bluuebunny/crossref_metadata_2025_split huggingface dataset:
Plasma fibroblast growth factor 21 levels increase with ectopic fat accumulation and its receptor levels are decreased in the visceral fat of patients with type 2 diabetes
Authors: Hong Eun Shil , Lim Cheong , Choi Hye Yeon , Lee Yun Kyung , Ku Eu Jeong , Moon Jae Hoon , Park Kyong Soo , Jang Hak Chul , Choi Sung Hee 
Published: November 2019

BackgroundFibroblast growth factor 21 (FGF21) is a novel metabolic regulator that has beneficial effects on glucose and lipid metabolism. However, plasma FGF21 levels are paradoxically increased in type 2 diabetes mellitus (T2DM) and obesity, suggesting resistance to this ligand. FGF21 acts mainly on adipose tissue and ectopic fat accumulation is a typical feature in metabolic deterioration such as diabetes, metabolic syndrome, and cardiovascular disease.ObjectiveTo investigate the relationship between FGF21 resistance and ectopic fat accumulation.Research design and methodsSubjects who underwent 64-slice multidetector CT (MDCT) were enrolled (n=190). Plasma FGF21 levels and MDCT data of ectopic fats at various sites were analyzed. Human visceral and subcutaneous fat tissues from abdominal and coronary artery bypass surgery were obtained. FGF21 receptor expression and postreceptor signaling in different fat deposits of both control and T2DM subjects were analyzed.ResultsPlasma FGF21 levels were significantly associated with body mass index, triglyceride, homeostatic model assessment of insulin resistance, and Matsuda index. Plasma FGF21 levels were significantly higher in patients with T2DM than in the pre-diabetes and normal glucose tolerance groups. The ectopic fat phenotypes (visceral, epicardial, intrahepatic, and intramuscular fat) of T2DM were significantly higher than controls. Plasma FGF21 levels were elevated and exhibited a strong positive correlation with ectopic fat accumulation in T2DM. The expression of genes comprising the FGF21 signaling pathway was also lower in visceral fat than in subcutaneous fat in this disease.ConclusionsHuman FGF21 resistance in T2DM could result from increases in FGF21-resistant ectopic fat accumulation. Our study provides novel clinical evidence linking FGF21 resistance and T2DM pathogenesis.
Assessing the quality of medication documentation: development and feasibility of the MediDocQ instrument for retrospective chart review in the hospital setting
Authors: Hammer Antje , Wagner Anke , Rieger Monika A , Manser Tanja 
Published: November 2019

ObjectiveThe medication process requires clear and transparent documentation in patient records. Incomplete or incorrect medication documentation may contribute to inappropriate clinical decision-making and adverse events. To comprehensively assess the quality of in-hospital medication documentation, we developed a retrospective chart review (RCR) instrument. We report on the development process, the feasibility of the instrument and describe our application of the instrument to a sample of patient records.DesignCross-sectional study using an RCR instrument to evaluate paper-based, non-standardised prescription and medication administration charts (MediDocQ).SettingTwo German university hospitals.ParticipantsRecords from 1361 patients admitted between April and July 2015 were evaluated.MethodsThe MediDocQ development process comprised six consecutive stages: focused literature review, web-based search, initial patient record screening, review by project advisory board, focus groups with professionals and pilot testing. The final 54-item RCR instrument covers three key components of medication documentation: (1) completeness of documented information (including prescription, medication administration and pro re nata (PRN) medication), (2) quality of transcriptions and (3) compliance with chart structure, legibility, handling of deletions and chart corrections. Descriptive statistics are presented as mean values, SD, median and interquartile ranges for individual items.ResultsOverall, 33 out of 54 items resulted in mean values above 0.75, indicating high-quality medication documentation. Documentation quality was particularly compromised for verbal and PRN orders (which involve more steps than standard orders) and when documentation was not completed at the same time as medication administration.ConclusionsMediDocQ is a patient safety instrument that can be used to evaluate the quality of medication documentation and identify components of the process where intervention is required. In our setting, standardisation of medication documentation, particularly regarding medication administration and PRN medication is a priority.
Predicting sudden cardiac death in a general population using an electrocardiographic risk score
Authors: Holkeri Arttu , Eranti Antti , Haukilahti M Anette E , Kerola Tuomas , Kenttä Tuomas V , Tikkanen Jani T , Anttonen Olli , Noponen Kai , Seppänen Tapio , Rissanen Harri , Heliövaara Markku , Knekt Paul , Junttila M Juhani , Huikuri Heikki V , Aro Aapo L 
Published: November 2019

