bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical risk factors for acute ischaemic and haemorrhagic stroke in patients with infective endocarditis
Authors: Valenzuela Ives , Hunter Madeleine D. , Sundheim Kathryn , Klein Bradley , Dunn Lauren , Sorabella Robert , Han Sang M. , Willey Joshua , George Isaac , Gutierrez Jose 
Published: May 2018

AbstractBackgroundStroke as a complication of infective endocarditis portends a poor prognosis, yet risk factors for stroke subtypes have not been well defined.AimTo identify risk factors associated with ischaemic and haemorrhagic strokes.MethodsA retrospective patient chart review was performed at a single US academic centre to identify risk factors and imaging for patients who were 18 years or older with infectious endocarditis (IE) and stroke diagnoses. Differences in patient characteristics by stroke status were assessed using univariate analysis, χ2 or student’s t‐test as well as logistic regression models for multivariable analyses and correlation matrices to identify possible collinearity between variables and to obtain odds ratios (OR) and their 95% confidence intervals.ResultsA final sample of 1157 participants was used for this analysis. The total number of non‐surgical strokes was 178, with a prevalence of 15.4% (78% ischaemic, 10% parenchymal haemorrhages, 8% subarachnoid haemorrhages and 4% mixed ischaemic/haemorrhagic). Multivariate risk factors for ischaemic stroke included prior stroke (OR 2.0, 1.3–3.1), Staphylococcus infection (OR 2.0, 1.3–3.0), mitral vegetations (OR 2.2, 1.4–3.3) and valvular abscess (OR 2.7, 1.7–4.3). Risk factors for haemorrhagic stroke included fungal infection (OR 6.4, 1.2–34.0), male gender (OR 3.5, 1.4–8.3) and rheumatic heart disease (OR 3.3, 1.1–10.4).ConclusionAmong patients with IE, there exist characteristics that relate differentially to ischaemic and haemorrhagic stroke risk.
Long‐term renal outcomes in multi‐ethnic Southeast Asians with lupus nephritis: a retrospective cohort study
Authors: Lim Cynthia C. , Tan Hui Z. , Hao Ying , Chin Yok M. , Woo Keng T. , Chan Choong M. , Choo Jason C. J. 
Published: May 2018

AbstractBackgroundRenal involvement is common among Asians with systemic lupus erythematosus and long‐term renal outcomes have been described in homogeneous Caucasian and East Asian populations with lupus nephritis, but data are scarce for other ethnicities.AimTo evaluate the incidence and risk factors for progressive chronic kidney disease (CKD) in multi‐ethnic Southeast Asians with lupus nephritis.MethodsThis is a single‐centre retrospective cohort study of adults with biopsy‐proven lupus nephritis diagnosed between May 2001 and May 2009. Demographic and clinical data were retrieved from electronic medical records. Patients were excluded if baseline comorbid, renal function or pharmacotherapy data were incomplete or if they default follow‐up within 3 months from time of diagnosis. Primary outcome was progressive CKD, defined by end‐stage renal disease or persistent doubling of serum creatinine or reduction in eGFR ≥50% for ≥3 months from baseline.ResultsWe studied 113 patients with newly diagnosed biopsy‐proven lupus nephritis. Median age was 42 (interquartile range 29–52) years; the majority were Chinese (76%; Malay 13% and others 11%) and female (81%). Two‐thirds had International Society of Nephrology and Renal Pathology Society Class III or IV nephritis; serum creatinine was 86 (67–125) μmol/L with heavy proteinuria (6.3 (2.5–12.2) g/g creatinine). Median follow‐up was 110 (83–142) months. Remission (partial and complete) occurred in 96% at 3.1 (1.6–5.2) months after diagnosis. Among patients who achieved remission, 56% had disease relapse at 19.0 (6.0–40.2) months after remission. Patients with progressive CKD (n = 13, 11%) had lower baseline CKD Epidemiology Collaboration estimated glomerular filtration rate (37.3 (16.5–82.0) vs 79.4 (57.5–101.0) mL/min/1.73 m2, P = 0.03) and higher chronicity index (5 (3–6) vs 3 (2–3), P = 0.04) than those who did not. Remission, early remission within 6 months, complete remission and non‐relapse were less frequently associated with progressive CKD (P < 0.01).ConclusionMulti‐ethnic Southeast Asians with biopsy‐proven lupus nephritis had high remission rates and low incidence of progressive CKD. Progressive CKD was associated with poorer baseline renal function, higher histological chronicity index, failure to achieve remission and occurrence of relapse.
New‐onset diabetes mellitus among patients with glomerular diseases
Authors: Lim Cynthia C. , Wong Maggie W. Y. , Koh Hui L. , Chin Yok M. , Mok Irene Y. J. , Choo Jason C. J. 
Published: May 2018

