bluuebunny/crossref_metadata_2025_split huggingface dataset:
Glycated Hemoglobin A1c Levels Are Not Affected by Critical Illness
Authors: Luethi Nora , Cioccari Luca , Tanaka Aiko , Kar Palash , Giersch Emma , Deane Adam M. , Mårtensson Johan , Bellomo Rinaldo 
Published: March 2016

Objectives:
Glycated hemoglobin A1c is used to estimate glycemic control. However, its value upon ICU admission may be altered by critical illness and not reflect true glycemic status. We assessed the relationship between ICU admission glycated hemoglobin A1c and premorbid glycated hemoglobin A1c levels.

Design:
Retrospective observational cohort study.

Setting:
Two tertiary ICUs in Australia.

Patients:
Cohort of 69 critically ill patients with diabetes and glycated hemoglobin A1c levels measured upon ICU admission and during the month prior to admission.

Interventions:
Measurement of glycated hemoglobin A1c.

Measurements and Main Results:
Mean (sd) glycated hemoglobin A1c level was 7.5% (1.8%) upon ICU admission and 7.8% (2.0%) in previous measurements from the preceding 30 days. The change in glycated hemoglobin A1c did not correlate with time elapsed between the two measurements (r
2 = 0.00005; p = 0.95), but there was a strong correlation between admission glycated hemoglobin A1c levels and premorbid glycated hemoglobin A1c levels (r
2 = 0.89; p < 0.001).

Conclusions:
Glycated hemoglobin A1c levels are not altered by the onset of critical illness. Glycated hemoglobin A1c quantified at ICU admission can, therefore, be used to reliably estimate chronic glycemic control and guide acute glycemic therapy.
Potential of Food and Natural Products to Promote Endothelial and Vascular Health
Authors: Auger Cyril , Said Amissi , Nguyen Phuong Nga , Chabert Philippe , Idris-Khodja Noureddine , Schini-Kerth Valérie B. 
Published: March 2016

Abstract:
Endothelial dysfunction is now well established as a pivotal early event in the development of major cardiovascular diseases including hypertension, atherosclerosis, and diabetes. The alteration of the endothelial function is often triggered by an imbalance between the endothelial formation of vasoprotective factors including nitric oxide (NO) and endothelium-dependent hyperpolarization, and an increased level of oxidative stress involving several prooxidant enzymes such as NADPH oxidase and, often also, the appearance of cyclooxygenase-derived vasoconstrictors. Preclinical studies have indicated that polyphenol-rich food and food-derived products such as grape-derived products, black and red berries, green and black teas and cocoa, and omega-3 fatty acids can trigger activating pathways in endothelial cells promoting an increased formation of nitric oxide and endothelium-dependent hyperpolarization. Moreover, intake of such food-derived products has been associated with the prevention and/or the improvement of an established endothelial dysfunction in several experimental models of cardiovascular diseases and in humans with cardiovascular diseases. This review will discuss both experimental and clinical evidences indicating that different types of food and natural products are able to promote endothelial and vascular health, as well as the underlying mechanisms.
INTRAVITREAL DEXAMETHASONE IMPLANTATION FOR BIRDSHOT CHORIORETINOPATHY
Authors: Walsh James , Reddy Ashvini K. 
Published: March 2016

Purpose:
Birdshot chorioretinopathy is a rare form of posterior uveitis. This article reports a case series of patients with HLA-A29+ birdshot chorioretinopathy managed with intravitreal dexamethasone implants.

Methods:
Retrospective case report.

Results:
Three patients with birdshot chorioretinopathy (6 eyes) were seen from 2013 to 2015 and managed with dexamethasone intravitreal implant; there was an average of 6 months between implants. All 3 experienced control of ocular inflammation and macular edema with intravitreal dexamethasone and achieved best-corrected visual acuity of at least 20/25 during the course of treatment. Two patients tolerated serial dexamethasone implants for over a year without glaucoma or cataract surgery. Dexamethasone implantation was not repeated in one patient with preexisting uveitic glaucoma because of persistently elevated intraocular pressure. In this series, all patients had improvement in visual acuity, macular edema, intraocular inflammation, and quality of life, and no patients developed visually significant cataracts. Only one eye with preexisting uveitic glaucoma exhibited an increased intraocular pressure requiring discontinuation of therapy.

