bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can delirium research activity impact on routine delirium recognition? A prospective cohort study
Authors: Welch Carly , Jackson Thomas A 
Published: November 2018

ObjectiveTo assess if ongoing delirium research activity within an acute admissions unit impacts on prevalent delirium recognition.DesignProspective cohort study.SettingSingle-site tertiary university teaching hospital.Participants125 patients with delirium, as diagnosed by an expert using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition reference criteria, were recruited to a prospective cohort study investigating use of informant tools to detect unrecognised dementia. This study evaluated recognition of delirium and documentation of delirium by medical staff.InterventionsThe main study followed an observational design; the intervention discussed was the implementation of this study itself.Primary and secondary outcome measuresThe primary outcome was recognition of delirium by the admitting medical team prior to study diagnosis. Secondary outcomes included recording of or description of delirium in discharge summaries, and factors which may be associated with unrecognised delirium.ResultsDelirium recognition improved between the first half (48%) and second half (71%) of recruitment (p=0.01). There was no difference in recording of delirium or description of delirium in the text of discharge summaries.ConclusionDelirium research activity can improve recognition of delirium. This has the potential to improve patient outcomes.
Distribution of nephrologists and regional variation in the clinical severity of IgA nephropathy at biopsy diagnosis in Japan: a cross-sectional study
Authors: Okabayashi Yusuke , Tsuboi Nobuo , Amano Hoichi , Miyazaki Yoichi , Kawamura Tetsuya , Ogura Makoto , Narita Ichiei , Ninomiya Toshiharu , Yokoyama Hitoshi , Yokoo Takashi 
Published: November 2018

ObjectivesThe clinical severity of IgA nephropathy (IgAN) at the time of biopsy diagnosis differs significantly among cases. One possible determinant of any such difference is the time taken for referral from the primary care physician to a nephrologist, but the definitive cause remains unclear. This study examined the contribution of the number of nephrologists per regional population as a potential social factor influencing the clinical severity at diagnosis among patients with IgAN in Japan, which has an ethnically homogeneous population.DesignA cross-sectional study.Setting and participantsPatients were registered in the Japan Renal Biopsy Registry (J-RBR), a nationwide multicentre registry, and 6426 patients diagnosed with IgAN were analysed. The facilities registered to the J-RBR were divided into 10 regions and the clinical features of IgAN at biopsy diagnosis, including renal function and level of proteinuria, were examined.Main outcome measuresRenal prognosis risk at the time of biopsy diagnosis defined by Kidney Disease Improving Global Outcomes guideline 2012.ResultsAmong the regions, there were significant differences in the estimated glomerular filtration rate (67.5–91.4 mL/min/1.73 m2), urinary protein excretion rate (0.93–1.93 g/day) and renal prognosis risk group distribution at diagnosis. The severity of all clinical parameters was inversely correlated with the number of nephrologists per regional population, which showed an up to 2.7-fold difference among regions. A generalised linear mixed model revealed that a low number of nephrologists per regional population were significantly associated with fulfilment of clinical criteria indicating a very-high-risk renal prognosis (β=−0.484, 95% CI −0.959 to −0.010).ConclusionsAmong Japanese patients with IgAN, significant regional differences were detected in clinical severity at the time of diagnosis. Social factors, such as an uneven distribution of nephrologists across regions, may influence the timing of biopsy and determine such differences.
Ethnic Minority Health in Ireland—Co-creating knowledge (EMH-IC): a participatory health research protocol
Authors: Hannigan Ailish , Basogomba Alphonse , LeMaster Joseph , Nurse Diane , O’Reilly Fiona , Roura Maria , Villarroel Nazmy , MacFarlane Anne 
Published: November 2018

