bluuebunny/crossref_metadata_2025_split huggingface dataset:
Apixaban for the Treatment of Chronic Disseminated Intravascular Coagulation: A Report of Two Cases
Authors: Janjetovic Snjezana , Holstein Katharina , Dicke Christina , Bokemeyer Carsten , Langer Florian 
Published: December 2018

AbstractCharacteristic features of disseminated intravascular coagulation (DIC) are the opposing risks of bleeding (due to consumptive coagulopathy and hyperfibrinolysis) and organ failure (due to widespread microvascular thromboses). The purpose of anticoagulation in DIC is to attenuate excessive thrombin generation and fibrin deposition. While heparins have been shown to be beneficial in this context, the safety and efficacy of direct oral anticoagulants have not yet been sufficiently addressed. Here, we report two patients in whom chronic DIC was stabilized upon administration of apixaban: an elderly male with aortic dissection presenting with significant mucocutaneous bleeding and a younger female with Klippel–Trénaunay–Weber syndrome presenting with multiple superficial vein thromboses (SVTs). In addition to an improvement in DIC parameters, both patients benefited clinically with resolution of bleeding symptoms and prevention of further SVTs, respectively. Oral apixaban thus showed promising safety and efficacy in the management of DIC caused by vascular abnormalities; still further investigations are needed to support these findings.
Impact of Electronic Physician Order-Set on Antibiotic Ordering Time in Septic Patients in the Emergency Department
Authors: Fargo Emily , D'Amico Frank , Pickering Aaron , Fowler Kathleen , Campbell Ronald , Baumgartner Megan 
Published: December 2018

Background Sepsis is a serious medical condition that can lead to organ dysfunction and death. Research shows that each hour delay in antibiotic administration increases mortality. The Surviving Sepsis Campaign Bundles created standards to assist in the timely treatment of patients with suspected sepsis to improve outcomes and reduce mortality.
Objective This article determines if the use of an electronic physician order-set decreases time to antibiotic ordering for patients with sepsis in the emergency department (ED).
Methods A retrospective chart review was performed on adult patients who presented to the ED of four community hospitals from May to July 2016. Patients with severe sepsis and/or septic shock were included. Primary outcome was the difference in time to antibiotic ordering in patients whose physicians utilized the order-set versus those whose physicians did not. Secondary outcomes included differences in time to antibiotic administration, time to lactate test, hospital length of stay, and posthospitalization disposition. The institution's Quality Improvement Committee approved the project.
Results Forty-five of 123 patients (36.6%) with sepsis had physicians who used the order-set. Order-set utilization reduced the mean time to ordering antibiotics by 20 minutes (99 minutes, 95% confidence interval [CI]: 69–128 vs. 119 minutes, 95% CI: 91–147), but this finding was not statistically significant. Mean time to antibiotic administration (145 minutes, 95% CI: 108–181 vs. 182 minutes, 95% CI: 125–239) and median time to lactate tests (12 minutes, 95% CI: 0–20 vs. 19 minutes, 95% CI: 8–34), although in the direction of the hypotheses, were not significantly different.
Conclusion Utilization of the order-set was associated with a potentially clinically significant, but not statistically significant, reduced time to antibiotic ordering in patients with sepsis. Electronic order-sets are a promising tool to assist hospitals with meeting the Centers for Medicare and Medicaid Services core measure.
Proanthocyanidin and anthocyanins from the hulls and beards of red-kerneled rice and their antiglycation properties
Authors: Ganeko Natsuki , Kato Nana , Watanabe Saki , Bastian Februadi , Miyake Masateru , Ito Hideyuki 
Published: December 2018

ABSTRACT
In the current study, we isolated a proanthocyanidin oligomer from the hulls of red-kerneled rice. The structure of the oligomer was characterized based on spectral data and chemical reaction. Furthermore, two anthocyanins were isolated from the beards of the same source. The proanthocyanidins and beard extract showed more potent inhibitory and cleaving activities than those of positive controls, respectively.
Inverse Relationship Between Coarse Food Grain Intake and Blood Pressure Among Young Chinese Adults
Authors: Liu Xin , Liao Xia , Gan Wei , Ding Xinyun , Gao Bei , Wang Hao , Zhao Xu , Liu Yingxue , Feng Leilei , Abdulkadil Wurrguli , Li Yanqin 
Published: December 2018

Abstract

BACKGROUND
Coarse food grains are rich in dietary fiber and contain a wide range of nutrients with potential health benefits, such as blood pressure control. Coarse food grains are very popular in China, where hypertension is a major challenge. We evaluated the associations between coarse food grain consumption and blood pressure among young Chinese adults.

