bluuebunny/crossref_metadata_2025_split huggingface dataset:
Age‐related Disparities in Trauma Center Access for Severe Head Injuries Following the Release of the Updated Field Triage Guidelines
Authors: Flottemesch Thomas J. , Raetzman Susan , Heslin Kevin C. , Fingar Katie , Coffey Rosanna , Barrett Marguerite , Moy Ernest 
Published: December 2016

AbstractObjectiveIn 2006, the American College of Surgeons’ Committee on Trauma and the Centers for Disease Control and Prevention released field triage guidelines with special consideration for older adults. Additional considerations for direct transport to a Level I or II trauma center (TC) were added in 2011, reflecting perceived undertriage to TCs for older adults. We examined whether age‐based disparities in TC care for severe head injury decreased following introduction of the 2011 revisions.MethodsA pre‐post design analyzing the 2009 and 2012 Healthcare Cost and Utilization Project State Emergency Department Databases and State Inpatient Databases with multivariable logistic regressions considered changes in 1) the trauma designation of the emergency department where treatment was initiated and 2) transfer to a TC following initial treatment at a non‐TC.ResultsCompared with adults aged 18 to 44 years, after multivariable adjustment, in both years TC care was less likely for adults aged 45 to 64 years (odds ratio [OR] = 0.76 in 2009 and 0.74 in 2012), aged 65 to 84 years (OR = 0.61 and 0.59), and aged 85+ years (OR = 0.53 and 0.56). Between 2009 and 2012, the likelihood of TC care increased for all age groups, with the largest increase among those aged 85+ years (OR = 1.18), which was statistically different (p = 0.02) from the increase among adults aged 18 to 44 years (OR = 1.12). The analysis of transfers yielded similar results.ConclusionsAlthough patterns of increased TC treatment for all groups with severe head trauma indicate improvements, age‐based disparities persisted.
Early improvement predicts 8‐week treatment outcome in patients with generalized anxiety disorder treated with escitalopram or venlafaxine
Authors: Qian Mincai , Shen Zhongxia , Lin Min , Guan Tiefeng , Yang Jianhong , Li Liang , Shen Xinhua , Yuan Yonggui 
Published: December 2016

AbstractIntroductionTo investigate whether early improvement can predict 8‐week treatment outcome in generalized anxiety disorder (GAD) patients.MethodsFor 8 weeks, 226 GAD patients were randomly treated with escitalopram or venlafaxine. Early improvement was defined as a ≧20% reduction from baseline in Hamilton anxiety rating scale at week 1 or 2. The positive and negative predictive values were calculated.ResultsThe positive and negative predictive values of early improvement in escitalopram or venlafaxine group at week 1 were (85.19%, 67.53%) vs (84.62%, 65.33%)DiscussionThe early improvement achieved within the first week treatment can predict a good 8‐week treatment outcome in GAD patients.
Inhibiting the Migration of M1 Microglia at Hyperacute Period Could Improve Outcome of tMCAO Rats
Authors: Huang Ming , Wan Yan , Mao Ling , He Quan‐Wei , Xia Yuan‐Peng , Li Man , Li Ya‐Nan , Jin Hui‐Juan , Hu Bo 
Published: December 2016

SummaryAimTo study whether inhibiting microglia migration to the ischemic boundary zone (IBZ) at the early phase could improve neurological outcomes after stroke.MethodsThe transient middle cerebral artery occlusion (tMCAO) was induced in adult male Sprague‐Dawley rats. AMD3100, a highly selective CXC‐chemokine receptor 4 (CXCR4) antagonist, was used to inhibit microglia migration. Microglia was evaluated by immunofluorescence in vivo, and their migration was tested by transwell assay in vitro. Expressions of cytokines were detected by real‐time PCR. Infarct volume was determined by triphenyltetrazolium chloride (TTC) staining. Functional recovery of tMCAO rats was evaluated by behavior tests.ResultsM1 microglia in the IBZ was rapidly increased within 3 days after tMCAO, accompanied with enhanced expression of CXCR4. Chemokine CXC motif chemokine ligand 12 (CXCL12) was also increased in the IBZ. And AMD3100 could obviously decline M1 microglia migration induced by CXCL12 and secretion of related inflammatory cytokines in the IBZ after stroke. This was accompanied by significant attenuated infarct volume and improved neurological outcomes.ConclusionThis study confirms the protective efficacy of inhibiting microglia migration at the hyperacute phase as a therapeutic strategy for ischemic stroke in tMCAO model of rats, and its therapeutic time window could last for 24 h after cerebral ischemia reperfusion.
Häufigkeit und Einteilung kutaner Manifestationen bei rheumatoider Arthritis
Authors: Ziemer Mirjana , Müller Anne‐Katrin , Hein Gert , Oelzner Peter , Elsner Peter 
Published: December 2016

