benign laparoscopic surgery. Studies on the role of MBP for gynecologic laparotomy and gynecologic cancer are urgent.
Analysis of the Risk Factors for Aerobic Vaginitis: A Case-Control Study
Authors: Geng Nv , Wu Wenjuan , Fan Aiping , Han Cha , Wang Chen , Wang Yingmei , Xue Fengxia
Published: June 2015

Aims: Aerobic vaginitis (AV) is a newly defined clinical entity which may interfere with women's reproductive health and have negative effects on pregnancy. This study was to identify the risk factors for AV. Methods: Participants in this case-control study included healthy women and women with AV. All participants completed a standardized questionnaire covering sociodemographic factors, sexual behaviors, personal hygiene habits and health behaviors. Uni- and multivariate logistic regression analyses were used for statistical evaluation. Results: A total of 290 women of reproductive age were enrolled. In the multivariate analysis, unmarried status (odds ratio [OR] 2.606, 95% confidence interval [CI] 1.257-5.402), use of an intrauterine device (OR 4.989, 95% CI 1.922-12.952), long-term use of antibiotics (OR 11.176, 95% CI 1.363-91.666) and frequent vaginal douching (OR 4.689, 95% CI 1.363-16.135) were independent risk factors for AV. On the contrary, consistent condom use (OR 0.546, 95% CI 0.301-0.991) and college-level education or above (OR 0.255, 95% CI 0.131-0.497) were independent protective factors. Conclusion: Measures that may be considered to prevent AV include enhancing education to improve women's knowledge related to reproductive health, especially unmarried women, encouraging them to consistently use condoms as a contraceptive method, to avoid long-term use of antibiotics and to stop frequent vaginal douching.
How Should Cancer Surveillance in Primary Sclerosing Cholangitis Be Performed?
Authors: Ehlken Hanno , Schramm Christoph
Published: June 2015

Background: Primary sclerosing cholangitis (PSC) is a chronic inflammatory disease affecting the intra- and extrahepatic bile duct system that can ultimately cause liver cirrhosis. Apart from the risk of progression to end-stage liver disease the prognosis of PSC is primarily determined by the risk to develop hepatobiliary or extrahepatic malignancies. A reasonable surveillance strategy for PSC patients must allow the detection of early cancer that will permit a potentially curative therapy. Methods: Current guidelines on malignancy within the context of PSC as well as the primary literature were reviewed for this article. Results: Here, we focus on a concise review of the three tumors most commonly associated with PSC: cholangiocellular carcinoma (CCA), gallbladder cancer, and colorectal carcinoma. For cancer surveillance in this patient group, endoscopy, cholangiography, cross-sectional imaging, and the use of serum tumor markers are principally available. Furthermore, for the diagnosis of CCA novel approaches were recently suggested to improve sensitivity and specificity to detect this malignancy. Conclusion: We review different aspects of cancer surveillance in patients with PSC. Since prospective data on the surveillance of malignant tumors is unavailable, we discuss a rational approach on how to perform cancer surveillance in patients with PSC.
СТАН ПРОТЕЇНАЗО-ІНГІБІТОРНОЇ СИСТЕМИ В ПЕЧІНЦІ ЗА УМОВ ФОРМУВАННЯ ЕКСПЕРИМЕНТАЛЬНОГО АЛЕРГІЧНОГО АЛЬВЕОЛІТУ ТА КОРЕКЦІЯ ЙОГО ПОРУШЕНЬ ТІОТРИАЗОЛІНОМ
Authors: Пасічник М. А.
Published: June 2015

У роботі показано поступове зростання вмісту азоальбуміну, азоказеїну, азоколагену та зниження рівня в печінці альфа-2-макроглобупіну й альфа-1-інгібітора протеолізу, особливо на 24-ту, 34-ту і 44-ту доби розвитку експериментального алергічного альвеоліту. Встановлено позитивний коригувальний вплив тіотриазоліну на показники протеолізу й інгібіторів у печінці при даній моделі захворювання.
Особливості ліпідного обміну у тварин з експериментальною черепно-мозковою травмою на тлі цукрового діабету
Authors: Мерецький В. М. , Корда М. М.
Published: June 2015