IntroductionInternational policy recommends continuous, cost-effective monitoring of health data to enable health services to identify and respond to health inequities as experienced by different ethnic groups. However, there is a lack of routinely collected ethnicity data, particularly in primary care, and very little implementation research internationally to understand how ethnic identifiers are introduced, embedded and used in healthcare settings. This paper describes a protocol for a novel participatory health research project with the objective of building the evidence base on ethnic minority health in Ireland. Findings on the participatory appraisal of ethnic identifiers as an intervention to generate useful data about minority and majority ethnic groups will have relevance in other settings and countries.Methods and analysisThis multidisciplinary project is designed as a participatory health research study where all stakeholders, including ethnic minority communities, participate in co-design of the research protocol, project governance, collaborative data interpretation and disseminating findings. A national catalogue of all routinely collected health data repositories will be electronically searched for any repositories that contain information on ethnicity. A secondary quantitative analysis of a population-representative cohort study, Growing Up in Ireland, will be carried out to compare the health of ethnic minority and majority groups. A qualitative case study informed by normalisation process theory will be carried out at three primary care sites to monitor the implementation of an ethnic identifier and identify barriers and levers to implementation.Ethics and disseminationEthical approval for the qualitative case study has been granted by the Irish Council for General Practitioners (06/09/17). Permission to access data from Growing Up in Ireland has been granted by the Director General of the Central Statistics Office. Dissemination will be carried out at community events and academic conferences, in peer-reviewed journal publications, and through academic and healthcare provider networks.
Expanding the phenotype of COPA syndrome: a kindred with typical and atypical features
Authors: Taveira-DaSilva Angelo M , Markello Thomas C , Kleiner David E , Jones Amanda M , Groden Catherine , Macnamara Ellen , Yokoyama Tadafumi , Gahl William A , Gochuico Bernadette R , Moss Joel 
Published: November 2018

BackgroundCopa syndrome is a rare autosomal dominant disorder with abnormal intracellular vesicle trafficking. The objective of this work is to expand the knowledge about this disorder by delineating phenotypic features of an unreported COPA family.Methods and resultsA heterozygous missense variant (c.698 G>A, p.Arg233His) inCOPAwas identified in four members of a three-generation kindred with lung, autoimmune and malignant disease of unknown aetiology. Ages of onset were 56, 26, 16 and 1 year, with earlier age of onset in successive generations. Presenting symptoms were cough and dyspnoea. Findings included small lung cysts, follicular bronchiolitis, interstitial lung disease, neuroendocrine cell hyperplasia, rheumatoid arthritis, avascular necrosis and select abnormal autoimmune serologies. Neither alveolar haemorrhage nor glomerular disease were present. Features not previously associated with Copa syndrome included neuromyelitis optica, pulmonary carcinoid tumour, clear cell renal carcinoma, renal cysts, hepatic cysts, nephrolithiasis, pyelonephritis and meningitis. Longitudinal evaluations demonstrated slow progression of lung disease and extrapulmonary cysts.ConclusionsWorsening severity with successive generations may be observed in Copa syndrome. Extrapulmonary cysts, malignancies, autoimmune neurological disorders and infections are clinical features that may be associated with Copa syndrome. Further studies are indicated to fully define the phenotypic spectrum of this disorder.
Point-of-sale marketing of little cigars and cigarillos on and near California Tribal lands
Authors: Smiley Sabrina L , Soto Claradina , Cruz Tess Boley , Kintz Natalie , Rodriguez Yaneth L , Sussman Steve , Baezconde-Garbanati Lourdes 
Published: November 2018

IntroductionAmerican Indians have the highest cigarette smoking prevalence of any racial/ethnic group in the USA. Tobacco marketing at point-of-sale is associated with smoking, possibly due to easy access to cheap tobacco products. The sale of novel tobacco products like little cigars/cigarillos (LCCs) has increased in recent years which may further increase combustible tobacco use among American Indians.MethodsBetween October 2015 and February 2017, trained community health workers collected LCC product and price information by conducting audits of tobacco retailers on Tribal lands (n=53) and retailers within a 1-mile radius of Tribal lands (n=43) in California. Χ2analyses were performed to examine associations among the availability and advertising of LCCs, including indoor price promotions and store location.ResultsOverall, 85.4% of stores sold LCCs, 76.0% sold flavoured LCCs and 51.0% sold LCCs for less than $1. Indoor price promotions were displayed at 45 (46.9%) stores. Stores within a 1-mile radius of Tribal lands sold significantly more LCC (p<0.01) and flavoured LCCs (p=0.01) than stores on Tribal lands. Stores within a 1-mile radius of Tribal lands also displayed significantly more LCCs priced at less than $1 (p<0.01) than stores on Tribal lands.ConclusionsLCCs are widely available in stores on and near California Tribal lands. Stores located a short distance away from Tribal lands were more likely to sell LCCs, including flavoured versions, more likely to sell LCCs priced below $1, and more likely to advertise little LCC price promotions than stores on Tribal lands. Policy-makers and Tribal leaders should consider regulations that would limit access to LCCs at point of sale to help prevent youth initiation and reduce smoking-related morbidity and mortality among American Indians.
"This is why we play"
Authors: Zhang Jason Shuo , Tan Chenhao , Lv Qin 
Published: November 2018

