bluuebunny/crossref_metadata_2025_split huggingface dataset:
The composition and distribution of the legal profession, and the use of law in Britain and Ireland, c.1500-c.1850
Authors: Houston R.A. 
Published: June 2018

Summary
The geography of the legal profession and legal culture, and the possibility that there were major regional differences in the use of law and legal institutions across historic Europe have been little studied by historians. This article compares England and Wales with Scotland, whose private law was different, and Ireland, where English common law worked alongside indigenous law traditions. Lawyers can be divided between those who pleaded and those who prepared documents, but the nomenclature and professional development of ‘men of law’ differed considerably within the component parts of Britain and Ireland. The article brings out these differences and, in so doing, hopes to provide a framework for comparing the place of the legal profession and the use of law over space and time. It is in two parts. The first explores the changing numbers of different sorts of legal practitioner in England and Wales, Scotland, and Ireland: barristers, solicitors/attorneys, advocates, writers, and notaries. From an early date, England and Wales had many more lawyers per head of population than other parts of what became the United Kingdom of Great Britain and Ireland; the legal profession was dominated by attorneys, who far outnumbered barristers, whereas in Scotland and Ireland those who pleaded formed a significant proportion of all men of law. The second part seeks to explain this difference, by examining how different societies related to the formal practices of law and to alternative forms of dispute resolution. The component parts of the British Isles had distinctive social structures, economic compositions, religious emphases, and cultural forms, which meant that the place of law and lawyers in their societies varied considerably. The argument is that, as well as having different legal institutions and professional structures, Scottish and Irish people used the law more selectively than their English (and perhaps also Welsh) equivalents.
Efficacy of discontinuing risedronate for patients with systemic lupus erythematosus: a prospective study
Authors: Ishida T , Yoshida S , Kimura Y , Fujiki Y , Kotani T , Takeuchi T , Makino S , Arawaka S 
Published: June 2018

Objective The objective of this study is to investigate the effectiveness of discontinuation of risedronate for patients with systemic lupus erythematosus (SLE) treated with glucocorticoid (GC). Methods The participants were patients with SLE treated with prednisolone (PSL) ≥ 2 mg/day and risedronate for at least three years. Lumbar spine and total hip bone mineral density (BMD) measurements were taken at baseline and 24 and 48 weeks after discontinuation of risedronate, and bone turnover markers were evaluated at baseline, 12, 24, 36, and 48 weeks. Results A total of 36 patients were enrolled, 25 of whom discontinued risedronate. The mean age was 46.8 ± 11.2 years, and 23 were female. The mean duration of GC treatment was 14.8 ± 11.4 years, the mean dose of PSL was 7.8 ± 3.9 mg/day, and the mean duration of risedronate was 5.8 ± 2.4 years. Seventeen patients showed decreased lumbar spine BMD at 48 weeks after discontinuation of risedronate, with a mean lumbar spine lumbar decrease of 1.42% ± 3.20% ( p = 0.034); 17 patients (71%) showed a decreased total hip BMD at 48 weeks after discontinuation of risedronate, with a mean total hip BMD decrease of 0.99% ± 2.10% ( p = 0.021). Serum tartrate-resistant acid phosphatase 5b (TRACP-5b) ≥ 309 mU/dl at baseline was a risk factor for decreased total hip BMD at 48 weeks compared with serum TRACP-5b < 309 mU/dl (56% vs 0%, p = 0.0098). One patient developed a clinical fracture of the lumbar spine at 20 weeks. Conclusions Discontinuation of risedronate treatment in patients with SLE who had received GC therapy led to decreases in lumbar spine and total hip BMD, particularly in patients with high baseline serum TRACP-5b levels.
Mesenchymal Stem Cell-Derived Extracellular Vesicles Improve the Renal Microvasculature in Metabolic Renovascular Disease in Swine
Authors: Eirin Alfonso , Zhu Xiang-Yang , Jonnada Sreela , Lerman Amir , van Wijnen Andre J. , Lerman Lilach O. 
Published: June 2018