ObjectiveWe investigated whether combining several ECG abnormalities would identify general population subjects with a high sudden cardiac death (SCD) risk.MethodsIn a sample of 6830 participants (mean age 51.2±13.9 years; 45.5% male) in the Mini-Finland Health Survey, a general population cohort representative of the Finnish adults aged ≥30 years conducted in 1978–1980, we examined their ECGs, following subjects for 24.3±10.4 years. We analysed the association between individual ECG abnormalities and 10-year SCD risk and developed a risk score using five ECG abnormalities independently associated with SCD risk: heart rate >80 beats per minute, PR duration >220 ms, QRS duration >110 ms, left ventricular hypertrophy and T-wave inversion. We validated the score using an external general population cohort of 10 617 subjects (mean age 44.0±8.5 years; 52.7% male).ResultsNo ECG abnormalities were present in 4563 subjects (66.8%), while 96 subjects (1.4%) had ≥3 ECG abnormalities. After adjusting for clinical factors, the SCD risk increased progressively with each additional ECG abnormality. Subjects with ≥3 ECG abnormalities had an HR of 10.23 (95% CI 5.29 to 19.80) for SCD compared with those without abnormalities. The risk score similarly predicted SCD risk in the validation cohort, in which subjects with ≥3 ECG abnormalities had HR 10.82 (95% CI 3.23 to 36.25) for SCD compared with those without abnormalities.ConclusionThe ECG risk score successfully identified general population subjects with a high SCD risk. Combining ECG risk markers may improve the risk stratification for SCD.
Evaluation of the delta of immature platelet fraction as a predictive biomarker of inflammatory response after cardiac surgery
Authors: Imperiali Claudia Elizabeth , Lopez-Delgado Juan Carlos , Dastis-Arias Macarena , Sanchez-Navarro Lourdes 
Published: November 2019

AimsCardiac surgery (CS) can induce an inflammatory response (IR) that is associated with poorer outcomes. Immature platelets are among the factors that may be associated with IR development. We aimed to evaluate whether immature platelet fraction (IPF) could be a predictive biomarker for IR and whether IPF could improve the prognosis assessment of IR for Acute Physiologic and Chronic Health Evaluation (APACHE II) and Sequential Organ Failure Assessment (SOFA) following CS.MethodsThree-hundred and twenty-seven (327) patients who underwent CS were enrolled during the study period. IR was defined according to the need for vasopressor support (>48 hours). Perioperative variables and outcomes were registered in our database. IPF was measured immediately following CS and at 24 hours by Sysmex XN analyzer and the difference between both measurements (ΔIPF) was calculated. To assess the relationship between ΔIPF and IR, univariate and multivariate logistic regression were performed. To analyse the additive value of ΔIPF in APACHE II and SOFA scores in predicting IR, an area under the receiver operating characteristic (AUROC) curve was calculated.ResultsAmong 327 patients included, 60 patients (18.3%) developed IR. Multivariate analysis showed ΔIPF was significantly associated with IR (OR: 1.26; 95% CI: 1.01 to 1.56; p=0.038). The combination of ΔIPF with scores improved the AUROC for IR prediction: 0.629 vs 0.728 (p=0.010) for APACHE II and 0.676 vs 0.715 (p=0.106) for SOFA.ConclusionThese findings suggested that ΔIPF may be a useful and low-cost biomarker for the early identification of patients at risk of IR development.
Outcomes in patients with gunshot wounds to the brain
Authors: Robinson Leigh Anna , Turco Lauren M , Robinson Bryce , Corsa Joshua G , Mount Michael , Hamrick Amy V , Berne John , Mederos Dalier R , McNickle Allison G , Chestovich Paul J , Weinberger Jason , Grigorian Areg , Nahmias Jeffry , Lee Jane K , Chow Kevin L , Olson Erik J , Pascual Jose L , Solomon Rachele , Pigneri Danielle A , Ladhani Husayn A , Fraifogl Joanne , Claridge Jeffrey , Curry Terry , Costantini Todd W , Kongwibulwut Manasnun , Kaafarani Haytham , San Roman Janika , Schreiber Craig , Goldenberg-Sandau Anna , Hu Parker , Bosarge Patrick , Uhlich Rindi , Lunardi Nicole , Usmani Farooq , Sakran Joseph Victor , Babcock Jessica M , Quispe Juan Carlos , Lottenberg Lawrence , Cabral Donna , Chang Grace , Gulmatico Jhoanna , Parks Jonathan J , Rattan Rishi , Massetti Jennifer , Gurney Onaona , Bruns Brandon , Smith Alison A , Guidry Chrissy , Kutcher Matthew E , Logan Melissa S , Kincaid Michelle Y , Spalding Chance , Noorbaksh Matthew , Philp Frances H , Cragun Benjamin , Winfield Robert D 
Published: November 2019

