bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treating People with Arthritis with Traditional Chinese Medicine (Tcm): An Examination of the Perception of Tcm Practitioners
Authors: Yang Lu , Peng Wenbo , Adams Jon , Sibbritt David William 
Published: March 2018

Introduction Emerging evidence has shown that traditional Chinese medicine (TCM) has a positive effect on arthritis. This research provides the first critical, systematic examination of TCM practitioners’ perceptions of TCM use for people with arthritis. Methods An online survey was distributed to all TCM professionals including acupuncturists and Chinese herbal medicine practitioners registered with the Practitioner Research and Collaborate Initiative (PRACI) practitioner database. The survey questions focus on practitioner characteristics, practice characteristics and clinical management approaches regarding arthritis care. Results The survey attracted a response rate of 53% (n=52). The average age of the respondents was 49.9 years, more than half were female, and the majority held a bachelor degree or higher qualification. More than two thirds of TCM practitioners in our study worked with other health professionals, while they had a high level of referral relationships with a wide range of conventional, allied health and complementary and alternative medicine (CAM) providers. Most of the TCM practitioners reported that their patients with arthritis used other treatments alongside TCM and a large number of the TCM practitioners who participated believed that TCM was effective for treating arthritis. Conclusions The TCM profession represents a substantial component of the healthcare field in Australia, and treating patients with arthritis appears to be an important area of TCM practice, among others. Further detailed research is needed to help ensure effective, safe patient care for those with arthritis who may be utilising TCM alongside a broader range of conventional medicine, allied health, and other CAM treatments.
Prognostic significance of autoantibodies for idiopathic pulmonary fibrosis: protocol for a systematic review
Authors: Kamiya Hiroyuki , Panlaqui Ogee Mer 
Published: March 2018

IntroductionIdiopathic pulmonary fibrosis(IPF) is chronic fibrosing interstitial pneumonia of unknown aetiology. IPF is diagnosed based on the exclusion of known causes such as connective tissue diseases(CTDs). However, some patients fail to meet defined CTD criteria regardless of an implication of immunological involvement and these cases were described in a variety of terms. The classification criteria of this clinical entity consist of a combination of clinical, serological and morphological findings and it is reported to be distinct from IPF. However, the significance of the sole presence of autoantibodies complicated with IPF is still unknown. Therefore, this systematic review aims to clarify the significance of autoantibodies complicated with IPF.Methods and analysisIPF with any autoantibody associated with CTDs is eligible for the review. Primary outcomes are all-cause mortality and pulmonary-cause mortality, while secondary outcomes include a progression of the disease, a deterioration of health-related quality of life and the development of a defined CTD. Primary studies of any type except a case report are included. Two reviewers search four electronic databases such as Medline, EMBASE, Science Citation Index Expanded and Google Scholar from each inception through 1 February 2018 and extract data independently. A risk of bias in individual studies is assessed by the Quality in Prognostic Studies tool. Meta-analysis is sought to be conducted if three or more studies report an outcome for a specific autoantibody with the same statistics. If it is inappropriate to combine data due to substantial heterogeneity, the result is reported qualitatively. Subgroup and sensitivity analyses are considered to identify the source of heterogeneity. The Grades of Recommendation, Assessment, Development and Evaluation method is applied to evaluate the evidence level of the result.Ethics and disseminationThere is no concerning ethical issue. The result will be sought for publication.PROSPERO registration numberCRD42017077336.
Psychosocial stress factors, including the relationship with the coach, and their influence on acute and overuse injury risk in elite female football players
Authors: Pensgaard Anne Marte , Ivarsson Andreas , Nilstad Agnethe , Solstad Bård Erlend , Steffen Kathrin 
Published: March 2018