У роботі наведено аналіз дослідження ліпідного обміну та ферментативного спектра крові у щурів з експериментальною черепно-мозковою травмою, стрептозотоциніндукованим цукровим діабетом та при їх поєднанні. Показано, що порушення жирового обміну та гіперферментемія супроводжують перебіг посттравматичного періоду і є ланкою патогенезу стрептозотоциніндукованого ЦД. Виявлені зміни більш виражені за умов комбінування ЧМТ і ЦД.
Непрохідність тонкої кишки. Спірні питання щодо дренування травного каналу.
Authors: Бенедикт В. В.
Published: June 2015

Лікування гострої непрохідності кишки супроводжується високою летальністю і залишається складним у плані вибору лікувальної тактики. В клінічних умовах обстежено 122 хворих на ГНК. Проведено ретроспективний аналіз 27 медичних карт стаціонарного хворого померлих пацієнтів. Причиною летального наслідку в 77,78 % випадків був синдром поліорганної недостатності. Назогастроінтестинальна інтубація у цих хворих була виконана у 60,0 % прооперованих і у 20,0 % пацієнтів під час релапаротомії. Дренування тонкої кишки за допомогою кінцевих стом під час релапаротомій використовували в 30,0 % померлих. У пацієнтів із ГНК в перші три доби після операції спостерігали суттєве зростання інтоксикаційного синдрому, показники якого зменшувалися після відновлення моторно-евакуаторної функції тонкої кишки. Наводяться клінічні випадки хворих на ГНК із різними способами дренування тонкої кишки. Запропоновано спосіб ентеростомії для дренування тонкої кишки. Наголошується на необхідності ранньої стимуляції рухової діяльності травного каналу. Наводиться алгоритм застосування дренування тонкої кишки у хворих на гостру непрохідність кишки. Звертається увага на необхідність врахування під час операції стадії компенсації основних функцій організму при цьому захворюванні.
Экзентерация таза в лечении первичных и рецидивных злокачественных опухолей.
Authors: Дронов А. И. , Крючина Е. А. , Горлач А. И. , Добуш Р. Д.
Published: June 2015

В данной работе проанализированы непосредственные и отдалённые результаты лечения 76 больных с распространёнными первичными и рецидивными опухолями таза, которым была выполнена энзентерация по поводу первичных (п=14) и рецидивных (п=62) опухолей таза с 2003 по 2012 г.
Порушення функції контралатеральної нирки при обтурувальних пухлинних тромбах інтерренального сегмента нижньої порожнистої вени.
Authors: Русин В. І , Корсак В. В. , Русин А. В. , Бойко С. О.
Published: June 2015

У роботі представлено 4 випадки нирково-клітинного раку, ускладненого обтурувальними пухлинними тромбами інтерренального сегмента нижньої порожнистої вени. За допомогою динамічної реносцинтиграфії у всіх випадках було виявлено більш значне порушення функції здорової нирки, ніж ураженої пухлиною. Єдиним методом лікування даного контингенту хворих є оперативний
ОПТИМІЗАЦІЯ ПЕРВИННОЇ ПРОФІЛАКТИКИ ГЛАУКОМИ ЯК ВЕКТОР ПОСИЛЕННЯ ПРОФІЛАКТИЧНОГО НАПРЯМКУ В ОФТАЛЬМОЛОГІЇ
Authors: ПОВЧ З.В.
Published: June 2015

Мета: аналіз шляхів оптимізації первинної профілактики глаукоми для своєчасного її виявлення та попередження розвитку незворотної втрати зорових функцій серед дорослого населення України.

Матеріали і методи. У дослідженні використано комплекс методів – статистичний; соціологічний; структурно-логічного аналізу; контент-аналіз нормативної бази.

Результати. Найбільш впливовими щодо розвитку глаукоми є медико-біологічні чинники. За результатами дослідження на первинному рівні надання медичної допомоги запроваджено доофтальмологічний скринінг на глаукому, що дозволяє лікарю загальної практики – сімейному лікарю сформувати групу ризику щодо цього захворювання для проведення відповідних діагностичних досліджень, освітніх та профілактичних заходів.