IntroductionGunshot wounds to the brain (GSWB) confer high lethality and uncertain recovery. It is unclear which patients benefit from aggressive resuscitation, and furthermore whether patients with GSWB undergoing cardiopulmonary resuscitation (CPR) have potential for survival or organ donation. Therefore, we sought to determine the rates of survival and organ donation, as well as identify factors associated with both outcomes in patients with GSWB undergoing CPR.MethodsWe performed a retrospective, multicenter study at 25 US trauma centers including dates between June 1, 2011 and December 31, 2017. Patients were included if they suffered isolated GSWB and required CPR at a referring hospital, in the field, or in the trauma resuscitation room. Patients were excluded for significant torso or extremity injuries, or if pregnant. Binomial regression models were used to determine predictors of survival/organ donation.Results825 patients met study criteria; the majority were male (87.6%) with a mean age of 36.5 years. Most (67%) underwent CPR in the field and 2.1% (n=17) survived to discharge. Of the non-survivors, 17.5% (n=141) were considered eligible donors, with a donation rate of 58.9% (n=83) in this group. Regression models found several predictors of survival. Hormone replacement was predictive of both survival and organ donation.ConclusionWe found that GSWB requiring CPR during trauma resuscitation was associated with a 2.1% survival rate and overall organ donation rate of 10.3%. Several factors appear to be favorably associated with survival, although predictions are uncertain due to the low number of survivors in this patient population. Hormone replacement was predictive of both survival and organ donation. These results are a starting point for determining appropriate treatment algorithms for this devastating clinical condition.Level of evidenceLevel II.
Crustal structure of the central sector of the NE Brazilian equatorial margin
Authors: Tamara Javier , McClay Ken R. , Hodgson Neil 
Published: November 2019

Abstract
The central equatorial Brazilian margin is divided into the Amazon and Barreirinhas divergent segments separated by the Pará-Maranhão transform segment. Analysis of regional 2D seismic lines allowed the definition of the crustal architecture of the margin. In the study area, the Barreirinhas segment has a proximal domain with a 30–35 km-thick continental crust, a 20–40 km-wide necked domain where the crust thins to 10 km, and an outboard domain with hyperextended continental crust. The Pará-Maranhão and Amazon segments consist of exhumation domains and their transition to ocean crust. Their structural styles indicate that this is a magma-poor passive margin with oceanic crust formed in a slow spreading centre. The Pará-Maranhão segment is bounded by two branches of the Saint Paul Fracture Zone that displace crustal domains with structures that document the transition from the distal part of a transform margin to an oceanic fracture zone. Two groups of post-rift volcanic complexes have been identified in the exhumation and oceanic domains, and whose distribution is controlled by the fracture zones. Late Cretaceous–Recent gravitationally-driven slide systems and mass-transport deposits indicate long-lived margin collapse and sediment redistribution fundamentally controlled by the underlying crustal structure of this part of the northeastern Brasilian passive margin.
Microfossil assemblages as key to reconstruct sea-level fluctuations, cooling episodes and palaeogeography: The Albian to Maastrichtian of Boreal and Peri-Tethyan Russia
Authors: Vishnevskaya Valentina S. , Kopaevich Ludmila F. 
Published: November 2019