BackgroundThe relationship between specific types of stressors (eg, teammates, coach) and acute versus overuse injuries is not well understood.ObjectiveTo examine the roles of different types of stressors as well as the effect of motivational climate on the occurrence of acute and overuse injuries.MethodsPlayers in the Norwegian elite female football league (n=193 players from 12 teams) participated in baseline screening tests prior to the 2009 competitive football season. As part of the screening, we included the Life Event Survey for Collegiate Athletes and the Perceived Motivational Climate in Sport Questionnaire (Norwegian short version). Acute and overuse time-loss injuries and exposure to training and matches were recorded prospectively in the football season using weekly text messaging. Data were analysed with Bayesian logistic regression analyses.ResultsUsing Bayesian logistic regression analyses, we showed that perceived negative life event stress from teammates was associated with an increased risk of acute injuries (OR=1.23, 95% credibility interval (1.01 to 1.48)). There was a credible positive association between perceived negative life event stress from the coach and the risk of overuse injuries (OR=1.21, 95% credibility interval (1.01 to 1.45)).ConclusionsPlayers who report teammates as a source of stress have a greater risk of sustaining an acute injury, while players reporting the coach as a source of stress are at greater risk of sustaining an overuse injury. Motivational climate did not relate to increased injury occurrence.
Impact of emergency department surge and end of shift on patient workup and treatment prior to referral to internal medicine: a health records review
Authors: Charbonneau Valerie , Kwok Edmund , Boyle Loree , Stiell Ian G 
Published: March 2018

BackgroundThe goal of this study was to determine if ED surge and end-of-shift assessment of patients affect the extent of diagnostic tests, therapeutic interventions and accuracy of diagnosis prior to referral to internal medicine.MethodsThis study was a health records review of consecutive patients referred to the internal medicine service with an ED diagnosis of heart failure, chronic obstructive pulmonary disease (COPD) or sepsis starting 1 December 2013 until 100 cases for each condition had been obtained. We developed a scoring system in consultation with emergency and internal medicine physicians to uniformly assess the completeness of treatments and investigations performed. These scores, expressed as percentage of possible points, were compared at high and low surge levels and at middle and end of shift at time of patient referral. End of shift was defined as 7:30–8:30, 15:30–16:30 and 23:30–00:30 as our shift changes occur at 8:00, 16:00 and 24:00. Rate of admission, diversion to other services and diagnosis disagreements were also assessed.ResultsWe included 308 patients (101 heart failure, 101 COPD, 106 sepsis) with a mean age of 74.7. Comparing middle of shift to end of shift, the mean scores were 91.9% versus 91.8% (difference 0.1% (95% CI −2.4 to 3.0)) for investigations and 73.0% versus 70.4% (difference 2.6% (95% CI −1.8 to 7.4)) for treatments. Comparing low to high surge times, the mean scores were 92.1% versus 91.7% (difference 0.4% (95% CI −1.2 to 2.4)) for investigations and 71.4% versus 73.6% (difference −2.2% (95% CI −5.6 to 1.3)) for treatments. We found low rates of diversion to alternate services (8.9% heart failure, 0% COPD, 6.6% sepsis) and low rates of diagnosis disagreement (4.0% heart failure, 10.9% COPD, 8.5% sepsis).ConclusionsWe found no evidence that surge levels and end of shift impact the extent of investigations and treatments provided to patients diagnosed in the ED with heart failure, COPD or sepsis and referred to internal medicine.
Temporal trends in the contribution of Chagas cardiomyopathy to mortality among patients with heart failure
Authors: Nadruz Wilson , Gioli-Pereira Luciana , Bernardez-Pereira Sabrina , Marcondes-Braga Fabiana G , Fernandes-Silva Miguel M , Silvestre Odilson M , Sposito Andrei C , Ribeiro Antonio L , Bacal Fernando , Fernandes Fabio , Krieger Jose E , Mansur Alfredo J , Pereira Alexandre C 
Published: March 2018