Background: Extracellular vesicles (EVs) released from mesenchymal stem/stromal cells (MSCs) mediate their paracrine effect, but their efficacy to protect the microcirculation of the kidney is unknown. Using a novel swine model of unilateral renovascular disease (RVD) complicated by metabolic syndrome (MetS), we tested the hypothesis that EVs would attenuate renal microvascular loss. Methods: Four groups of pigs ( n = 7 each) were studied after 16 weeks of diet-induced MetS and RVD (MetS+RVD), MetS+RVD treated 4 weeks earlier with a single intra-renal delivery of EVs harvested from autologous adipose tissue-derived MSCs, and Lean and MetS Sham controls. Stenotic-kidney renal blood flow (RBF) and glomerular filtration rate (GFR) were measured in-vivo (fast CT), whereas EV characteristics, renal microvascular architecture (micro-CT), and injury pathways were studied ex-vivo. Results: mRNA sequencing and proteomic analysis revealed that EVs are packed with several pro-angiogenic genes and proteins, such as vascular endothelial growth factor. Labeled EVs were detected in the stenotic kidney 4 weeks after injection internalized by tubular and endothelial cells. EVs restored renal expression of angiogenic factors and improved cortical microvascular and peritubular capillary density. Renal apoptosis, oxidative stress, tubular injury, and fibrosis were also attenuated in EV-treated pigs. RBF and GFR decreased in MetS+RVD compared with MetS, but normalized in MetS+RVD+EVs. Conclusions: Intra-renal delivery of MSC-derived EVs bearing pro-angiogenic properties restored the renal microcirculation and in turn hemodynamics and function in chronic experimental MetS+RVD. Our study suggests a novel therapeutic potential for MSC-derived EVs in restoring renal hemodynamics in experimental MetS+RVD.
Nuclear factor kappa B regulated monocyte chemoattractant protein-1/chemokine CC motif receptor-2 expressing in spinal cord contributes to the maintenance of cancer-induced bone pain in rats
Authors: Wang Yungong , Ni Huadong , Li Hongbo , Deng Houshen , Xu Long S , Xu Shijie , Zhen Ying , Shen Hui , Pan Huan , Yao Ming 
Published: June 2018

Background: Chemokine, monocyte chemoattractant protein-1 (MCP-1), is a potential factor to cause cancer-induced bone pain (CIBP). NF-κB signaling is very important in mediating the expression of chemokines and may have a role in CIBP. However, the mechanism is still unclear. This study investigates the role of NF-κB in CIBP by regulating MCP-1/chemokine CC motif receptor-2 (CCR2) signaling pathway. Methods: A rat CIBP model was established by injecting Walker-256 cells into the tibia medullary cavity. Nine days later, animals were intrathecally administrated with MCP-1 neutralizing antibody, CCR2 antagonist (RS504393), or NF-кB inhibitor (BAY11–7081). Mechanical paw withdrawal threshold was used to assess pain behavior and sciatic functional index, and radiographic images were adopted to evaluate the damage of nerve and bone. The spinal cords were harvested for Western blot and quantitative reverse transcription polymerase chain reaction. The distribution of MCP-1, CCR2, and NF-кB was detected by double immunofluorescent staining. Results: CIBP caused remarkable bone destruction, injury of sciatic and femoral nerve, and persistent (>15 days) mechanical allodynia in rats. Tumor cell inoculation upregulate MCP-1 and NF-кB in activated neurons as well as CCR2 in neurons and microglia of the spinal cord. MCP-1 antibody, RS504393, and BAY11–7081 partially reversed CIBP-induced mechanical allodynia, and CIBP regulated the expression levels of pro-inflammatory cytokines, tumor necrosis factor-α and interferon-γ, and anti-inflammatory cytokine, interleukin 4, and BAY11–7081 lowered CIBP-induced MCP-1 and CCR2 expressions in a dose-dependent manner. Conclusion: In conclusion, NF-кB signaling pathway regulates the expressions of MCP-1/CCR2-induced inflammatory factors in the spinal cord of CIBP rats.
Baseline NIH Stroke Scale is an inferior predictor of functional outcome in the era of acute stroke intervention
Authors: Reznik Michael E , Yaghi Shadi , Jayaraman Mahesh V , McTaggart Ryan A , Hemendinger Morgan , Mac Grory Brian C , Burton Tina M , Cutting Shawna M , Siket Matthew S , Madsen Tracey E , Thompson Bradford B , Wendell Linda C , Mahta Ali , Potter N Stevenson , Furie Karen L 
Published: June 2018