ZusammenfassungHintergrund und FragestellungHautveränderungen bei rheumatoider Arthritis (RA) sind nur in wenigen Studien an größeren Patientenkollektiven untersucht. Deshalb sollen hier die aktuelle Prävalenz und das Spektrum an Hautveränderungen bei RA unter Berücksichtigung von Krankheitsaktivitäts‐Scores, Anti‐CCP‐Antikörpern sowie neueren medikamentösen Therapien erfasst werden.Patienten und MethodikZwischen November 2006 und Juli 2007 wurden prospektiv 214 Patienten, die im Funktionsbereich Rheumatologie mit RA behandelt wurden, erfasst.ErgebnisseBei 27,5 % der Untersuchten wurden RA‐assoziierte Hautveränderungen beobachtet, wobei es sich fast ausschließlich um Rheumaknoten handelte. Signifikant gehäuft traten Rheumaknoten bei längerer Erkrankungsdauer, Nachweis von Rheumafaktoren und Anti‐CCP‐Antikörpern, aber auch unter Gabe von Leflunomid und TNFα‐Blockern auf. Vergleichsweise niedrige Prävalenzen wurden hingegen für die „palisadenförmige neutrophile und granulomatöse Dermatitis“ und die „rheumatoide Vaskulitis“ ermittelt.SchlussfolgerungenTrotz zunehmend frühzeitiger Therapie der RA und dem Einsatz neuerer Medikamente ist die Prävalenz von Rheumaknoten als wichtigste Manifestation der RA am Hautorgan hoch. Deren verstärkte Ausbildung unter Leflunomid und TNFα‐Blockern könnte ein Hinweis dafür sein, dass bei der Entstehung von Rheumaknoten eine pathogenetische Wegstrecke eine Rolle spielt, die von den Therapeutika nur unzureichend beeinflusst wird. Hingegen scheinen die palisadenförmige neutrophile und granulomatöse Dermatitis und die „rheumatoide Vaskulitis“ durch neuere Medikamente besser beeinflussbar zu sein.
Twelve‐month course and outcome of methamphetamine‐induced psychosis compared with first episode primary psychotic disorders
Authors: Hajebi Ahmad , Amini Homayoun , Kashani Leila , Sharifi Vandad 
Published: December 2016

BackgroundTo assess the clinical course and outcome of patients with methamphetamine‐induced psychosis in comparison with patients with primary psychotic disorders.MethodsThis prospective study was conducted on patients with methamphetamine‐induced psychosis, and 2 groups of primary psychotic disorders: affective psychosis and non‐affective psychosis admitted to 2 psychiatric hospitals in Tehran, Iran, with a first episode of a psychotic illness. A total of 165 subjects (55 in each group) were selected using convenience sampling. They were assessed at the time of admission, discharge and 6 and 12 months after discharge using the Positive and Negative Syndrome Scale, the Young Mania Rating Scale and the Global Assessment of Functioning Scale. The frequency of readmissions and suicide attempts were also assessed.ResultsSignificant differences were found in the trend of changes of symptoms and functioning among the 3 groups. At all‐time points, the severity of negative psychotic symptoms and dysfunction in the non‐affective psychosis group were greater than those in affective or methamphetamine‐induced psychosis groups, with latter 2 having similar profiles. However, the course of positive symptoms in methamphetamine‐induced psychosis was more similar to non‐affective psychosis. Number of suicide attempts and readmissions were non‐significantly higher in methamphetamine‐induced psychosis than in the other groups.ConclusionMethamphetamine‐induced psychosis does not have a satisfactory course and in some cases symptoms may remain even after many months of follow‐up. Rate of certain outcomes such as re‐hospitalization is also considerably high. It is a challenge for the health‐care system that requires evidence‐based interventions.
MiR‐151a is involved in the pathogenesis of atopic dermatitis by regulating interleukin‐12 receptor β2
Authors: Chen Xiao‐Fan , Zhang Li‐Juan , Zhang Jie , Dou Xia , Shao Yong , Jia Xiao‐Jian , Zhang Wei , Yu Bo 
Published: December 2016

