bluuebunny/crossref_metadata_2025_split huggingface dataset:
Responses of dural mast cells in concussive and blast models of mild traumatic brain injury in mice: Potential implications for post-traumatic headache
Authors: Levy Dan , Edut Shahaf , Baraz-Goldstein Renana , Rubovitch Vardit , Defrin Ruth , Bree Dara , Gariepy Helaine , Zhao Jun , Pick Chaim G 
Published: November 2015

Background Chronic post-traumatic headache (PTH) is one of the most common symptoms of mild traumatic brain injury (mTBI) but its underlying mechanisms remain unknown. Inflammatory degranulation of dural mast cells (MCs) is thought to promote headache, and may play a role in PTH. Whether mTBI is associated with persistent degranulation of dural MCs is yet to be determined. Methods Histochemistry was used to evaluate time course changes in dural MC density and degranulation level in concussive head trauma and blast mouse models of mTBI. The effects of sumatriptan and the MC stabilizer cromolyn sodium on concussion-evoked dural MC degranulation were also investigated. Results Concussive head injury evoked persistent MC degranulation for at least 30 days. Blast trauma gave rise to a delayed MC degranulation response commencing at seven days that also persisted for at least 30 days. Neither sumatriptan nor cromolyn treatment reduced concussion-evoked persistent MC degranulation. Conclusions mTBI evoked by closed head injury or blast exposure is associated with persistent dural MC degranulation. Such a response in mTBI patients may contribute to PTH. Amelioration of PTH by sumatriptan may not involve inhibition of dural MC degranulation. If persistent dural MC degranulation contributes to PTH, then cromolyn treatment may not be effective.
Implications of semi-quantitative HPV viral load estimation by Hybrid capture 2 in colposcopy practice
Authors: Basu Partha , Muwonge Richard , Mittal Srabani , Banerjee Dipanwita , Ghosh Ishita , Panda Chinmay , Mandal Ranajit , Sankaranarayanan Rengaswamy 
Published: November 2015

Objective High viral load of oncogenic human papillomavirus (HPV) significantly increases risk of CIN 2 or worse (CIN 2+) lesions. Semi-quantitative estimation of oncogenic HPV viral load by Hybrid Capture 2 (HC2) correlates well with viral load estimated by real-time polymerase chain reaction. We correlated viral load estimated by HC2 with colposcopy and histology diagnosis, to determine if high viral load could detect the CIN 2+ lesions missed by colposcopy in HPV positive women. Methods Using HPV testing by HC2, 39,728 women were screened. Positive results were categorized into low-positive, intermediate, and high viral load groups, based on relative light unit/cut-off ratios. HPV-positive and some HPV-negative women underwent colposcopy and biopsy. Results A total of 278 CIN 2+ lesions were detected. Detection rate of CIN 2+ was significantly higher in intermediate and high viral load groups. Nearly half (48.3%) of CIN 2+ and 80.4% of CIN 3+ lesions missed or under-diagnosed by colposcopy had viral load in intermediate to high ranges. Risk of CIN 2+ in the high viral load group was 46 times higher than HPV-negative women, even when colposcopy was apparently normal. Discussion Women with intermediate or high viral load should have multiple punch biopsies, even if colposcopy is apparently normal or suggests low grade lesions. Women with high viral load and suspected low grade lesion on colposcopy may be considered for ‘see-and-treat’, as their risk of CIN 2+ is nearly 200 times higher than HPV-negative women.
A pilot randomized controlled trial of telephone intervention to increase Breast Cancer Screening uptake in socially deprived areas in Scotland (TELBRECS)
Authors: Chambers Julie A , Gracie Kerry , Millar Rosemary , Cavanagh Julie , Archibald Debbie , Cook Alan , O’Carroll Ronan E 
Published: November 2015