AbstractBackgroundGlomerulonephritis commonly causes kidney failure. Immunosuppressant treatment may be diabetogenic, but data on hyperglycaemia in glomerulonephritis treated with usual clinical care are scant.AimTo assess the epidemiology, risk factors and outcomes for new‐onset diabetes among patients with glomerular disease (NODAG).MethodsA single‐centre retrospective cohort of nondiabetic adults diagnosed with glomerulonephritis between January 2011 and July 2015. Clinical, laboratory and pharmacotherapy data were retrieved from electronic medical records. Using modified American Diabetes Association criteria, the primary outcome of NODAG was present if fasting venous glucose was ≥7 mmol/L for at least two readings, HbA1c was ≥6.5% or if patient required antidiabetic medications. Secondary outcomes were end‐stage renal disease, cardiovascular disease and death.ResultsNODAG occurred in 48 patients (10.7%); 22 required antidiabetic medication at median 6.2 (interquartile range 1.7, 20.0) months after glomerulonephritis diagnosis. Patients with NODAG had higher prebiopsy fasting glucose, greater proteinuria and lower fasting high‐density lipoprotein cholesterol levels. Methylprednisolone and cyclophosphamide were more commonly used among patients with NODAG. In multivariate logistic regression, greater proteinuria (odds ratio 1.08 (95% confidence interval 1.01, 1.16), P = 0.02) and methylprednisolone use (odds ratio 4.02 (95% confidence interval 1.76, 9.18), P = 0.001) were significantly associated with NODAG, independent of the triglyceride/high‐density lipoprotein cholesterol ratio as a surrogate measure of insulin resistance. Median follow up was 39.6 (26.9, 57.2) months. Secondary outcomes were not significantly different in patients with and without NODAG.ConclusionProteinuria and methylprednisolone were associated with incident diabetes among patients with glomerular disease treated with usual care. At‐risk patients should be appropriately counselled and monitored for hyperglycaemia.
‘Walking the tightrope’: The role of peer support workers in facilitating consumers’ participation in decision‐making
Authors: Cleary Michelle , Raeburn Toby , Escott Phil , West Sancia , Lopez Violeta 
Published: May 2018

AbstractIn adult mental health services, the participation of consumers is essential. The aim of this study was to explore the challenges faced by peer support workers when involving mental health consumers in decision‐making about their care and the strategies they employed to overcome these challenges so as to improve mental health consumers’ participation in decision‐making and recovery. Semi‐structured individual interviews were conducted with six peer support workers currently employed in psychiatric hospitals and/or community mental health systems. Thematic analysis identified challenges related to role definition, power imbalance, doctor‐centric medical approaches to care, and lack of resources. Strategies to overcome these challenges that were reported, included the following: facilitating meaningful involvement for service users, appropriate use of the lived experience, building relationships and communication, promoting rights and advocacy, and promoting professionalism of peer support workers (PSWs). Nursing staff need ongoing support and education to understand and value the varied roles of PSWs and thereby empower PSWs to engage in enhancing consumer decision‐making. The roles of the PSWs should be viewed as complementary, and greater appreciation and understanding of roles would better support recovery‐oriented care.
The rocky road to universal health coverage in Egypt: A political economy of health insurance reform from 2005–15
Authors: Ismail Sharif A. 
Published: May 2018

