bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fetuin-B Links Nonalcoholic Fatty Liver Disease to Chronic Kidney Disease in Obese Chinese Adults: A Cross-Sectional Study
Authors: Lin Mingzhu , Liu Changqin , Liu Yongwen , Wang Dongmei , Zheng Caiyu , Shi Xiulin , Chen Zheng , Liu Jing , Li Xuejun , Yang Shuyu , Li Zhibin 
Published: April 2019

<b><i>Background:</i></b> There is no evidence available on the association of Fetuin-B with chronic kidney disease (CKD), and mechanisms linking nonalcoholic fatty liver disease (NAFLD) to CKD are not fully understood. We aimed to explore the independent associations and potential mechanisms of Fetuin-B and NAFLD with CKD. <b><i>Methods:</i></b> A cross-sectional study of 1,072 Chinese adults who underwent serum Fetuin-B test and hepatic ultrasonography scanning was conducted in Xiamen, China. CKD was defined as estimated glomerular filtration rate &#x3c; 60 mL/min/1.73 m<sup>2</sup> and/or the presence of albuminuria. <b><i>Results:</i></b> Subjects with CKD showed significantly higher prevalence of NAFLD (69.5 vs. 57.2%, <i>p</i> &#x3c; 0.001) and serum Fetuin-B levels (4.32 ± 1.45 vs. 4.05 ± 1.36 µg/mL, <i>p</i> = 0.007) than their controls. Increased serum Fetuin-B was also significantly associated with increased levels of fasting insulin and homeostasis model assessment – insulin resistance (both <i>p</i> values &#x3c; 0.05). NAFLD and higher serum Fetuin-B were significantly associated with increased risk of CKD, and the unadjusted ORs (95% CIs) were 1.701 (1.256–2.303, <i>p</i> = 0.001) and 1.213 (1.053–1.399, <i>p</i> = 0.008, per SD increase of Fetuin-B), respectively. With adjustment for potential confounding factors, including metabolic/insulin resistance syndrome, NAFLD but not serum Fetuin-B was still significantly associated with increased risk of CKD, and the adjusted ORs (95% CIs) were 1.820 (1.327–2.496, <i>p</i> &#x3c; 0.001) and 1.116 (0.959–1.298, <i>p</i> = 0.153, per SD increase of Fetuin-B), respectively. <b><i>Conclusions:</i></b> Fetuin-B might link NAFLD to CKD via inducing insulin resistance, and NAFLD contributes independently to the pathogenesis of CKD via multiple mechanisms besides of metabolic/insulin resistance syndrome.
Maternal Anemia and Coagulation/Fibrinolysis after Fetoscopic Laser Photocoagulation for Twin-to-Twin Transfusion Syndrome
Authors: Morikawa Mamoru , Yamada Takashi , Nakagawa Kinuko , Hosokawa-Miyanishi Ami , Umazume Takeshi , Chiba Kentaro , Kawaguchi Satoshi , Cho Kazutoshi , Watari Hidemichi 
Published: April 2019

<b><i>Aim:</i></b> This study was performed to evaluate maternal changes in laboratory characteristics after fetoscopic laser photocoagulation (FLP) for twin-to-twin transfusion syndrome (TTTS). <b><i>Methods:</i></b> A retrospective review was conducted among 30 women with monochorionic diamniotic twin pregnancy with TTTS who underwent FLP at 16–26 weeks of gestation. Maternal laboratory parameters were measured before and after FLP. <b><i>Results:</i></b> The pre-FLP mean hemoglobin level (10.0 g/dL), hematocrit level (30.0%), platelet count (229 × 10<sup>9</sup>/mL), fibrinogen level (461 mg/dL), and antithrombin activity (96.8%) decreased after FLP (8.5 g/dL, 25.5%, 204 × 10<sup>9</sup>/mL, 403 mg/dL, and 83.6%, respectively) and returned to normal spontaneously within 2 weeks (9.6 g/dL, 29.4%, 293 × 10<sup>9</sup>/mL, 460 mg/dL, and 102.4%, respectively). The D-dimer level before FLP (2.41 μg/mL) increased after FLP (4.28 μg/mL), and the elevated level was maintained for 2 weeks (3.24 μg/mL). The symptomatic venous thromboembolism (VTE) was not detected after FLP in any of the 30 patients. However, one woman had pulmonary embolism after subsequent cesarean section. <b><i>Conclusion:</i></b> Changes in maternal anemia and coagulation/fibrinolysis after FLP for TTTS returned to normal spontaneously within 2 weeks. Maternal elevation of D-dimer level after FLP might be a warning indicator of VTE.
Clinical and Angiographic Predictors of Patient-Reported Angina 1 Year After Coronary Artery Bypass Graft Surgery
Authors: Hattler Brack , Carr Brendan M. , Messenger John , Spertus John , Ebrahimi Ramin , Bishawi Muath , Quin Jacquelyn A. , Almassi G. Hossein , Collins Joseph F. , Kozora Elizabeth , Grover Frederick L. , Shroyer A. Laurie W. 
Published: April 2019