BackgroundChagas cardiomyopathy (ChC) prevalence is decreasing in Brazil and medical therapies for heart failure (HF) have improved in the last decade. Whether these changes modified the prognosis of ChC relative to non-Chagas cardiomyopathies (NChC) remains unknown. This study evaluated the temporal trends in population attributable risk (PAR) of ChC for 2-year mortality among patients with HF enrolled at years 2002–2004 (era 1) and 2012–2014 (era 2) in a Brazilian university hospital.MethodsWe prospectively studied 362 (15% with ChC) and 582 (18% with ChC) HF patients with ejection fraction ≤50% in eras 1 and 2, respectively and estimated the PAR of ChC for 2-year mortality.ResultsThere were 145 deaths (29 in ChC) in era 1 and 85 deaths (26 in ChC) in era 2. In multivariable Cox-regression analysis adjusted for age, sex, ejection fraction, heart rate, body mass index, hypertension, diabetes mellitus, systolic blood pressure and ischaemic/valvar aetiology, ChC was associated with higher risk of death in era 1 (HR (95% CI)=1.92 (1.00 to 3.71), p=0.05) and era 2 (HR (95% CI)=3.51 (1.94 to 6.36), p<0.001). In fully adjusted analysis, the PAR of ChC for mortality increased twofold from era 1 (PAR (95% CI)=11.0 (2.8 to 18.5)%) to era 2 (PAR (95% CI)=21.9 (16.5 to 26.9)%; p=0.023 versus era 1).ConclusionAlthough the absolute death rates decreased over time in the ChC and NChC groups, the PAR of ChC for mortality increased among patients with HF, driven by increases in the HR associated with ChC. Our results highlight the need for additional efforts aiming to prevent and treat ChC.
Characterisation of mesenchymal stem cells from patients with amyotrophic lateral sclerosis
Authors: Matejckova Nicole , Zajicova Alena , Hermankova Barbora , Kossl Jan , Bohacova Pavla , Holan Vladimir , Javorkova Eliska 
Published: March 2018

AimsMesenchymal stem cells (MSCs) have recently been tested in clinical trials to treat severe diseases, including amyotrophic lateral sclerosis (ALS). Since autologous MSCs are frequently used for therapy, we aimed to evaluate the possible influence of the disease on characteristics and function of these cells.MethodsMSCs were isolated from the bone marrow of patients with ALS and compared with MSCs from healthy controls (HC). The cells were tested for phenotype, growth properties, differentiation ability, metabolic activity, secretory potential, expression of genes for immunomodulatory molecules and for the ability to regulate proliferation of mitogen-stimulated peripheral blood leucocytes. MSCs from patients with ALS and HC were either unstimulated or treated with proinflammatory cytokines for 24 hours before testing.ResultsMSCs isolated from patients with ALS have a higher differentiation potential into adipocytes, express elevated levels of mRNA for interleukin-6, but produce less hepatocyte growth factor than MSCs from HC. On the other hand, there were no significant differences between MSCs from patients with ALS and HC in the expression of phenotypic markers, growth properties, metabolic activity, osteogenic differentiation potential and immunoregulatory properties.ConclusionsThe results suggest that, in spite of some differences in cytokine production, MSCs from patients with ALS can be useful as autologous cells in therapy of ALS.
Influence of low-protein diets and protease and bromelain supplementation on growth performance, nutrient digestibility, blood urine nitrogen, creatinine, and faecal noxious gas in growing–finishing pigs
Authors: Nguyen D.H. , Lee S.I. , Cheong J.Y. , Kim I.H. 
Published: March 2018

A total of 180 crossbred pigs [(Landrace × Yorkshire) × Duroc] with an average body weight of 22.61 ± 1.23 kg were used in an 18 wk study to determine the effect of protease and bromelain in low-protein diets in grower–finisher pigs. Dietary treatments included: T1, basal diet treatment; T2, low-protein treatment; T3 (T2 + 0.2 g kg−1protease); and T4 (T2 + 0.3 g kg−1bromelain). Pigs fed protease- and bromelain-supplemented diets increased average daily gain and gain to feed ratio at week 18, dry matter and nitrogen digestibility at week 6, as well as energy digestibility at week 12, compared with low-protein diet (P < 0.05). Pigs fed T3 and T4 diets led to a trend of decreased (P < 0.05) blood urine nitrogen (BUN) and creatinine concentrations at the 12th wk. A reduction of ammonia (NH3) and hydrogen sulfide (H2S) emission was observed in pigs fed the dietary protease and bromelain supplementation at the 6th wk (P < 0.05). There was no effect on all parameters between the protease and bromelain supplementation treatments. In conclusion, supplementation of protease and bromelain to low-protein diet enhanced growth performance, nutrient digestibility, and reduced NH3and H2S in growing–finishing pigs.
Geological and geotechnical considerations, associated with some sections of the M25 construction
Authors: Newman R. L. 
Published: March 2018