Objectives To determine whether a brief telephone support intervention could increase breast cancer screening uptake among lower socio-demographic women in Scotland, via eliciting and addressing barriers to screening attendance. Methods In a pilot randomized controlled trial, participants receiving a reminder letter for a missed screening appointment (February-June 2014) were randomized to four arms: No telephone call (control), Simple telephone reminder (TEL), Telephone support (TEL-SUPP), or Telephone support plus anticipated regret (TEL-SUPP-AR). Primary outcomes were making an appointment and attending breast screening. Results Of 856 women randomized and analysed on intention-to-treat basis, compared with controls, more women in the telephone intervention groups made an appointment (control: 8.8%, TEL: 20.3%, TEL-SUPP: 14.1%; TEL-SUPP-AR: 16.8%, χ2(3) = 12.0, p = .007) and attended breast screening (control: 6.9%, TEL: 16.5%, TEL-SUPP: 11.3%; TEL-SUPP-AR: 13.1%, χ2(3) = 9.8, p = .020). Of 559 women randomized to the three telephone groups, 404 were successfully contacted and 247 participated in the intervention. Intervention participants (ie. per protocol analysis) were more likely to make (17% versus 10%, χ2(1) = 7.0, p = .008) and attend (13% versus 7%, χ2(1) = 5.5, p = .019) an appointment than non-participants, but there were no differences in attendance between the three telephone groups. Conclusions A simple telephone reminder doubled attendance at breast screening in women from lower socio-demographic areas who had not attended their initial appointment, compared with a reminder letter only (odds ratio 2.12, 95% CI (1.2, 3.8)). However, contacting women proved problematic and there was no additional effect of telephone support or anticipated regret.
Building Community Capacity in Bereavement Support
Authors: Breen Lauren J. , Aoun Samar M. , Rumbold Bruce , McNamara Beverley , Howting Denise A. , Mancini Vincent 
Published: November 2015

Background: Most bereaved people do not require specialist intervention, yet building community capacity in providing bereavement support is underdeveloped. While family caregivers indicate a need for more information about bereavement, there is little evidence to guide what this information might contain. Objective: The study’s purpose was to inform bereavement support by determining the advice people bereaved through expected deaths in palliative care have for others in that situation. Design: Four funeral providers posted a questionnaire to previous clients who had used their services 6 to 24 months prior and 678 bereaved people responded. Setting/Participants: The sample size for this study comprised 265 bereaved people whose relative used palliative care services. Measurements: The questionnaire comprised 82 questions about caregiving, bereavement support, current bereavement-related distress, and 2 open-ended questions concerning their bereavement, one of them on advice they have to other people in the same situation. Results: Family caregivers (n = 140) of people who received palliative care responded to the open-ended question about advice for others. An open content analysis yielded 3 themes—preparations for bereavement, utilizing social networks, and strategies for dealing with grief. Conclusions: Bereaved family caregivers’ experiential knowledge can be harnessed to progress the development of bereavement care strategies for the good of the community. These responses could be incorporated into information brochures, posters, and other community education avenues in order to upskill palliative care bereavement volunteers and the wider community so that bereaved family caregivers are best supported.
Radiographic Recurrence of Deformity After Hallux Valgus Surgery in Patients With Metatarsus Adductus
Authors: Aiyer Amiethab , Shub Jeffery , Shariff Raheel , Ying Li , Myerson Mark 
Published: November 2015

Background: Metatarsus adductus (MA) is a congenital condition that may lead to the development of hallux valgus (HV). The associated anatomic deformities may lead to recurrence of the HV in patients with MA. The goals of the study were to identify radiographic rates of recurrence of HV following surgery for HV in patients with MA. Methods: Between 2002 and 2013, 587 patients who underwent HV surgery were retrospectively identified. The radiographic parameters recorded included the hallux valgus angle (HVA), the intermetatarsal angle (IMA), and the metatarsus adductus angle (MAA) obtained from initial radiographs and at final follow-up. The MAA was considered abnormal if the value was greater than 20 degrees. Radiographic recurrence was defined as HV deformity >20 degrees. Results: The rate of radiographic recurrence of HV was 15% in patients without MA and 29.6% in patients with MA ( P < .05). In the group with MA, rate of deformity recurrence did not differ among the operative procedures performed (Lapidus, 28.5%; distal first metatarsal osteotomy, 29.4%; proximal first metatarsal osteotomy, 28.9%). Patients with severe MA (MAA > 31 degrees) were found to have a recurrence rate of 18%, whereas those with less severe MA (MAA < 31 degrees) were found to have a recurrence rate of 82%. Of the patients with severe MA who did not have radiographic recurrence of HV, 60% had undergone a Lapidus arthrodesis and realignment arthrodesis of the second/third tarsometatarsal joints. Conclusion: The rate of radiographic recurrence for patients with MA undergoing HV correction was ~30%. This finding was consistent with our hypothesis that MA increases the risk of radiographic recurrence of HV deformity irrespective of the procedure performed. We believe the lower rate of recurrence of HV among patients with severe MA deformities is suggestive that more complete management of the deformity is warranted. Level of Evidence: Level III, retrospective comparative series.
Apixaban for the Secondary Prevention of Thrombosis Among Patients With Antiphospholipid Syndrome
Authors: Woller Scott C. , Stevens Scott M. , Kaplan David A. , Branch D. Ware , Aston Valerie T. , Wilson Emily L. , Gallo Heather M. , Johnson Eric G. , Rondina Matthew T. , Lloyd James F. , Evans R. Scott , Elliott C. Gregory 
Published: November 2015

