bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hemispheric Asymmetry of White Matter Hyperintensity in Association With Lacunar Infarction
Authors: Ryu Wi‐Sun , Schellingerhout Dawid , Ahn Hee‐Seung , Park Soo‐Hyun , Hong Keun‐Sik , Jeong Sang‐Wuk , Park Man‐Seok , Choi Kang‐Ho , Kim Joon‐Tae , Kim Beom Joon , Han Moon‐Ku , Lee Jun , Cha Jae‐Kwan , Kim Dae‐Hyun , Nah Hyun‐Wook , Lee Soo Joo , Cho Yong‐Jin , Lee Byung‐Chul , Yu Kyung‐Ho , Oh Mi‐Sun , Park Jong‐Moo , Kang Kyusik , Lee Kyung Bok , Park Tai‐Hwan , Park Sang‐Soon , Smith Eric E. , Lee Juneyoung , Bae Hee‐Joon , Kim Dong‐Eog 
Published: December 2018

Background

White matter hyperintensities (
WMHs
) are commonly asymmetric between hemispheres but for unknown reasons. We investigated asymmetric
WMHs
associated with lacunar infarcts.

Methods and Results

A total of 267 consecutive patients with small first‐ever supratentorial infarcts (≤20 mm) were included. None had a relevant vascular stenosis.
WMH
asymmetry was measured based on the hemispheric difference of a modified Scheltens scale score (≥3 defined as asymmetric). We analyzed the association of the hemispheric
WMH
asymmetry with old silent lacunar infarcts or acute lacunar infarcts. We compared lesion frequency maps between groups and generated t‐statistics maps. The mean age of patients was 64 years, and 63% were men. Asymmetric
WMH
was more than 3‐fold as frequent (
P
<0.001) in the group with old silent lacunar infarcts (42%, 43/102) than in the group without old silent lacunar infarcts (15%, 24/165). In patients with left hemispheric dominance of
WMHs
, an acute lacunar infarct was more likely to be located in the left (versus right) hemisphere (74% versus 26%,
P
<0.001). In patients with right hemispheric dominance of
WMHs
, an acute lacunar infarct was more likely to be located on the right (versus left) hemisphere (81% versus 19%,
P
<0.001). Mapping studies showed that the side of hemispheric dominance of
WMHs
was associated with acute and silent lacunes on the same side.

Conclusions

These are the first data to show that asymmetric
WMH
s are associated with both old silent lacunar infarcts and acute lacunar infarcts ipsilateral to the greatest
WMH
burden. This suggests that the hemisphere with relatively large
WMHs
is more vulnerable to ischemia.
Role of ADTRP (Androgen‐Dependent Tissue Factor Pathway Inhibitor Regulating Protein) in Vascular Development and Function
Authors: Patel Maulin M. , Behar Amanda R. , Silasi Robert , Regmi Girija , Sansam Christopher L. , Keshari Ravi S. , Lupu Florea , Lupu Cristina 
Published: December 2018

Background

The physiological function of
ADTRP
(androgen‐dependent tissue factor pathway inhibitor regulating protein) is unknown. We previously identified
ADTRP
as coregulating with and supporting the anticoagulant activity of tissue factor pathway inhibitor in endothelial cells in vitro. Here, we studied the role of
ADTRP
in vivo, specifically related to vascular development, stability, and function.

Methods and Results

Genetic inhibition of
Adtrp
produced vascular malformations in the low‐pressure vasculature of zebrafish embryos and newborn mice: dilation/tortuosity, perivascular inflammation, extravascular proteolysis, increased permeability, and microhemorrhages, which produced partially penetrant lethality. Vascular leakiness correlated with decreased endothelial cell junction components
VE
‐cadherin and claudin‐5. Changes in hemostasis in young adults comprised modest decrease of tissue factor pathway inhibitor antigen and activity and increased tail bleeding time and volume. Cell‐based reporter assays revealed that
ADTRP
negatively regulates canonical Wnt signaling, affecting membrane events downstream of low‐density lipoprotein receptor‐related protein 6 (
LRP
6) and upstream of glycogen synthase kinase 3 beta.
ADTRP
deficiency increased aberrant/ectopic Wnt/β‐catenin signaling in vivo in newborn mice and zebrafish embryos, and upregulated matrix metallopeptidase (
MMP
)‐9 in endothelial cells and mast cells (
MCs
). Vascular lesions in newborn
Adtrp

−/−

pups displayed accumulation of
MCs
, decreased extracellular matrix content, and deficient perivascular cell coverage. Wnt‐pathway inhibition reversed the increased
mmp9
in zebrafish embryos, demonstrating that
mmp9
expression induced by Adtrp deficiency was downstream of canonical Wnt signaling.