Висновки. Первинна профілактики глаукоми має стати пріоритетним напрямком діяльності офтальмологічної служби на первинному рівні надання медичної допомоги.
КЛЮЧОВІ СЛОВА: глаукома, фактори ризику, первинна профілактика.
ІМУНОЛОГІЧНІ ОСОБЛИВОСТІ ПАТОГАНЕЗУ ГІПЕРПЛАСТИЧНИХ ПРОЦЕСІВ ЕНДОМЕТРІЮ
Authors: Борода А. М. , Бичкова Н. Г.
Published: June 2015

Проведено дослідження імунного статусу у жінок з гіперплазією ендометрію. Встановлено, що зниження компенсаторних властивостей ендометрію відбувається на фоні посилення імунного дизбалансу. Оцінка параметрів імунного статусу може бути використана для визначення функціонального стану ендометрію з метою його корекції, та як критерій ефективності проведеного лікування та клінічного прогнозу.
ШЛЯХИ ПІДВИЩЕННЯ ЕФЕКТИВНОСТІ ЛІКУВАННЯ ПАТАЛОГІЇ ПУБЕРТАНТНОГО ПЕРІОДУ У ДІВЧАТ З ДИФУЗНОЮ ГІПЕРПЛАЗІЄЮ ЩИТОПОДІБНОЇ ЗАЛОЗИ
Authors: Іванов І. І. , Косолапова Н. В.
Published: June 2015

Проведено дослідження ефективності санітарно-курортного лікування затримки статевого розвитку та порушень менструального циклу в пубертантному періоді у дівчаток із дифузною еутиреоїдною гіперплазією щитоподібної залози. Встановлено, що запропонований комплекс лікування є високоефективним при різній патології пубертантного періоду. Одночасне призначення препаратів йоду дозволяє більш ефективно корегувати функцію щитоподібної залози.
АНАФІЛАКТИЧНИЙ ШОК: СУЧАСНИЙ АЛГОРИТМ ЕКСТРЕНО ДОГОСПІТАЛЬНО ТА РАННЬО ГОСПІТАЛЬНО МЕДИЧНО ДОПОМОГИ
Authors: Ляхович Р. М.
Published: June 2015

РЕЗЮМЕ. У статті висвітлені основні причини, варіанти перебігу та сучасний алгоритм надання екстрено догоспітально
та ранньо госпітально медично допомоги при розвитку різних форм анафілактичного шоку.
КЛЮЧОВІ СЛОВА: анафілактичний шок, первинне та вторинне обстеження, екстрена медична допомога.
ОЦІНКА АНТИБІ0ТИК0РЕЗИСТЕНТН0СТІ УРОПАТОГЕНІВ ПРИ ІНФЕКЦІЯХ СЕЧОВИХ ТА СТАТЕВИХ ШЛЯХІВ
Authors: Андреєва І. Д. , Осолодченко Т. П. , Рябова І. С. , Завада Н. П. , Батрак О. А. , Лук’яненко Т. В.
Published: June 2015

Інфекції сечовивідних та статевих шляхів відносяться
до найпоширеніших видів патологій людини.
Джерелом інфекцій сечових та статевих шляхів є
нормальна мікрофлора, що колонізує періурет-
ральну ділянку та дистальний відділ сечовипускального
каналу. За останні роки спостерігається
значне збільшення резистентності уропатогенів до
антибактеріальних препаратів.
Association Between Atrial Fibrillation Symptoms, Quality of Life, and Patient Outcomes
Authors: Freeman James V. , Simon DaJuanicia N. , Go Alan S. , Spertus John , Fonarow Gregg C. , Gersh Bernard J. , Hylek Elaine M. , Kowey Peter R. , Mahaffey Kenneth W. , Thomas Laine E. , Chang Paul , Peterson Eric D. , Piccini Jonathan P.
Published: June 2015

Background—

Instruments to assess symptom burden and quality of life among patients with atrial fibrillation (AF) have not been well evaluated in community practice or associated with patient outcomes.

Methods and Results—

Using data from 10 087 AF patients in the Outcomes Registry for Better Informed Treatment of AF (ORBIT-AF), symptom severity was evaluated using the European Heart Rhythm Association (EHRA) classification system, and quality of life was assessed using the Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnaire. The association between AF-related symptoms, quality of life, and outcomes was assessed using Cox regression. The majority of AF patients (61.8%) were symptomatic (EHRA >2) and 16.5% had severe or disabling symptoms (EHRA 3–4). EHRA symptom class was well correlated with the AFEQT score (Spearman correlation coefficient −0.39). Over 1.8 years of follow-up, AF symptoms were associated with a higher risk of hospitalization (adjusted hazard ratio for EHRA ≥2 versus EHRA 1 1.23, 95% confidence interval, 1.15–1.31) and a borderline higher risk of major bleeding. Lower quality of life was associated with a higher risk of hospitalization (adjusted hazard ratio for lowest quartile of AFEQT versus highest 1.49, 95% confidence interval, 1.2–1.84), but not other major adverse events, including death.

