bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of combination drugs on antihypertensive medication adherence in a real-world setting: a Korean Nationwide Study
Authors: Kim Seung Jae , Kwon Oh Deog , Cho BeLong , Oh Seung-Won , Lee Cheol Min , Choi Ho-Chun 
Published: June 2019

ObjectivesWe tried to clarify, by using representative national data in a real-world setting, whether single-pill combinations (SPCs) of antihypertensives actually improve medication adherence.DesignA nationwide population-based study.SettingWe used a 2.2% cohort (n=1 048 061) of the total population (n=46 605 433) that was randomly extracted by National Health Insurance of Korea from 2008 to 2013.ParticipantsWe included patients (n=116 677) who were prescribed with the same antihypertensive drugs for at least 1 year and divided them into groups of angiotensin II receptor blocker (ARB)-only, calcium channel blocker (CCB)-only, multiple-pill combinations (MPCs) and SPCs of ARB/CCB.Primary outcome measuresMedication possession ratio (MPR), a frequently used indirect measurement method of medication adherence.ResultsAdjusted MPR was higher in combination therapy (89.7% in SPC, 87.2% in MPC) than monotherapy (81.6% in ARB, 79.7% in CCB), and MPR of SPC (89.7%, 95% CI 89.3 to 90.0) was higher than MPR of MPC (87.2%, 95% CI 86.7 to 87.7) (p<0.05). In subgroup analysis, adherence of SPC and MPC was 92.3% (95% CI 91.5 to 93.0) vs 88.1% (95% CI 87.1 to 89.0) in those aged 65–74 years and 89.3% (95% CI 88.0 to 90.7) vs 84.8% (95% CI 83.3 to 92.0) in those ≥75 years (p<0.05). According to total pill numbers, adherence of SPC and MPC was 90.9% (CI 89.8 to 92.0) vs 85.3% (95% CI 84.1 to 86.5) in seven to eight pills and 91.2% (95% CI 89.3 to 93.1) vs 82.5% (95% CI 80.6 to 84.4) in nine or more (p<0.05). The adherence difference between SPC and MPC started to increase at five to six pills and at age 50–64 years (p<0.05). When analysed according to elderly status, the adherence difference started to increase at three to four pills in the elderly (≥65 years) and at five to six in the non-elderly group (20–64 years) (p<0.05). These differences all widened further with increasing age and the total medications.ConclusionSPC regimens demonstrated higher adherence than MPC, and this tendency is more pronounced with increasing age and the total number of medications.
Community determinants of COPD exacerbations in elderly patients in Poland: protocol for a retrospective Big Data observational cohort study
Authors: Zakowska Izabela , Kosiek Katarzyna , Kowalczyk Anna , Grabowski Jacek , Godycki-Cwirko Maciek 
Published: June 2019

IntroductionAnalyses of large sets of electronic health-related data (Big Data), including local community indicators, may improve knowledge of the outcomes of chronic diseases among patients and healthcare systems. Our study will estimate the prevalence of chronic obstructive pulmonary disease (COPD) and its exacerbations in elderly patients in the Lodz region, Poland; it will also evaluate local community factors potentially associated with disease exacerbations and rank local communities according to health and local community indicators.Methodsand analysisLocal community factors, including medical/health, socioeconomic and environmental values potentially associated with COPD exacerbations will be identified. A retrospective analysis of a cohort of about half a million people 65 years old and older, living in local communities of the Lodz region in 2016 will be performed. Relevant data will be extracted from databases, including those of the National Health Fund, Tax Office and National Statistics Centre. This cross-sectional study will include data for a 1 year period, from 1 January until 31 December 2016. The data will first be checked for quality, cleaned and analysed using data mining techniques, and then multilevel logistic regression will be used to discover the community determinants of COPD exacerbations.Ethics and disseminationThe study protocol has been approved by the Bioethical Committee of Medical University of Lodz (RNN/248/18/KE, 10 July 2018). Our findings will be published in peer-reviewed journals and reports.
Improving transition outcomes in adolescents with permanent hearing loss
Authors: Spyridakou Chrysa , Mendis Surangi , DeVal Daniel 
Published: June 2019