Background:
Studies of the relationship between patient self-reported angina symptoms using the Seattle Angina Questionnaire (SAQ) and angiographic findings after coronary artery bypass grafting surgery (CABG) are lacking. Nested within a randomized controlled trial, this prospective observational cohort comparison study aimed to assess which clinical characteristics and angiographic findings are associated with self-reported angina 1 year after CABG.

Methods and Results:
Patients from the ROOBY trial (Randomized On/Off Bypass) with protocol-specified 1-year post-CABG coronary angiography and SAQ assessments were included (n=1258). Patients reporting no angina (62.3%) within 4 weeks before the 1-year post-CABG study visit on the SAQ angina frequency domain were compared with patients reporting angina (37.7%). Multivariable modeling identified clinical variables and angiographic findings associated with angina. Sequential univariate and multivariable modeling found the following demographic and clinical factors were associated with angina after CABG: younger age, worse preoperative SAQ angina frequency score, smoking, diabetes mellitus, and pre-CABG depression. The only 1-year angiographic finding significantly associated with angina was incomplete revascularization of the left anterior descending (LAD) territory. Graft occlusions, incomplete revascularization of non-LAD territories, and ≥70% lesions in nonrevascularized native coronary arteries were not correlated with the presence or absence of angina. Further, only 30.6% of subjects reporting angina at 1 year had a residual major coronary artery stenosis of ≥70%.

Conclusions:
Self-reported angina 1 year after CABG is associated with younger age, worse baseline SAQ angina frequency score, smoking, diabetes mellitus, and depression. The only angiographic finding associated with angina was a poorly revascularized LAD territory. These results may help guide physicians when counseling patients on expected improvements in angina symptoms and in making decisions regarding the need for coronary angiography after CABG. Whether intensive treatment of these comorbidities improves post-CABG angina symptoms requires further study.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT00032630.
Differences in Laryngeal Neurotrophic Factor Gene Expression after Recurrent Laryngeal Nerve and Vagus Nerve Injuries
Authors: Halum Stacey L. , Bijangi-Vishehsaraei Khadijeh , Saadatzadeh M. Reza , McRae Bryan R. 
Published: April 2019

Objectives Recurrent laryngeal nerve (RLN) and vagus nerve (VN) injuries characteristically are followed by differing degrees of spontaneous reinnervation, yet laryngeal muscle neurotrophic factor (NF) expression profiles after RLN and VN injuries have not been well elucidated. This study's objective was to determine the relative changes in gene expression of 5 well-characterized NFs from laryngeal muscle after RLN or VN injuries in a time-dependent fashion, and demonstrate how these changes correspond with electromyography-assessed innervation status. Methods Thirty-six male rats underwent left RLN transection (12 rats), left VN transection (12 rats), or a sham procedure (12 rats). The primary outcomes included electromyographic assessment and laryngeal muscle NF expression quantification with reverse transcription polymerase chain reaction at 3 days and at 1 month. Results Electromyography at 3 days demonstrated electrical silence in the VN injury group, normal activity in the sham group, and nascent units with decreased recruitment in the RLN injury group. Reverse transcription polymerase chain reaction demonstrated that changes in NF gene expression from laryngeal muscles varied depending on the type of nerve injury (RLN or VN) and the specific laryngeal muscle (posterior cricoarytenoid or adductor) assessed. Conclusions Laryngeal muscle NF expression profiles after cranial nerve X injury depend both upon the level of nerve injury and upon the muscles involved.
Why are UK junior doctors taking time out of training and what are their experiences? A qualitative study
Authors: Rizan Chantelle , Montgomery Julia , Ramage Charlotte , Welch Jan , Dewhurst Graeme 
Published: April 2019