AbstractProcesses of public policy formation and implementation in the Middle East and North Africa are underexplored. This article presents a case study in public policy reform, focusing on efforts to expand health insurance coverage in Egypt. The account draws on a thematic analysis of peer and non‐peer reviewed literature and print media between 2005 and 2015, with a particular focus on the period to 2011. This analysis shows that reform initiatives failed for much of this period because of fundamental disagreements between key actors over the goals, proposals and the political process for change. The success of planned reforms in Egypt may well depend on the extent to which account is taken of the varied agendas and evolving power relations of these actors, especially given the profound political, social and economic challenges the Egyptian health system now faces.
Spatial and environmental factors predict skull variation and genetic structure in the cosmopolitan bat Tadarida brasiliensis
Authors: Morales Ariadna E. , De‐la‐Mora Marisol , Piñero Daniel 
Published: May 2018

AbstractAimTo assess if geographical and/or environmental factors are driving skull morphology and genetic structure in the cosmopolitan bat species, Tadarida brasiliensis.LocationNorth, Central and South America, Greater and Lesser Antilles.MethodsWe analysed morphometric, genetic and environmental data from the entire distribution of T. brasiliensis. Individuals were genotyped at nine nuclear loci, and clustering analyses were used to detect genetic groups and test correlations between genetic, geographical, and environmental distances. Museum specimens were photographed and 111 two‐dimensional landmarks were digitized per individual. Multivariate analyses were applied to explore whether factors such as sex, genetic group, subspecies, biogeographical regions, latitude, longitude and/or environment contribute to the morphometric variation of this species. We also applied a novel approach based on trend surface analyses and model selection to compare models of spatial and environmental dependence and to predict size, shape, and allometry‐free variation across the Americas.ResultsGenetic and morphometric differences among populations coincide with major biogeographical and climatic breaks in Nearctic, Neotropical and Antillean regions. Trend surface analyses showed that skull size variation can be explained by spatial factors (latitude and longitude), whereas skull shape can be explained by the interaction of spatial and environmental factors. However, allometry‐free shape variation might respond to complex interactions not captured by our models.Main conclusionOur explicit testing of spatial and environmental dependence using geostatistical model selection approaches allowed us to identify extrinsic factors that shape genetic and phenotypic responses in a cosmopolitan bat species. Our findings suggest that skull size is primarily driven by geographical factors (genetic drift), whereas shape variation is driven by adaptive responses to environmental conditions.
Seeking reproducibility: Assessing a multimodal study of the testing effect
Authors: Beardsley M. , Hernández‐Leo D. , Ramirez‐Melendez R. 
Published: May 2018

AbstractLow‐cost devices have widened the use of multimodal data in experiments providing a more complete picture of behavioural effects. However, the accurate collection and combination of multimodal and behavioural data in a manner that enables reproducibility is challenging and often requires researchers to refine their approaches. This paper presents a direct replication of a multimodal wordlist experiment. Specifically, we use a low‐cost Emotiv EPOC® to acquire electrophysiological measures of brain activity to investigate whether retrieval during learning facilitates the encoding of subsequent learning as measured by performance on recall tests and reflected by changes in alpha wave oscillations. Behavioural results of the wordlist experiment were replicated, but physiological results were not. We conclude the paper by highlighting the challenges faced in terms of replicating the previous work and in attempting to facilitate the reproducibility of our own experiment.
The moderating effects of intrinsic load on the relationship between self‐regulated effort and germane load
Authors: Lange C. , Costley J. 
Published: May 2018

AbstractHighly interactive and complex content within e‐learning induces high levels of intrinsic load. Self‐regulated effort represents one strategy that may help learners overcome such issues within e‐learning. Using intrinsic load items representative of content complexity, germane load items representative of learning, and self‐regulated effort items representative of effort, this study analysed survey responses from a group of university students (n = 1,471) who participated in e‐learning courses in South Korea. The results showed that intrinsic load had a negative relationship with germane load, self‐regulated effort had a positive relationship with germane load, and intrinsic load positively moderated the relationship between self‐regulated effort and germane load. These results add to what current research states about the ability to overcome the processing of complicated content through higher levels of student effort.
Profiling sympathetic arousal in a physics course: How active are students?
Authors: Pijeira-Díaz H.J. , Drachsler H. , Kirschner P.A. , Järvelä S. 
Published: May 2018