Conclusion:
Intravitreal dexamethasone implant can be an effective alternative in the management of birdshot chorioretinopathy.
Attitudes of Turkish Nursing Students Related to Ageism
Authors: Özdemir Özlem , Bilgili Naile 
Published: March 2016

ABSTRACT

Background:
The sociocultural structure of society, changes in attitude and behaviors, and individual and social perspectives on aging all affect the nature of services that are offered to elderly people. “Ageism” is one of the problems that has an impact on the level and quality of service that is provided to the older adults.

Purpose:
This study was undertaken to examine the attitudes of Turkish undergraduate nursing students toward aging.

Methods:
A cross-sectional survey was given to 495 nursing students in four universities in Turkey. A questionnaire developed from the related literature and the Ageism Attitude Scale were used to collect data, which was analyzed using standard descriptive statistical methods.

Results:
The variables of school year, age, cohabitation with an elderly person (yes/no), prior experience with the older adults (yes/no), and willingness to work with the older adults after graduation all significantly influenced the attitudes of participants toward aging (p < .05).

Conclusions/Implications for Practice:
The results from the Ageism Attitude Scale revealed that the participants held a generally positive attitude toward aging. It is of great importance to include more lessons on the older adults and the aging process and to increase activities to develop awareness of ageism, to help students develop positive attitudes and perspectives toward the care of the older adults. Because experience caring for the older adults is important in developing a positive attitude toward the older adults, arranging relevant clinical practice, especially at institutions with an elderly population, may be an effective approach to strengthening the communication and experiences of nursing students.
Large arterial occlusive strokes as a medical emergency: need to accurately predict clot location
Authors: Vanacker Peter , Faouzi Mohamed , Eskandari Ashraf , Maeder Philippe , Meuli Reto , Michel Patrik 
Published: March 2016

Background
Endovascular treatment for acute ischemic stroke with a large intracranial occlusion was recently shown to be effective. Timely knowledge of the presence, site, and extent of arterial occlusions in the ischemic territory has the potential to influence patient selection for endovascular treatment. We aimed to find predictors of large vessel occlusive strokes, on the basis of available demographic, clinical, radiological, and laboratory data in the emergency setting.

Methods
Patients enrolled in ASTRAL registry with acute ischemic stroke and computed tomography (CT)-angiography within 12 h of stroke onset were selected and categorized according to occlusion site. Easily accessible variables were used in a multivariate analysis.

Results
Of 1645 patients enrolled, a significant proportion (46.2%) had a large vessel occlusion in the ischemic territory. The main clinical predictors of any arterial occlusion were in-hospital stroke [odd ratios (OR) 2.1, 95% confidence interval 1.4–3.1], higher initial National Institute of Health Stroke Scale (OR 1.1, 1.1–1.2), presence of visual field defects (OR 1.9, 1.3–2.6), dysarthria (OR 1.4, 1.0–1.9), or hemineglect (OR 2.0, 1.4–2.8) at admission and atrial fibrillation (OR 1.7, 1.2–2.3). Further, the following radiological predictors were identified: time-to-imaging (OR 0.9, 0.9–1.0), early ischemic changes (OR 2.3, 1.7–3.2), and silent lesions on CT (OR 0.7, 0.5–1.0). The area under curve for this analysis was 0.85. Looking at different occlusion sites, National Institute of Health Stroke Scale and early ischemic changes on CT were independent predictors in all subgroups.

Conclusion
Neurological deficits, stroke risk factors, and CT findings accurately identify acute ischemic stroke patients at risk of symptomatic vessel occlusion. Predicting the presence of these occlusions may impact emergency stroke care in regions with limited access to noninvasive vascular imaging.
Hospital Readmission and Length of Stay Over Time in Patients Undergoing Major Cardiovascular and Orthopedic Surgery
Authors: Sedrakyan Art , Kamel Hooman , Mao Jialin , Ting Henry , Paul Subroto 
Published: March 2016

Background:
Readmission and length of stay (LOS) are increasingly accepted as quality measures for surgical care. Centers for Medicare & Medicaid Services will soon assess penalties for excessive readmissions after coronary artery bypass graft (CABG) surgery and hip and knee replacements.

Objective:
To determine and compare population level changes in LOS and relationship with 30-day readmission over time for patients undergoing CABG and hip and knee replacements. Secondary objective was to determine relationship between LOS and discharge disposition as well as mortality.