Background and aims Baseline National Institutes of Health Stroke Scale (NIHSS) scores have frequently been used for prognostication after ischemic stroke. With the increasing utilization of acute stroke interventions, we aimed to determine whether baseline NIHSS scores are still able to reliably predict post-stroke functional outcome. Methods We retrospectively analyzed prospectively collected data from a high-volume tertiary-care center. We tested strength of association between NIHSS scores at baseline and 24 h with discharge NIHSS using Spearman correlation, and diagnostic accuracy of NIHSS scores in predicting favorable outcome at three months (defined as modified Rankin Scale 0–2) using receiver operating characteristic curve analysis with area under the curve. Results There were 1183 patients in our cohort, with median baseline NIHSS 8 (IQR 3–17), 24-h NIHSS 4 (IQR 1–11), and discharge NIHSS 2 (IQR 1–8). Correlation with discharge NIHSS was r = 0.60 for baseline NIHSS and r = 0.88 for 24-h NIHSS. Of all patients with follow-up data, 425/1037 (41%) had favorable functional outcome at three months. Receiver operating characteristic curve analysis for predicting favorable outcome showed area under the curve 0.698 (95% CI 0.664–0.732) for baseline NIHSS, 0.800 (95% CI 0.772–0.827) for 24-h NIHSS, and 0.819 (95% CI 0.793–0.845) for discharge NIHSS; 24 h and discharge NIHSS maintained robust predictive accuracy for patients receiving mechanical thrombectomy (AUC 0.846, 95% CI 0.798–0.895; AUC 0.873, 95% CI 0.832–0.914, respectively), while accuracy for baseline NIHSS decreased (AUC 0.635, 95% CI 0.566–0.704). Conclusion Baseline NIHSS scores are inferior to 24 h and discharge scores in predicting post-stroke functional outcomes, especially in patients receiving mechanical thrombectomy.
Infarct location is associated with quality of life after mild ischemic stroke
Authors: Lin Chen , Sangha Rajbeer , Lee Jungwha , Corado Carlos , Jalasutram Anvesh , Chatterjee Neil , Ingo Carson , Carroll Timothy , Prabhakaran Shyam 
Published: June 2018

Background In patients with mild ischemic stroke, small but eloquent infarcts may have devastating effects, particularly on health-related quality of life. Aim This study investigates the association between acute infarct location and three-month health-related quality of life in patients with mild ischemic stroke. Methods We evaluated consecutively enrolled patients from a single center between August 2012 and July 2013. Our primary outcome at three months was impairment in any health-related quality of life domain (upper extremity, lower extremity, executive function, and general concerns) defined by a T-score <45. We analyzed the association between acute infarct locations and impaired health-related quality of life at three months in univariate and multivariable analysis. Results Among 229 patients (mean age 64.9 years, 55% male, 29.7% black, and median initial NIHSS score 1), impaired health-related quality of life was noted in 84 (36.2%) patients at three months. In univariate analysis, patients with subcortical infarcts (56.0% vs. 39.3%, p = 0.02) and brainstem infarcts (21.4% vs. 10.3%, p = 0.02) were more likely to have impaired health-related quality of life. In multivariable analysis, patients with subcortical and/or brainstem infarcts had increased odds of impaired health-related quality of life (adjusted OR 2.54, 95% CI 1.29–5.01, p = 0.01). Conclusions After mild ischemic stroke, subcortical and brainstem infarct locations predict impairment in health-related quality of life.
Arthroscopically Repaired Bucket-Handle Meniscus Tears: Patient Demographics, Postoperative Outcomes, and a Comparison of Success and Failure Cases
Authors: Saltzman Bryan M. , Cotter Eric J. , Wang Kevin C. , Rice Richard , Manning Blaine T. , Yanke Adam B. , Forsythe Brian , Verma Nikhil N. , Cole Brian J. 
Published: June 2018