Young people with permanent hearing loss need to transition into adult services and engagement with the transition process is required to achieve this. Although there are clear national recommendations about the transition process and transfer to the adult services limited evidence has been published about the implementation and efficacy of transition programmes in young adults with permanent hearing loss. The primary aim of this quality improvement project was to significantly increase the number of teenagers with a clear transition protocol documented in their notes. The secondary aims were to ensure good medical and audiological outcomes based on all completing their medical investigations prior to transfer to the adult services and also based on a survey regarding attitudes to hearing aids use. A multiphase intervention programme was developed ; (1) staff update with national transition protocols, (2) development of a clear transition protocol, (3) allocated key worker (4) access and (5) engagement. Through these interventions we increased the number of teenagers who had a clear transition protocol documented in their notes from 11% to 91%. 84% of our teenagers had completed their medical investigations, although documented discussion about the investigations had been done with 100% of the cohort. 9.2 % of adolescents felt pressurised to use hearing aids compared to 35% prior to the interventions. This project resulted in clear, measurable conclusions and we have shown that we better understand the needs of ourpatients and the improvement is sustainable.
Botulinum neurotoxin treatment in jerky and tremulous functional movement disorders: a double-blind, randomised placebo-controlled trial with an open-label extension
Authors: Dreissen Yasmine Emma Maria , Dijk Joke M , Gelauff Jeannette M , Zoons Evelien , van Poppelen Daniël , Contarino Maria Fiorella , Zutt Rodi , Post Bart , Munts Alexander G , Speelman Johannes D , Cath Danielle C , de Haan Rob J , Koelman Johannes HTM , Tijssen Marina A J 
Published: June 2019

Objective
To study the effect of botulinum neurotoxin (BoNT) treatment in jerky and tremulous functional movement disorders (FMD).

Methods
Patients with invalidating, chronic (>1 year) symptoms were randomly assigned to two subsequent treatments with BoNT or placebo every 3 months with stratification according to symptom localisation. Improvement on the dichotomised Clinical Global Impression-Improvement scale (CGI-I) (improvement vs no change or worsening) at 4 months, assessed by investigators blinded to the allocated treatment was the primary outcome. Subsequently all patients were treated with BoNT in a ten month open-label phase.

Results
Between January 2011 and February 2015 a total of 239 patients were screened for eligibility of whom 48 patients were included. No difference was found on the primary outcome (BoNT 16 of 25 (64.0%) vs Placebo 13 of 23 patients (56.5%); proportional difference 0.075 (95% CI −0.189 to 0.327; p=0.77). Secondary outcomes (symptom severity, disease burden, disability, quality of life and psychiatric symptoms) showed no between-group differences. The open-label phase showed improvement on the CGI-I in 19/43 (44.2%) of remaining patients, with a total of 35/43 (81.4%) improvement compared with baseline.

Conclusions
In this double-blind randomised controlled trial of BoNT for chronic jerky and tremulous FMD, we found no evidence of improved outcomes compared with placebo. Motor symptoms improved in a large proportion in both groups which was sustained in the open-label phase. This study underlines the substantial potential of chronic jerky and tremulous FMD patients to recover and may stimulate further exploration of placebo-therapies in these patients.

Trial registration number
NTR2478
Evolution of prodromal parkinsonian features in a cohort ofGBAmutation-positive individuals: a 6-year longitudinal study
Authors: Avenali Micol , Toffoli Marco , Mullin Stephen , McNeil Alisdair , Hughes Derralynn A , Mehta A , Blandini Fabio , Schapira Anthony H V 
Published: June 2019