Conclusions—

In a community-based study, most patients with AF were symptomatic and had impaired quality of life. Quality of life measured by the AFEQT correlated closely with symptom severity measured by the EHRA class. AF symptoms and lower quality of life were associated with higher risk of hospitalization but not mortality during follow-up.
Outcomes and Predictors of Perinatal Mortality in Fetuses With Ebstein Anomaly or Tricuspid Valve Dysplasia in the Current Era
Authors: Freud Lindsay R. , Escobar-Diaz Maria C. , Kalish Brian T. , Komarlu Rukmini , Puchalski Michael D. , Jaeggi Edgar T. , Szwast Anita L. , Freire Grace , Levasseur Stéphanie M. , Kavanaugh-McHugh Ann , Michelfelder Erik C. , Moon-Grady Anita J. , Donofrio Mary T. , Howley Lisa W. , Tierney Elif Seda Selamet , Cuneo Bettina F. , Morris Shaine A. , Pruetz Jay D. , van der Velde Mary E. , Kovalchin John P. , Ikemba Catherine M. , Vernon Margaret M. , Samai Cyrus , Satou Gary M. , Gotteiner Nina L. , Phoon Colin K. , Silverman Norman H. , McElhinney Doff B. , Tworetzky Wayne
Published: June 2015

Background—

Ebstein anomaly and tricuspid valve dysplasia are rare congenital tricuspid valve malformations associated with high perinatal mortality. The literature consists of small, single-center case series spanning several decades. We performed a multicenter study to assess the outcomes and factors associated with mortality after fetal diagnosis in the current era.

Methods and Results—

Fetuses diagnosed with Ebstein anomaly and tricuspid valve dysplasia from 2005 to 2011 were included from 23 centers. The primary outcome was perinatal mortality, defined as fetal demise or death before neonatal discharge. Of 243 fetuses diagnosed at a mean gestational age of 27±6 weeks, there were 11 lost to follow-up (5%), 15 terminations (6%), and 41 demises (17%). In the live-born cohort of 176 live-born patients, 56 (32%) died before discharge, yielding an overall perinatal mortality of 45%. Independent predictors of mortality at the time of diagnosis were gestational age <32 weeks (odds ratio, 8.6; 95% confidence interval, 3.5–21.0;
P
<0.001), tricuspid valve annulus diameter z-score (odds ratio, 1.3; 95% confidence interval, 1.1–1.5;
P
<0.001), pulmonary regurgitation (odds ratio, 2.9; 95% confidence interval, 1.4–6.2;
P
<0.001), and a pericardial effusion (odds ratio, 2.5; 95% confidence interval, 1.1–6.0;
P
=0.04). Nonsurvivors were more likely to have pulmonary regurgitation at any gestational age (61% versus 34%;
P
<0.001), and lower gestational age and weight at birth (35 versus 37 weeks; 2.5 versus 3.0 kg; both
P
<0.001).

Conclusion—

In this large, contemporary series of fetuses with Ebstein anomaly and tricuspid valve dysplasia, perinatal mortality remained high. Fetuses with pulmonary regurgitation, indicating circular shunt physiology, are a high-risk cohort and may benefit from more innovative therapeutic approaches to improve survival.
Protecting the Self
Authors: Owens Nicole
Published: June 2015

This study was used to examine how practicing veterinarians protect the self when dealing with people at work. Veterinarians interact with the people attached to their patients in myriad ways in order to accomplish their organizational goals. Data collected during semistructured interviews with 17 veterinarians revealed that these veterinarians considered client interactions just as important as treating nonhuman animals. Impression management concepts were used to describe many of the interactional strategies veterinarians employ to protect the self when dealing with difficult clients. Building trust with clients and giving front stage performances were common strategies adopted. Despite veterinarians wanting their jobs to be animal-centric, these data show that they are not.
The Rights of Pre-verbal Children involved in Video-recorded Research
Authors: Mudaly Neerosh
Published: June 2015

There is considerable research on the impact of maternal mental health issues on infants’ development. These studies emphasise the importance of early interventions to prevent the development of psychopathology later in life. In many studies infants who are involved in video-recorded studies show an observable distressed reaction. Whilst these studies have made major contributions to the field of child development, a key question that arises is: is it ethically acceptable in research with pre-verbal children for them to experience emotional distress during the research process?