Objective To define patient demographics, preoperative, and intraoperative surgical variables associated with successful or failed repair of bucket-handle meniscal tears. Design All patients who underwent arthroscopic repair of a bucket-handle meniscus tear at a single institution between May 2011 and July 2016 with minimum 6-month follow-up were retrospectively identified. Patient demographic, preoperative (including imaging), and operative variables were collected and evaluated. A Kaplan-Meier curve was generated to demonstrate meniscus repair survivorship. Results In total, 75 patients (78 knees) with an average age of 26.53 ± 10.67 years met inclusion criteria. The average follow-up was 23.41 ± 16.43 months. Fifteen knees (19.2%) suffered re-tear of the repaired meniscus at an average 12.24 ± 9.50 months postoperatively. Survival analysis demonstrated 93.6% survival at 6 months, 84.6% survival at 1 year, 78.4% survival at 2 years, and 69.9% survival at 3 years. There was significant improvement from baseline to time of final follow-up in all patient-reported outcome ( P < 0.05) except Marx score ( P = 0.933) and SF-12 Mental Subscale ( P = 0.807). The absence of other knee pathology (including ligament tear, contralateral compartment meniscal tear, or cartilage lesions) noted intraoperatively was the only variable significantly associated with repair failure ( P = 0.024). Concurrent anterior cruciate ligament reconstruction (vs. no concurrent anterior cruciate ligament reconstruction) trended toward significance ( P = 0.059) as a factor associated with successful repair. Conclusions With the exception of the absence of other knee pathology (including ligament tear, contralateral compartment meniscal tear, or cartilage lesions) noted intraoperatively, no other variables were significantly associated with re-tear. The results are relatively durable with 84.6% survival at 1 year. Surgeons should attempt meniscal repair when presented with a bucket-handle tear.
Anti-inflammatory effect of wogonin on allergic responses in ovalbumin-induced allergic rhinitis in the mouse
Authors: Kim Kyeong Ah , Jung Joo Hyun , Choi Yun Sook , Kang Gyu , Kim Seon Tae 
Published: June 2018

Background Wogonin is commonly used for the treatment of allergic diseases. However, neither its precise effect in preventing allergic rhinitis (AR) nor its mechanism of action are known. Objectives In this study, the effect of wogonin on allergic responses in ovalbumin (OVA) induced AR was investigated in mice. Methods BALB/c mice were sensitized with intraperitoneal (i.p.) OVA and then challenged intranasally with OVA. Wogonin (10 and 30 mg/kg) was given to the treatment groups, and the effect of wogonin on the release of allergic inflammatory mediators, specifically OVA-specific immunoglobulin E (IgE) and inflammatory cytokines, was explored. Eosinophil infiltration and the levels of interleukin (IL) 5 and IL-13 were measured by immunohistochemistry. Results In mice with AR, wogonin decreased OVA-specific IgE levels in serum, and the levels of the cytokines IL-4, IL-5, IL-13, eotaxin, and RANTES in nasal lavage fluid. Serum levels of IL-4, IL-5, and IL-13 were lower in both groups of wogonin-pretreated mice than in the OVA group. A reduction in eosinophil infiltration of the nasal mucosa and inhibition of the expression of IL-5 and IL-13 were also noted in the treated groups. Conclusion Wogonin induced antiallergic effects in a murine model of AR by decreasing the infiltration of eosinophils and levels of T-helper type 2 cytokines. Thus, wogonin merits consideration as a therapeutic agent for treating AR.
Analysis of differential expression of protease-activated receptors in patients with allergic fungal rhinosinusitis
Authors: Sawhney Shikhar , Bansal Sandeep , Kalyan Madhur , Verma Indu , Singh Virk Ramandeep , Gupta Ashok Kumar 
Published: June 2018