ObjectivesGBA1mutations are a frequent risk factor for Parkinson disease (PD). The aim of this study is to evaluate clinical features in a group ofGBA1mutation–positive individuals over a 6-year follow-up.MethodsThis is a longitudinal study on a cohort ofGBA1-positive carriers. We enrolled 31 patients with Gaucher disease type 1 (GD), 29GBA1heterozygous carriers (HetGBAgroup) and 30 controls (HC) at baseline and followed them for 6 years. We assessed baseline motor and non-motor signs of PD in all subjects using clinical questionnaires and scales (reduced Unified Multiple System Atrophy Rating Scale (UMSARS), Montreal Cognitive assessment (MoCA), University of Pennsylvania Smell Identification Test (UPSIT), REM Sleep Behavior Disorder screening questionnaire (RBDsq), Movement Disorders Society Unified Parkinson’s Disease Rating Scale motor subscale (MDS-UPDRS III) and Beck Depression Inventory (BDI). We repeated these at the 6-year follow-up alongside venous blood sampling for measurement of glucocerebrosidase enzymatic activity (GCase). We explored whether the GCase activity level was altered in leucocytes of these subjects and how it was related to development of PD.ResultsWe observed a significant worsening in UMSARS, RBDsq, MDS-UPDRS III and BDI scores at the 6-year follow-up compared with baseline in both the GD and HetGBAgroups. Intergroup comparisons showed that GD subjects had significantly worse scores in UPSIT, UMSARS, MoCA and MDS-UPDRS III than HC, while HetGBAdisplayed worse outcomes in UPSIT and MDS-UPDRS III compared with HC. InGBA1mutation–positive individuals (HetGBAand GD), an UPSIT score of 23 at baseline was correlated with worse outcome at 6 years in UPSIT, MoCA, MDS-UPDRS III and BDI.ConclusionIn this 6-year-long longitudinal study,GBA1mutation–positive subjects showed a worsening in motor and non-motor prodromal PD features.
Trabecular cutting: a novel surgical therapy to increase diastolic compliance
Authors: Oglesby Meagan , Escobedo Danny , Escobar Gladys Patricia , Fatemifar Fatemeh , Sako Edward Y. , Bailey Steven R. , Han Hai-Chao , Feldman Marc D. 
Published: June 2019

Heart failure with preserved ejection fraction (HFpEF) is a common cause of hospital admission in patients over 65 yr old and has high mortality. HFpEF is characterized by left ventricular (LV) hypertrophy that reduces compliance. Current HFpEF therapies control symptoms, but no existing medications or therapies can sustainably increase LV compliance. LV trabeculae develop hypertrophy and fibrosis that contribute to reduced LV compliance. This study expands our previous results in ex vivo human hearts to show that severing LV trabeculae increases diastolic compliance in an ex vivo working rabbit heart model. Trabecular cutting was performed in ex vivo rabbit hearts set up in a working heart perfusion system perfused with oxygenated Krebs-Henseleit buffer. A hook was inserted in the LV to cut trabeculae. End-systolic and end-diastolic pressure-volume relationships during transient preload reduction were recorded using an admittance catheter in the following three groups: control (no cutting; n = 9), mild cutting (15 cuts; n = 5), and aggressive cutting (30 cuts; n = 5). In a second experiment, each heart served as its own control. Hemodynamic data were recorded before and after trabecular cutting ( n = 10) or sham cutting ( n = 5) within the same heart. In the first experiments, trabecular cutting did not affect systolic function ( P > 0.05) but significantly increased overall diastolic compliance ( P = 0.009). Greater compliance was seen as trabecular cutting increased ( P = 0.002, r2 = 0.435). In the second experiment, significant increases in systolic function ( P = 0.048) and diastolic compliance ( P = 0.002) were seen after trabecular cutting compared with baseline. In conclusion, trabecular cutting significantly increases diastolic compliance without reducing systolic function. NEW & NOTEWORTHY We postulate that, in mammalian hearts, free-running trabeculae carneae exist to provide tensile support to the left ventricle and minimize diastolic wall stress. Because of hypertrophy and fibrosis of trabeculae in patients with left ventricular hypertrophy, this supportive role can become pathologic, worsening diastolic compliance. We demonstrate a novel operation involving cutting trabeculae as a method to acutely increase diastolic compliance in patients presenting with heart failure and diastolic dysfunction to improve their left ventricle compliance.
Blood Pressure Variability Predicts Poor In-Hospital Outcome in Spontaneous Intracerebral Hemorrhage
Authors: Divani Afshin A. , Liu Xi , Di Napoli Mario , Lattanzi Simona , Ziai Wendy , James Michael L. , Jafarli Alibay , Jafari Mostafa , Saver Jeffrey L. , Hemphill J. Claude , Vespa Paul M. , Mayer Stephan A. , Petersen Alexander 
Published: June 2019

Background and Purpose—
There is increasing evidence that higher systolic blood pressure variability (SBPV) may be associated with poor outcome in patients with intracerebral hemorrhage (ICH). We explored the association between SBPV and in-hospital ICH outcome.

