bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fatal injuries in rural and urban areas in northern Finland: a 5‐year retrospective study
Authors: Raatiniemi L. , Steinvik T. , Liisanantti J. , Ohtonen P. , Martikainen M. , Alahuhta S. , Dehli T. , Wisborg T. , Bakke H. K. 
Published: January 2016

BackgroundFinland has the fourth highest injury mortality rate in the European Union. To better understand the causes of the high injury rate, and prevent these fatal injuries, studies are needed. Therefore, we set out to complete an analysis of the epidemiology of fatal trauma, and any contributory role for alcohol, long suspected to promote fatal injuries. As a study area, we chose the four northernmost counties of Finland; their mix of remote rural areas and urban centres allowed us to correlate mortality rates with ‘rurality’.MethodsThe Causes of Death Register was consulted to identify deaths from external causes over a 5‐year time period. Data were retrieved from death certificates, autopsy reports and medical records. The municipalities studied were classified as either rural or urban.ResultsOf 2915 deaths categorized as occurring from external causes during our study period, 1959 were eligible for inclusion in our study. The annual crude mortality rate was 54 per 100,000 inhabitants; this rate was higher in rural vs. urban municipalities (65 vs. 45 per 100,000 inhabitants/year). Additionally, a greater number of pre‐hospital deaths from accidental high‐energy trauma occurred in rural areas (78 vs. 69%). 42% of all pre‐hospital deaths occurred under the influence of alcohol.ConclusionThe crude mortality rate for fatal injuries was high overall as compared to other studies, and elevated in rural areas, where pre‐hospital deaths were more common. Almost half of pre‐hospital deaths occurred under the influence of alcohol.
Absence of Tau triggers age‐dependent sciatic nerve morphofunctional deficits and motor impairment
Authors: Lopes Sofia , Lopes André , Pinto Vítor , Guimarães Marco R. , Sardinha Vanessa Morais , Duarte‐Silva Sara , Pinheiro Sara , Pizarro João , Oliveira João Filipe , Sousa Nuno , Leite‐Almeida Hugo , Sotiropoulos Ioannis 
Published: January 2016

SummaryDementia is the cardinal feature of Alzheimer's disease (AD), yet the clinical symptoms of this disorder also include a marked loss of motor function. Tau abnormal hyperphosphorylation and malfunction are well‐established key events in AD neuropathology but the impact of the loss of normal Tau function in neuronal degeneration and subsequent behavioral deficits is still debated. While Tau reduction has been increasingly suggested as therapeutic strategy against neurodegeneration, particularly in AD, there is controversial evidence about whether loss of Tau progressively impacts on motor function arguing about damage of CNS motor components. Using a variety of motor‐related tests, we herein provide evidence of an age‐dependent motor impairment in Tau−/− animals that is accompanied by ultrastructural and functional impairments of the efferent fibers that convey motor‐related information. Specifically, we show that the sciatic nerve of old (17–22‐months) Tau−/− mice displays increased degenerating myelinated fibers and diminished conduction properties, as compared to age‐matched wild‐type (Tau+/+) littermates and younger (4–6 months) Tau−/− and Tau+/+ mice. In addition, the sciatic nerves of Tau−/− mice exhibit a progressive hypomyelination (assessed by g‐ratio) specifically affecting large‐diameter, motor‐related axons in old animals. These findings suggest that loss of Tau protein may progressively impact on peripheral motor system.
Generalizability and Effectiveness of Butterfly Phlebotomy in Reducing Hemolysis
Authors: Barnaby Douglas P. , Wollowitz Andrew , White Deborah , Pearlman Scott , Davitt Michelle , Holihan Laura , Bijur Polly , Gallagher E. John 
Published: January 2016

AbstractObjectivesThe objective was to test the hypothesis that exclusive use of butterfly needles for phlebotomy, compared with sample collection via intravenous (IV) catheter, will reduce rates of sample hemolysis.MethodsThis was an observational study of hemolysis rates before and after implementation of a “butterfly‐only” phlebotomy protocol. Weekly hemolysis rates, generated by the central laboratory, were collected and the proportion of hemolyzed specimens before and after protocol implementation were compared.ResultsPrior to institution of the butterfly‐only protocol, 11.3% of specimens sent from the emergency department were reported as hemolyzed. During the postintervention period, only 4.3% of specimens were hemolyzed for a proportionate decrease of 62% and an absolute decrease of 7.0% (95% confidence interval = 6.6% to 7.3%).ConclusionsUse of a butterfly‐only phlebotomy protocol cuts hemolysis rates by more than half when compared with IV catheter phlebotomy.
Aortic Hemostasis and Resuscitation: Preliminary Experiments Using Selective Aortic Arch Perfusion With Oxygenated Blood and Intra‐aortic Calcium Coadministration in a Model of Hemorrhage‐induced Traumatic Cardiac Arrest
Authors: Manning James E. , Ross James D. , McCurdy Shane L. , True Nicholas A. 
Published: January 2016