Research Design:
Observational cohort study of patients undergoing CABG and hip and knee replacements in New York and California. Temporal trends in LOS, discharge disposition, 30-day readmission, and mortality were examined. Generalized linear-mixed models, accounting for hospital clustering, were used to assess differences in outcomes.

Subjects:
Patients undergoing CABG and hip and knee replacements in New York and California between 2005 and 2011.

Measures:
Trends in LOS, discharge disposition, 30-day readmission and mortality, and risk-adjusted odds of all-cause 30-day readmission.

Results:
We identified 206,784, 336,271, and 416,391 patients who underwent CABG, hip, and knee replacements, respectively, in New York State and California between 2005 and 2011. The risks of readmission within 30 days decreased over time in both states. LOS decreased by 1 day after hip and knee surgery and remained unchanged after CABG. Adjusted analysis confirmed these trends. In secondary analyses patients in New York had higher overall odds of 30-day readmission compared with patients in California.

Conclusions:
We found no evidence of inverse relationship between LOS and readmission over time. In hip and knee replacement there is strong evidence that both LOS and readmission have been reduced simultaneously.
Are Older Adults With Hip Fractures Disadvantaged in Level 1 Trauma Centers?
Authors: Metcalfe David , Olufajo Olubode A. , Zogg Cheryl K. , Gates Jonathan D. , Weaver Michael J. , Harris Mitchel B. , Rios-Diaz Arturo J. , Haider Adil H. , Salim Ali 
Published: March 2016

Background:
Large regional hospitals achieve good outcomes for patients with complex conditions. However, recent studies have suggested that some patient groups might not benefit from treatment in higher-level trauma centers.

Objective:
To test the hypothesis that older adults with isolated hip fractures experience delayed surgical treatment and worse clinical outcomes when treated in higher-level trauma centers.

Research Design:
Retrospective cohort study using a statewide longitudinal database that captured 98% of inpatients within California (2007–2011).

Subjects:
All older adults (aged 65 y and above) admitted with an isolated hip fracture who did not require interhospital transfer.

Measures:
Days to operation, length of stay, inhospital mortality, 30-day risk of unplanned readmission, 30-day venous thromboembolism, decubitus ulcers, and pneumonia.

Results:
There were 91,401 patients, 6.1% of whom were treated in a level 1 trauma center (L1TC), 17.7% in a level 2 trauma center (L2TC), and 70.2% in a nontrauma center (NTC). Within multivariable logistic and generalized linear regression models, patients treated in L1TCs underwent surgery later (predicted mean difference: 0.30 d; 95% CI, 0.08–0.53), had prolonged inpatient stays (0.99 d, 0.40–1.59), and had higher odds of both 30-day readmission (aOR=1.62; 95% CI, 1.35–1.93) and venous thromboembolism (aOR=1.32, 1.01–1.74) relative to NTCs. There were no differences in mortality, decubitus ulcers, or pneumonias. L2TCs were not different from NTCs across any of the measured outcomes.

Conclusions:
Older adults with hip fractures may be disadvantaged in L1TCs. Further research should aim to develop our understanding of this disparity to ensure that all patient groups benefit from the resources and expertise available within these hospitals.
Developing the Pediatric Gastrointestinal Endoscopy Unit
Authors: Pall Harpreet , Lerner Diana , Khlevner Julie , Reynolds Carrie , Kurowski Jacob , Troendle David , Utterson Elizabeth , Evans Pamela M. , Brill Herbert , Wilsey Michael , Fishman Douglas S. 
Published: March 2016

ABSTRACTThere is significant variability in the design and management of pediatric endoscopy units. Although there is information on adult endoscopy units, little guidance is available to the pediatric endoscopy practitioner. The purpose of this clinical report, prepared by the NASPGHAN Endoscopy and Procedures Committee, is to review the important considerations for setting up an endoscopy unit for children. A systematic review of the literature was undertaken in the preparation of this report regarding the design, management, needed equipment, motility setup, billing and coding, and pediatric specific topics.
Effects of 3,4-Methylenedioxymethamphetamine on Patient Utterances in a Psychotherapeutic Setting
Authors: Corey Vicka Rael , Pisano Vincent D. , Halpern John H. 
Published: March 2016

