bluuebunny/crossref_metadata_2025_split huggingface dataset:
Performance of a postnatal metabolic gestational age algorithm: a retrospective validation study among ethnic subgroups in Canada
Authors: Hawken Steven , Ducharme Robin , Murphy Malia S Q , Atkinson Katherine M , Potter Beth K , Chakraborty Pranesh , Wilson Kumanan 
Published: September 2017

ObjectivesBiological modelling of routinely collected newborn screening data has emerged as a novel method for deriving postnatal gestational age estimates. Validation of published models has previously been limited to cohorts largely consisting of infants of white Caucasian ethnicity. In this study, we sought to determine the validity of a published gestational age estimation algorithm among recent immigrants to Canada, where maternal landed immigrant status was used as a surrogate measure of infant ethnicity.DesignWe conducted a retrospective validation study in infants born in Ontario between April 2009 and September 2011.SettingProvincial data from Ontario, Canada were obtained from the Institute for Clinical Evaluative Sciences.ParticipantsThe dataset included 230 034 infants born to non-landed immigrants and 70 098 infants born to immigrant mothers. The five most common countries of maternal origin were India (n=10 038), China (n=7468), Pakistan (n=5824), The Philippines (n=5441) and Vietnam (n=1408). Maternal country of origin was obtained from Citizenship and Immigration Canada’s Landed Immigrant Database.Primary and secondary outcome measuresPerformance of a postnatal gestational age algorithm was evaluated across non-immigrant and immigrant populations.ResultsRoot mean squared error (RMSE) of 1.05 weeks was observed for infants born to non-immigrant mothers, whereas RMSE ranged from 0.98 to 1.15 weeks among infants born to immigrant mothers. Area under the receiver operating characteristic curve for distinguishing term versus preterm infants (≥37 vs <37 weeks gestational age or >34 vs ≤34 weeks gestational age) was 0.958 and 0.986, respectively, in the non-immigrant subgroup and ranged from 0.927 to 0.964 and 0.966 to 0.99 in the immigrant subgroups.ConclusionsAlgorithms for postnatal determination of gestational age may be further refined by development and validation of region or ethnicity-specific models. However, our results provide reassurance that an algorithm developed from Ontario-born infant cohorts performs well across a range of ethnicities and maternal countries of origin without modification.
Biopsychosocial factors associated with non-recovery after a minor transport-related injury: protocol for a systematic review
Authors: Samoborec Stella , Ruseckaite Rasa , Romero Lorena , Evans Sue M 
Published: September 2017

IntroductionGlobally, road transport accidents contribute substantially to the number of deaths and also to the burden of disability. Up to 50 million people suffer a transport-related non-fatal injury each year, which often leads to long-term disability. It has been shown that substantial number of people with minor injuries struggle to recover and the reasons are still not well explored.Despite the high prevalence, little is known about the factors hindering recovery following minor traffic-related injuries. The aim of this paper is to present a protocol for the systematic review aiming to understand biopsychosocial factors related to non-recovery and identify current gaps in the literature.Methods and analysisThe review will be conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol guidelines. A search of the electronic databases, MEDLINE, EMBASE, Cochrane Central Register of Controlled trials, will be undertaken, in addition to Google Scholar and grey literature to identify studies in period from 2006 to 2016. Quantitative and qualitative research articles describing and identifying biopsychosocial factors associated with non-recovery and health outcomes such as pain, disability, functional recovery, health-related quality of life, post-traumatic stress disorder, depression, anxiety and return to work will be included. A conceptual framework developed to identify biopsychosocial factors will be applied to assure defined criterion.At present, there is little anticipation for meta-analyses due to the heterogeneity of factors and outcomes assessed. Therefore, a narrative synthesis based on study findings will be conducted.Ethics and disseminationEthical approval is not required as primary data will not be collected. Review results will be published as a part of thesis, peer-reviewed journal and conferences.Trialregistration numberPROSPEROregistration number: CRD42016052276.
Intermittent catheter users’ symptom identification, description and management of urinary tract infection: a qualitative study
Authors: Okamoto Ikumi , Prieto Jacqui , Avery Miriam , Moore Katherine , Fader Mandy , Sartain Samantha , Clancy Bridget 
Published: September 2017