AbstractObjectivesSelective aortic arch perfusion (SAAP) uses a thoracic aortic balloon occlusion catheter for heart and brain perfusion in cardiac arrest to achieve return of spontaneous circulation (ROSC). SAAP with oxygenated stored blood was studied in a model of hemorrhage‐induced cardiac arrest. The study hypothesis was that intra‐aortic calcium coadministration would be required to maintain normal aortic arch blood ionized calcium during SAAP and to achieve ROSC.MethodsTwelve anesthetized, domestic swine underwent severe hemorrhage and liver injury resulting in cardiac arrest. Whole blood and packed red blood cells (RBCs) stored in citrate anticoagulant served as perfusates for SAAP. Experiments were performed with four combinations of SAAP with oxygenated stored blood and intra‐aortic calcium gluconate infusion: 1) whole blood without calcium, 2) whole blood with calcium, 3) lactated Ringers–diluted packed RBCs with calcium, and 4) normal saline‐diluted packed RBCs with calcium. Aortic arch blood ionized calcium was monitored. Occurrence of ventricular dysrhythmias, success rate for ROSC, and the need for simultaneous intra‐aortic calcium infusion were assessed.ResultsSelective aortic arch perfusion using whole blood without intra‐aortic calcium (n = 2) resulted in severe aortic blood ionized hypocalcemia, refractory ventricular fibrillation, and no ROSC. SAAP using whole blood with intra‐aortic calcium (n = 4) resulted in ROSC in all four animals. Two of four developed ventricular fibrillation that was successfully defibrillated. SAAP using packed RBCs with intra‐aortic calcium resulted in ROSC in all six animals, but the intra‐aortic calcium dose needed to maintain normal aortic arch blood ionized calcium levels was one‐third of that needed for SAAP with whole blood. Dilution of packed RBCs with lactated Ringers (n = 2) resulted in formation of small clots in the perfusion circuit which were not seen with packed RBCs diluted with normal saline (n = 4).ConclusionsSelective aortic arch perfusion with stored whole blood or packed RBCs requires simultaneous intra‐aortic calcium infusion to overcome citrate anticoagulant calcium binding, avoid refractory ventricular fibrillation, and allow for ROSC.
Comparison of Four Bleeding Risk Scores to Identify Rivaroxaban‐treated Patients With Venous Thromboembolism at Low Risk for Major Bleeding
Authors: Kline Jeffrey A. , Jimenez David , Courtney D. Mark , Ianus Juliana , Cao Lynn , Lensing Anthonie W.A. , Prins Martin H. , Wells Philip S. 
Published: January 2016