METHODS
A total of 104 men and women aged 18–35 years, who participated in a pilot study of the Carbohydrate Alternatives and Metabolic Phenotypes study, were included in the present analysis. Food frequency questionnaires were used to collect dietary intake data. Blood pressure was measured using a digital monitor. A multivariate general linear model was used to evaluate the putative associations.

RESULTS
Overall, 12.5% of our participants have regular habits of coarse food grain intake (at least 4 days/week). Age was positively associated with both systolic blood pressure (SBP) and diastolic blood pressure (DBP) (all Ps for trend &lt; 0.05). With multivariable adjustment, including for body mass index and physical activity level, the frequency of coarse food grain intake was inversely associated with both SBP and DBP (all Ps for trend &lt; 0.05). Similar associations were observed for estimated daily coarse food grain intake with SBP (β coefficient ± SE = −0.039 ± 0.017, P = 0.024) and DBP (β coefficient ± SE = −0.033 ± 0.013, P = 0.016).

CONCLUSIONS
In our sample of young Chinese adults, higher coarse food grain intake was associated with lower SBP and DBP.
Examination of Regression-based Discrepancy Scores for the RBANS in Detecting Cognitive Impairment from an Archival Sample
Authors: Goette William F , Schmitt Andrew L 
Published: December 2018

AbstractObjectiveThe purpose of this study was to evaluate the clinical utility of regression-based formulas for the RBANS indexes in screening for cognitive impairment.MethodA database of neuropsychological test results was created from archival records in a memory assessment clinic. The sample consisted of 83 individuals (37 males/46 females) with an average age of 70.1 (SD = 9.8) and 14.6 years of education (SD = 2.8). Diagnostic accuracy of regression-based predictions provided by Duff and Ramezani (2015) (Duff, K., & Ramezani, A. (2015). Regression-based normative formulae for the Repeatable Battery for the Assessment of Neuropsychological Status for older adults. Archives of Clinical Neuropsychology, 30, 600–604.) and from regression of WTAR standard score were examined via receiver operator characteristic curves. Preliminary generalizability investigation was completed using two additional datasets.ResultsThe WTAR was found to mediate the relationship between education and all RBANS index scores. The WTAR standard score was also found to contribute uniquely and significantly to the prediction of RBANS performance. Results of diagnostic accuracy analyses showed similar discriminating accuracy for all scores. There was limited support for using the WTAR over demographic variables alone in the estimation of RBANS performance; however, the WTAR was found to be more predictive than education, indicating potential clinical utility to using the word-reading score over just years of attained education.ConclusionsUse of these derived Total Scale score variants is recommended for the screening of cognitive impairment, particularly in individuals with superior or poor educational quality. Further research is required to evaluate the utility of these variations in more diverse samples.
Neural Correlates of Enhanced Memory for Meaningful Associations with Age
Authors: Amer Tarek , Giovanello Kelly S , Nichol Daniel R , Hasher Lynn , Grady Cheryl L 
Published: December 2018