Background: Antiphospholipid syndrome (APS) is an acquired thrombophilia characterized by thrombosis, pregnancy morbidity, and the presence of characteristic antibodies. Current therapy for patients having APS with a history of thrombosis necessitates anticoagulation with the vitamin K antagonist warfarin, a challenging drug to manage. Apixaban, approved for the treatment and prevention of venous thrombosis with a low rate of bleeding observed, has never been studied among patients with APS. Aims and Methods: We report study rationale and design of Apixaban for the Secondary Prevention of Thrombosis Among Patients With Antiphospholipid Syndrome (ASTRO-APS), a prospective randomized open-label blinded event pilot study that will randomize patients with a clinical diagnosis of APS receiving therapeutic anticoagulation to either adjusted-dose warfarin or apixaban 2.5 mg twice a day. We aim to report our ability to identify, recruit, randomize, and retain patients with APS randomized to apixaban compared with warfarin. We will report clinically important outcomes of thrombosis and bleeding. All clinical outcomes will be adjudicated by a panel blinded to the treatment arm. A unique aspect of this study is the enrollment of patients with an established clinical diagnosis of APS. Also unique is our use of electronic medical record interrogation techniques to identify patients who would likely meet our inclusion criteria and use of an electronic portal for follow-up visit data capture. Conclusion: ASTRO-APS will be the largest prospective study to date comparing a direct oral anticoagulant with warfarin among patients with APS for the secondary prevention of thrombosis. Our inclusion criteria assure that outcomes obtained will be clinically applicable to the routine management of patients with APS receiving indefinite anticoagulation.
Incidence, characteristics and impact of hypoglycaemia in patients receiving intensified treatment for inadequately controlled type 2 diabetes mellitus
Authors: Tschöpe Diethelm , Bramlage Peter , Schneider Steffen , Gitt Anselm K 
Published: November 2015

Aims: With the intensification of antidiabetic treatment, there is an increasing risk of hypoglycaemia. We aimed to determine incidence, characteristics and outcomes. Methods: Prospective, observational, multicenter cohort study. The included 3810 patients with type 2 diabetes had their treatment intensified at baseline. Results: The incidence of hypoglycaemia was 11.4% per year with 4.2 ± 4.4 episodes per patient. Hypoglycaemia was more frequent in patients with high blood glucose variability. Predictors were heart failure (odds ratio: 1.66; 95% confidence interval: 1.20–2.29) and insulin use (odds ratio: 4.03; 95% confidence interval: 3.05–5.33), with dipeptidyl peptidase–4 inhibitors being associated with reduced risk (odds ratio: 0.69; 95% confidence interval: 0.53–0.89). Macrovascular events were more frequent among patients reporting severe episodes of hypoglycaemia (odds ratio: 3.39; 95% confidence interval: 1.32–8.73). Microvascular events were more frequent in patients with non-severe episodes (odds ratio: 1.92; 95% confidence interval: 1.49–2.49). Conclusion: Case-by-case evaluation of patients as well as appropriate selection of antidiabetic pharmacotherapy and blood glucose treatment goals could maximize the benefits while reducing the risks of antidiabetic treatment.
Multiple, zonal and multi‐zone adenoma detection rates according to quality of cleansing during colonoscopy
Authors: Pontone Stefano , Hassan Cesare , Maselli Roberta , Pontone Paolo , Angelini Rita , Brighi Manuela , Patrizi Gregorio , Pironi Daniele , Magliocca Fabio Massimo , Filippini Angelo 
Published: November 2015