AbstractObjectivesOutpatient treatment of acute venous thromboembolism (VTE) requires the selection of patients with a low risk of bleeding during the first few weeks of anticoagulation. The accuracy of four systems, originally derived for predicting bleeding in VTE treated with vitamin K antagonists (VKAs), was assessed in VTE patients treated with rivaroxaban.MethodsAll patients treated with rivaroxaban in the multinational EINSTEIN deep vein thrombosis (DVT) and pulmonary embolism (PE) trials were included. Major bleeding was defined as ≥2 g/dL drop in hemoglobin or ≥2‐unit blood transfusion, bleeding in critical area, or bleeding contributing to death. The authors examined the incidence of major bleeding in patients with low‐risk assignment by the systems of Ruiz‐Gimenez et al. (score = 0 to 1), Beyth et al. (score = 0), Kuijer et al. (score = 0), and Landefeld and Goldman. (score = 0). For clinical relevance, the definition of low risk for all scores except Kuijer includes all patients < 65 years with no prior bleeding history and no comorbid conditions (current cancer, renal insufficiency, diabetes mellitus, anemia, prior stroke, or myocardial infarction).ResultsA total of 4,130 patients (1,731 with DVT only, 2,399 with PE with or without DVT) were treated with rivaroxaban for a mean (±SD) duration of 207.6 (±95.9) days. Major bleeding occurred in 1.0% (40 of 4,130; 95% confidence interval [CI] = 0.7% to 1.3%) overall. Rates of major bleeding for low‐risk patients during the entire treatment period were similar: Ruiz‐Gimenez et al., 12 of 2,622 (0.5%; 95% CI = 0.2% to 0.8%); Beyth et al., nine of 2,249 (0.4%; 95% CI = 0.2% to 0.8%); Kuijer et al., four of 1,186 (0.3%; 95% CI = 0.1% to 0.9%); and Landefeld and Goldman, 11 of 2,407 (0.5%; 95% CI = 0.2% to 0.8%). At 30 days, major bleed rates for low‐risk patients were as follows: Ruiz‐Gimenez et al., five of 2,622 (0.2%; 95% CI = 0.1% to 0.4%); Beyth et al., five of 2,249 (0.2%; 95% CI = 0.1% to 0.5%); Kuijer et al., three of 1,186 (0.3%; 95% CI = 0.1% to 0.7%); and Landefeld and Goldman, seven of 2,407 (0.3%; 95% CI = 0.1% to 0.6%). No low‐risk patient had a fatal bleed.ConclusionsFour scoring systems that use criteria obtained in routine clinical practice, derived to predict low bleeding risk with VKA treatment for VTE, identified patients with less than a 1% risk of major bleeding during full‐course treatment with rivaroxaban.
Changes in the utilization of psychiatric hospital facilities in Denmark by patients diagnosed with schizophrenia from 1970 through 2012
Authors: Jeppesen R. M. , Christensen T. , Vestergaard C. H. 
Published: January 2016

ObjectiveThe Danish psychiatric system has gone through several structural changes in the last four decades. The deinstitutionalization of the mental healthcare system was implemented in Denmark in the late 1970s with the intention of increasing out‐patient treatment. One of the aims in the reorganization was to treat the patient in the local environment rather than during long‐term hospitalization. This study focuses on the changes in the utilization of hospital facilities.MethodUsing register data from secondary healthcare treatment of patients diagnosed with schizophrenia in Denmark 1970–2012, we analysed the development in the use of hospital facilities.ResultsOur major finding was a 220% increase between 1970 and 2012 in the total number of hospital admissions due to schizophrenia each year, while at the same time the number of annual schizophrenia bed days was reduced by 76%. Furthermore, the readmission rate within a year after discharge with a diagnosis of schizophrenia reached 70% in 2012 compared to 51% in 1970. Finally, the total bed occupancy continued to rise over the four decades and has exceeded 100% in several years since 1999.ConclusionThe findings indicate that the reorganization of the Danish mental healthcare system has created a problem of ‘revolving door’ schizophrenia patients’ who since the 1970s have been increasingly hospitalized but for shorter periods. Possible explanations of the findings are premature discharge of patients with schizophrenia due to lack of beds or/and that community psychiatry has not been providing adequate relapse prevention.
Polyceraty (multi‐horns) in Damara sheep maps to ovine chromosome 2
Authors: Greyvenstein O. F. C , Reich C. M. , van Marle‐Koster E. , Riley D. G. , Hayes B. J. 
Published: January 2016

SummaryPolyceraty (presence of multiple horns) is rare in modern day ungulates. Although not found in wild sheep, polyceraty does occur in a small number of domestic sheep breeds covering a wide geographical region. Damara are fat‐tailed hair sheep, from the south‐western region of Africa, which display polyceraty, with horn number ranging from zero to four. We conducted a genome‐wide association study for horn number with 43 Damara genotyped with 606 006 SNP markers. The analysis revealed a region with multiple significant SNPs on ovine chromosome 2, in a location different from the mutation for polled in sheep on chromosome 10. The causal mutation for polyceraty was not identified; however, the region associated with polyceraty spans nine HOXD genes, which are critical in embryonic development of appendages. Mutations in HOXD genes are implicated in polydactly phenotypes in mice and humans. There was no evidence for epistatic interactions contributing to polyceraty. This is the first report on the genetic mechanisms underlying polyceraty in the under‐studied Damara.
Relative suitability of DMSO and NaHCO3 for reversal of RISUG® induced long‐term contraception
Authors: Ansari A. S. , Hussain M. , Khan S. R. , Lohiya N. K. 
Published: January 2016