Objectives The number of doctors directly entering UK specialty training after their foundation year 2 (F2) has steadily declined from 83% in 2010 to 42.6% in 2017. The year following F2, outside the UK training pathway, is informally termed an ‘F3’ year. There is a paucity of qualitative research exploring why increasingly doctors are taking F3s. The aim of this study is to explore the reasons why F2 doctors are choosing to take a year out of training and the impact upon future career choices. Design This is an exploratory qualitative study, using in-depth interviews and content analysis. Setting UK. Participants Fourteen participants were interviewed from one foundation school. Participants included five doctors who commenced their F3 in 2015, five who started in 2016 and finally four recently starting this in 2017. Main outcome measures Content analysis was conducted to distill the themes which exemplified the totality of the experience of the three groups. Results There were four predominant themes arising within the data set which can be framed as ‘unmet needs’ arising within foundation years, sought to be fulfilled by the F3 year. First, doctors describe exhaustion and stress resulting in a need for a ‘break’. Second, doctors required more time to make decisions surrounding specialty applications and prepare competitive portfolios. Third, participants felt a loss of control which was (partially) regained during their F3s. The final theme was the impact of taking time out upon return to training (for those participants who had completed their F3 year). When doctors returned to NHS posts they brought valuable experience. Conclusions This study provides evidence to support the important ongoing initiatives from Health Education England and other postgraduate bodies, exploring approaches to further engage, retain and support the junior doctor workforce.
Overheating risk in Passivhaus dwellings
Authors: Mitchell Rachel , Natarajan Sukumar 
Published: April 2019

Highly insulated and airtight homes designed to reduce energy consumption are perceived as having a greater summer overheating risk than less insulated homes. If true, dwellings built to the well-known low-energy Passivhaus (PH) standard could be at greatest risk due to the use of superinsulation, especially as the climate warms. Existing studies are inconclusive and even contradictory, mainly due to small sample sizes. Hence, this paper presents the first large-scale overheating risk analysis of UK Passivhaus dwellings using high-resolution internal temperature data from 82 homes across the UK. Both the Passivhaus and the recently published Chartered Institution of Building Services Engineers TM59 criteria are analysed. Results show that the whole-dwelling Passivhaus standard, which uses a fixed temperature threshold, is met more frequently (83%) than when applied on a room-by-room basis (e.g. only 60% of bedrooms in houses meet the standard). TM59-1A, which uses an adaptive temperature threshold, is easier to meet with 100% of flats and 82% of houses in compliance. However, 55% of bedrooms assessed under TM59-1B fail, with little difference between flats and houses. This is a remarkable finding given that the summers under consideration were either typically mild or cooler than average, and that sleep impairment can significantly affect both physical and mental health. These results suggest that highly insulated dwellings such as Passivhaus should consider overheating in individual rooms, rather than at whole-dwelling level. Analysis should be undertaken throughout the year with particular attention to bedrooms, using either the good-practice PH-5% exceedance threshold which maps well to TM59-1B, or TM59-1B itself. Practical application: Overheating risk in new dwellings is an industry concern. Having the correct tools to predict this risk at design stage is important to help design comfortable and healthy dwellings for both today's climate and future, hotter climates. Comparing two different tools and their methodologies using in-use data is critical to gain confidence in their application at the design stage and to further understand overheating risk, including which dwelling types and rooms are more vulnerable to overheating.
Providing Palliative Care to Older Adults: Context and Challenges
Authors: Ross Margaret M. , Mcdonald Beth 
Published: April 2019