Abstract
Evidence suggests that age differences in associative memory are attenuated for associations that are consistent with prior knowledge. Such knowledge structures have traditionally been associated with the default network (DN), which also shows reduced modulation with age. In the present study, we investigated whether DN activity and connectivity patterns could account for this age-related effect. Younger and older adults underwent functional magnetic resonance imaging as they learned realistic and unrealistic prices of common grocery items. Both groups showed greater activity in the DN during the encoding of realistic, relative to unrealistic, prices. Moreover, DN activity at encoding and retrieval and its connectivity with an attention control network at encoding were associated with enhanced memory for realistic prices. Finally, older adults showed overactivation of control regions during retrieval of realistic prices relative to younger adults. Our findings suggest that DN activity and connectivity patterns (traditionally viewed as indicators of cognitive failure with age), and additional recruitment of control regions, might underlie older adults’ enhanced memory for meaningful associations.
Persistence of Imported Malaria Into the United Kingdom: An Epidemiological Review of Risk Factors and At-risk Groups
Authors: Moyo Qubekani M , Besser Martin , Lynn Roderick , Lever Andrew M L 
Published: December 2018

Abstract

Background
The United Kingdom documented a decline of &gt;30% in imported cases of malaria annually between 1996 and 2003; however, there are still approximately 1700 cases and 5–10 deaths each year. Prophylaxis health messages focus on families returning to their country of origin.

Methods
We reviewed 225 records of patients seen in Cambridge University Hospital Foundation Trust [CUHFT], a tertiary referral center in Cambridge, England. All records of patients seen in CUHFT between 2002–2016 were analyzed in the context of national figures from Public Health England.

Results
Between 2004–2016, there was no decrease in imported cases of malaria locally or nationally. Plasmodium falciparum remains responsible for most imported infections (66.7%); Plasmodium vivax contributed 15.1%, Plasmodium malariae 4%, and Plasmodium ovale 6.7%; 7.5% (17/225) of patients had an incomplete record. Most cases were reported in people coming from West Africa. Sierra Leone and the Ivory Coast had the highest proportions of travelers being infected at 8 and 7 per 1000, respectively. Visiting family in the country of origin (27.8%) was the commonest reason for travel. However, this was exceeded by the combined numbers traveling for business and holidays (22.5% and 20.1%, respectively). Sixty percent of patients took no prophylaxis. Of those who did, none of the patients finished their chemoprophylaxis regimen.

Conclusions
Significant numbers of travelers to malarious countries still take no chemoprophylaxis. Health advice about prophylaxis before travel should be targeted not only at those visiting family in their country of origin but also to those traveling for holiday and work.
Low Admission Plasma Gelsolin Concentrations Identify Community-acquired Pneumonia Patients at High Risk for Severe Outcomes
Authors: Self Wesley H , Wunderink Richard G , DiNubile Mark J , Stossel Thomas P , Levinson Susan L , Williams Derek J , Anderson Evan J , Bramley Anna M , Jain Seema , Edwards Kathryn M , Grijalva Carlos G 
Published: December 2018

AbstractBackgroundPlasma gelsolin (pGSN) is an abundant circulating protein that neutralizes actin exposed by damaged cells, modulates inflammatory responses, and enhances alveolar macrophage antimicrobial activity. We investigated whether adults with low pGSN at hospital admission for community-acquired pneumonia (CAP) were at high risk for severe outcomes.MethodsAdmission pGSN concentrations in 455 adults hospitalized with CAP were measured using enzyme-linked immunosorbent assay. Patients were grouped into the following 4 hierarchical, mutually exclusive categories based on maximum clinical severity experienced during their hospitalization: general floor care without intensive care unit (ICU) admission, invasive respiratory or vasopressor support (IRVS), or death; ICU care without IRVS or death; IRVS without death; or death. Admission pGSN concentrations were compared across these discrete outcome categories. Additionally, outcomes among patients in the lowest quartile of pGSN concentration were compared to those in the upper 3 quartiles.ResultsOverall, median (interquartile range) pGSN concentration was 38.1 (32.1, 45.7) μg/mL. Patients with more severe outcomes had lower pGSN concentrations (P = .0001); median values were 40.3 μg/mL for floor patients, 36.7 μg/mL for ICU patients, 36.5 μg/mL for patients receiving IRVS, and 25.7 μg/mL for patients who died. Compared to patients with higher pGSN concentrations, patients in the lowest quartile (pGSN ≤ 32.1 μg/mL) more often required IRVS (21.2% vs 11.7%, P = .0114) and died (8.8% vs 0.9%, P < .0001).ConclusionsAmong adults hospitalized with CAP, lower pGSN concentrations were associated with more severe clinical outcomes. Future studies are planned to investigate possible therapeutic benefits of recombinant human pGSN in this population.
Implication of interleukin-2 receptor antibody induction therapy in standard risk renal transplant in the tacrolimus era: a meta-analysis
Authors: Ali Hatem , Mohiuddin Atif , Sharma Ajay , Shaheen Ihab , Kim Jon Jin , El Kosi Mohsen , Halawa Ahmed 
Published: December 2018