This article explores the ethical issues of harm and benefit from the perspective of the child. It aims further to refine discussion and understanding of children’s vulnerability and examines pre-verbal children’s ethical rights in video-recorded observation studies.
Unidimensional IRT Item Parameter Estimates Across Equivalent Test Forms With Confounding Specifications Within Dimensions
Authors: Matlock Ki Lynn , Turner Ronna
Published: June 2015

When constructing multiple test forms, the number of items and the total test difficulty are often equivalent. Not all test developers match the number of items and/or average item difficulty within subcontent areas. In this simulation study, six test forms were constructed having an equal number of items and average item difficulty overall. Manipulated variables were the number of items and average item difficulty within subsets of items primarily measuring one of two dimensions. Data sets were simulated at four levels of correlation (0, .3, .6, and .9). Item parameters were estimated using the Rasch and two-parameter logistic unidimensional item response theory models. Estimated discrimination and difficulty were compared across forms and to the true item parameters. The average unidimensional estimated discrimination was consistent across forms having the same correlation. Forms having a larger set of easy items measuring one dimension were estimated as being more difficult than forms having a larger set of hard items. Estimates were also investigated within subsets of items, and measures of bias were reported. This study encourages test developers to not only maintain consistent test specifications across forms as a whole but also within subcontent areas.
Lactobacillus reuteri DSM 17938 as a Probiotic for Preterm Neonates
Authors: Athalye‐Jape Gayatri , Rao Shripada , Patole Sanjay
Published: June 2015

Introduction: Prevention of necrotizing enterocolitis (NEC) while optimizing enteral nutrition (EN) is a priority in preterm neonates. Lactobacillus reuteri DSM 17938 (L reuteri) is known to improve gut motility. Previous systematic reviews have not adequately assessed the effects of L reuteri in improving feed tolerance in preterm neonates. Objective: To assess the effects of L reuteri in preterm neonates. Design: A systematic review of randomized controlled trials (RCTs) and non‐RCTs of L reuteri was conducted. We searched the Cochrane Central Register of Controlled Trials, PubMed, EMBASE, and CINAHL databases and proceedings of Pediatric Academic Society meetings in December 2014. Results: Six RCTs (n = 1778) and 2 non‐RCTs (n = 665) were included. Meta‐analysis of RCTs estimated that the time to full feeds (mean difference [MD], –1.34 days; 95% confidence interval [CI], −1.81 to −0.86; 2 RCTs), duration of hospitalization (–10.77 days; 95% CI, −13.67 to −7.86; 3 RCTs), and late‐onset sepsis (LOS) (relative risk [RR], 0.66; 95% CI, 0.52 to 0.83; 4 RCTs) were reduced in the L reuteri group. Mortality (RR, 0.79; 95% CI, 0.57–1.09; 3 RCTs) and ≥ stage II NEC (RR, 0.69; 95% CI, 0.47–1.01; 3 RCTs) were reduced but statistically not significant. There were no adverse effects of supplementation. Both non‐RCT studies showed significant improvement in the incidence of NEC with L reuteri supplementation. Conclusions: Evidence from a limited number of studies suggests that L reuteri supplementation has the potential to reduce the risk of NEC and LOS while facilitating EN in preterm infants. Larger definitive RCTs are needed to confirm these findings.
Bridging the Gap
Authors: Nicoll Benjamin
Published: June 2015