SummaryAmong the vas‐based methods on trial, reversible inhibition of sperm under guidance (RISUG®), a co‐polymer of styrene and maleic anhydride is being projected as an effective alternative to No Scalpel Vasectomy. RISUG offers long‐term contraception with safety, efficacy in human trials and can be delivered by no‐scalpel injection. Currently, the procedure is under phase‐III clinical trial. However, reversal of this vas‐based drug‐induced contraception needs to be established in animal models prior to clinical trials to ensure its claim as an effective alternative for vasectomy. In the present investigation, the relative suitability of dimethyl sulphoxide (DMSO) and NaHCO3 for RISUG induced long‐term vas occlusion reversal was carried out in albino rats. Animals were allocated into four groups (n = 10), viz., sham‐operated control (group‐I), vas occlusion with RISUG for 360 days (group‐II), vas occlusion with RISUG for 360 days and reversal with DMSO (group‐III) and vas occlusion with RISUG for 360 days and reversal with NaHCO3 (group‐IV). A variable response in fertility was observed in different groups. Absolute sterility in group III at all mating intervals, while, zero percent fertility in groups II and IV following 90 days of occlusion was observed. Following reversal restoration of fertility with DMSO at 45 days, whereas, reversal by NaHCO3 at 30 days was noticed. Ejaculated spermatozoa of RISUG injected and initial intervals of reversed animals exhibited various degrees of abnormalities. The testes exhibited focal degeneration in vas occluded animals. The occluded lumen of the vas deferens contained an eosinated polymer with exfoliated epithelium. Following vas occlusion reversal, a complete regeneration in the vas epithelium was seen. All other parameters remained unaltered. The reversal with NaHCO3 resulted into an early resumption of fertility when compared with DMSO and the procedure found to be successful, feasible and safe up to F1 generation. Thus, RISUG provides a hope for reversible male contraceptives.
In Vivo Evaluation of Active and Passive Physiological Control Systems for Rotary Left and Right Ventricular Assist Devices
Authors: Gregory Shaun D. , Stevens Michael C. , Pauls Jo P. , Schummy Emma , Diab Sara , Thomson Bruce , Anderson Ben , Tansley Geoff , Salamonsen Robert , Fraser John F. , Timms Daniel 
Published: January 2016

AbstractPreventing ventricular suction and venous congestion through balancing flow rates and circulatory volumes with dual rotary ventricular assist devices (VADs) configured for biventricular support is clinically challenging due to their low preload and high afterload sensitivities relative to the natural heart. This study presents the in vivo evaluation of several physiological control systems, which aim to prevent ventricular suction and venous congestion. The control systems included a sensor‐based, master/slave (MS) controller that altered left and right VAD speed based on pressure and flow; a sensor‐less compliant inflow cannula (IC), which altered inlet resistance and, therefore, pump flow based on preload; a sensor‐less compliant outflow cannula (OC) on the right VAD, which altered outlet resistance and thus pump flow based on afterload; and a combined controller, which incorporated the MS controller, compliant IC, and compliant OC. Each control system was evaluated in vivo under step increases in systemic (SVR ∼1400–2400 dyne/s/cm5) and pulmonary (PVR ∼200–1000 dyne/s/cm5) vascular resistances in four sheep supported by dual rotary VADs in a biventricular assist configuration. Constant speed support was also evaluated for comparison and resulted in suction events during all resistance increases and pulmonary congestion during SVR increases. The MS controller reduced suction events and prevented congestion through an initial sharp reduction in pump flow followed by a gradual return to baseline (5.0 L/min). The compliant IC prevented suction events; however, reduced pump flows and pulmonary congestion were noted during the SVR increase. The compliant OC maintained pump flow close to baseline (5.0 L/min) and prevented suction and congestion during PVR increases. The combined controller responded similarly to the MS controller to prevent suction and congestion events in all cases while providing a backup system in the event of single controller failure.
On the Use of the Platelet Activity State Assay for the In Vitro Quantification of Platelet Activation in Blood Recirculating Devices for Extracorporeal Circulation
Authors: Consolo Filippo , Valerio Lorenzo , Brizzola Stefano , Rota Paolo , Marazzato Giulia , Vincoli Valentina , Reggiani Stefano , Redaelli Alberto , Fiore Gianfranco 
Published: January 2016