AbstractLow arousal states (especially boredom) have been shown to be more deleterious to learning than high arousal states, though the latter have received much more attention (e.g., test anxiety, confusion, and frustration). Aiming at profiling arousal in the classroom (how active students are) and examining how activation levels relate to achievement, we studied sympathetic arousal during two runs of an elective advanced physics course in a real classroom setting, including the course exam. Participants were high school students (N = 24) who were randomly selected from the course population. Arousal was indexed from electrodermal activity, measured unobtrusively via the Empatica E4 wristband. Low arousal was the level with the highest incidence (60% of the lesson on average) and longest persistence, lasting on average three times longer than medium arousal and two times longer than high arousal level occurrences. During the course exam, arousal was positively and highly correlated (r = .66) with achievement as measured by the students' grades. Implications for a need to focus more on addressing low arousal states in learning are discussed, together with potential applications for biofeedback, teacher intervention, and instructional design.
Glycaemic status affects the subgingival microbiome of diabetic patients
Authors: Longo Priscila L. , Dabdoub Shareef , Kumar Purnima , Artese Hilana P. C. , Dib Sergio A. , Romito Giuseppe A. , Mayer Marcia Pinto Alves 
Published: May 2018

AbstractAimPeriodontitis is correlated with type 2 diabetes mellitus (T2DM), but little is known about glycaemic status effect on subgingival microbiota associated with periodontitis. This study evaluated if periodontal microbiome of T2DM patients is affected by glycaemic status.Materials and methodsTwenty‐one T2DM non‐smoking patients with chronic periodontitis and body mass index ≤40 kg/m2 were allocated into two groups according to systemic glycaemic status: inadequate (DMI‐ HbA1c ≥ 8%) and adequate (DMA‐ HbA1c <7.8%). Subgingival biofilm was collected from sites with moderate (PD = 4–6 mm) and severe disease (PD ≥ 7 mm) in two quadrants. The V5–V6 hypervariable region of the 16SrRNA was sequenced using the GS‐FLX‐454 Titanium platform. Sequences were compared with HOMD database using QIIME and PhyloToAST pipelines. Statistical comparisons were made using two‐sample t‐tests.ResultsDMA microbiome presented higher diversity than DMI. Inadequate glycaemic control favoured fermenting species, especially those associated with propionate/succinate production, whereas those forming butyrate/pyruvate was decreased in DMI. Higher abundances of anginosus group and Streptococcus agalactiae in DMI may indicate that subgingival sites can be reservoir of potentially invasive pathogens. Altered subgingival microbiome in DMI may represent an additional challenge in the periodontal treatment of these patients and in the prevention of more invasive infections.ConclusionGlycaemic status in T2DM patients seems to modulate subgingival biofilm composition.
Cumulative childhood risk is associated with a new measure of chronic inflammation in adulthood
Authors: Rasmussen Line Jee Hartmann , Moffitt Terrie E. , Eugen‐Olsen Jesper , Belsky Daniel W. , Danese Andrea , Harrington HonaLee , Houts Renate M. , Poulton Richie , Sugden Karen , Williams Benjamin , Caspi Avshalom 
Published: May 2018