This article recovers the popular imaginaries surrounding an obsolete video game platform, the Neo Geo Advanced Entertainment System (AES), through a thematic discourse analysis of British and North American gaming magazines from the 1990s. Released in Japan in 1990, the Neo Geo AES was marketed as a home video game system capable of bridging the gap between the public space of the gaming arcade and the domestic environment of the home. “Imaginaries” in this context refer to the dreams and fantasies that accompanied the Neo Geo AES’s negotiation of arcade and home spaces as well as the discourses, images, ideas, and beliefs that helped mold its identity as a cultural object. Gaming magazines, I argue, help articulate how the system’s failure was tied to its unsuccessful navigation of cultural tensions during a period when gaming culture underwent a rapid relocation from the arcade to the home.
Mid-term results of ligament tenodesis in treatment of scapholunate dissociation: a retrospective study of 20 patients
Authors: Elgammal A. , Lukas B.
Published: June 2015

The purpose of this retrospective study was to assess the modified Brunelli technique for the treatment of chronic irreparable complete scapholunate ligament rupture, causing a reducible carpal malalignment without secondary osteoarthritis. A total of 20 patients were treated using this technique. At a mean follow-up period of 24 months (range 6–53, SD 15), pain on a visual analogue scale had improved from 6 (range 3–10) to 3 (range 0–7). Function measured with the DASH score had improved from 37 (range 11–90) to 20 (range 0–53). Range of motion was reduced in flexion by a mean of 19° (range 10–45), and in extension by a mean of 14° (range 0–35). Mean grip strength at last follow-up was 81% of the uninjured hand (range 50–100%) Three patients developed scapholunate advanced collapse (stage II) requiring salvage surgery. Scapholunate ligament reconstruction with the modified Brunelli technique showed satisfactory results in this study. Extended studies are needed to determine the long-term benefits of this reconstructive procedure.

Level of evidence: IV.
Targeting of anti-citrullinated protein/peptide antibodies in rheumatoid arthritis using peptides mimicking endogenously citrullinated fibrinogen antigens
Authors: Fernandes-Cerqueira Cátia , Ossipova Elena , Gunasekera Sunithi , Hansson Monika , Mathsson Linda , Catrina Anca I. , Sommarin Yngve , Klareskog Lars , Lundberg Karin , Rönnelid Johan , Göransson Ulf , Jakobsson Per-Johan
Published: June 2015

Introduction

We have previously identified endogenously citrullinated peptides derived from fibrinogen in rheumatoid arthritis (RA) synovial tissues. In this study, we have investigated the auto-antigenicity of four of those citrullinated peptides, and explored their feasibility to target anti-citrullinated protein/peptide antibodies (ACPA).

Methods

The autoantigenic potential of the fibrinogen peptides was investigated by screening 927 serum samples from the Epidemiological Investigation of RA (EIRA) cohort on a peptide microarray based on the ImmunoCAP ISAC® system. In order to assay for ACPA blocking, two independent pools of purified ACPA were incubated with the respective targeting peptide prior to binding to cyclic citrullinated peptide (CCP)2 using the CCPlus® ELISA kit.

Results

Two peptides derived from the fibrinogen α chain, Arg573Cit (563-583) and Arg591Cit (580-600), referred to as Cit573 and Cit591, and two peptides from the fibrinogen β chain, Arg72Cit (62-81) and Arg74Cit (62-81) (Cit72 and Cit74), displayed 65 %, 15 %, 35 %, and 53 % of immune reactivity among CCP2-positive RA sera, respectively. In CCP2-negative RA sera, a positive reactivity was detected in 5 % (Cit573), 6 % (Cit591), 8 % (Cit72), and 4 % (Cit74). In the competition assay, Cit573 and Cit591 peptides reduced ACPA binding to CCP2 by a maximum of 84 % and 63 % respectively. An additive effect was observed when these peptides were combined. In contrast, Cit74 and Cit72 were less effective. Cyclization of the peptide structure containing Cit573 significantly increased the blocking efficiency.