This paper presents the findings of a study aimed at understanding more fully the work of nurses who provide care to older adults who are dying at home. The method employed was qualitative in nature and involved the use of focus groups for data collection. Data were gathered from a total of 40 community-based nurses during four sessions lasting approximately two hours each. Analysis revealed that the provision of care occurred within a context of aging and dying characterized by clients’ awareness of impending death, the presence of multiple pathologies, diminishing social support, and a lack of control. Challenges to providing care stemmed from an ethic of high expectation and a health care system experienced as fragmented, bureaucratic, and driven by cost efficiency. Challenges included working in isolation, achieving closure, securing personal support, working collaboratively with others, and keeping up to date. Findings from this study have implications for both education and practice. Résumé / Cet article rapporte les résultats d'une étude visant à obtenir une meilleure compréhension du travail des infirmières qui soignent les personnes ägées mourantes à domicile. La méthode utilisée était de type qualitative et elle faisait appel aux discussions de groupes-cibles pour la collecte des données. L'information a ainsi été recueillie auprès de 40 infirmières communautaires lors de 4 sessions d'environ 2 heures chacune. L'analyse des discussions révèlent d'abord que ces soins sont dispensés dans un contexte particulier où les personnes ägées sont conscientes de leur mort imminente. De plus elles souffrent de multiples pathologies, de perte d'autonomie et n'ont peu ou pas de personnes sur qui elles peuvent compter dans leur entourage. Les défis reliés aux soins de ces malades à domicile sont doubles. D'une part l'attente des patients est grande et, d'autre part, en raison de la bureaucratisation et de la fragmentation du système de santé, les infirmières se sentent impuissantes à y répondre. L'infirmière communautaire qui soigne ces personnes se sent souvent isolée et éprouve de la difficulté à rompre les liens avec la famille après le décès du malade. Le défi pour elle consiste donc à collaborer avec d'autres, à recourir au support moral de ses pairs et de son entourage tout en maintenant ses connaissances à jour. Les résultats de cette recherche ont des implications tant sur la formation que sur la pratique.
Perspective on Underpricing of IPOs in Emerging Economies
Authors: Ramana L V 
Published: April 2019

Pricing of initial public offerings (IPOs) has received considerable attention from the perspective of asymmetric information theories, among others. Specific aspects of emerging markets have been incorporated into models to explain the varying degrees of underpricing. Using three features that are deemed to be important for such economies, that is, principal–principal conflicts, disclosure norms and legitimacy of the top management, and two different classes of investors, institutional and retail, two frameworks have been designed to explain the expected levels of underpricing under various pair-wise combinations of these parameters. The state of the secondary market, which is an important determinant of the decision to go public, is incorporated into the framework. JEL Classifications: G3, G14, G15, G18
Gambling involvement, type of gambling and grade point average among 18–29-year-old Finnish men and women
Authors: Latvala Tiina , Alho Hannu , Raisamo Susanna , Salonen Anne H 
Published: April 2019

Aims: This study explores the associations between gambling involvement, type of gambling, at-risk and problem gambling (ARPG) and register-based grade point average (GPA), among Finnish people aged 18–29 years ( N = 676). It is assumed that high gambling involvement and engaging in certain types of gambling are linked to ARPG, and that low school achievement is positively associated with these measures. Methods: A nationwide cross-sectional random sample was collected in 2015. The data were weighted based on gender, age and region. Analyses were carried out using logistic regression models. Results: Frequent gambling, playing several game types, online gambling and ARPG were more common among men than women. Those with low GPA played fast and low-paced daily lottery games and used online casinos significantly more often than men and women with average/high GPA. Men with a low GPA were also more likely to gamble on a weekly basis and played casino games and online poker more often. For women with a low GPA online gambling and playing slot machines were more common than for women with an average/high GPA. When controlling for sociodemographic variables and gambling involvement, men’s participation in daily lottery games and online poker was significantly associated with a low GPA, but among women none of the game types remained statistically significant. Among women, playing several different game types was linked with a low GPA. Conclusions: It seems that poorer school achievement is associated not only with frequent gambling, a large number of game types played and online gambling, but also, to some extent at least, with game type preferences.
Women in the European Stroke Organisation: One, two, many… – A Top Down and Bottom Up approach
Authors: Sandset Else Charlotte , de Sousa Diana Aguiar , Christensen Hanne , Cordonnier Charlotte , Fischer Urs , Katan Mira , Kremer Christine , Pavlovic Aleksandra , Sprigg Nikola , Bart van der Worp H , Zedde Marialuisa , Caso Valeria 
Published: April 2019