ObjectivesTo elucidate the views of intermittent catheter (IC) users regarding urinary tract infection (UTI) symptom presentation, terminology for describing signs and symptoms, the cause of UTI and management strategies.DesignQualitative study with semi-structured interviews. The transcribed text was analysed thematically.Setting12 general practitioner (GP) surgeries in Hampshire and Dorset, UK.ParticipantsA convenience sample of 30 IC users, aged over 18, using IC for at least 3 months who had at least one self-reported UTI since starting IC.ResultsParticipants reported a variety of signs and symptoms, such as urine cloudiness and smell, as indicators of UTI. The terms used often differed from those in the modified National Institute on Disability and Rehabilitation Research (NIDRR) symptom set. IC users had difficulty distinguishing possible UTI symptoms from those of their comorbidities. They expressed uncertainty about the cause of UTI, often attributing it to poor hygiene and lifestyle behaviours. Whereas some viewed UTI as an expected consequence of IC use that could be self-managed, others felt more concerned and were more reliant on their GP for support. A range of management strategies was described, including drinking more fluids, increased attention to personal hygiene and self-medicating with antibiotics.ConclusionsThere is uncertainty among IC users about UTI signs and symptoms and when to seek help. Individual accounts of UTI fitted generally within the modified NIDRR descriptors but adopted less technical and more ‘lay’ language. IC users’ descriptions of UTI signs and symptoms can lack precision, owing partly to the presence of underlying health conditions. This, together with differing levels of concern about the need to seek help and self-medication with antibiotics, presents challenges for the GP. This study provides the basis for developing a self-help tool which may aid identification of UTI and enhance communication with healthcare professionals.
Perceived effects of the economic recession on population mental health, well-being and provision of care by primary care users and professionals: a qualitative study protocol in Portugal
Authors: Antunes Ana , Frasquilho Diana , Cardoso Graça , Pereira Nádia , Silva Manuela , Caldas-de-Almeida José Miguel , Ferrão João 
Published: September 2017

IntroductionEconomic recession periods can pose accentuated risks to population’s mental health and well-being as well as additional threats to health systems. Users and health professionals are key stakeholders in care delivery; however, little attention has been given to their experiences of the crisis. This paper presents a qualitative study protocol to assess users’ and health professionals’ perceptions about the effects of the post-2008 economic recession on mental health and care delivery in the Lisbon Metropolitan Area, Portugal.Methods and analysisThe methodology to assess perceived effects of the economic recession by primary care users and professionals on population mental health, well-being and provision of care is presented. Focus groups with users and semistructured interviews with health professionals will be carried out in three primary healthcare units in Lisbon areas especially affected by the crisis. Thematic analysis of full-transcribed interviews will be conducted using an iterative and reflexive approach.Ethics and disseminationThe study protocol was approved by the Ethics Committee of NOVA Medical School, NOVA University of Lisbon. The findings will be useful for other researchers and policy-makers to develop and implement the assessment of prevailing experiences of users and health professionals on the effects of the economic recession on mental health and quality of care in primary health context, promoting their involvement and contribution to services responsiveness.
Telemedicine-guided education on secondary stroke and fall prevention following inpatient rehabilitation for Texas patients with stroke and their caregivers: a feasibility pilot study
Authors: Jhaveri Mansi M , Benjamin-Garner Ruby , Rianon Nahid , Sherer Mark , Francisco Gerard , Vahidy Farhaan , Kobayashi Kayta , Gaber Mary , Shoemake Paige , Vu Kim , Trevino Alyssa , Grotta James , Savitz Sean 
Published: September 2017