Professional sports constitute an important part of people's modern life. People spend substantial amounts of time and money supporting their favorite players and teams, and sometimes even riot after games. However, how team performance affects fan behavior remains understudied at a large scale. As almost every notable professional team has its own online fan community, these communities provide great opportunities for investigating this research question. In this work, we provide the first large-scale characterization of online fan communities of professional sports teams.
Since user behavior in these online fan communities is inherently connected to game events and team performance, we construct a unique dataset that combines 1.5M posts and 43M comments in NBA-related communities on Reddit with statistics that document team performance in the NBA. We analyze the impact of team performance on fan behavior both at the game level and the season level. First, we study how team performance in a game relates to user activity during that game. We find that surprise plays an important role: the fans of the top teams are more active when their teams lose and so are the fans of the bottom teams in an unexpected win. Second, we study fan behavior over consecutive seasons and show that strong team performance is associated with fans of low loyalty, likely due to "bandwagon fans." Fans of the bottom teams tend to discuss their team's future such as young talents in the roster, which may help them stay optimistic during adversity. Our results not only contribute to understanding the interplay between online sports communities and offline context but also provide significant insights into sports management.
Acute administration of IL-6 improves indices of hepatic glucose and insulin homeostasis in lean and obese mice
Authors: Peppler Willem T. , Townsend Logan K. , Meers Grace M. , Panasevich Matthew R. , MacPherson Rebecca E. K. , Rector R. Scott , Wright David C. 
Published: November 2018

Obesity can lead to impairments in hepatic glucose and insulin homeostasis, and although exercise is an effective treatment, the molecular targets remain incompletely understood. As IL-6 is an exercise-inducible cytokine, we aimed to identify whether IL-6 itself influences hepatic glucose and insulin homeostasis and whether this response differs during obesity. In vivo, male mice were fed a low-fat diet (LFD; 10% kcal) or a high-fat diet (HFD; 60% kcal) for 7 wk, which induced obesity and hepatic lipid accumulation. LFD- and HFD-fed mice were injected with IL-6 (400 ng, 75 min) or PBS and then with insulin (1 U/kg; ~15 min) or saline, at which point livers were collected. In both LFD- and HFD-fed mice, IL-6 decreased blood glucose and mRNA expression of gluconeogenic genes alongside increased phosphorylation of AKT in comparison to PBS controls, and this occurred without changes in circulating insulin. To determine whether this effect of IL-6 was directly on the liver, we completed in vitro isolated primary hepatocyte experiments from chow-fed mice and cultured with or without exposure to free fatty acid (250 μm palmitate and 250 μm oleate, 24 h) to induce lipid accumulation. In both control and free fatty acid-treated hepatocytes, IL-6 (20 ng/ml, 75 min) slightly attenuated insulin-stimulated (10 nM; ~15 min) AKT phosphorylation. Together, these data suggest that IL-6 may lead to improvements in indices of hepatic glucose and insulin homeostasis in vivo; however, this is likely due to an indirect effect on the hepatocyte. NEW & NOTEWORTHY In this study, we used lean and obese mice and found that a single injection of IL-6 improved glucose tolerance, decreased hepatic gluconeogenic gene expression, and increased hepatic phosphorylation of AKT. In primary hepatocytes cultured under control and lipid-laden conditions, IL-6 had a mild, but deleterious, effect on phosphorylation of AKT. Our results show that the beneficial effects of IL-6 on glucose and insulin homeostasis, in vivo, are maintained in obesity.
Evidence of sex differences in the acute impact of oscillatory shear stress on endothelial function
Authors: Tremblay Joshua C. , Stimpson Taylor V. , Pyke Kyra E. 
Published: November 2018