AbstractWe designed an experimental setup to characterize the thrombogenic potential associated with blood recirculating devices (BRDs) used in extracorporeal circulation (ECC). Our methodology relies on in vitro flow loop platelet recirculation experiments combined with the modified‐prothrombinase platelet activity state (PAS) assay to quantify the bulk thrombin production rate of circulated platelets, which correlates to the platelet activation (PA) level. The method was applied to a commercial neonatal hollow fiber membrane oxygenator. In analogous hemodynamic environment, we compared the PA level resulting from multiple passes of platelets within devices provided with phosphorylcholine (PC)‐coated and noncoated (NC) fibers to account for flow‐related mechanical factors (i.e., fluid‐induced shear stress) together with surface contact activation phenomena. We report for the first time that PAS assay is not significantly sensitive to the effect of material coating under clinically pertinent flow conditions (500 mL/min), while providing straightforward information on shear‐mediated PA dynamics in ECC devices. Being that the latter is intimately dependent on local flow dynamics, according to our results, the rate of thrombin production as measured by the PAS assay is a valuable biochemical marker of the selective contribution of PA in BRDs induced by device design features. Thus, we recommend the use of PAS assay as a means of evaluating the effect of modification of specific device geometrical features and/or different design solutions for developing ECC devices providing flow conditions with reduced thrombogenic impact.
Prevalence and clinical impact of antiretinal antibodies in uveitis
Authors: ten Berge Josianne C. E. M. , Schreurs Marco W. J. , Vermeer Jacolien , Meester‐Smoor Magda A. , Rothova Aniki 
Published: January 2016

AbstractPurposeTo determine the prevalence of serum antiretinal antibodies (ARAs) among patients with uveitis and establish their clinical relevance.MethodsThis prospective study assessed the presence of ARAs by indirect immunofluorescence (IIF) using primate retina in 126 patients with uveitis and 60 healthy controls. Clinical data of uveitis patients were collected from medical charts and included the classification of uveitis, cause of uveitis or its association with systemic disease, stage and activity of uveitis and specific retinal features. Correlations between the presence of specific ARAs and various clinical characteristics were analysed.ResultsThe presence of ARAs was observed in 49 of 104 (47%) of patients with uveitis and in 10 of 59 (17%) of healthy controls (p < 0.001). Staining of the nuclear layers or the photoreceptors were both more often observed in patients with uveitis compared to healthy controls (p = 0.002 and p = 0.018, respectively). No specific associations were found between the presence of serum ARAs and various clinical characteristics.ConclusionSerum ARAs were more frequent in patients with uveitis compared to healthy controls, but their clinical role remains elusive. The assessment of intraocular production of specific ARAs may provide further insight into the role of ocular autoantibodies in diverse uveitis entities.
Prevalence, symptom patterns and management of episodic diarrhoea in the community: a population‐based survey in 11 countries
Authors: Hungin A. P. S. , Paxman L. , Koenig K. , Dalrymple J. , Wicks N. , Walmsley J. 
Published: January 2016

SummaryBackgroundThe extent of episodic diarrhoea in the community is relatively unknown.AimTo ascertain the prevalence, symptoms and management behaviours associated with self‐reported diarrhoea across 11 countries.MethodsCommunity screening surveys were conducted using quota sampling of respondents to identify a nationally representative sample of individuals suffering from ‘episodic’ diarrhoea (occurring once a month or more often). Second‐phase in‐depth surveys provided data on epidemiology, symptoms, attributed causes and management of episodic diarrhoea.ResultsA total of 11 508 phase 1 and 6613 phase 2 surveys were completed. The prevalence of self‐reported episodic diarrhoea ranged from 16% to 23% across the 11 countries. The majority of episodic diarrhoea sufferers were female (57%) and were not diagnosed with pre‐existing irritable bowel syndrome (IBS); IBS diagnosis ranged from 9% in Mexico to 44% in Italy. Diarrhoea was frequently attributed to anxiety/stress, food‐related causes, gastrointestinal ‘sensitivity’ and menstruation. Accompanying symptoms included ‘stomach pain/cramping’ (35–62%), ‘stomach grumbling’ (29–68%) and ‘wind’ (18–74%). The proportion of episodic sufferers who reported treating their symptoms with remedies or medications ranged between 46% in Belgium and Canada and 90% in Mexico.ConclusionsA substantial proportion of the population in middle‐ to high‐income countries report episodic diarrhoea in the absence of a pre‐existing diagnosis. These symptoms are likely to be associated with substantial social and economic costs, and have implications on how best to configure and guide self‐led, pharmacist‐led and primary care management.