BackgroundThe safety and diagnostic accuracy of colonoscopy depend on the quality of colon cleansing. The adenoma detection rate is usually used as a quality measurement score.ObjectiveWe aimed to introduce and evaluate three new parameters to determine polyps and adenomas segmental localization and their distribution in association with different bowel preparation levels during colonoscopy. We introduce the multiple adenoma detection rate (the percentage of patients with >2 adenomas diagnosed during colonoscopy), the zonal adenoma detection rate (the percentage of patients with >2 adenomas diagnosed during colonoscopy in different colon areas (rectum, sigmoid, descending, transverse, ascending and cecum colon)), and multi‐zone adenoma detection rate (the percentage of patients with >2 adenomas diagnosed during colonoscopy in different colon areas with at least a segment between them with or without lesions (i.e. rectum and descending colon with or without lesions in the sigmoid)).MethodsWe prospectively enrolled outpatients who underwent colonoscopy from January 2013 to October 2014. The bowel preparation quality, according to the Aronchick modified scale, number and location of lesions, Paris classification and histology, were recorded. The multiple adenoma/polyp detection rate, zonal adenoma/polyp detection rate, and multi‐zone adenoma/polyp detection rate were determined.ResultsIn total, 519 consecutive patients (266/253 M/F; mean age 55.3 ± 12.8 years) were enrolled. The adenoma and polyp detection rates were 21% and 35%, respectively. Multiple adenomas were detected in 28 patients. Adenoma and polyp detection rate and new parameters were statistically significantly higher in the optimal as compared with the adequate bowel preparation.ConclusionsAn optimal level of bowel preparation was strongly associated not only with a higher adenoma detection rate, but also with a higher chance of detecting multiple clinically relevant lesions in adjacent or discrete segments of the colon.
Post-operative use of Low Molecular Weight Heparin: Are patients doing their bit?
Authors: Hardy TJ , Upchurch E , Duff H , Davenport K 
Published: November 2015

Introduction: Current National Institute for Health and Care Excellence (NICE) guidelines recommend the use of Low Molecular Weight Heparin (LMWH) for one month post-operatively in abdominal and pelvic cancer surgery to reduce risk of venous thromboembolism. We audited the prescription of LMWH at discharge and the compliance of patients with LMWH post-operatively and instigated measures to improve compliance. Materials and Methods: All patients undergoing major urological surgery from November 2011 to April 2012 were audited, with data collected on evidence of post-operative prescription (from discharge summaries). Patients within this 3-month period were questioned regarding compliance following discharge. Following this, changes were instigated to improve compliance (earlier discussion of post-operative LMWH administration in clinic, improved patient and junior doctor education). All patients undergoing surgery from November 2012 to June 2013 were identified and a re-audit completed. Results: Post-operative prescription of LMWH improved overall from 73% to 88%. Patient compliance to complete LMWH course improved from 23% to 88%. At re-audit, 97% of patients felt that training was adequate, and 94% of patients understood the rationale for taking LMWH at re-audit. Conclusion: Education of junior doctors improved prescription of LMWH at discharge. Improved patient education improves community LMWH use compliance post-discharge.
Assessment of Quality of Life in Patients With Skin Disorders Undergoing Ayurvedic Panchakarma (Biopurification) as Management
Authors: Deshpande Harish , Shivakumar  , Kavita M. B. , Tripathy T. B. , Chaturvedi Ashutosh 
Published: November 2015

Background. Chronic skin conditions can have a negative impact on one’s quality of life, affecting their physical, functional, and emotional well-being. Whereas biopurifactory measures ( panchakarma) of Ayurveda claims to provide better quality of life after treatment. Hence current study is planned to provide evidence in patients with skin disorders, undergoing Ayurvedic treatment. Methodology. Sixty patients with skin disorder, who underwent purification therapies like therapeutic emesis and therapeutic purgation, were randomly placed in 2 groups to assess quality of life. Quality of life assessment was done with the help of Skindex-29 among the patients before and after Ayurvedic purification therapy. Thereafter, the quality of life assessment was done on the first follow-up. Results. A statistically significant improvement in the quality of life domains—emotions, functioning, and symptoms—after the Ayurvedic management was observed with P value <.001. Conclusion. Study concludes that there is improvement in quality of life among patients with skin disease after undergoing Ayurveda purification therapies.
Residual Impact of Previous Injury on Musculoskeletal Characteristics in Special Forces Operators
Authors: Parr Jeffrey J. , Clark Nicholas C. , Abt John P. , Kresta Julie Y. , Keenan Karen A. , Kane Shawn F. , Lephart Scott M. 
Published: November 2015