Conclusions

Here we demonstrate extensive autoantibody reactivity against in vivo citrullinated fibrinogen epitopes, and further show the potential use of these peptides for antagonizing ACPA.
How do migrants save? Evidence from the British Household Panel Survey on temporary and permanent migrants versus natives
Authors: De Arcangelis Giuseppe , Joxhe Majlinda
Published: June 2015

This paper investigates the saving behavior of migrants in the UK across different dimensions, i.e., comparing temporary versus permanent migrants and migrants versus natives. Established theoretical predictions show that migrants save more when they plan to stay in the destination only temporarily as target savers. Our empirical evidence takes into account the contemporaneous choice of savings and remittances. Moreover, when comparing the saving profiles of both natives and migrants, we uncover the weight of observable socio-economic characteristics other than income and wealth. We use the British Household Panel Survey for the period 1991-2008. The estimation results confirm that temporary migrants have a propensity to save 26 per cent higher than permanent migrants in UK. We also introduce an index of financial capability adjusted for income as an explanatory variable and, when employing the Blinder-Oaxaca decomposition for the Tobit model of saving choice, migrants are more affected by observable social-economic characteristics than natives.
Pathological conditions re-shape physiological Tregs into pathological Tregs
Authors: Yang William Y , Shao Ying , Lopez-Pastrana Jahaira , Mai Jietang , Wang Hong , Yang Xiao-feng
Published: June 2015

CD4+FOXP3+ regulatory T cells (Tregs) are a subset of CD4 T cells that play an essential role in maintaining peripheral immune tolerance, controlling acute and chronic inflammation, allergy, autoimmune diseases, and anti-cancer immune responses. Over the past 20 years, a significant progress has been made since Tregs were first characterized in 1995. Many concepts and principles regarding Tregs generation, phenotypic features, subsets (tTregs, pTregs, iTregs, and iTreg35), tissue specificity (central Tregs, effector Tregs, and tissue resident Tregs), homeostasis (highly dynamic and apoptotic), regulation of Tregs by receptors for PAMPs and DAMPs, Treg plasticity (re-differentiation to other CD4 T helper cell subsets, Th1, Th2, Tfh, and Th17), and epigenetic regulation of Tregs phenotypes and functions have been innovated. In this concise review, we want to briefly analyze these eight new progresses in the study of Tregs. We have also proposed for the first time a novel concept that “physiological Tregs” have been re-shaped into “pathological Tregs” in various pathological environments. Continuing of the improvement in our understanding on this important cellular component about the immune tolerance and immune suppression would lead to the future development of novel therapeutics approaches for acute and chronic inflammatory diseases, allergy, allogeneic transplantation-related immunity, sepsis, autoimmune diseases, and cancers.
Differential effects of IFN-β on IL-12, IL-23, and IL-10 expression in TLR-stimulated dendritic cells
Authors: Yen Jui-Hung , Kong Weimin , Hooper Kirsten M , Emig Frances , Rahbari Kate M , Kuo Ping-Chang , Scofield Barbara A , Ganea Doina
Published: June 2015

MS is an autoimmune disease characterized by immune cell infiltration in the CNS, leading to cumulative disability. IFN-β, used clinically in RR-MS reduces lesion formation and rates of relapse. Although the molecular mechanisms are not entirely elucidated, myeloid cells appear to be a major target for the therapeutic effects of IFN-β. DCs have a critical role in experimental models of MS through their effect on encephalitogenic Th1/Th17 cell differentiation and expansion. Here we focused on the effects of IFN-β on DC expression of cytokines involved in the control of Th1/Th17 differentiation and expansion. Administration of IFN-β to mice immunized with MOG35–55 inhibited IL-12 and IL-23 expression in splenic DC and reduced in vivo differentiation of Th1/Th17 cells. IFN-β affected cytokine expression in TLR-stimulated DC in a similar manner in vitro, inhibiting IL-12 and IL-23 and stimulating IL-10 at both mRNA and protein levels, by signaling through IFNAR. We investigated the role of the signaling molecules STAT1/STAT2, IRF-1 and IRF-7, and of the PI3K→GSK3 pathway. IFN-β inhibition of the IL-12 subunits p40 and p35 was mediated through STAT1/STAT2, whereas inhibition of IL-23 was STAT1 dependent, and the stimulatory effect on IL-10 expression was mediated through STAT2. IFN-β induces IRF-7 and, to a lesser degree, IRF-1. However, neither IRF mediated the effects of IFN-β on IL-12, IL-23, or IL-10. We found that the PI3K pathway mediated IL-12 inhibition but did not interfere with the inhibition of IL-23 or stimulation of IL-10.
Toward automated delineation of ground-penetrating radar facies in clastic sediments: An example from stratified glaciofluvial deposits
Authors: Tronicke Jens , Allroggen Niklas
Published: June 2015

