bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ultrafiltration rate in conventional hemodialysis: Where are the limits and what are the consequences?
Authors: Slinin Yelena , Babu Megha , Ishani Areef 
Published: June 2018

AbstractBackgroundUltrafiltration rate (UFR) has attracted attention as a modifiable aspect of volume management.ObjectiveThe objective of this review is to summarize the evidence that links UFR to patient outcomes and discuss UFR cut‐offs proposed, and discuss possible consequences of adapting UFR as a quality metric.ResultsHigher UFRs has been associated with younger age, longer dialysis vintage, greater prevalence of comorbidities, higher Kt/V, lower weight, greater interdialytic weight gain, lower residual renal function, and shorter treatment times. Many of the characteristics associated with high UFRs have also been independently associated with poor patient outcomes. Four observational studies have assessed the association between UFR and patient mortality. All of them reported an association between higher UFR and greater patient mortality, though the studies differed in their definition of UFR, follow‐up, and adjustment for confounding. Evidence for the association between higher UFR and potential mediations of the mortality association, such as interdialytic hypotension, cardiac remodeling, and cardiovascular events was less consistent. There was a graded association between higher UFRs and all‐cause mortality; no definitive cut‐off for acceptable UFR can be established based on the current evidence. Targeting UFR in isolation might result in volume expansion and worsening patient outcomes. Residual confounding likely contributed to the findings of the observational studies. No randomized controlled trials addressed the questions.ConclusionEvidence supporting UFR limits is weak and confounded. Randomized controlled trials are needed before UFR can be used as a quality of care indicator.
The complement lectin pathway after cardiac arrest
Authors: Haugaard S. F. , Jeppesen A. N. , Troldborg A. , Kirkegaard H. , Thiel S. , Hvas A.‐M. 
Published: June 2018

AbstractThe lectin pathway (LP) of the complement system may initiate inflammatory reactions when body tissue is altered. We aimed to investigate the levels of the LP proteins in out‐of‐hospital cardiac arrest patients, and to compare these with healthy individuals. Furthermore, we aimed to clarify whether the duration of targeted temperature management influenced LP protein levels, and we further examined whether LP proteins were associated with 30‐day mortality. We included 82 patients resuscitated from out‐of‐hospital cardiac arrest. The patients were randomly assigned to 24 or 48 hours of targeted temperature management at 33 ± 1°C. Blood samples were obtained 22, 46 and 70 hours after target temperature was reached. Levels of the LP proteins (mannan‐binding lectin [MBL], M‐ficolin, H‐ficolin, collectin liver 1 [CL‐L1], MBL‐associated serine protease 1 [MASP‐1], MASP‐2, MASP‐3 and MBL‐associated protein of 44 kDa [MAp44]) were measured using time‐resolved immunofluorometric assays. Data from 82 gender matched healthy individuals were used for comparison. Levels of CL‐L1, MASP‐1, MASP‐2 and MAp44 were significantly higher, whereas M‐ficolin levels were significantly lower in cardiac arrest patients compared with healthy individuals. MASP‐2, MASP‐3 and M‐ficolin levels changed significantly when comparing 24 and 48 hours of targeted temperature management. The LP protein levels were not different between 30‐day survivors and non‐survivors after cardiac arrest. The differences in LP protein levels between patients and healthy individuals may indicate that cardiac arrest patients have an activated LP. Overall, the LP protein levels were not influenced by the duration of targeted temperature management, and the levels were not associated with 30‐day mortality.
High dose hypofractionated frameless volumetric modulated arc radiotherapy is a feasible method for treating canine trigeminal nerve sheath tumors
Authors: Dolera Mario , Malfassi Luca , Marcarini Silvia , Mazza Giovanni , Carrara Nancy , Pavesi Simone , Sala Massimo , Finesso Sara , Urso Gaetano 
Published: June 2018