Conclusions

Our studies demonstrate that
ADTRP
plays a major role in vascular development and function, most likely through expression in endothelial cells and/or perivascular cells of Wnt‐regulated genes that control vascular stability and integrity.
Exercise Treadmill Testing in Moderate or Severe Aortic Stenosis: The Left Ventricular Correlates of an Exaggerated Blood Pressure Rise
Authors: Saeed Sahrai , Mancia Giuseppe , Rajani Ronak , Seifert Reinhard , Parkin Denise , Chambers John B. 
Published: December 2018

Background
Exaggerated blood pressure response during exercise predicts future hypertension and cardiovascular events in general population and different patients groups. However, its clinical and prognostic implications in patients with aortic stenosis have not been previously evaluated.

Methods and Results

We retrospectively studied 301 patients with moderate to severe asymptomatic aortic stenosis (aged 65±12 years) who underwent echocardiography and a modified Bruce exercise treadmill test. An exaggerated blood pressure response was defined as peak systolic blood pressure ≥190 mm Hg. An abnormal blood pressure response (either blunted or exaggerated) was found in 58% of patients and abnormal left ventricular geometry in 82%. There was no difference in the rates of abnormal blood pressure responses between patients with moderate and severe aortic stenosis ([exaggerated blood pressure response: 21% versus 22%,
P
=0.876] and [blunted blood pressure response: 35% versus 40%,
P
=0.647]). Patients with exaggerated blood pressure response (21%) were more likely to be older, have hypertension, higher pretest systolic blood pressure, left ventricular ejection fraction and mass, and increased arterial stiffness (all
P
<0.05). In a multivariate logistic regression analysis, an exaggerated blood pressure response was associated with higher pulse pressure/stroke volume index (odds ratio 2.45, 95% confidence interval 1.02–6.00,
P
=0.037) and left ventricular mass (odds ratio 2.04, 95% confidence interval 1.23–3.38,
P
=0.012) independent of age, hypertension, aortic annulus and left atrium diameter, and left ventricular ejection fraction.

Conclusions
In those with aortic stenosis, exaggerated blood pressure was strongly related to higher resting blood pressure values, left ventricular mass, and increased arterial stiffness independent of hypertension.
Presentation, Management, and Outcomes of Acute Stroke in Palestine
Authors: Khatib Rasha , Jawaadah Assef M. , Khammash Umaieyh , Babiker Ahmed , Huffman Mark D. , Prabhakaran Shyam 
Published: December 2018

Background
Stroke is a leading cause of death and disability in the Middle East. Data on the uptake of evidence‐based practices are limited in the region. We aimed to examine patterns of stroke presentation, management, and outcomes at public Palestinian hospitals.

Methods and Results

Comprehensive data from all patients with acute stroke admitted to 2 public hospitals in the West Bank of Palestine were prospectively collected. Acute stroke presentation patterns, in‐hospital evaluation and management, mortality, and stroke complications were evaluated. Data were available for 150 patients with acute stroke between September 2017 and May 2018. The mean (
SD
) age was 65 (14) years and 49% were women. Only 25% of patients utilized ambulance services for transportation to the hospital. All patient received head computed tomography scans, although few received other investigations such as magnetic resonance imaging (8%) or carotid Doppler (4%). Most patients with ischemic stroke received antiplatelet therapy (98%), although none received thrombolysis. Only 17% received physical therapy evaluation. In‐hospital mortality was 12%, 23% of patients had at least 1 poststroke complication, and the median modified Rankin Score at discharge was 4 (interquartile range, 2–5).

Conclusions
We identified high stroke mortality and discharge disability rates in Palestine. Key evidence‐based gaps were highlighted, suggesting opportunities for quality improvement.
Duration of Heightened Ischemic Stroke Risk After Acute Myocardial Infarction
Authors: Merkler Alexander E. , Diaz Ivan , Wu Xian , Murthy Santosh B. , Gialdini Gino , Navi Babak B. , Yaghi Shadi , Weinsaft Jonathan W. , Okin Peter M. , Safford Monika M. , Iadecola Costantino , Kamel Hooman 
Published: December 2018

Background

The duration of heightened stroke risk after acute myocardial infarction (
MI
) remains uncertain.