Introduction

A joint meeting of the Engineering Group and the Institution of Highway Engineers was held at Burlington House on Tuesday, 10 January 1984. The topic of the meeting inspired practising engineers, academics and researchers alike, and this was reflected in an extremely well attended meeting. The audience listened to a number of speakers who have been actively involved with construction of particular sections of the M25 and who related their experiences in dealing with various ground engineering problems. There is currently no project so prestigious nor so intently observed in the UK as the M25, and this fact together with the fascination of ground engineering meant that the meeting was destined to be of great interest.
The Chairman of the Engineering Group of the Geological Society, Dr A. B. Hawkins, introduced the meeting and related some facts about the M25. The 120 miles of 3–4 lane dual carriageway will constitute the largest orbital road in the world. The most heavily trafficked sections, for instance between the A30 and M4 in the southwest sector, are expected to accommodate between 70 000 and 80 000 vehicles during a 16-h day in 1987. The M25 will provide a much needed fast and problem-free route to cross London and its connections to 18 major radial link roads will greatly improve communications to and from central London. It is anticipated that it will generate traffic and that its excellent communications will encourage development of a new network of industry.
Figure 1 shows the present
UBC-Nepal Expedition: imposed oscillatory shear stress does not further attenuate flow-mediated dilation during acute and sustained hypoxia
Authors: Tremblay Joshua C. , Howe Connor A. , Ainslie Philip N. , Pyke Kyra E. 
Published: March 2018

Experimentally induced oscillatory shear stress (OSS) and hypoxia reduce endothelial function in humans. Acute and sustained hypoxia may cause increases in resting OSS; however, whether this influences endothelial susceptibility to further increases in OSS is unknown. Healthy lowlanders ( n = 15, 30 ± 6 yr; means ± SD) participated in three OSS interventions: two interventions at sea level [normoxia and after 20 min of normobaric hypoxia (acute hypoxia, 11% O2)] and one intervention 5–7 days after a 9-day ascent to 5,050 m (sustained hypoxia). OSS was provoked in the brachial artery using a 30-min distal cuff inflation (75 mmHg). Endothelial function was assessed before and after each intervention by reactive hyperemia flow-mediated dilation (FMD). Shear stress magnitude and patterns were obtained via Duplex ultrasound. Baseline retrograde shear stress and OSS were greater in acute hypoxia versus normoxia ( P < 0.001), and OSS was elevated in sustained hypoxia versus normoxia ( P = 0.011). The intervention further augmented OSS during each condition. Preintervention FMD was decreased by 29 ± 48% in acute hypoxia and by 25 ± 31% in sustained hypoxia compared with normoxia ( P = 0.001 and 0.026); these changes correlated with changes in baseline mean and antegrade shear stress. After the intervention, FMD decreased during normoxia (−41 ± 26%, P < 0.001) and was unaltered during acute or sustained hypoxia. Therefore, a 30-min exposure to OSS reduced FMD during normoxia, a condition with an unchallenged, healthy endothelium; however, imposed OSS did not appear to worsen endothelial function during acute or sustained hypoxia. Exposure to an altered magnitude and pattern of shear stress at baseline in hypoxia may contribute to the insensitivity to further acute augmentation of OSS. NEW & NOTEWORTHY We investigated whether the endothelium remains sensitive to experimental increases in oscillatory shear stress in acute (11% O2) and sustained (2 wk at 5,050 m) hypoxia. Hypoxia altered baseline shear stress and decreased endothelial function (flow-mediated dilation); however, exposure to experimentally induced oscillatory shear stress only impaired flow-mediated dilation in normoxia.
Peli1 Modulates the Subcellular Localization and Activity of Mdmx
Authors: Li Dawei , Tavana Omid , Sun Shao-Cong , Gu Wei 
Published: March 2018

Abstract
Mdm2 and Mdmx, both major repressors of p53 in human cancers, are predominantly localized to the nucleus and cytoplasm, respectively. The mechanism by which subcellular localization of Mdmx is regulated remains unclear. In this study, we identify the E3 ligase Peli1 as a major binding partner and regulator of Mdmx in human cells. Peli1 bound Mdmx in vitro and in vivo and promoted high levels of ubiquitination of Mdmx. Peli1-mediated ubiquitination was degradation-independent, promoting cytoplasmic localization of Mdmx, which in turn resulted in p53 activation. Consistent with this, knockdown or knockout Peli1 in human cancer cells induced nuclear localization of Mdmx and suppressed p53 activity. Myc-induced tumorigenesis was accelerated in Peli1-null mice and associated with downregulation of p53 function. Clinical samples of human cutaneous melanoma had decreased Peli1 expression, which was associated with poor overall survival. Together, these results demonstrate that Peli1 acts as a critical factor for the Mdmx–p53 axis by modulating the subcellular localization and activity of Mdmx, thus revealing a novel mechanism of Mdmx deregulation in human cancers.
Significance: Peli1-mediated regulation of Mdmx, a major inhibitor of p53, provides critical insight into activation of p53 function in human cancers. Cancer Res; 78(11); 2897–910. ©2018 AACR.
Goldilocks Dosing of TKIs: A Dose that Is Just Right Leads to Optimal Outcomes
Authors: Rini Brian I. 
Published: March 2018