Ground-penetrating radar (GPR) is an established geophysical method to explore near-surface sedimentary environments. Interpreting GPR images is largely based on manual procedures following concepts known as GPR facies analysis. We have developed a novel strategy to distinguish GPR facies in a largely automated and more objective manner. First, we calculate 13 textural attributes to quantify GPR reflection characteristics. Then, this database is reduced using principal component analysis. Finally, we image the dominating principal components using composite imaging and classify them using standard clustering methods. The potential of this workflow is evaluated using a 2D GPR field example collected across stratified glaciofluvial deposits. Our results demonstrate that the derived facies images are well correlated with the composition and the porosity of the sediments as known from independent borehole logs. Our analysis strategy eases and improves the interpretability of GPR data and will help in a variety of geologic and hydrological problems.
Commemoration by Deformation: Julian Stryjkowski's Linguistic Strategy
Authors: Adamczyk-Garbowska Monika
Published: June 2015

The article focuses on Julian Stryjkowski's best-known novel, Voices in the Darkness, analyzed in the context of this leading Jewish Polish writer's biography and his complicated linguistic and cultural position. A special emphasis is placed on the author's use of the Yiddish language below the Polish surface, so that it comes to the Polish reader in the form of literal translation and leads to stylization at different levels: syntactic, semantic-lexical, and phonetic-orthographic. This strategy has met with a mixed reception, because it can be perceived either as an innovative way to commemorate the world of the writer's childhood or as a deformation on the verge of mockery.
Functional development of carbon dioxide detection in the maxillary palp of Anopheles gambiae
Authors: Omondi Bonaventure Aman , Majeed Shahid , Ignell Rickard
Published: June 2015

Olfactory information drives several behaviours critical for the survival and persistence of insect pests and vectors. Insect behaviour is variable, linked to their biological needs, and regulated by physiological dynamics. For mosquitoes, carbon dioxide (CO2) is an important cue that signifies the presence of a host, and which elicits activation and attraction. To investigate the genetic basis of olfactory modulation in mosquitoes, we assayed changes in CO2 detection from receptor gene expression through physiological function to behaviour, associated with the onset of host seeking in the malaria vector, Anopheles gambiae. The gene encoding for a subunit of the CO2 receptor, AgGr22, was found significantly upregulated in host seeking females, consistent with a significant increase in sensitivity of CO2-responsive neurons (cpA) housed in capitate peg sensilla of the maxillary palp. In addition, AgOr28, which is expressed in cpC neurons, was significantly upregulated. In contrast, AgOr8, which is expressed in cpB neurons, was not affected by this change in physiological state, concomitant with results for the obligate co-receptor Orco. Moreover, the sensitivity of the cpB neuron to (R)-1-octen-3-ol, a well-known mammalian kairomone, did not change in response to the onset of host seeking. The concentration of CO2 flux influenced both the propensity of An. gambiae to take off into the wind and the speed with which this activation occurred. Female An. gambiae mosquitoes responded to CO2 whether mature for host seeking or not, but onset of host seeking enhanced sensitivity and speed of activation at relevant doses of CO2.
Co-evolution problems of anthroposphere and technosphere, quantum-synergetic approach
Authors: Буданов  , Budanov V.
Published: June 2015

An anthropological turn in the middle of XXI century was caused by termination of V technological structure and depletion of technogenic recourses of evolution of our civilization. An era of de-liberate co-evolution of anthropological and technogenic natural environment is coming in which engineering gets more and more cognitive and intellectual human competences. Moreover, it in-creasingly gets more animated, and we lose our human being in inability to work with complex realty. Convergent NBICS technologies that have created new technoscientific complexes are one of key to future that is not always optimistic. Further, we are going to talk about near strategies within the responsibility of real social and political practice.
Risk management and how dementia affects ability: Article 1/4. Assessing risk
Authors: Nazarko Linda
Published: June 2015

The oldest and most vulnerable of our citizens—those aged over 85 who have dementia—are at greatest risk of being admitted to hospital. Once in hospital, the older person with dementia is at risk of becoming less able because of admission and at risk of adverse outcomes such as developing an infection, a pressure ulcer or falling. Caregivers instinctively wish to protect vulnerable older people, but sometimes in our efforts to protect, we can disable the individual. This article, the first of a four-part series, examines the risks of hospital admission and explores how we can assess a person's abilities.