Methods and Results

We performed a retrospective cohort study using claims between 2008 and 2015 from a nationally representative 5% sample of Medicare beneficiaries aged ≥66 years. Both acute
MI
and ischemic stroke were ascertained using previously validated
International Classification of Diseases, Ninth Revision, Clinical Modification
(
ICD‐9‐CM
), diagnosis codes. To exclude periprocedural strokes from percutaneous coronary intervention, we did not count strokes occurring during an acute
MI
hospitalization. Patients were censored at the time of ischemic stroke, death, end of Medicare coverage, or September 30, 2015. We fit Cox regression models separately for the groups with and without acute
MI
to examine its association with ischemic stroke after adjustment for demographics, stroke risk factors, and Charlson comorbidities. We used the corresponding survival probabilities to compute the hazard ratio in each 4‐week interval after discharge. Confidence intervals were computed using the nonparametric bootstrap method. Among 1 746 476 eligible beneficiaries, 46 182 were hospitalized for acute
MI
and 80 466 for ischemic stroke. After adjustment for demographics, stroke risk factors, and Charlson comorbidities, the risk of ischemic stroke was highest in the first 4 weeks after discharge from the
MI
hospitalization (hazard ratio: 2.7; 95% confidence interval, 2.3–3.2), remained elevated during weeks 5 to 8 (hazard ratio: 2.0; 95% confidence interval, 1.6–2.4) and weeks 9 to 12 (hazard ratio: 1.6; 95% confidence interval, 1.3–2.0), and was no longer significantly elevated afterward.

Conclusions

Acute
MI
is associated with an elevated risk of ischemic stroke that appears to extend beyond the 1‐month window that is currently considered the at‐risk period.
The contribution of Ghanaian patients to the reporting of adverse drug reactions: a quantitative and qualitative study
Authors: Jacobs Tom G. , Hilda Ampadu H. , Hoekman Jarno , Dodoo Alexander N. O. , Mantel-Teeuwisse Aukje K. 
Published: December 2018

Abstract

Background
Under-reporting of adverse drug reactions (ADRs) is a major challenge for pharmacovigilance in Africa. This study sets out to assess the level of awareness of Ghanaian patients about ADRs and ADR-reporting and explores how different patients in Ghana recognize an ADR and the steps they take when they experience an ADR.

Methods
This was a two-part study consisting of a survey to quantify the awareness of Ghanaian patients on ADRs and ADR-reporting, and in-depth interviews to explore how patients recognize an ADR and the steps they take thereafter. Participants were selected from 28 health care facilities (HCF) in rural and urban areas in 4 out of the 10 administrative regions of Ghana. Chi-square tests were used to examine associations between demographic variables and i) awareness of ADRs and ADR-reporting, ii) ADR experience and iii) awareness of the Ghana Food and Drug Authority (Ghana-FDA) and its patient reporting system (PRS). Only participants that indicated they experienced an ADR were included for the in-depth interviews. Data was investigated for participants’ awareness of ADRs, ADR reporting and steps taken when they experience ADRs.

Results
Of the total 572 participants enrolled in the study, 14% indicated they were unaware of ADRs and were excluded. Of the remaining 491 participants, 38% had experienced an ADR, of which 67% reported the ADR, 68% of them reported it to a doctor. Only 3% of the 491 participants were aware of the Ghana-FDA’s PRS. The interview phase consisted of 33 patients who had experienced an ADR. Three key findings from the interview phase were; most participants recognized an ADR themselves, the symptoms of the ADR were the most mentioned reason for reporting and participants experienced a wide variety of obstacles in ADR-reporting.

Conclusions
Most Ghanaian patients appear unaware of or unable/unwilling to use formal national channels for ADR reporting like the Ghana-FDA PRS. Motivation for ADR reporting appeared mainly personal and not communal. These findings warrant further attention in order to increase patient reporting of ADRs.
Proximate and antioxidant activities of bio-preserved ogi flour with garlic and ginger
Authors: Olaniran Abiola F. , Abiose Sumbo H. 
Published: December 2018