AbstractMicroRNAs (miRNAs) have been reported to circulate in the blood in a highly stable and cell‐free form. Dysregulated expression of miRNAs has been detected in various pathological conditions including atopic dermatitis. In our study, human blood plasma miRNAs were identified by high‐throughput sequencing and compared among patients of atopic dermatitis and healthy controls. We found that miR‐151a was differentially expressed in the plasma of atopic dermatitis patients. MiR‐151a regulates the expression of IL12RB2 by targeting two loci in the 3′ untranslated region of the Il12rb2 gene. Moreover, IL12RB2 was remarkably downregulated in Jurkat cells overexpressing miR‐151a. Jurkat cells treated with phytohemagglutinin also showed reduced expression of IFN‐γ, interleukin‐2 (IL‐2) and IL‐12. Together, these results suggest that miR‐151a is involved in the pathogenesis of atopic dermatitis by regulating IL12RB2.
Acoustic emission detection of fatigue cracks in wind turbine blades based on blind deconvolution separation
Authors: Bo Z , Yanan Z , Changzheng C 
Published: December 2016

AbstractThe occurrence and expansion of fatigue cracks in large wind turbine blades may lead to catastrophic blade failure. Each fatigue phase of a material has been associated with a typical set of acoustic emission (AE) signal frequency components, providing a logical base for establishing a clear connection between AE signals and the fatigue condition of a material. The relevance of efforts to relate recorded AE signals to a material's mechanical behaviour relies heavily on accurate AE signal processing. The main objective of the present study is to establish a direct correlation between the fatigue condition of a material and recorded AE signals. We introduce the blind deconvolution separation (BDS) approach because the result of AE monitoring is usually a convoluted mixture of signals from multiple sources. The method is implemented on data acquired from a fatigue test rig employing a wind turbine blade with an artificial transverse crack seeded in the surface at the base of the blade. Two different sets of fatigue loading were conducted. The convoluted signals are collected from the AE acquisition system, and the weak crack feature is extracted and analysed based on the BDS algorithm. The study reveals that the application of BDS‐based AE signal analysis is an appropriate approach for distinguishing and interpreting the different fatigue damage states of a wind turbine blade. The novel methodology proposed for fatigue crack identification will allow for improved predictive maintenance strategies for the glass‐epoxy blades of wind turbines. The experimental results clearly demonstrate that the AE signals generated by a fatigue crack on a wind turbine blade can be synchronously separated and identified. Characterizing and assessing fatigue conditions by AE monitoring based on BDS can prevent catastrophic failure and the development of secondary defects, as well as reduce unscheduled downtime and costs. The possibility of using AE monitoring to assess the fatigue condition of fibre composite blades is also considered.
The importance of TH22 and TC22 cells in the pathogenesis of Helicobacter pylori‐associated gastric diseases
Authors: Shamsdin Seyedeh Azra , Alborzi Abdolvahab , Rasouli Manoochehr , Ghaderi Abbas , Lankrani Kamran B. , Dehghani Seyed Mohsen , Pouladfar Gholam reza 
Published: December 2016

AbstractBackgroundAn association exists between Helicobacter pylori (H. pylori), peptic ulcers, gastritis, and sometimes gastric carcinomas. Th22 cells have protective and inflammatory roles in defense against microbes.AimWe investigated the frequencies of Th22, Tc22, Th22/17, and Tc22/17 cells in addition to the changes in levels of cytokines IL‐22, IL‐6, IL‐23, TNF‐α, IL‐1β, and TGF‐β in sera from patients with H. pylori‐associated gastritis, and peptic ulcer, and in uninfected patients.MethodsA total of 76 patients with H. pylori‐associated disorders formed the studied group. Frequencies of T‐cell subsets were determined by flow cytometry. Levels of cytokines IL‐22, IL‐6, IL‐23, TNF‐α, IL‐1β, and TGF‐β in the sera and supernatants of patients were measured by ELISA and flow cytometry.ResultsThe study participants included 32 males and 44 females with a mean age of 38.5±15.3 years. We divided the infected group into peptic ulcer and gastritis (mild, moderate, active chronic, and chronic). The frequencies of Th22, Tc22, and Tc22/17 increased significantly in the peptic ulcer, moderate, active chronic, and chronic gastritis groups compared to the uninfected group. Th22/17 only increased significantly in the chronic gastritis group. We observed significant increases in IL‐22 in the moderate and active chronic gastritis, IL‐23 in the active chronic and chronic gastritis, and TNF‐α in the peptic ulcer and moderate gastritis groups. Following in vitro antigenic stimulation, we observed significantly higher levels of IL‐1β, IL‐23, and IL‐6 in the active chronic gastritis group, as well as IL‐6 and IL‐1β in the chronic gastritis group compared to the uninfected group.ConclusionIncreased Th22, Tc22, and Tc22/17 cells and IL‐22 levels appear to be influential in progression and severity of H. pylori infection. Th22/17 can be an interesting therapeutic target for chronic H. pylori infections where eradication is more difficult.
RNA interference unveils the importance ofPseudotrichonympha grassii cellobiohydrolase, a protozoan exoglucanase, in termite cellulose degradation
Authors: Liu X.‐J. , Xie L. , Liu N. , Zhan S. , Zhou X.‐G. , Wang Q. 
Published: December 2016