Abstract
3,4-Methylenedioxymethamphetamine (MDMA) administered as an adjunct to talk therapy influences patient speech content and increases improvement in treatment-resistant posttraumatic stress disorder (PTSD). Data came from the recordings of Mithoefer et al. (2011). In the third therapeutic session studied, patients were assigned, double blind, to an MDMA or a placebo group. Condition-blind scorers listened to therapy recordings and scored utterances where patients initiated topics that were empathic (regarding others' emotions), entactic (requesting or appreciating physical touch), or ensuic (describing a change in their sense of themselves). Patients who received MDMA produced high levels of ensuic, empathic, and entactic utterances compared with those who received the placebo. Interrater discourse scoring was reliable. The relationship between the number of scored utterances and the Clinician Administered PTSD Scale scores measuring PTSD severity after the treatment was significant, and reanalysis grouped bimodally into “many” or “few” such utterances remained significant. MDMA assisted these patients in having meaningful and disorder-resolving thoughts and discourse in talk therapy.
Benign Paroxysmal Positional Vertigo in 2 Children: A Case Series
Authors: Fay Jennifer L. 
Published: March 2016

Purpose:
The purpose of this case report is to present the cases of 2 boys with benign paroxysmal positional vertigo (BPPV).

Key Points:
Patient A (11 years old) and Patient B (9 years old) had complaints of vertigo with position changes. Both exhibited left torsion upbeating nystagmus in the left Dix-Hallpike (DH) test and complaints of vertigo with reproduction of their symptoms, indicating BPPV. Both were treated with a left canalith repositioning maneuver and reported decreased incidence of positional vertigo upon reevaluation. Scores on the Dizziness Handicap Inventory and the Visual Analog Scale for Dizziness decreased after treatment for 1 of the boys.

Conclusion:
Benign paroxysmal positional vertigo is considered rare in children. Migraines may also cause vertigo. Differential diagnosis in these cases was made by performing the DH test.

Recommendations for Clinical Practice:
Children with vertigo should be screened for BPPV through use of history taking, and the DH test.
Building the Composite Face Lift: A Personal Odyssey
Authors: Hamra Sam T. 
Published: March 2016

Summary:
This article is a 42-year history of the development of a comprehensive face-lift technique by the author. It describes how the composite rhytidectomy has been constructed, anatomical area by anatomical area, over the author’s lifetime career as a plastic surgeon. Over the course of these years, beginning with Skoog’s 1973 description of using the platysma muscle of the lower face, it describes how progressively the other significant structures of anatomy necessary to be used in achieving significant rejuvenation have been analyzed by the author and in turn surgically repositioned. The theory was based on creating a composite flap of the face, keeping the orbicularis oculi muscle, facial platysma muscle, and cheek fat in their normal anatomical and intimate relationship with each other by using the skin as the carriage. In addition, differences of vectors between the composite rhytidectomy and traditional techniques are demonstrated. The gradual and persistent pursuit of periorbital rejuvenation using the lower eyelid fat and the septal orbitale is described. Each of the anatomical structures involved and the description of their importance and surgical execution have been published over the surgical career of the author, including use of the same principles for reversing suboptimal face-lift results.
High Variability of Hormonal Levels and No Clinically Relevant Interaction Between Ethinyl Estradiol, Desogestrel and Lopinavir/Ritonavir in a Small Sample of HIV-positive Adolescents
Authors: Kancheva Landolt Nadia , Bunupuradah Torsak , Kosalaraksa Pope , Ubolyam Sasiwimol , Thammajaruk Narukjaporn , Cremers Serge , Zott Roseann , Kerr Stephen , Ananworanich Jintanat ,   on behalf of HIV-NAT 176 study
Published: March 2016

Background:
We report the pharmacokinetic interactions of combined oral contraceptive (COC) containing ethinyl estradiol (EE2)/desogestrel (DSG) with lopinavir/ritonavir (LPV/r) in 16 HIV-positive adolescents.

Methods:
We measured Ctrough of EE2 and etonogestrel (ENG), the active metabolite of DSG, in HIV-positives on LPV/r-based ART; Ctrough of LPV/r with and without COC; endogenous progesterone. EE2/ENG levels were compared with our own historical data of HIV-negative controls.