AbstractThe aim of this prospective pilot study was to evaluate the feasibility and effectiveness of curative intent high dose hypofractionated frameless volumetric modulated arc radiotherapy for treatment of canine trigeminal peripheral nerve sheath tumors. Client‐owned dogs with a presumptive imaging‐based diagnosis of trigeminal peripheral nerve sheath tumor were recruited for the study during the period of February 2010 to December 2013. Seven dogs were enrolled and treated with high dose hypofractionated volumetric modulated arc radiotherapy delivered by a 6 MV linear accelerator equipped with a micro‐multileaf beam collimator. The plans were computed using a Monte Carlo algorithm with a prescription dose of 37 Gy delivered in five fractions on alternate days. Overall survival was estimated using a Kaplan–Meier curve analysis. Magnetic resonance imaging (MRI) follow‐up examinations revealed complete response in one dog, partial response in four dogs, and stable disease in two dogs. Median overall survival was 952 days with a 95% confidence interval of 543–1361 days. Volumetric modulated arc radiotherapy was demonstrated to be feasible and effective for trigeminal peripheral nerve sheath tumor treatment in this sample of dogs. The technique required few sedations and spared organs at risk. Even though larger studies are required, these preliminary results supported the use of high dose hypofractionated volumetric modulated arc radiotherapy as an alternative to other treatment modalities.
Two antimicrobial compounds drimane sesquiterpene polygodial and 11-hydroxydrim-8-en-7-one from the stem bark of Drimys arfakensis Gibbs. (Winteraceae)
Authors: Santoso Bimo Budi , Hernandez Hidelisa Padua , Rodriguez Evelyn Bernadeth , Dalmacio Ida Farida 
Published: June 2018

Antimicrobial-guided fractionation and isolation of the bioactive compounds from the stem bark of Drimys arfakensis Gibbs. were carried out. Two antimicrobial compounds were isolated. The sructures of the compounds were elucidated by spectroscopic methods such as 1H NMR, 13C NMR, 2-D NMR, ESI-MS and EI-MS. Based on the spectroscopic data, the two antimicrobial compounds were polygodial, 1 and and 11-Hydroxydrim-8-en-7-one, 2. . Compound 1 exhibited very strong activity against methicillin-resistant Staphylococcus aureus (MRSA) (B-1823), and yeast-like fungi Candida albicans (B-2219) with both having MIC values of 7.8 µg.mL-1. It also showed strong activity against gram negative bacteria Escherichia coli (B-1634 ) with MIC value of 31.2 µg.mL-1 . While compound 2 only possesses strong activity against S. aureus (MRSA), no activity against C. albicans and E. coli was observed. This is the first report on the antimicrobial activity of compound 2 and on the isolation of these two compounds from D. arfakensis Gibbs.
Pharmaceutical quality assurance of local private distributors: a secondary analysis in 13 low-income and middle-income countries
Authors: Van Assche Kerlijn , Nebot Giralt Ariadna , Caudron Jean Michel , Schiavetti Benedetta , Pouget Corinne , Tsoumanis Achilleas , Meessen Bruno , Ravinetto Raffaella 
Published: June 2018

IntroductionThe rapid globalisation of the pharmaceutical production and distribution has not been supported by harmonisation of regulatory systems worldwide. Thus, the supply systems in low-income and middle-income countries (LMICs) remain exposed to the risk of poor-quality medicines. To contribute to estimating this risk in the private sector in LMICs, we assessed the quality assurance system of a convenient sample of local private pharmaceutical distributors.MethodsThis descriptive study uses secondary data derived from the audits conducted by the QUAMED group at 60 local private pharmaceutical distributors in 13 LMICs. We assessed the distributors’ compliance with good distribution practices (GDP), general quality requirements (GQR) and cold chain management (CCM), based on an evaluation tool inspired by the WHO guidelines ’Model Quality Assurance System (MQAS) for procurement agencies'. Descriptive statistics describe the compliance for the whole sample, for distributors in sub-Saharan Africa (SSA) versus those in non-SSA, and for those in low-income countries (LICs) versus middle-income countries (MICs).ResultsLocal private pharmaceutical distributors in our sample were non-compliant, very low-compliant or low-compliant for GQR (70%), GDP (60%) and CCM (41%). Only 7/60 showed good to full compliance for at least two criteria. Observed compliance varies by geographical region and by income group: maximum values are higher in non-SSA versus SSA and in MICs versus LICs, while minimum values are the same across different groups.ConclusionThe poor compliance with WHO quality standards observed in our sample indicates a concrete risk that patients in LMICs are exposed to poor-quality or degraded medicines. Significant investments are needed to strengthen the regulatory supervision, including on private pharmaceutical distributors. An adapted standardised evaluation tool inspired by the WHO MQAS would be helpful for self-evaluation, audit and inspection purposes.
Shared decision-making for people living with dementia in extended care settings: a systematic review
Authors: Daly Rachel Louise , Bunn Frances , Goodman Claire 
Published: June 2018