AbstractBased on prior work, a cellulase from glycosyl hydrolase family 7 (GHF7) was identified and found to be expressed at a high level inCoptotermes formosanus. To determine the function of GHF7 family membersin vivo, we used RNA interference (RNAi) to functionally analyse the exoglucanase genePseudotrichonympha grassii cellobiohydrolase gene (PgCBH), which was highly expressed inPseudotrichonympha grassii, a flagellate found in the hindgut ofC. formosanus. In this study, the expression level ofPgCBHwas down‐regulated by RNAi, causing the death ofP. grassii, but no effect was observed for other flagellates found inC. formosanus. RNAi also resulted in significantly reduced exoglucanase activity, and no effect was observed for endoglucanase and β‐glucosidase activities. This result demonstrated that thePgCBHgene plays a role in the protist lignocellulolytic process and is also important for host survival.PgCBHcan be used as a target gene and has potential as a bioinsecticide for use against termites.
Clinical Outcomes Associated with Medication Regimen Complexity in Older People: A Systematic Review
Authors: Wimmer Barbara C , Cross Amanda J , Jokanovic Natali , Wiese Michael D , George Johnson , Johnell Kristina , Diug Basia , Bell J. Simon 
Published: December 2016

ObjectivesTo systematically review clinical outcomes associated with medication regimen complexity in older people.DesignSystematic review of EMBASE, MEDLINE, International Pharmaceutical Abstracts, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane library.SettingHospitals, home, and long‐term care.ParticipantsEnglish‐language peer‐reviewed original research published before June 2016 was eligible if regimen complexity was quantified using a metric that considered number of medications and at least one other parameter, regimen complexity was calculated for participants’ overall regimen, at least 80% of participants were aged 60 and older, and the study investigated a clinical outcome associated with regimen complexity.MeasurementsQuality assessment was conducted using an adapted version of the Joanna Briggs Institute critical appraisal tool.ResultsSixteen observational studies met the inclusion criteria. Regimen complexity was associated with medication nonadherence (2/6 studies) and higher rates of hospitalization (2/4 studies). One study found that participants with less‐complex medication administration were more likely to stop medications when feeling worse. One study each identified an association between regimen complexity and higher ability to administer medications as directed, medication self‐administration errors, caregiver medication administration hassles, hospital discharge to non‐home settings, postdischarge potential adverse drug events, all‐cause mortality, and lower patient knowledge of their medication. Regimen complexity had no association with postdischarge medication modification, change in medication‐ and health‐related problems, emergency department visits, or quality of life as rated by nursing staff.ConclusionResearch into whether medication regimen complexity is associated with nonadherence and hospitalization has produced inconsistent results. Moderate‐quality evidence from four studies (two each for nonadherence and hospitalization) suggests that medication regimen complexity is associated with nonadherence and higher rates of hospitalization.
Balance and Mobility in Community‐Dwelling Older Adults: Effect of Daytime Sleepiness
Authors: Tyagi Shachi , Perera Subashan , Brach Jennifer S. 
Published: December 2016