Background Ever since its characterization in the 1970s, allergic fungal rhinosinusitis (AFRS) has been the subject of much controversy, especially regarding its pathogenesis. In this study, we analyzed the differential expression of genes that encode protease-activated receptors (PAR) in patients with AFRS and patients with chronic rhinosinusitis, and tried to understand the pathogenic basis of this disease. Objective To analyze the differential expression of PAR genes in patients with AFRS and in patients with chronic rhinosinusitis. Methods Mucosa from ethmoid sinuses of 51 patients (tests and controls) was biopsied and evaluated for messenger RNA expression of PAR genes by using reverse transcriptase–polymerase chain reaction. Each of the four PAR genes, i.e., par1, par2, par3 and par4 was amplified, the final gene products were run on 1.8% agarose gel and analyzed by densitometry to calculate differential expression. The significance level was determined as p ≤ 0.05. Results It was observed that the expressions of all four par genes were higher in the test samples compared with the controls, but statistical significance was achieved only for par1 (p=0.004) and par2 (p=0.05). Comparative expression of the four PAR genes was also performed within the test and control groups, and a statistically significant difference was seen between par1 and par2 (p=0.007), par1 and par3 (p=0.029), par1 and par4 (p=0.0001), par2 and par4 (p=0.002), and par3 and par4 (p=0.009) in the test group. In the control group as well, par1, par2, and par3 exhibited a higher expression compared with par4 but the difference was significant between par3 and par4 genes only. Conclusion Patients with AFRS expressed increased levels of PAR genes in their nasal mucosa, and, of the four PAR genes, a higher expression of par1, par2, and par3 was observed in both the groups compared with par4. This information contributes toward our understanding of pathogenesis and possibly treatment of AFRS.
Gaps Between Alarm Capabilities and Decision-making Needs: An Observational Study of Detecting Patient Decompensation
Authors: Horwood Chelsea R. , Rayo Michael F. , Fitzgerald Morgan , Balkin E. Asher , Moffatt-Bruce Susan D. 
Published: June 2018

Decompensation is a change in the overall ability to maintain physiological function in the presence of a stressor or disease. In the medical setting, clinicians utilize a wide range of technological tools to aid in their clinical decision making and to identify early warning signals for decompensation. However, many of these technologies have underperformed and are not aligned with the actual role of practitioners, resulting in unintended consequences and adverse events. The primary aim of this study is to explore how different nurses interpret early warning signs in order to anticipate decompensation. The secondary aim is to assess which technologies nurses rely on when anticipating decompensation, and if those technologies are adequately aiding them in their clinical decision making. Two researchers performed semi-structured ethnographic interviews that were recorded and transcribed during the summer of 2017. In total, 43 nurses were interviewed from different medical and surgical floors within the same hospital. Participants were asked questions focused on how they use and respond to alarms and how they anticipate patient decompensation. Constant Comparative Analysis was used to reveal patterns of responses between participants. Based on the qualitative analysis 6 major themes emerged:  1. Anticipating patient decompensation requires creating a complete mental “picture of the patient” by the nurses  2. Nurse-to-nurse communication and expertise is essential to understanding the patient’s history  3. Warning signs for decompensation were largely determined by a patient’s baseline  4. Change over time, or trends, is informative for anticipating decompensation. Numbers (regarding vital signs and labs) alone are not  5. Consistent care of patients improved nurse’s confidence in decision making  6. Anticipating decompensation requires “staying ahead of the machines Our research suggests that there is a gap between the information practitioners need to accurately anticipate patient decompensation, and the information current alarm technologies provide. Alarms are the primary tool provided to nurses to aid them in detecting hazardous events, however, current alarms are not well-suited in supporting signals that anticipate patient decompensation before it happens.
Creative Research Approaches For Complex Questions In Pre-Hospital Emergency Medicine
Authors: Bitan Yuval , Jaffe Eli , Gisick Logan M. , Hallihan Greg , Keebler Joseph 
Published: June 2018

Pre-Hospital Emergency Medical Service work environments are complex, presenting unique challenges for the design of environments and equipment, digital technologies, and inter-organizational operational strategies. As researchers, our challenge is to understand how providers operate in these complex environments, especially during emergency situations, to ensure solutions to these challenges are well informed by representative evidence. This requires collecting data regarding human-system interactions occurring between many people with shifting roles, in dynamic and potentially dangerous environments, with complex patients and often acute time constraints. A lot is happening simultaneously, and our ability to learn and provide meaningful insights is challenged. In search for methods that will help us asses these situations we often use mixed methods that are adapted to the unique and changing conditions of each study. The goal of this session was to present Case Studies and methods used for the panelist’s research involving the emergency medical services work environment. We took a close look at the tools and methods employed by the panelists for their research, and learned about the benefits and limitations of their unique approaches, as they were implemented in unique contexts.