Abstract
The main palaeogeographic features of the Late Cretaceous Eastern European Platform and its southern framework are reconstructed mainly based on micropalaeontological data. An integrated foraminiferal–radiolarian zonation for the Upper Albian–Maastrichtian serves as a basis for palaeogeographic reconstructions and as a framework for the interpretation of palaeoclimate and sea-level trends. The study focuses on time slices of late Albian–Cenomanian, Turonian–Coniacian and Santonian–Campanian intervals. The late Albian was characterized by the gradual disappearance of a meridional seaway and the opening of connections into the Tethys Ocean and parts of the Peri-Tethys seas during the Cenomanian. As a result, mainly carbonate sedimentation prevailed during middle Turonian–Santonian times, characterized by high global sea-level. A cold Boreal water influence can be discerned not only along the northern margin of the Eastern European Platform, but as far south as the Northern Caucasus during certain time intervals, particularly during the Campanian. The Western Siberia Boreal Basin also influenced the study area, giving evidence of cooler-water episodes through the Palaeo-Ural territory and the Turgai Seaway.
Loop analysis of the anal sphincter complex in fecal incontinent patients using functional luminal imaging probe
Authors: Zifan Ali , Mittal Ravinder K. , Kunkel David C. , Swartz Jessica , Barr Garrett , Tuttle Lori J. 
Published: November 2019

Cardiac loops have been used extensively to study myocardial function. With changes in cardiac pump function, loops are shifted to the right or left. Functional luminal imaging probe (FLIP) recordings allow for loop analysis of the anal sphincter and puborectalis muscle (PRM) function. The goal was to characterize anal sphincter area-pressure/tension loop changes in fecal incontinence (FI) patients. Fourteen healthy subjects and 14 patients with FI were studied. A custom-designed FLIP was placed in the vagina and then in the anal canal, and deflated in 20-ml steps, from 90 to 30 ml. At each volume, subjects performed maximal voluntary squeezes. Area-pressure (AP) and area-tension (AT) loops were generated for each squeeze cycle. Three-dimensional ultrasound imaging of the anal sphincter and PRM were obtained to determine the relationship between anal sphincter muscle damage and loop movements. With the increase in bag volume, AP loops and AT loops shifted to the right and upward in normal subjects (both anal and vaginal). The shift to the right was greater, and the upward movement was less in FI patients. The difference in the location of AP loops and AT loops was statistically significant at volumes of 50 ml to 90 ml ( P < 0.05). A similar pattern was found in the vaginal loops. There is a significant relationship between the damage to the anal sphincter and PRM, and loop location of FI patients. We propose AP and AT loops as novel ways to assess the anal sphincter and PRM function. Such loops can be generated by real-time measurement of pressure and area within the anal canal.NEW & NOTEWORTHY We describe the use of area-pressure (AP) and area-tension (AT)-loop analysis of the anal sphincters and puborectalis muscles in normal subjects and fecal incontinent patients using the functional luminal imaging probe (FLIP). There are differences in the magnitude of the displacement of the loops with increase in the FLIP bag volume between normal subjects and patients with fecal incontinence. The latter group shifts more to the right in AP and AT space.
Ranirestat Improved Nerve Conduction Velocities, Sensory Perception, and Intraepidermal Nerve Fiber Density in Rats with Overt Diabetic Polyneuropathy
Authors: Asano Saeko , Himeno Tatsuhito , Hayami Tomohide , Motegi Mikio , Inoue Rieko , Nakai-Shimoda Hiromi , Miura-Yura Emiri , Morishita Yoshiaki , Kondo Masaki , Tsunekawa Shin , Kato Yoshiro , Kato Koichi , Naruse Keiko , Nakamura Jiro , Kamiya Hideki 
Published: November 2019

Distal sensory-motor polyneuropathy is one of the most frequent diabetic complications. However, few therapies address the etiology of neurodegeneration in the peripheral nervous systems of diabetic patients. Several metabolic mechanisms have been proposed as etiologies of this polyneuropathy. In this study, we revisited one of those mechanisms, the polyol pathway, and investigated the curative effects of a novel strong aldose reductase inhibitor, ranirestat, in streptozotocin-induced diabetic rats with preexisting polyneuropathy. Twelve weeks after the onset of diabetes, rats which had an established polyneuropathy were treated once daily with a placebo, ranirestat, or epalrestat, over 6 weeks. Before and after the treatment, nerve conduction velocities and thermal perception threshold of hindlimbs were examined. After the treatment, intraepidermal fiber density was evaluated. As an ex vivo assay, murine dorsal root ganglion cells were dispersed and cultured with or without 1 μmol/l ranirestat for 48 hours. After the culture, neurite outgrowth was quantified using immunological staining. Sensory nerve conduction velocity increased in diabetic rats treated with ranirestat (43.3±3.6 m/s) compared with rats treated with placebo (39.8±2.3). Motor nerve conduction velocity also increased in the ranirestat group (45.6±3.9) compared with the placebo group (38.9±3.5). The foot withdrawal latency to noxious heating was improved in the ranirestat group (17.7±0.6 seconds) compared with the placebo group (20.6±0.6). The decrease in the intraepidermal fiber density was significant in the diabetic placebo group (21.6±1.7/mm) but not significant in the diabetic ranirestat group (26.2±1.2) compared with the nondiabetic placebo group (30.3±1.5). Neurite outgrowth was promoted in the neurons supplemented with ranirestat (control 1446±147 μm/neuron, ranirestat 2175±149). Ranirestat improved the peripheral nervous dysfunctions in rats with advanced diabetic polyneuropathy. Ranirestat could have potential for regeneration in the peripheral nervous system of diabetic rats.
Hepatocyte Growth Factor in Blood and Gastric Cancer Risk: A Nested Case–Control Study
Authors: Jang Jieun , Ma Seung Hyun , Ko Kwang-Pil , Choi Bo Yul , Yoo Keun-Young , Park Sue K. 
Published: November 2019