Background An increasing proportion of physicians are women, yet they still face challenges with career advancement. In 2014, the European Stroke Organisation established the goal of increasing the number and participation of women within the society using a Top Down and Bottom Up approach. The ‘Women’s Initiative for Stroke in Europe’ was created the same year by a group of women active within the organisation. We aimed to assess the current status of women in European Stroke Organisation, and to explore the change in sex differences after the introduction of focused approaches to address disparities in 2014. Methods Using organisational records, we collected data on sex differences in core activities from 2008 up to 2017 including membership, participation in conferences, courses and in the official journal of the society, and positions of seniority and leadership. We estimated sex distribution differences in each of the activities from 2014 to date. Results In 2017, the proportion of female members was 40%, while 24% of fellows, 22% of the executive board and 19% of the editorial board in the official journal of the society were women. From 2014 to 2017, there was a significant increase in the proportion of female members (p = 0.0002) and in women participating in the annual conference as faculty (p = 0.001). There was no significant change in the sex distribution among the faculty members in junior educational activities (≤27%) or fellows. Interpretation In 2017, the proportion of women holding positions of seniority and leadership is still significantly lower to the proportion of women attending educational activities. Transparent data on sex distribution will assist implementing tailored programmes to achieve progress against sex-based barriers.
Diacylglycerol kinase ζ is a negative regulator of GPVI-mediated platelet activation
Authors: Moroi Alyssa J. , Zwifelhofer Nicole M. , Riese Matthew J. , Newman Debra K. , Newman Peter J. 
Published: April 2019

AbstractDiacylglycerol kinases (DGKs) are a family of enzymes that convert diacylglycerol (DAG) into phosphatidic acid (PA). The ζ isoform of DGK (DGKζ) has been reported to inhibit T-cell responsiveness by downregulating intracellular levels of DAG. However, its role in platelet function remains undefined. In this study, we show that DGKζ was expressed at significant levels in both platelets and megakaryocytes and that DGKζ-knockout (DGKζ-KO) mouse platelets were hyperreactive to glycoprotein VI (GPVI) agonists, as assessed by aggregation, spreading, granule secretion, and activation of relevant signal transduction molecules. In contrast, they were less responsive to thrombin. Platelets from DGKζ-KO mice accumulated faster on collagen-coated microfluidic surfaces under conditions of arterial shear and stopped blood flow faster after ferric chloride–induced carotid artery injury. Other measures of hemostasis, as measured by tail bleeding time and rotational thromboelastometry analysis, were normal. Interestingly, DGKζ deficiency led to increased GPVI expression on the platelet and megakaryocyte surfaces without affecting the expression of other platelet surface receptors. These results implicate DGKζ as a novel negative regulator of GPVI-mediated platelet activation that plays an important role in regulating thrombus formation in vivo.
Optimal principal component analysis of STEM XEDS spectrum images
Authors: Potapov Pavel , Lubk Axel 
Published: April 2019

AbstractSTEM XEDS spectrum images can be drastically denoised by application of the principal component analysis (PCA). This paper looks inside the PCA workflow step by step on an example of a complex semiconductor structure consisting of a number of different phases. Typical problems distorting the principal components decomposition are highlighted and solutions for the successful PCA are described. Particular attention is paid to the optimal truncation of principal components in the course of reconstructing denoised data. A novel accurate and robust method, which overperforms the existing truncation methods is suggested for the first time and described in details.