Abstract

Background
Interleukin-2 (IL-2) antagonist has been used as an induction therapy in many centres in calcineurin inhibitor-sparing regimens. Tacrolimus has overwhelmingly replaced cyclosporine in the maintenance immunosuppressive protocols in many transplant centres. The aim of our study and meta-analysis is to explore the effect of IL-2 induction therapy on the rate of rejection and patient and graft survival in standard-risk renal transplant patients with tacrolimus-based maintenance immunotherapy. Secondary aims included assessment of the effect of IL-2 induction therapy on creatinine change and the risk of cytomegalovirus (CMV) infection.

Methods
We conducted a systematic review in different databases to identify studies and research work that assessed the effect of IL-2 antibody induction therapy on renal transplant outcomes. Inclusion criteria for our meta-analysis were all studies that compared IL-2 induction therapy with placebo or no induction therapy in standard-risk renal transplant recipients on tacrolimus-based maintenance immunosuppressive therapy. Data collected were the name of the first author, journal title, year of publication, country where the study was conducted, number of patients in the IL-2 induction therapy arm and in the placebo arm, number of patients who had biopsy-proven rejection and graft survival in each arm. A random effects model was used for the meta-analysis.

Results
Of the 470 articles found in different databases, 7 were included in the meta-analysis. Forest plot analysis for rate of rejection during the follow-up period post-transplant showed no significant difference between the groups. There was no evidence of heterogenicity between included studies (I2 = 21.8%, P = 0.27). The overall risk difference was −0.02 [95% confidence interval (CI) −0.05–0.01]. A random effects meta-analysis for patient and graft survival was performed using forest plot analysis and showed no significant effect of IL-2 receptor (IL-2R) antibody induction on patient or graft survival compared with placebo. The overall risk difference was −0.01 (95% CI −0.04–0.01) and 0.00 (95% CI −0.00–0.01), respectively. Three of the included studies showed no effect of basiliximab on creatinine change, two showed no effect on risk of CMV infection and two showed less risk of post-transplant diabetes in the basiliximab group.

Conclusion
IL-2R antibody induction therapy has no significant effect on the rate of rejection or patient or graft survival in standard-risk renal transplant recipients on tacrolimus-based maintenance immunotherapy. More randomized controlled studies are needed.
Dental arch effects after early and later timed cervical headgear treatment—a randomized controlled trial
Authors: Julku Johanna , Hannula Matti , Pirilä-Parkkinen Kirsi , Tolvanen Mimmi , Pirttiniemi Pertti 
Published: December 2018

Summary

Background
Cervical headgear (CH) is a commonly used orthodontic appliance and its dentoalveolar changes are known. However, the effects related to gender and timing have gained less attention.

Objectives
To examine dimensions of dental arches among children with Class II occlusion without posterior mandibular rotation according to timing of Kloehn-type CH treatment.

Trial design
Prospective, randomized, parallel-group controlled trial.

Methods
Sixty-seven seven-year-old children with a Class II occlusion were included in the study. The children were randomized into two equal-size groups in 1:1 ratio by sealed-envelope randomization. The early group (EG, n = 33) was treated between T0 and T1 (26 months), right after eruption of the first maxillary molars. The late group (LG, n = 34) was treated between T1 and T2 (24 months). The children were treated with CH until normal Class I occlusion on first molars was achieved. Impressions for dental casts were taken from all participants at T0, T1, and T2. Blinding was applicable for outcome assessors. Changes in dental cast measurements were compared between the groups and genders using t-test, Mann-Whitney U-test, and repeated measures analysis of variance.