IntroductionThe aftermath of stroke leaves many consequences including cognitive deficits and falls due to imbalance. Stroke survivors and families struggle to navigate the complex healthcare system with little assistance posthospital discharge, often leading to early hospital readmission and worse stroke outcomes. Telemedicine Guided Education on Secondary Stroke and Fall Prevention Following Inpatient Rehabilitation feasibility study examines whether stroke survivors and their caregivers find value in telerehabilitation (TR) home visits that provide individualised care and education by a multidisciplinary team after discharge from inpatient rehabilitation.Methods and analysisA prospective, single arm, pilot study is designed to evaluate the feasibility of weekly TR home visits initiated postdischarge from inpatient rehabilitation. Newly diagnosed patients with stroke are recruited from a Houston-based comprehensive stroke centre inpatient rehabilitation unit, loaned an iPad with data plan and trained to use information technology security-approved videoconferencing application. After hospital discharge, six weekly TR home visits are led by rotating specialists (pharmacist, physical/occupational therapist, speech therapist, rehabilitation physician, social worker, geriatrician specialised in fracture prevention) followed by satisfaction survey on week 7. Specialists visually assess patients in real time, educate them on secondary stroke and fall prevention and suggest ways to improve function including direct medical interventions when indicated. Primary outcomes are proportion of eligible patients consenting to the study, participation rate in all six TR home visits and satisfaction score. The study started 31 December 2015 with plan to enrol up to 50 patients over 24 months. Feasibility study results will inform us as to whether a randomised controlled trial is warranted to determine efficacy of TR home visit intervention in improving stroke outcomes.Ethics and disseminationEthics approval obtained by the Institutional Review Board (IRB), Committee for the Protection of Human Subjects, IRB number: HSC-MS-14–0994. Study results will be submitted for publication in a peer-reviewed journal.
Reducing DNACPR complaints to zero: designing and implementing a treatment escalation plan using quality improvement methodology
Authors: Shermon Elizabeth , Munglani Laura , Oram Sarah , William Linda , Abel Julian 
Published: September 2017

IntroductionDo Not Attempt Resuscitation (DNAR)decisions have traditionally formed the basis of ceiling of care discussions. However, poor quality discussions can lead to high patient and relative dissatisfaction, generating hospital complaints. Treatment escalation plans (TEPs) aim to highlight the wider remit of treatment options with a focus on effective communication. We aimed to improve TEP discussions and documentation at Weston General Hospital by introducing a standardised form.Aims and methodWe aimed to develop a TEP document to reduce resuscitation-related complaints by improving communication and documentation. Qualitative and quantitative data were collected over 2 years and used to develop plan-do-study-act (PDSA) cycles using quality improvement methodology. Main barriers to improvement included time constraints and clinician’s resistance.ResultsAnalysis of patient liaison services data showed a progressive reduction in complaints regarding resuscitation, with no complaints having been received for the final six months of the project. Through use of a standardised form including treatment prompts, the quality of discussions and plans improved. Qualitative feedback demonstrated increased patient and relative satisfaction. In addition, junior doctors report the plans are helpful when making out-of-hours decisions.ConclusionDevelopment of a user-friendly form to document patient-guided TEPs helped junior doctors to lead advanced care planning discussions. The use of PDSA cycles demonstrated improvement in the quality of forms, which in turn improved communication, documentation and satisfaction. Future developments could include involvement of specialist teams to ensure TEP forms remain relevant to all clinical areas. In addition, with widespread use of the TEP forms, the traditional tick-box DNAR could be replaced to focus on patient-led care planning.
Lower airways inflammation in patients with ARDS measured using endotracheal aspirates: a pilot study
Authors: Spadaro Savino , Kozhevnikova Iryna , Casolari Paolo , Ruggeri Paolo , Bellini Tiziana , Ragazzi Riccardo , Barbieri Federica , Marangoni Elisabetta , Caramori Gaetano , Volta Carlo Alberto 
Published: September 2017

IntroductionOur knowledge of acute respiratory distress syndrome (ARDS) pathogenesis is incomplete. The goal of this pilot study is to investigate the feasibility of measuring lower airways inflammation in patients with ARDS using repeated endotracheal aspirates (ETAs).MethodsETAs were obtained within 24 hours by intensive care unit admission from 25 mechanically ventilated patients with ARDS and 10 of them underwent a second ETA within 96 hours after the first sampling. In each sample, cell viability was assessed using trypan blue exclusion method and the total and differential cell counts were measured using Neubauer-improved cell counting chamber and cytospins stained with Diff-Quik.ResultsThe median cell viability was 89 (IQR 80–93)%, with a median total cell count of 305 (IQR 130–1270)×103/mL and a median macrophage, neutrophil, lymphocyte and eosinophil count, respectively, of 19.8 (IQR 5.4–71.6)×103/mL; 279 (IQR 109–1213)×103/mL; 0 (IQR 0–0.188)×103/mL; 0 (IQR 0–1.050)×103/mL. Eosinophil count in the ETA correlated with the number of blood eosinophils (r=0.4840, p=0.0142). Cell viability and total and differential cell counts were neither significantly different in the second ETA compared with the first ETA nor were unaffected by the presence or absence of bacteria in the blood and/or ETA, or by the ARDS aetiology, apart from the macrophage count which was significantly increased in patients with ARDS associated with acute pancreatitis compared with those associated with pneumonia (p=0.0143).ConclusionsETA can be used to investigate the cellularity of the lower airways in patients with ARDS and it is an easy-to-perform and non-invasive procedure. Eosinophil counts in ETA and blood are significantly correlated. The number of macrophages in ETA may be affected by the aetiology of the ARDS.
Trimethylamine‐N‐Oxide Induces Vascular Inflammation by Activating the NLRP3 Inflammasome Through the SIRT3‐SOD2‐mtROS Signaling Pathway
Authors: Chen Ming‐liang , Zhu Xiao‐hui , Ran Li , Lang He‐dong , Yi Long , Mi Man‐tian 
Published: September 2017