BackgroundShared decision-making is recognised as an important element of person-centred dementia care.ObjectivesThe aim of this review was to explore how people living with dementia and cognitive impairment can be included in day-to-day decisions about their health and care in extended care settings.DesignA systematic review including primary research relating to shared decision-making, with cognitively impaired adults in (or transferrable to) extended care settings. Databases searched were: CINAHL, PubMed, the Cochrane Library, NICE Evidence, OpenGrey, Autism Data, Google Scholar, Scopus and Medicines Complete (June to October 2016 and updated 2018) for studies published in the last 20 years.ResultsOf the 19 included studies 15 involved people with living dementia, seven in extended care settings. People living with cognitive impairment often have the desire and ability to participate in decision-making about their everyday care, although this is regularly underestimated by their staff and family care partners. Shared decision-making has the potential to improve quality of life for both the person living with dementia and those who support them. How resources to support shared decision-making are implemented in extended care settings is less well understood.ConclusionsEvidence suggests that people living with cognitive impairment value opportunities to be involved in everyday decision-making about their care. How these opportunities are created, understood, supported and sustained in extended care settings remains to be determined.Trial registration numberCRD42016035919
Sexual assaults in individuals with visual impairment: a cross-sectional study of a Norwegian sample
Authors: Brunes Audun , Heir Trond 
Published: June 2018

ObjectiveTo examine the prevalence of sexual assaults among individuals with visual impairment (VI) compared with the general population and to investigate the association between sexual assault and outcomes of self-efficacy and life satisfaction.DesignCross-sectional interview-based study conducted between February and May 2017.ParticipantsA probability sample of adults with VI (≥18 years) who were members of the Norwegian Association of the Blind and Partially Sighted. A total of 736 (61%) members participated, of whom 55% were of female gender. We obtained norm data for sexual assaults from a representative survey of the general Norwegian population.Outcome measuresSexual assaults (Life Event Checklist for DSM-5), self-efficacy (General Self-Efficacy Scale) and life satisfaction (Cantril’s Ladder of Life Satisfaction).ResultsThe prevalence of sexual assaults (rape, attempted rape and forced into sexual acts) in the VI population was 17.4% (95% CI 14.0 to 21.4) among women and 2.4% (95% CI 1.2 to 4.7) among men. For women, the VI population had higher rates of sexual assaults across age strata than the general population. For men, no significant differences were found. In the population of people with VI, the risk of sexual assault was greater for those having other impairments in addition to the vision loss. Individuals with VI who experienced sexual assaults had lower levels of self-efficacy (adjusted relative risk (ARR): 0.18, 95% CI 0.05 to 0.61) and life satisfaction (ARR: 0.31, 95% CI 0.19 to 0.50) than others.ConclusionsThe risk of experiencing sexual assault appears to be higher in individuals with VI than in the general population. Preventive measures as well as psychosocial care for those who have been exposed are needed.
Impact of the introduction of a universal childhood influenza vaccination programme on influenza-related admissions to paediatric intensive care units in England
Authors: Hardelid Pia , Kapetanstrataki Melpo , Norman Lee , Fleming Sarah J , Lister Paula , Gilbert Ruth , Parslow Roger C 
Published: June 2018