Acutely imposed oscillatory shear stress (OSS) reduces reactive hyperemia flow-mediated dilation (RH-FMD) in conduit arteries of men; however, whether a similar impairment occurs in women or with FMD in response to a controlled, sustained shear stress stimulus (SS-FMD) is unknown. The purpose of this study was to determine the impact of OSS on RH-FMD and SS-FMD in men and women. OSS was provoked in the brachial artery using a 30-min forearm cuff inflation (70 mmHg). Healthy men [ n = 16, 25 yr (SD 3)] and women [ n = 16, 21 yr (SD 2)] completed the OSS intervention twice (separate days). Brachial artery endothelial function was assessed pre- and postintervention via either RH-FMD or 6 min of handgrip SS-FMD using Duplex ultrasound. The RH-FMD stimulus was calculated as shear rate area under the curve 60 s postdeflation (SRAUC60), whereas SS-FMD shear rate was targeted to produce a similar stimulus pre- and postintervention. The OSS intervention decreased RH-FMD in both sexes [men: 6.2% (SD 3.4) to 5.2% (SD 3.0); women: 5.4% (SD 2.0) to 3.1% (SD 1.8), P < 0.001), although this was accompanied by a reduced SRAUC60. There was no significant effect of the intervention on RH-FMD with SRAUC60 as a covariate ( P = 0.310). Handgrip exercise elicited a similar stimulus before and after the intervention ( P = 0.287) in men and women ( P = 0.873). Men demonstrated blunted SS-FMD [4.8% (SD 1.9) to 3.2% (SD 1.9), P < 0.001], whereas women displayed preserved SS-FMD following the intervention [3.5% (SD 1.9) to 4.0% (SD 1.9), P = 0.061]. The lower SS-FMD in men but not women following OSS provides evidence of sex differences in the effects of OSS on conduit artery endothelial function. NEW & NOTEWORTHY Acute exposure to oscillatory shear stress induces transient endothelial dysfunction in men; however, whether women experience similar impairments is unknown. Following acutely imposed oscillatory shear stress, there was a decrease in flow-mediated dilation stimulated by a physiologically relevant sustained increase in shear stress in men but not in premenopausal women. These findings demonstrate, for the first time in humans that there are sex differences in the impact of oscillatory shear stress on endothelial function.
Increased Risk for Cardiovascular Events in Patients with Diabetic Kidney Disease and Non-Alcoholic Fatty Liver Disease
Authors: Chinnadurai Rajkumar , Chrysochou Constantina , Kalra Philip A. 
Published: November 2018

<b><i>Background/Aims:</i></b> Non-alcoholic fatty liver disease (NAFLD) is recognised to be a strong risk factor for causing cardiovascular disease (CVD) and chronic kidney disease (CKD), independent of the presence of diabetes mellitus. The association of NAFLD with outcomes in patients with diabetic kidney disease (DKD) has been variably reported. This study aimed to investigate the association of NAFLD with cardiovascular, renal outcomes and mortality in patients with advanced DKD (CKD 3–5, not on dialysis). <b><i>Methods:</i></b> This observational study was carried out on 192 patients with DKD within a cohort of 2,974 non-dialysis CKD patients, who had an ultrasound (US) of their liver done between January 2000 and end of December 2014. From these 192 patients, 149 patients (NAFLD 48 and normal US 101) were included for comparative analysis, as they had complete datasets. Patient demographics, comorbidities and blood results were collected at study baseline. Follow-up data on non-fatal cardiovascular events (NFCVE), mortality and serial estimated glomerular filtration rate (eGFR) was gathered until study end point. Cox-regression analysis was used to study the association of NAFLD with NFCVE and mortality, and linear regression analysis was used for the estimation of renal progression. <b><i>Results:</i></b> Median follow-up time was 69 months, similar in both groups (<i>p</i> = 0.09). Median eGFR was 31.6 mL/min/1.73 m<sup>2</sup>, with a median urine protein creatinine ratio of 46 g/mol. A total of 20 (41.7%) NFCVE were recorded in the NAFLD group compared to 14 (13.9%) in the normal US group. Multivariable Cox-regression analysis showed NAFLD as an independent risk factor (hazard ratio 2.95; 95% CI 1.31–6.60; <i>p</i> = 0.01) for NFCVE even after including all cardiovascular risks parameters that were significant in the univariable model. There was no significant difference in survival between the 2 groups over the follow-up period (log-rank test, <i>p</i> = 0.76). The overall rate of decline in eGFR was 3.46 mL/min/1.73 m<sup>2</sup>/year and this was not observed to be different between the groups (<i>p</i> = 0.65). <b><i>Conclusion:</i></b> In our cohort of patients with advanced DKD, NAFLD showed a strong independent association with cardiovascular outcomes. Further prospective studies are warranted to strengthen these associations and plan a strategy for screening NAFLD in this high-risk group.
Неінвазивні методи діагностики в плануванні реконструктивних втручань на кінцівках складними комплексами тканин
Authors: Ponomarenko O. V. , Grigoryeva M. Yu. 
Published: November 2018