Background

Trimethylamine‐N‐oxide (
TMAO
) has recently been identified as a novel and independent risk factor for promoting atherosclerosis through inducing vascular inflammation. However, the exact mechanism is currently unclear. Studies have established a central role of nucleotide‐binding oligomerization domain–like receptor family pyrin domain–containing 3 (
NLRP
3) inflammasome in the pathogenesis of vascular inflammation. Here, we examined the potential role of the
NLRP
3 inflammasome in
TMAO
‐induced vascular inflammation in vitro and in vivo and the underlying mechanisms.

Methods and Results

Experiments using liquid chromatography‐tandem mass spectrometry, Western blot, and fluorescent probes showed that
TMAO
‐induced inflammation in human umbilical vein endothelial cells (
HUVEC
s) and aortas from ApoE
−/−
mice. Moreover,
TMAO
promoted
NLRP
3 and activated caspase‐1 p20 expression and caspase‐1 activity in vitro and in vivo. Notably, a caspase‐1 inhibitor (
YVAD
), an
NLRP
3 inhibitor (
MCC
950), as well as

NLRP
3

short interfering
RNA
attenuated
TMAO
‐induced activation of the
NLRP
3 inflammasome, subsequently leading to suppression of inflammation in
HUVEC
s.
TMAO
additionally stimulated reactive oxygen species (
ROS
) generation, in particular, mitochondrial
ROS
, while inhibiting manganese superoxide dismutase 2 (SOD2) activation and sirtuin 3 (
SIRT
3) expression in
HUVEC
s and aortas from ApoE
−/−
mice.
TMAO
‐induced endothelial
NLRP
3 inflammasome activation was ameliorated by the mitochondrial
ROS
scavenger Mito‐
TEMPO
, or

SIRT
3

overexpression in
HUVEC
s. Conversely,
TMAO
failed to further inhibit SOD2 and activate the
NLRP
3 inflammasome or induce inflammation in

SIRT
3

short interfering
RNA
–treated
HUVEC
s and aortas from
SIRT
3
−/−
mice.

Conclusions

TMAO
promoted vascular inflammation by activating the
NLRP
3 inflammasome, and the
NLRP
3 inflammasome activation in part was mediated through inhibition of the
SIRT
3‐
SOD
2–mitochondrial
ROS
signaling pathway.
MMI‐0100 Inhibits Cardiac Fibrosis in a Mouse Model Overexpressing Cardiac Myosin Binding Protein C
Authors: Meng Qinghang , Bhandary Bidur , Osinska Hanna , James Jeanne , Xu Na , Shay‐Winkler Kritton , Gulick James , Willis Monte S. , Lander Cynthia , Robbins Jeffrey 
Published: September 2017

Background

Cardiac stress can trigger production of a 40‐kDa peptide fragment derived from the amino terminus of the cardiac myosin‐binding protein C. Cardiac stress, as well as
cMyBP
‐C mutations, can trigger production of 1 such truncated protein fragment, a 40‐kDa peptide fragment derived from the amino terminus of
cMyBP
‐C. Genetic expression of this 40‐kDa fragment in mouse cardiomyocytes (
cMyBP
‐C
40k
) leads to cardiac disease, fibrosis, and death within the first year. Fibrosis can occur in many cardiovascular diseases, and mitogen‐activated protein kinase––activated protein kinase‐2 signaling has been implicated in a variety of fibrotic processes. Recent studies demonstrated that mitogen‐activated protein kinase––activated protein kinase‐2 inhibition using the cell‐permeant peptide inhibitor
MMI
‐0100 is protective in the setting of acute myocardial infarction. We hypothesized that
MMI
‐0100 might also be protective in a chronic model of fibrosis, produced as a result of
cMyBP
‐C
40k
cardiomyocyte expression.