ObjectivesTo examine the effect of self‐reported daytime sleepiness on performance‐based balance measures and self‐reported balance confidence in community‐dwelling older adults.DesignCross‐sectional secondary analysis of an observational cohort study designed to develop and refine measures of balance and mobility in community‐dwelling older adults.SettingCommunity.ParticipantsOlder adults (aged 78.2 ± 5.9) (n = 120).MeasurementsThe performance‐based gait and balance measures included gait speed, double support time, and step width. Narrow walk, obstacle walk, and timed standing balance were also assessed. The Activities‐Specific Balance Confidence Scale was included as a self‐reported measure. Daytime sleepiness was defined as an Epworth Sleepiness Scale score of 9 or greater. Body mass index, fall‐related comorbidities, and use of central nervous system (CNS) medications were considered as covariates.ResultsForty‐five percent of participants reported daytime sleepiness. Participants reporting daytime sleepiness differed significantly from those without in gait speed (adjusted difference (standard error (SE)) −0.09 (0.04) m/s, P = .03), step width (adjusted difference (SE) 0.02 (0.01), P = .03), and self‐reported balance confidence (adjusted difference (SE) −1.02 (0.38), P = .01) even after adjusting for covariates. Two‐way analysis of variance of CNS medication use and daytime sleepiness showed no significant interaction effects.ConclusionSelf‐reported daytime sleepiness is associated with slower gait speed and poor balance confidence in community‐dwelling older adults. Subjective sleep assessment should be considered when assessing balance and implementing interventions for improving balance in older adults. Further study is needed to examine the role of CNS medication use.
‘You never come back the same’: the challenge of spiritual care in a deployed military nursing context
Authors: Ormsby Andrew , Harrington Ann , Borbasi Sally 
Published: December 2016

Aims and objectivesTo explore the experience of spirituality and spiritual care by military nurses on deployed operations.BackgroundDespite an increasing body of research addressing spirituality in nursing care in a variety of clinical settings, the deployed military nursing context remains poorly understood.DesignA qualitative, philosophical hermeneutic design.MethodTen Australian military nurses were interviewed about their experiences of spirituality and spiritual care while on deployed operations. Analyses were performed using a phenomenological method informed by philosophical hermeneutics.ResultsThe participants perceived that they had an important role in the provision of spiritual care in the absence of family on deployed operations. However, the nurse also needed to care for their own spiritual needs. The results suggested that spirituality and spiritual care may provide positive benefits in protecting against the long‐term psychological, emotional and spiritual impacts of military service on deployed operations.ConclusionsMilitary nurses need to understand the factors that influence spiritual care delivery in their practice setting. Nurses need to be cognizant of the importance of spiritual care in the deployed military context, not only for their patients and colleagues, but also for themselves. Spirituality is argued as a protective factor against the challenges and consequences often associated with deployment. Well‐developed spiritual resilience may assist in ensuring that military personnel return home emotionally, psychologically and spiritually ‘fit’.Relevance for clinical practiceTo provide effective spiritual nursing care to deployed military populations, the nurse needs to understand the complex military practice environment, the personal and individual nature of spiritual expressions and their own spiritual care requirements. Meaningful spiritual care aids resilience against the psychological, emotional and spiritual dangers of deployment.
Developing a patient‐led electronic feedback system for quality and safety within Renal PatientView
Authors: Giles Sally J. , Reynolds Caroline , Heyhoe Jane , Armitage Gerry 
Published: December 2016

SUMMARYBackgroundIt is increasingly acknowledged that patients can provide direct feedback about the quality and safety of their care through patient reporting systems. The aim of this study was to explore the feasibility of patients, healthcare professionals and researchers working in partnership to develop a patient‐led quality and safety feedback system within an existing electronic health record (EHR), known as Renal PatientView (RPV).MethodsPhase 1 (inception) involved focus groups (n = 9) and phase 2 (requirements) involved cognitive walkthroughs (n = 34) and 1:1 qualitative interviews (n = 34) with patients and healthcare professionals. A Joint Services Expert Panel (JSP) was convened to review the findings from phase 1 and agree the core principles and components of the system prototype. Phase 1 data were analysed using a thematic approach. Data from phase 1 were used to inform the design of the initial system prototype. Phase 2 data were analysed using the components of heuristic evaluation, resulting in a list of core principles and components for the final system prototype.ResultsPhase 1 identified four main barriers and facilitators to patients feeding back on quality and safety concerns. In phase 2, the JSP agreed that the system should be based on seven core principles and components.DiscussionStakeholders were able to work together to identify core principles and components for an electronic patient quality and safety feedback system in renal services. Tensions arose due to competing priorities, particularly around anonymity and feedback. Careful consideration should be given to the feasibility of integrating a novel element with differing priorities into an established system with existing functions and objectives.