Results:
Ctrough of EE2 and ENG varied from 3 to 57 pg/mL and from 1051 to 5000 pg/mL, respectively. The geometric mean ratios (GMR) of Ctrough in HIV-positives on LPV/r with COC versus HIV-negative controls with COC only were 0.68 (95% CI: 0.42 to 1.08) or 32% decreased (P = 0.10) for EE2; and 1.08 (95% CI: 0.73 to 1.60) or 8% increased (P = 0.68) for ENG. Endogenous progesterone was <1.0 ng/mL in all participants, consistent with anovulation. Ctrough of LPV decreased statistically insignificantly with COC and remained above the desired therapeutic minimum of 1.0 mg/L in all.

Conclusions:
The study found no clinically relevant interaction between EE2/DSG and LPV/r. This was supported by suppressed ovulation, assessed by low endogenous progesterone levels in all participants; and preserved antiretroviral activity, assessed by LPV/r levels above the desired therapeutic minimum in all participants. However, the high variability of hormonal levels warrants individual monitoring and further investigation. Condom use should always be encouraged for infection prevention.
AVOCADO: Visualization of Workflow-Derived Data Provenance for Reproducible Biomedical Research
Authors: Stitz Holger , Luger Stefan , Streit Marc , Gehlenborg Nils 
Published: March 2016

AbstractA major challenge of data-driven biomedical research lies in the collection and representation of data provenance information to ensure reproducibility of findings. In order to communicate and reproduce multi-step analysis workflows executed on datasets that contain data for dozens or hundreds of samples, it is crucial to be able to visualize the provenance graph at different levels of aggregation. Most existing approaches are based on node-link diagrams, which do not scale to the complexity of typical data provenance graphs. In our proposed approach we reduce the complexity of the graph using hierarchical and motif-based aggregation. Based on user action and graph attributes a modular degree-of-interest (DoI) function is applied to expand parts of the graph that are relevant to the user. This interest-driven adaptive provenance visualization approach allows users to review and communicate complex multi-step analyses, which can be based on hundreds of files that are processed by numerous workflows. We integrate our approach into an analysis platform that captures extensive data provenance information and demonstrate its effectiveness by means of a biomedical usage scenario.
Adaptive divergence in transcriptome response to heat and acclimation inArabidopsis thalianaplants from contrasting climates
Authors: Zhang Nana , Vierling Elizabeth , Tonsor Stephen J. 
Published: March 2016

AbstractPhenotypic variation in stress response has been widely observed within species. This variation is an adaptive response to local climates and is controlled by gene sequence variation and especially by variation in expression at the transcriptome level. Plants from contrasting climates are thus expected to have different patterns in gene expression. Acclimation, a pre-exposure to sub-lethal temperature before exposing to extreme high temperature, is an important adaptive mechanism of plant survival. We are interested to evaluate the gene expression difference to heat stress for plants from contrasting climates and the role of acclimation in altering their gene expression pattern. NaturalArabidopsis thalianaplants from low elevation mediterranean and high elevation montane climates were exposed to two heat treatments at the bolting stage: a) 45°C: a direct exposure to 45°C heat; b) 38/45°C: an exposure to 45°C heat after a 38°C acclimation treatment. Variation in overall gene expression patterns was investigated. We also explored gene expression patterns for Hsp/Hsf pathway and reactive oxygen species (ROS) pathway. In both heat treatments, high elevation plants had more differentially expressed (DE) genes than low elevation plants. In 45°C, only Hsp/Hsf pathway was activated in low elevation plants; both Hsp/Hsf and ROS pathways were activated in high elevation plants. Small Hsps had the highest magnitude of change in low elevation plants while Hsp70 and Hsp90 showed the largest magnitude of fold in high elevation plants. In 38/45°C, Hsp/Hsf and ROS pathways were activated in both low and high elevation plants. Low elevation plants showed up-regulation in all Hsps, especially small Hsps; high elevation plants showed down-regulation in all Hsps. Low elevation and high elevation also adopted different genes in the ROS pathway. We also observed genes that shifted expression in both low and high elevation plants but with opposite directions of change. This study indicates that low and high elevation plants have evolved adaptive divergence in heat stress response. The contrasting patterns of temperature variation in low and high elevation sites appears to have played a strong role in the evolution of divergent patterns to high temperature stress, both pre-acclimation and direct exposure gene expression responses.Molecular EcologyThe Plant Journal IF: 6.8 (TPJ welcomes functional genomics manuscripts when a scientific question, rather than the technology used, has driven the research)