Methods and Results

Nontransgenic and
cMyBP
‐C
40k
inducible transgenic mice were given
MMI
‐0100 or
PBS
daily for 30 weeks. In control groups, long‐term
MMI
‐0100 was benign, with no measurable effects on cardiac anatomy, function, cell viability, hypertrophy, or probability of survival. In the inducible transgenic group,
MMI
‐0100 treatment reduced cardiac fibrosis, decreased cardiac hypertrophy, and prolonged survival.

Conclusions

Pharmaceutical inhibition of mitogen‐activated protein kinase––activated protein kinase‐2 signaling via
MMI
‐0100 treatment is beneficial in the context of fibrotic
cMyBPC
40k
disease.
Vena Cava Filter Retrieval Rates and Factors Associated With Retrieval in a Large US Cohort
Authors: Brown Joshua D. , Raissi Driss , Han Qiong , Adams Val R. , Talbert Jeffery C. 
Published: September 2017

Background

Retrieval of vena cava filters (
VCF
s) is important for safety as complications increase with longer dwell times. This study assessed
VCF
retrieval rates and factors associated with retrieval in a national cohort.

Methods and Results

VCF
s were identified by procedural codes from an administrative claims database. Patients were identified who had a
VCF
placement during a hospitalization from a national commercial administrative claims database. Indications for
VCF
placement were identified as pulmonary embolism with or without deep vein thrombosis, deep vein thrombosis only, or prophylactic. Patient demographic and clinical characteristics were included in proportional hazard regression models to find associations with early (90‐day) and 1‐year
VCF
retrieval. Initiation of anticoagulation and the correlation between time‐to‐retrieval and time‐to‐initiation of anticoagulation were observed. Of 54 766 patients receiving a
VCF
, 36.9% had pulmonary embolism, 43.9% had deep vein thrombosis only, and 19.2% had no apparent venous thromboembolism present. Over the 1 year of follow‐up, the cumulative incidence of
VCF
retrieval was 18.4%. Retrieval increased over time from a low of 14.0% in 2010 up to ≈24% in 2014. In adjusted time‐to‐event models, increasing age, differing regions, and some comorbidities were associated with poorer retrieval rates. Initiation of anticoagulation was poorly correlated with retrieval, with anticoagulation preceding retrieval by a median of 51 days while those without retrieval had a median of 278 days of exposure to anticoagulation.

Conclusions

VCF
retrieval increased over the study period but remained suboptimal and was weakly correlated with anticoagulation initiation.
A Fast Two-Stream-Like Multiple-Scattering Method for Atmospheric Characterization and Radiative Transfer
Authors: Burley Jarred L. , Fiorino Steven T. , Elmore Brannon J. , Schmidt Jaclyn E. 
Published: September 2017

AbstractMultiple-scattering effects can significantly impact radiative transfer calculations for remote sensing and directed-energy applications. This study describes the development and implementation of a fast-calculating two-stream-like multiple-scattering algorithm that captures azimuthal and elevation variations into the Air Force Institute of Technology Center for Directed Energy’s Laser Environmental Effects Definition and Reference (LEEDR) atmospheric characterization and radiative transfer code. LEEDR is a fast-calculating, first-principles, worldwide surface-to-100-km, atmospheric characterization package for the creation of vertical profiles of temperature, pressure, water vapor content, optical turbulence, atmospheric particulates, and hydrometeors as they relate to line-by-line layer transmission and radiance from the ultraviolet to radio frequencies. The newly implemented multiple-scattering algorithm fully solves for molecular, aerosol, cloud, and precipitation single-scatter layer effects with a Mie algorithm at every atmospheric layer. A unique set of asymmetry and backscattering phase-function parameter calculations accounts for radiance loss due to the molecular and aerosol constituent reflectivity within a layer and accurately characterize diffuse layers that contribute to multiple-scattered radiances in inhomogeneous atmospheres. LEEDR is valid for spectral bands between 200-nm and radio wavelengths. Accuracy is demonstrated by comparing LEEDR results with published sky radiance observations and experimental data. Determining accurate aerosol loading via an iterative visibility/particle-count calculation method is ultimately essential to achieve agreement between observations and model results for realistic atmospheres.