Methods—
We collected 10-years of consecutive data of spontaneous ICH patients at 2 healthcare systems. Demographics, medical history, laboratory tests, computed tomography scan data, in-hospital treatments, and neurological and functional assessments were recorded. Blood pressure recordings were extracted up to 24 hours postadmission. SBPV was measured using SD, coefficient of variation, successive variation (SV), range and 1 novel index termed functional SV. The effects of SBPV on the functional outcome at discharge were evaluated by multivariate logistic and ordinal regression analyses for dichotomous and trichotomous modified Rankin Scale categorizations, respectively. In secondary analyses, associations between SBPV, history of hypertension, and hematoma expansion were explored.

Results—

The analysis included 762 subjects. All 5 SBPV indices were significantly associated with the probability of unfavorable outcome (modified Rankin Scale score, 4–6) in logistic models. In ordinal models, SD, coefficient of variation, range, and functional SV were found to have a significant effect on the probabilities of poor (modified Rankin Scale score, 3–4) and severe/death (modified Rankin Scale score, 5–6) outcomes. Normotensive patients had significantly lower mean SBPV compared with the untreated-hypertension cohort for all SBPV indices and compared with treated-hypertension patients for 3 out of 5 SBPV indices. Lower mean SBPV of treated-hypertension subjects compared with untreated-hypertension subjects was only detected in the SV and functional SV indices (
P
=0.045). None of the SBPV indices were significantly associated with the probability of hematoma expansion.

Conclusions—
Higher SBPV in the first 24 hours of admission was associated with unfavorable in-hospital outcome among ICH patients. Further prospective studies are warranted to understand any cause-effect relationship and whether controlling for SBPV may improve the ICH outcome.
References to the Coral Islands in Huang Zhong’s Hai yu 海語
Authors: Ptak Roderich 
Published: June 2019

Abstract
There are many studies on the history of the islands in the South China Sea. The present article looks at the references to these islands in one source, Huang Zhong’s 黄衷 Hai yu 海語 (preface 1536). This mainly concerns two entries in that work. One entry bears the title Wanli shitang 萬里石塘, the other is called Wanli changsha 萬里長沙. The article presents English translations of these entries together with detailed comments. These comments are necessary because both entries contain several terms and passages that are difficult to understand. The comments investigate questions related to the geography and other phenoma of this area. This involves citations from contemporary sources as well as from some earlier and later works. In that sense the article may classify as a long philological note, or a collection of glosses, on a particular aspect described in one important mid-Ming text.
Tropical and Midlatitude Impact on Seasonal Polar Predictability in the Community Earth System Model
Authors: Blanchard-Wrigglesworth Edward , Ding Qinghua 
Published: June 2019

Abstract
The impact on seasonal polar predictability from improved tropical and midlatitude forecasts is explored using a perfect-model experiment and applying a nudging approach in a GCM. We run three sets of 7-month long forecasts: a standard free-running forecast and two nudged forecasts in which atmospheric winds, temperature, and specific humidity (U, V, T, Q) are nudged toward one of the forecast runs from the free ensemble. The two nudged forecasts apply the nudging over different domains: the tropics (30°S–30°N) and the tropics and midlatitudes (55°S–55°N). We find that the tropics have modest impact on forecast skill in the Arctic or Antarctica both for sea ice and the atmosphere that is mainly confined to the North Pacific and Bellingshausen–Amundsen–Ross Seas, whereas the midlatitudes greatly improve Arctic winter and Antarctic year-round forecast skill. Arctic summer forecast skill from May initialization is not strongly improved in the nudged forecasts relative to the free forecast and is thus mostly a “local” problem. In the atmosphere, forecast skill improvement from midlatitude nudging tends to be largest in the polar stratospheres and decreases toward the surface.
The Impact of State-Owned Enterprises on China’s Economic Growth
Authors: Qi Hao , Kotz David M. 
Published: June 2019