Background Musculoskeletal injuries are a significant burden to United States Army Special Operations Forces. The advanced tactical skill level and physical training required of Army Special Operators highlights the need to optimize musculoskeletal characteristics to reduce the likelihood of suffering a recurrent injury. Purpose To identify the residual impact of previous injury on musculoskeletal characteristics. Study Design Cross-sectional study; Level of evidence, 3. Methods Isokinetic strength of the knee, shoulder, and back and flexibility of the shoulder and hamstrings were assessed as part of a comprehensive human performance protocol, and self-reported musculoskeletal injury history was obtained. Subjects were stratified based on previous history of low back, knee, or shoulder injury, and within-group and between-group comparisons were made for musculoskeletal variables. Results Knee injury analysis showed no significant strength or flexibility differences. Shoulder injury analysis found internal rotation strength of the healthy subjects (H) was significantly higher compared with injured (I) and uninjured (U) limbs of the injured group (H, 60.8 ± 11.5 percent body weight [%BW]; I, 54.5 ± 10.5 %BW; U, 55.5 ± 11.3 %BW) ( P = .014 [H vs I] and P = .05 [H vs U]). The external rotation/internal rotation strength ratio was significantly lower in the healthy subjects compared with injured and uninjured limbs of the injured group (H, 0.653 ± 0.122; I, 0.724 ± 0.121; U, 0.724 ± 0.124) ( P = .026 [H vs I] and P = .018 [H vs U]). Posterior shoulder tightness was significantly different between the injured and uninjured limb of the injured group (I, 111.6° ± 9.4°; U, 114.4° ± 9.3°; P = .008). The back injury analysis found no significant strength differences between the healthy and injured groups. Conclusion Few physical differences existed between operators with prior knee or back injury. However, operators with a previous history of shoulder injury demonstrated significantly less shoulder strength than uninjured operators as well as decreased shoulder flexibility on the injured side. All operators, regardless of prior injury, must perform the same tasks; therefore, a targeted injury rehabilitation/human performance training specifically focused on internal rotation strength and tightness of the posterior capsule may help reduce the risk for recurrence of injury. Operators presenting with musculoskeletal asymmetries and/or insufficient strength ratios may be predisposed to musculoskeletal injury. Clinical Relevance Specific fitness programs to compensate for deficiencies in strength and flexibility need to be designed that may reduce the risk of injuries in Special Forces Operators.
Brain Natriuretic Peptide Constitutively Downregulates P2X3 Receptors by Controlling their Phosphorylation State and Membrane Localization
Authors: Marchenkova Anna , Vilotti Sandra , Fabbretti Elsa , Nistri Andrea 
Published: November 2015

Background ATP-gated P2X3 receptors are important transducers of nociceptive stimuli and are almost exclusively expressed by sensory ganglion neurons. In mouse trigeminal ganglion (TG), P2X3 receptor function is unexpectedly enhanced by pharmacological block of natriuretic peptide receptor-A (NPR-A), outlining a potential inhibitory role of endogenous natriuretic peptides in nociception mediated by P2X3 receptors. Lack of change in P2X3 protein expression indicates a complex modulation whose mechanisms for downregulating P2X3 receptor function remain unclear. Results To clarify this process in mouse TG cultures, we suppressed NPR-A signaling with either siRNA of the endogenous agonist BNP, or the NPR-A blocker anantin. Thus, we investigated changes in P2X3 receptor distribution in the lipid raft membrane compartment, their phosphorylation state, as well as their function with patch clamping. Delayed onset of P2X3 desensitization was one mechanism for the anantin-induced enhancement of P2X3 activity. Anantin application caused preferential P2X3 receptor redistribution to the lipid raft compartment and decreased P2X3 serine phosphorylation, two phenomena that were not interdependent. An inhibitor of cGMP-dependent protein kinase and siRNA-mediated knockdown of BNP mimicked the effect of anantin. Conclusions We demonstrated that in mouse trigeminal neurons endogenous BNP acts on NPR-A receptors to determine constitutive depression of P2X3 receptor function. Tonic inhibition of P2X3 receptor activity by BNP/NPR-A/PKG pathways occurs via two distinct mechanisms: P2X3 serine phosphorylation and receptor redistribution to nonraft membrane compartments. This novel mechanism of receptor control might be a target for future studies aiming at decreasing dysregulated P2X3 receptor activity in chronic pain.