Results
Of the children, 56 completed the study. The maxillary arch length and the transversal changes between the upper canines and upper first molars were significantly increased in EG at T0−T1 (P < 0.001). At T2, the transversal dimension between the upper first molars was larger (P < 0.05), and in the lower arch the mandibular arch length (P < 0.05) and the transversal dimension between the lower first molars (P < 0.01) were increased in EG males compared to LG males. No harms were encountered.

Conclusions
The male gender benefits most from early timing of the CH treatment, showing larger dimensions at the end of the follow-up. The results clearly indicated a wider and longer upper dental arch and spontaneous expansion of the lower dental arch after treatment.

Clinical Registration
NCT02010346.
The Duke’s Favourites: Towards a Gendered View of the Politics of Concubinage at the Early Modern Court*
Authors: Maritz Regine 
Published: December 2018

Abstract
Mistresses at the early modern court have only recently been discovered as subjects of political history. They are now increasingly discussed alongside male favourites, and while this essay welcomes this development, it also argues that this should not result in the degendering of the practice of concubinage. The upkeep of extramarital relationships was not a viable option for ruling women, and if they transgressed this cultural norm, they were sanctioned severely, as is illustrated by case of Sophie Dorothea of Celle. Such a clear gendering of a specific practice indicates that there was power at stake. Here it is argued that we can only fully appreciate the political dimension of concubinage if we broaden our perspective beyond the mistress-ruler relationship to include the political configuration of the ruling ‘working couple’, which was of crucial importance specifically at Protestant German-speaking courts. The comparison of a male favourite and a female favourite in the duchy of Württemberg exemplifies how both these actors could recalibrate specific configurations of power in ways that departed from the God-given order of governance and thus induce anxiety in contemporaries. Female favourite Magdalena Möringer took on functions of the local duchess and thus helped the duke concentrate power in his person by breaking up the deeply rooted assumptions about the collaborative labour of ruling couples that were influential in early modern Germany.
Patterns of body mass index milestones in early life and cardiometabolic risk in early adolescence
Authors: Aris Izzuddin M , Rifas-Shiman Sheryl L , Li Ling-Jun , Kleinman Ken P , Coull Brent A , Gold Diane R , Hivert Marie-France , Kramer Michael S , Oken Emily 
Published: December 2018

Abstract

Background
Few studies have examined the independent and combined relationships of body mass index (BMI) peak and rebound with adiposity, insulin resistance and metabolic risk later in life. We used data from Project Viva, a well-characterized birth cohort from Boston with repeated measures of BMI, to help fill this gap.

Methods
Among 1681 children with BMI data from birth to mid childhood, we fitted individual BMI trajectories using mixed-effects models with natural cubic splines and estimated age, and magnitude of BMI, at peak (in infancy) and rebound (in early childhood). We obtained cardiometabolic measures of the children in early adolescence (median 12.9 years) and analysed their associations with the BMI parameters.

Results
After adjusting for potential confounders, age and magnitude at infancy BMI peak were associated with greater adolescent adiposity, and earlier adiposity rebound was strongly associated with greater adiposity, insulin resistance and metabolic risk score independently of BMI peak. Children with a normal timing of BMI peak plus early rebound had an adverse cardiometabolic profile, characterized by higher fat mass index {β 2.2 kg/m2 [95% confidence interval (CI) 1.6, 2.9]}, trunk fat mass index [1.1 kg/m2 (0.8, 1.5)], insulin resistance [0.2 units (0.04, 0.4)] and metabolic risk score [0.4 units (0.2, 0.5)] compared with children with a normal BMI peak and a normal rebound pattern. Children without a BMI peak (no decline in BMI after the rise in infancy) also had adverse adolescent metabolic profiles.

Conclusions
Early age at BMI rebound is a strong risk factor for cardiometabolic risk, independent of BMI peak. Children with a normal peak-early rebound pattern, or without any BMI decline following infancy, are at greatest risk of adverse cardiometabolic profile in adolescence. Routine monitoring of BMI may help to identify children who are at greatest risk of developing an adverse cardiometabolic profile in later life and who may be targeted for preventive interventions.