Background: Ogi from locally available cereals remains a relatively affordable complementary food in West Africa, but has a tendency to spoil due it high moisture content. This study explored effects of garlic and ginger as biopreservatives in ogi flour. Methods: Ogi flour was prepared from sorghum and quality protein maize grains with different concentrations of garlic and ginger powder (2 and 4% w/w) by fermentation technique. These samples were stored for 16 weeks during which the total titratable acidity, pH, proximate composition, mineral content and total antioxidant activities were determined. Results: The proximate compositions of bio-preserved ogi samples were relatively stable throughout storage. The addition of garlic and ginger slightly increased the ash (0.04%), crude protein and mineral contents (mg/ 100g) of the samples. Magnesium (10.85-13.13 and 5.17-9.72); zinc (1.37-1.78 and 7.01-8.50), manganese (1.30-1.71 and 0.45-0.86) and iron (1.53-1.77 and 0.68-2.77) contents increased on addition (of garlic and ginger) to maize ogi and sorghum ogi flours respectively. The free radical scavenging activity; total phenolic and flavonoid contents increased correspondingly with the antioxidants activity. Conclusion: Although not well known to ogi consumer, the bio-preserved ogi flours showed better nutritional values and have potential as a health food.
Nrf2-Mediated Antioxidant Activity of the inner bark extracts obtained from Tabebuia rosea (Bertol) DC and Tabebuia chrysantha (JACQ) G. Nicholson.
Authors: Garzón-Castaño Sandra C. , Lopera-Castrillón Iván A. , Jiménez-González Francisco J. , Siller-López Fernando , Veloza Luz A. , Sepúlveda-Arias Juan Carlos 
Published: December 2018

Background: Several ethnobotanical and ethnopharmacological studies have shown the therapeutic potential of plants from the genus Tabebuia, which have long been used in traditional medicine in rural areas of South America, for the treatment of several human diseases. This study aimed to evaluate the Nrf2-mediated antioxidant activity of the inner bark extracts obtained from Tabebuia rosea and Tabebuia chrysantha. Methods: The antioxidant activity of extracts obtained from the inner bark of T. rosea and T. chrysantha was evaluated using the Oxygen radical absorbance capacity (ORAC) technique. The effect of extracts on the viability of HepG2 cells was determined using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) method. The translocation of Nrf2 to the nucleus after exposure of HepG2 cells to the extracts and controls (α-lipoic acid, curcumin and hydrogen peroxide) was evaluated using the Nrf2 transcription factor kit. Induction of the Nrf2-mediated antioxidant response gene (NQO1) was evaluated by real-time PCR. Results: The ethyl acetate extract obtained from both species displayed the highest ORAC activity (12,523 and 6,325 µmoles Eq Trolox/g extract, respectively). In addition, the extracts had the ability to activate and to translocate Nrf2 to the nucleus, as well as to induce the expression of NQO1. Conclusion: These results indicate that the ethyl acetate extracts obtained from the inner bark of T. chrysantha and T. rosea have an important antioxidant effect mediated by Nrf2 activation, and could be used as a new source of natural antioxidants.
Factors affecting age-appropriate timeliness of vaccination coverage among children in Lebanon
Authors: Mansour Ziad , Said Racha , Brandt Lina , Khachan Joseph , Rady Alissar , Fahmy Kamal , Danovaro-Holliday M. Carolina 
Published: December 2018

Background: The effect of immunization does not only depend on its completeness, but also on its timely administration. Routine childhood vaccinations schedules recommend that children receive the vaccine doses at specific ages. This article attempts to assess timeliness of routine vaccination coverage among a sub-sample of children from a survey conducted in 2016. Methods: This analysis was based on data from a cross-sectional multistage cluster survey conducted between December 2015 and June 2016 among caregivers of children aged 12-59 months in all of Lebanon using a structured survey questionnaire. The analysis used Kaplan–Meier curves and logistic regression to identify the predictors of age-appropriate immunization. Results: Among the 493 randomly selected children, timely administration of the third dose of polio vaccine, diphtheria-tetanus-pertussis (DTP)-containing vaccine and hepatitis B (HepB) vaccine occurred in about one-quarter of children. About two-thirds of children received the second dose of a measles-containing vaccine (MCV) within the age interval recommended by the Expanded Programme on Immunization (EPI). Several factors including socio-demographic, knowledge, beliefs and practices were found to be associated with age-appropriate vaccination; however, this association differed between the types and doses of vaccine. Important factors associated with timely vaccination included being Lebanese as opposed to Syrian and being born in a hospital for hepatitis B birth dose; believing that vaccination status was up-to-date was related to untimely vaccination. Conclusions: The results suggest that there is reason for concern over the timeliness of vaccination in Lebanon. Special efforts need to be directed towards the inclusion of timeliness of vaccination as another indicator of the performance of the EPI in Lebanon.
Dual sensory impairment among a cohort of older adults living in Ireland: A nested case-control study of the Irish Longitudinal Study on Ageing cohort
Authors: Cleary Eimear , McCallion Philip , McCarron Mary 
Published: December 2018