Abstract
Higher concentrations of TKIs, such as pazopanib, are associated with improved outcomes in advanced RCC. A phase III trial failed to show disease-free survival benefit to pazopanib in the adjuvant setting, but improved DFS was seen in patients with higher Ctrough levels, supporting adequate drug exposure for optimal clinical outcome. Clin Cancer Res; 24(13); 2979–80. ©2018 AACR.
See related article by Sternberg et al., p. 3005
Accelerating the Pace of Cancer Prevention- Right Now
Authors: Colditz Graham A. , Emmons Karen M. 
Published: March 2018

AbstractAs a nation, we underinvest in prevention and fail to implement strategies that ensure all population groups equitably share in the return on investment in prevention research and the benefits of prevention effectiveness. There is significant evidence indicating that by applying knowledge that we already have to reduce tobacco, inactivity, and obesity (known modifiable causes of cancer), we can prevent more than 50% of cancers. Vaccination against HPV, aspirin and selective estrogen receptor modulators, and screening programs further reduce risk. Evidence-based prevention strategies are inconsistently implemented across the United States. Substantial variation across States indicates that there is much room for improvement in implementation of prevention. Implementation science applies innovative approaches to identifying, understanding, and developing strategies for overcoming barriers to the adoption, adaptation, integration, scale-up, and sustainability of evidence-based interventions, tools, policies, and guidelines that will prevent cancer through application of evidence-based interventions. When we get implementation of prevention programs right and at scale, we achieve substantial population benefits. Although many efforts are underway to maximize our knowledge about the causes and treatments of cancer, we can achieve reductions in the cancer burden right now by doing what we already know. The time to start is now. Cancer Prev Res; 11(4); 171–84. ©2018 AACR.
Thirty-Day Readmissions After Left Ventricular Assist Device Implantation in the United States
Authors: Agrawal Sahil , Garg Lohit , Shah Mahek , Agarwal Manyoo , Patel Brijesh , Singh Amitoj , Garg Aakash , Jorde Ulrich P. , Kapur Navin K. 
Published: March 2018

Background:
Early readmissions contribute significantly to heart failure–related morbidity and negatively affect quality of life. Data on left ventricular assist device (LVAD)–related 30-day readmissions are scarce and limited to small studies.

Methods and Results:
Patients undergoing LVAD implantation between January 2013 and November 2014 who survived the index hospitalization were identified in the Nationwide Readmissions Database. We analyzed the incidence, predictors, causes, and costs of 30-day readmissions. Of 2510 LVAD recipients, 788 (31%) were readmitted within 30 days. Length of index hospitalization ≥31 days (hazard ratio [HR], 1.26; 95% confidence interval [CI], 1.07–1.50) and female sex (HR, 1.19; 95% CI, 1.01–1.42) were associated with a higher risk of 30-day readmission, whereas private insurance (HR, 0.83; 95% CI, 0.70–0.99), pre-LVAD use of short-term mechanical circulatory support (HR, 0.53; 95% CI, 0.29–0.98), and discharge to a short-term hospital facility (HR, 0.41; CI, 0.21–0.78) were associated with a lower risk. Cardiac causes accounted for 23.8% of readmissions: heart failure (13.4%) and arrhythmias (8.1%). Noncardiovascular causes accounted for 76.2% of readmissions: infection (30.2%), bleeding (17.6%), and device-related causes (8.2%). Mean length of stay for readmission was 10.7 days (median, 6 days), and average hospital cost per readmission was $34 948±2457.

Conclusions:
Early readmissions are frequent after LVAD implantation even in contemporary times. Preimplant identification of high-risk patients, and a protocol-driven follow-up using a multidisciplinary approach will be needed to reduce readmissions and improve outcomes.