Мета роботи: дослідити ефективність методу ультразвукового дуплексного сканування в плануванні реконструктивних втручань при дефектах покривних тканин кінцівок складними комплексами тканин.
Матеріали і методи. У роботі проаналізовано дані про 50 хворих, яким у передопераційному періоді з метою вибору об’єму оперативного втручання виконували ультразвукове дуплексне сканування (УЗДС). До задач дослідження гемодинаміки кінцівки входило підтвердження прохідності судин та ступінь їх функціонування. Окрім того, УЗДС використовували для дослідження реґіонарної гемодинаміки у зоні ранового дефекту та у донорській ділянці майбутнього складного клаптя.
Результати досліджень та їх обговорення. В I групі (n = 15), хворим із надвеликою (понад 1 % площі) рановою поверхнею й пошкодженням м’яких тканин нижче глибокої фасції після детальної передопераційної підготовки та дослідження гемодинаміки ділянки пошкодження виконано 25 (20,2 %) відновних операцій ДПТ. II група (n = 13) складалася з постраждалих із ДПТ, які виникли разом або внаслідок пошкодження кістково – суглобового апарату – 42 (33,9 %) втручань. III група (n = 22), хворих із поєднаною чи множинною травмою, що супроводжувалася пошкодженням магістральних судин, нервів, частковим або повним відокремленням кінцівки. В цій групі виконано 57 (45,9 %) реконструкцій ДПТ.
Поєднані ушкодження нервових та сухожилково-м’язових структур на передпліччі, що супроводжуються їх значними дефектами: роль вимушеної транспозиції м’язів у відновленні основних функцій кисті
Authors: Tretyak I. B. , Gatskiy A. A. , Kovalenko I. V. , Tretyakova A. I. 
Published: November 2018

Мета роботи: оцінити ефективність “вимушених” транспозицій при ушкодженнях сухожилково-м’язових та нервових структур на відновлення основних захватів кисті.
Матеріали і методи. Проведено ретроспективний аналіз результатів реконструктивних втручань у 9 пацієнтів (6 чоловіків та 3 жінки) віком від 9 до 70 року (середній вік 36,4 року) із наслідками проксимальних поєднаних ушкоджень довгих нервів та сухожилково-м’язового апарату передньої поверхні передпліччя. Травма сухожилково-м’язового апарату була поєднана із ушкодженням в 4 випадках серединного нерва, в 4 випадках серединного та ліктьового нервів, в одному випадку – серединного нерва та поверхневої гілки променевого нерва. Термін, в який проводились реконструктивні втручання, складав у середньому 5 місяців (від 2 до 11 місяців) після травми. У 6 пацієнтів хірургічна реконструкція нервів полягала у виконанні автологічної пластики, у 2 пацієнтів – невролізу, в одного пацієнта – шва нерва. У 5 випадках “вимушена” транспозиція була виконана з метою відновлення незалежної функції довгого згинача 1 пальця, у 6 випадках – незалежної функції глибоких згиначів 2–3 пальців. Відновлення неврологічних функцій оцінювали за MRC Scale, класифікацією за Seddon, відновленням 4 захватів кисті, власною оцінкою відновлених функцій за Brief Michigan Hand Questionnaire.
Результати досліджень та їх обговорення. У всіх 4 пацієнтів із ушкодженням лише серединного нерва відновлення чутливості становило в середньому 3,75 за Seddon. У 4 пацієнтів із ушкодженням серединного та ліктьового нервів відновлення чутливості становило в середньому 3 та 2 за Seddon відповідно. Неефективне відновлення протиставлення першого пальця в 2 пацієнтів скореговано транспозицією за Bunnel. У 4 пацієнтів із ушкодженням серединного та ліктьового нервів ми спостерігали незадовільне відновлення “внутрішніх” м’язів кисті. У 5 пацієнтів «вимушені» транспозиції відновили незалежну функцію довгого згинача 1 пальця, у 6 пацієнтів – незалежну функцію глибоких згиначів 2–3 пальців. У 9 пацієнтів комплексна хірургічна реконструкція відновила функцію поперечного долонного, діагонального долонного та щипкового захватів. У 4 пацієнтів (44 %) не досягнуто відновлення ключового захвату, у зв’язку із незадовільним відновленням “внутрішніх” м’язів кисті (ліктьовий нерв). Середня власна оцінка функції кисті за MBHQ відповідала задовільній у 9 пацієнтів – 70,12 балів в середньому (від 43,75 до 89,6).