IntroductionA universal childhood influenza vaccination programme was introduced in the UK in September 2013. We examine the impact of the gradual introduction of this programme on influenza-related paediatric intensive care unit (PICU) admission rates in England.MethodsWe extracted data on all influenza-related admissions to PICUs in England in resident children aged 0–15 years old between October 2003 and March 2017 from the Paediatric Intensive Care Audit Network (PICANet) database. We estimated influenza-associated PICU admission rates per 100 000 children by age group, sex and winter season (October to March), and used Poisson regression models to estimate incidence rate ratios (IRRs) in the winter seasons since the introduction of universal childhood vaccination compared with the two winters before the introduction of the programme (2011–2013).ResultsWe identified 929 influenza-related PICU admissions among 873 children. 48.3% of admissions were among children aged less than 2 years old. The influenza-associated PICU admission rate was 1.32 per 100 000 children (95% CI 1.23 to 1.40). We identified a significant increase in influenza PICU admissions in the winters following the introduction of the universal childhood vaccination programme compared with the winters of 2010/2011–2012/2013 among children aged <5 years old: IRR 1.58 (1.05, 2.37) in children <1 year, 2.71 (1.43, 5.17) in 1 year-olds and 1.98 (1.18, 3.31) in children 2–4 years old. No significant difference was found among children aged 5–15 years.ConclusionThe universal childhood influenza vaccination has not yet reduced the influenza-associated burden on PICUs in England during its early phase of introduction. Monitoring of influenza PICU admission rates needs to continue in England to assess the long-term impact of universal paediatric influenza vaccination. Linkage between PICANet and national infection surveillance databases would better enable such monitoring.
Characteristics and outcomes of accidental hypothermia in Japan: the J-Point registry
Authors: Matsuyama Tasuku , Morita Sachiko , Ehara Naoki , Miyamae Nobuhiro , Okada Yohei , Jo Takaaki , Sumida Yasuyuki , Okada Nobunaga , Watanabe Makoto , Nozawa Masahiro , Tsuruoka Ayumu , Fujimoto Yoshihiro , Okumura Yoshiki , Kitamura Tetsuhisa , Ohta Bon 
Published: June 2018

BackgroundAccidental hypothermia (AH) has higher incidence and mortality in geriatric populations. Japan has a rapidly ageing population, and little is known about the epidemiology of hypothermia in this country.MethodsWe created an AH registry based on retrospective review of patients visiting the ED of 12 institutions with temperature ≤35°C between April 2011 and March 2016. The severity of AH was classified as mild (≤35, ≥32°C), moderate (<32, ≥28°C) or severe (<28°C). The relationship between in-hospital mortality and severity of AH was assessed using a multivariable logistic regression analysis.ResultsA total of 572 patients were registered in this registry and 537 patients were eligible for our analysis. The median age was 79 (IQR 66–87) years and the proportion of men was 51.2% (273/537). AH was more likely to occur in elderly patients aged ≥65 years (424/537, 80.0%) and in indoor settings (418/537, 77.8%). The condition most frequently associated with AH, irrespective of severity, was acute medical illness. A lower mean outside temperature was associated with a higher prevalence of AH, and particularly severe AH (p for trend <0.001). The overall proportion of cases resulting in in-hospital death was 24.4% (131/537), with no significant difference between severity levels observed in a multivariable logistic regression analysis (severe group (37/118, 31.4%) vs mild group (42/192, 21.9%), adjusted OR (AOR) 1.01, 95% CI 0.61 to 1.68; and moderate group (52/227, 22.9%) vs mild group, AOR 1.11, 95% CI 0.58 to 2.14).ConclusionActive prevention and intervention should occur for this important public health issue.
Dark matter direct detection of a fermionic singlet at one loop
Authors: Herrero-García Juan , Molinaro Emiliano , Schmidt Michael A. 
Published: June 2018

AbstractThe strong direct detection limits could be pointing to dark matter – nucleus scattering at loop level. We study in detail the prototype example of an electroweak singlet (Dirac or Majorana) dark matter fermion coupled to an extended dark sector, which is composed of a new fermion and a new scalar. Given the strong limits on colored particles from direct and indirect searches we assume that the fields of the new dark sector are color singlets. We outline the possible simplified models, including the well-motivated cases in which the extra scalar or fermion is a Standard Model particle, as well as the possible connection to neutrino masses. We compute the contributions to direct detection from the photon, the Z and the Higgs penguins for arbitrary quantum numbers of the dark sector. Furthermore, we derive compact expressions in certain limits, i.e., when all new particles are heavier than the dark matter mass and when the fermion running in the loop is light, like a Standard Model lepton. We study in detail the predicted direct detection rate and how current and future direct detection limits constrain the model parameters. In case dark matter couples directly to Standard Model leptons we find an interesting interplay between lepton flavor violation, direct detection and the observed relic abundance.
Ticagrelor Use in Acute Myocardial Infarction: Insights From the National Cardiovascular Data Registry
Authors: Basra Sukhdeep S. , Wang Tracy Y. , Simon DaJuanicia N. , Chiswell Karen , Virani Salim S. , Alam Mahboob , Nambi Vijay , Denktas Ali E. , Deswal Anita , Bozkurt Biykem , Ballantyne Christie M. , Peterson Eric D. , Jneid Hani 
Published: June 2018

Background

Ticagrelor is a P2Y
12
receptor inhibitor with superior clinical efficacy compared with clopidogrel. However, it is associated with reduced efficacy when combined with a high‐dose aspirin.