BackgroundChildhood risk factors are associated with elevated inflammatory biomarkers in adulthood, but it is unknown whether these risk factors are associated with increased adult levels of the chronic inflammation marker soluble urokinase plasminogen activator receptor (suPAR). We aimed to test the hypothesis that childhood exposure to risk factors for adult disease is associated with elevated suPAR in adulthood and to compare suPAR with the oft‐reported inflammatory biomarker C‐reactive protein (CRP).MethodsProspective study of a population‐representative 1972–1973 birth cohort; the Dunedin Multidisciplinary Health and Development Study observed participants to age 38 years. Main childhood predictors were poor health, socioeconomic disadvantage, adverse childhood experiences (ACEs), low IQ, and poor self‐control. Main adult outcomes were adulthood inflammation measured as suPAR and high‐sensitivity CRP (hsCRP).ResultsParticipants with available plasma samples at age 38 were included (N = 837, 50.5% male). suPAR (mean 2.40 ng/ml; SD 0.91) was positively correlated with hsCRP (r 0.15, p < .001). After controlling for sex, body mass index (BMI), and smoking, children who experienced more ACEs, lower IQ, or had poorer self‐control showed elevated adult suPAR. When the five childhood risks were aggregated into a Cumulative Childhood Risk index, and controlling for sex, BMI, and smoking, Cumulative Childhood Risk was associated with higher suPAR (b 0.10; SE 0.03; p = .002). Cumulative Childhood Risk predicted elevated suPAR, after controlling for hsCRP (b 0.18; SE 0.03; p < .001).ConclusionsExposure to more childhood risk factors was associated with higher suPAR levels, independent of CRP. suPAR is a useful addition to studies connecting childhood risk to adult inflammatory burden.
Effect of oak (Quercus persica) acorn level on apparent digestibility, ruminal fermentation, nitrogen balance and urinary purine derivatives in pregnant goats
Authors: Jafari H. , Fatahnia F. , Khatibjoo A. , Taasoli G. , Fazaeli H. , Varmaghany S. 
Published: May 2018

SummaryThe aim of this experiment was to investigate the effect of dietary oak (Quercus persica) acorn (OA) level on dry matter intake (DMI), apparent nutrient digestibility, nitrogen (N) utilization, ruminal fermentation, protozoa population and urinary purine derivatives (PD) during the last 60 days of goat pregnancy. Twenty‐four multiparous pregnant goats (41.7 ± 2.3 kg BW) were assigned to one of three experimental diets consisted of control diet (C, without OA) and diets containing 20 (OA20) or 40 g/100 g of OA (OA40) on a DM basis in a completely randomized block design. Goats fed OA40 had lower DMI (p < .01), DM (p < .01), OM (p < .01) and NDF (p < .05) digestibility, ruminal NH3‐N concentration (p < .01), N intake (p < .01) and N retention (p < .01). Crude protein digestibility and ruminal acetate and total volatile fatty acid (VFA) concentration were lower in animals fed OA‐contained diets (p < .01), whereas ruminal propionate concentration was higher in goats fed the C diet (p < .01). Animals fed OA40 had higher faecal N excretion and lower urinary N excretion (p < .01). Urinary PD was lower in goats fed diets containing OA in relation to those fed the C diet (p < .01). Total protozoa population decreased linearly with increasing OA level in the diet (p < .05). These results suggest that feeding OA, especially high level, has negative impacts on DMI, nutrient digestibility, VFA concentration, N retention and urinary PD excretion that may have adverse effects on metabolism and performance of pregnant goats.
Intracellular free magnesium concentration in healthy horses
Authors: Winter J. C. , Sponder G. , Merle R. , Aschenbach J. R. , Gehlen H. 
Published: May 2018

SummaryEquine metabolic syndrome (EMS) is a worldwide disease in horses that parallels human diabetes mellitus type 2. In both diseases, patients show an altered peripheral insulin sensitivity as a key feature. In humans, multiple studies have demonstrated the beneficial effect of magnesium supplementation on insulin sensitivity. However, serum magnesium levels vary and are therefore not a reliable indicator of the patients’ magnesium status. Determining the intracellular free magnesium concentration appears to be a more sensitive diagnostic indicator. In this study, the free intracellular magnesium concentration was measured using mag‐fura 2 spectrophotometry in blood lymphocytes in 12 healthy, non‐obese horses at 9 a.m., 12 a.m. and 4 p.m. to establish reference ranges according to a protocol designed for human blood lymphocytes. Additionally, the serum magnesium concentration was measured. In all horses, the total serum magnesium concentration was within the reference range. The mean free magnesium concentration in blood lymphocytes of all horses was 0.291 ± 0.067 mmol/L with no significant difference between the time points. The reference range for the free intracellular magnesium concentration in equine lymphocytes was set at 0.16–0.42 mmol/L. The established values are slightly lower than those in healthy humans. The designed protocol for the measurement of the intracellular free magnesium concentration might be an excellent research tool to assess the cellular magnesium status and to reliably diagnose an altered magnesium homeostasis in EMS. Further studies shall elucidate possible alterations in cellular magnesium status in horses with EMS.