Abstract

Background:
Potential of hepatocyte growth factor (HGF)–stimulating signaling pathways related to cytotoxin-associated gene A (CagA) to predict gastric cancer development has not been fully investigated.

Methods:
We conducted a nested case–control study consisting of 238 gastric cancer cases and 238 matched controls within the Korean Multicenter Cancer Cohort. Plasma HGF concentrations were measured with a human HGF ELISA. Odds ratios (OR) and 95% confidence intervals (CI) for gastric cancer development according to HGF level were calculated using conditional logistic regression model.

Results:
Sequential elevation of gastric cancer risk according to HGF level increase was observed (OR, 10.99; 95% CI, 4.91–24.62) for highest quartile HGF (≥364 pg/mL) versus lowest quartile HGF (&lt;167 pg/mL). A significantly increased gastric cancer risk associated with high HGF level measured even 6 or more years prior to cancer diagnosis was also found. The group with both high risk of HGF and CagA-related genetic variants was associated with highest gastric cancer risk compared with the group with both low risk of HGF and genetic variants (Pinteraction = 0.05). Model performance using HGF and CagA-related genetic variants to discriminate gastric cancer was fair [area under the curve of receiver operating characteristic (AUC-ROC), 0.71; 95% CI, 0.64–0.78] and significantly higher than that of model not including those biomarkers.

Conclusions:
Our results suggest HGF as a potential biomarker to predict gastric cancer development.

Impact:
These findings suggest HGF as a useful biomarker to predict gastric cancer risk. Further research to assess gastric cancer risk based on useful biomarkers, including HGF, may contribute to primary prevention of gastric cancer.
Adult Cancer Survivors' Engagement and Interest in Patient-Centered Research
Authors: Lubas Margaret M. , Lu Yan , Gehr Aaron W. , Ghabach Bassam , Tanna Bhavna , Narra Kalyani , Brinkman Tara M. , Ojha Rohit P. 
Published: November 2019

Abstract

Background:
Limited information is available about the representativeness of survivors engaging in patient-centered research, despite the potential for threats to generalizability. We thus aimed to assess the representativeness of survivors engaged or interested in research development.

Methods:
We used data from the Health Information National Trends Survey, a nationally representative survey, to identify survivors of adult cancers. Our outcomes of interest were based on responses to questions about engagement or interest in developing patient-centered research. We estimated the ratio of relative frequencies (RRF) and corresponding 95% confidence limits (CL) of sociodemographic and survivorship characteristics between survivors engaged or interested in patient-centered research and the overall survivor population.

Results:
Our study population comprised 934 survivors, of whom 5% reported being engaged in patient-centered research and 26% reported an interest in participating. Relative frequencies of characteristics were discordant for engaged survivors but largely similar for interested survivors compared with all survivors. In particular, engaged survivors had a higher relative frequency of individuals ages 50 to 64 years (RRF = 1.7; 95% CL, 1.1–2.5), Hispanic (RRF = 2.9; 95% CL, 1.2–6.9), non-Hispanic Black (RRF = 2.9; 95% CL, 1.1–2.5), and unemployment (RRF = 4.7; 95% CL, 1.4–16).

Conclusions:
We observed several meaningful differences in the characteristics of survivors engaged in patient-centered research compared with all survivors, which raises concerns about the generalizability of findings from such studies.

Impact:
Patient-centered research may not benefit the broader survivor community if survivors engaging in research development are not representative of all survivors. Greater attention to recruiting mechanisms is necessary to avoid creating disparities.