This paper considers the impact of state-owned enterprises on economic growth in China. We consider several possible channels through which state-owned enterprises might play a pro-growth role: first, stabilizing growth in economic downturns by carrying out massive investments; second, promoting technical progress by investing in riskier areas of technology; third, by following a high-road approach to treating workers by paying a living wage which is favorable for China to move toward a more sustainable growth model in the future. Our empirical analysis finds that a higher share of state-owned enterprises is favorable to long-run growth and tends to offset the adverse effect of economic downturns on the regional level. JEL Classification: E11, O47, P31
Low-Dose Alteplase for the Treatment of Submassive Pulmonary Embolism: A Case Series
Authors: Layman Sara N. , Guidry Tommie J. , Gillion Amanda R. 
Published: June 2019

Purpose: Pulmonary embolism (PE) can lead to significant morbidity and mortality. Thrombolytics are currently approved for the treatment of massive PE; however, the CHEST guidelines recommend against systemic thrombolytic use in acute PE patients without hypotension, unless these patients deteriorate on anticoagulation alone. Several studies have demonstrated the effectiveness of thrombolysis in submassive PE; however, the full thrombolytic dose resulted in significantly increased risk of non-intracranial bleeding and hemorrhagic stroke. The MOPETT trial demonstrated that low-dose tissue plasminogen activator (tPA) significantly reduced the risk of pulmonary hypertension and recurrent PE compared to anticoagulation alone in submassive PE patients without any bleeding events. Summary: This case series highlights 5 patient cases utilizing low-dose tPA for submassive PE. All patients had successful resolution of their symptoms and improvement in vitals and laboratory values. Furthermore, no patient had any bleeding during or after tPA administration. Three patients showed improved right ventricle function and reduced or normal right ventricle size on echocardiogram after tPA administration. Conclusion: The potential for low-dose tPA as a safe and efficacious treatment option for submassive PE is illustrated by this case series. However, larger, randomized controlled trials are needed to establish low-dose tPA as an accepted treatment modality.
Correlation of miRNA expression with intensity of neuropathic pain in man
Authors: Tavares-Ferreira Diana , Lawless Nathan , Bird Emma V , Atkins Simon , Collier David , Sher Emanuele , Malki Karim , Lambert Daniel W , Boissonade Fiona M 
Published: June 2019

Background Peripheral nerve injury causes changes in expression of multiple receptors and mediators that participate in pain processing. We investigated the expression of microRNAs (miRNAs) – a class of post-transcriptional regulators involved in many physiological and pathophysiological processes – and their potential role in the development or maintenance of chronic neuropathic pain following lingual nerve injury in human and rat. Methods We profiled miRNA expression in Sprague-Dawley rat and human lingual nerve neuromas using TaqMan® low-density array cards. Expression of miRNAs of interest was validated via specific probes and correlated with nerve injury-related behavioural change in rat (time spent drinking) and clinical pain (visual analogue scale (VAS) score). Target prediction was performed using publicly available algorithms; gene enrichment and pathway analysis were conducted with MetaCore. Networks of miRNAs and putative target genes were created with Cytoscape; interaction of miRNAs and target genomes in rat and human was displayed graphically using CircosPlot. Results rno-miR-138 was upregulated in lingual nerve of injured rats versus sham controls. rno-miR-138 and rno-miR-667 expression correlated with behavioural change at day 3 post-injury (with negative (rno-miR-138) and positive (rno-miR-667) correlations between expression and time spent drinking). In human, hsa-miR-29a was downregulated in lingual nerve neuromas of patients with higher pain VAS scores (painful group) versus patients with lower pain VAS scores (non-painful). A statistically significant negative correlation was observed between expression of both hsa-miR-29a and hsa-miR-500a, and pain VAS score. Conclusions Our results show that following lingual nerve injury, there are highly significant correlations between abundance of specific miRNAs, altered behaviour and pain scores. This study provides the first demonstration of correlations between human miRNA levels and VAS scores for neuropathic pain and suggests a potential contribution of specific miRNAs to the development of chronic pain following lingual nerve injury. Putative targets for candidate miRNAs include genes related to interleukin and chemokine receptors and potassium channels.