Background: Little information is available on the implications of hearing loss, visual impairment and dual sensory impairment among older adults with an intellectual disability (ID) living in Ireland and this paper aims to address the health concerns associated with sensory impairment among this population. Methods: A representative sample of 753 persons aged 40 years and older at all levels of ID and full range of residential circumstances from the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA) participants were matched with general older population TILDA participants on age, sex and geographic location within Ireland. Demographic data on samples included age, sex, visual impairment (yes/no), hearing impairment (yes/no) and dual sensory impairment (yes/no). For those with intellectual disability (ID) data was also gathered on level of intellectual disability, residence, needing assistance with activities of daily living (ADL) and instrumental activities of daily living, self-rated health, loneliness, doctor’s diagnosis of endocrine disease and of dementia and doctor’s report of two or more chronic health conditions. Bivariate analysis of associations between visual, hearing and dual sensory impairment with the measures of physical and mental health was completed and logistic regression analysis to generate adjusted odds ratios for associations between sensory impairment and physical and mental health conditions. Results: As compared to the matched general population participants, in participants with ID dual sensory impairment was more often associated with poor self-rated health, limitations with two or more ADLs, loneliness and multimorbidity. People with ID were 4.4 times more likely to be multimorbid if they were visually impaired compared with an odds ratio of 2.4 in TILDA participants. Conclusion: Previous studies found significant associations between hearing and visual impairment among older populations. Analysis here also suggests the burden of sensory impairment increases both with ID and then with level of ID
Effectiveness of bioactive combinations of several plant substances to inhibit the growth of Escherichia coli and Salmonella sp.
Authors: Pasaribu T. , Sinurat A. P. , Wina E. , Purwadaria T. , Haryati T. , Susana I.W. R. 
Published: December 2018

The use of antibiotic growth promoters (AGP) has been banned as feed additives in many countries, therefore the alternatives need to be found. An in vitro experiment was conducted to study the potential of combination of some plant extract to inhibit growth of pathogen bateria that normally occur in the poultry gastro intestinal tract.The combination of three plants bioactives (liquid smoke of cashew shells of Anacardium occidentaleor CLS, Phyllanthus niruri L. extract (EM), and Synzygium aromaticum extract (EDC) were formulated and evaluated for its effectiveness to inhibit growth of Escherichia coli and Salmonella sp. in vitro.The mixtures (KE) were then made in 3 different concentrations, i.e. 100 % KE, 50% KE, and 25% KE and studied their effectiveness to inhibit growth of E. coli or Salmonella sp. using microplate reader method. The results showed that the higher the concentration of the bioactive combination (KE100) the higher the ability to inhibit the growth of E. coli or Salmonella sp. The combination of bioactive substances CAM, EM, and EDC more effectively than Zn-bacitracin antibiotics to inhibit the growth of E. coli and Salmonella sp. The optimum concentration of KE with the similar effectiveness as the AGP was 25%. It was concluded that the combination of CAM, EM, and EDC was able to inhibit the growth of E. coli and even capable to eliminate the presence of Salmonella sp. In the biological assay, a combination of CAM, EM, and EDC either extract or powder form, high dose, medium or low does not affect the weight of the spleen, bursa fabricius, and blood profile. The best combination of CAM, EM, and EDC extracts to decreases the total bacterial population and E. coli was middle dose ie 0.0625% (extract) and 0.625% (powder). Likewise for live weight gain that was a good dose of extract or powder form can replace antibiotics. It was concluded that combinations of CAM, EM, and EDC had potential as a substitute for AGP in poultry feed, especially chickens.
A constituição do campo acadêmico da política educacional no Brasil: Aspectos históricos
Authors: Stremel Silvana , Mainardes Jefferson 
Published: December 2018

Este artigo analisa a constituição do campo acadêmico da política educacional no Brasil. A fundamentação teórica baseia-se nas contribuições da teoria de Pierre Bourdieu sobre a noção de campo. A partir dos resultados da análise das fontes da pesquisa, apresentam-se os aspectos históricos da constituição do campo acadêmico da política educacional no Brasil, divididos em três momentos, a saber: 1) Os antecedentes do campo acadêmico da política educacional no Brasil (década de 1820 a 1950); 2) A institucionalização do campo acadêmico da política educacional (a partir da década de 1960); e 3) A expansão do campo acadêmico da política educacional (a partir da década de 1990). Concluiu-se que se trata de um campo abrangente e em permanente expansão e construção. Devido a sua natureza, a política educacional não se constitui em monopólio de uma comunidade científica, de periódicos, de redes de pesquisa, etc., pois é algo de interesse público, podendo ser debatida em diferentes espaços sociais e políticos.