Methods and Results

Patients in the acute coronary treatment and intervention outcomes network (
ACTION
) Registry‐Get With The Guidelines (
GWTG
) with acute myocardial infarction from October 2013 through December 2014 were included in the study (167 455 patients; 622 sites). We evaluated temporal trends in the prescription of P2Y
12
inhibitors, and identified factors associated with ticagrelor use at discharge. Among patients discharged on ticagrelor and aspirin (21 262 patients), we evaluated the temporal trends and independent factors associated with high‐dose aspirin prescription at discharge. Ticagrelor prescription at discharge increased significantly from 12% to 16.7% (
P
<0.0001). Decreases in prasugrel and clopidogrel use at discharge (15.7%–13.9% and 54.2%–51.1%, respectively,
P
<0.0001) were also observed. Independent factors associated with preferential ticagrelor prescription at discharge over clopidogrel included younger age, white race, home ticagrelor use, invasive management, and in‐hospital re‐infarction and stroke (
P
<0.0001 for all), whereas older age, female sex, prior stroke, home ticagrelor use, and in‐hospital stroke (
P
<0.0001 for all) were associated with preferential ticagrelor prescription at discharge over prasugrel. High‐dose aspirin was used in 3.1% of patients discharged on ticagrelor. Independent factors associated with high‐dose aspirin prescription at discharge included home aspirin use, diabetes mellitus, previous myocardial infarction, previous coronary artery bypass graft, ST‐segment–elevation myocardial infarction, cardiogenic shock, and geographic region (
P
=0.01).

Conclusions
Our contemporary analysis shows a modest but significant increase in the use of ticagrelor and a high rate of adherence to the use of low‐dose aspirin at discharge.
Upward Shift and Steepening of the Blood Pressure Response to Exercise in Hypertensive Subjects at High Altitude
Authors: Caravita Sergio , Faini Andrea , Baratto Claudia , Bilo Grzegorz , Macarlupu Josè Luis , Lang Morin , Revera Miriam , Lombardi Carolina , Villafuerte Francisco C. , Agostoni Piergiuseppe , Parati Gianfranco 
Published: June 2018

Background
Acute exposure to high‐altitude hypobaric hypoxia induces a blood pressure rise in hypertensive humans, both at rest and during exercise. It is unclear whether this phenomenon reflects specific blood pressure hyperreactivity or rather an upward shift of blood pressure levels. We aimed at evaluating the extent and rate of blood pressure rise during exercise in hypertensive subjects acutely exposed to high altitude, and how these alterations can be counterbalanced by antihypertensive treatment.

Methods and Results

Fifty‐five subjects with mild hypertension, double‐blindly randomized to placebo or to a fixed‐dose combination of an angiotensin‐receptor blocker (telmisartan 80 mg) and a calcium‐channel blocker (nifedipine slow release 30 mg), performed a cardiopulmonary exercise test at sea level and after the first night's stay at 3260 m altitude. High‐altitude exposure caused both an 8 mm Hg upward shift (
P
<0.01) and a 0.4 mm Hg/mL/kg per minute steepening (
P
<0.05) of the systolic blood pressure/oxygen consumption relationship during exercise, independent of treatment. Telmisartan/nifedipine did not modify blood pressure reactivity to exercise (blood pressure/oxygen consumption slope), but downward shifted (
P
<0.001) the relationship between systolic blood pressure and oxygen consumption by 26 mm Hg, both at sea level and at altitude. Muscle oxygen delivery was not influenced by altitude exposure but was higher on telmisartan/nifedipine than on placebo (
P
<0.01).

Conclusions
In hypertensive subjects exposed to high altitude, we observed a hypoxia‐driven upward shift and steepening of the blood pressure response to exercise. The effect of the combination of telmisartan/nifedipine slow release outweighed these changes and was associated with better muscle oxygen delivery.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
01830530.