bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multi-centre prospective internal and external evaluation of the Brompton Harefield Infection Score (BHIS)
Authors: Rochon Melissa , Jarman Julian WE , Gabriel Joseph , Butcher Lisa , Morais Carlos , Still Martin , Ahmed Ishtiaq , Petrou Mario , Trimlett Richard , DeSouza Anthony , Yadav Rashmi , Raja Shahzad G 
Published: December 2017

Background: Previously, we reported that the Brompton Harefield Infection Score (BHIS) accurately predicts surgical site infection (SSI) after coronary artery bypass grafting (CABG). The BHIS was developed using two-centre data and stratifies SSI risk into three groups based on female gender, diabetes or HbA1c > 7.5%, body mass index ≥ 35, left ventricular ejection fraction < 45% and emergency surgery. The purpose of this study was to prospectively evaluate BHIS internally as well as externally. Methods: Multi-centre prospective evaluation involving three tertiary centres took place between October 2012 and November 2015. SSI was classified using the Public Health England protocol. Receiver operating characteristic (ROC) curves assessed predictive accuracy. Results: Across the four hospital sites, 168 of 4308 (3.9%) CABG patients had a SSI. Categorising the hospitals by BHIS score revealed that 65% of all patients were low risk (BHIS 0–1), 26% were medium risk (BHIS 2–3) and 8% were high risk (BHIS ≥ 4). The area under the ROC curve was in the range of 0.702–0.785. Overall area under the ROC curve was 0.709. Conclusions: BHIS provides a novel, internally and externally evaluated score for a patient’s risk of SSI after CABG. It enables clinicians to focus on strategies to prospectively identify high-risk patients and improve outcomes.
Likelihood of reporting medication errors in hospitalized children: a survey of nurses and physicians
Authors: Rishoej Rikke Mie , Hallas Jesper , Juel Kjeldsen Lene , Thybo Christesen Henrik , Almarsdóttir Anna Birna 
Published: December 2017

Background: Hospitalized children are at risk of medication errors (MEs) due to complex dosage calculations and preparations. Incident reporting systems may facilitate prevention of MEs but underreporting potentially undermines this system. We aimed to examine whether scenarios involving medications should be reported to a national mandatory incident reporting system and the likelihood of self- and peer-reporting these scenarios among paediatric nurses and physicians. Methods: Participants’ reporting of MEs was explored through a questionnaire involving 20 medication scenarios. The scenarios represented different steps in the medication process, types of error, patient outcomes and medications. Reporting rates and odds ratios with 95% confidence interval [OR, (95% CI)] were calculated. Barriers to and enablers of reporting were identified through content analysis of participants’ comments. Results The response rate was 42% (291/689). Overall, 61% of participants reported that scenarios should be reported. The likelihood of reporting was 60% for self-reporting and 37% for peer-reporting. Nurses versus physicians, and healthcare professionals with versus without patient safety responsibilities assessed to a larger extent that the scenarios should be reported [OR = 1.34 (1.05–1.70) and OR = 1.41 (1.12–1.78), respectively]; were more likely to self-report, [OR = 2.81 (1.71–4.62) and OR = 2.93 (1.47–5.84), respectively]; and were more likely to peer-report [OR = 1.89 (1.36–2.63) and OR = 3.61 (2.57–5.06), respectively]. Healthcare professionals with versus without management responsibilities were more likely to peer-report [OR = 5.16 (3.44–7.72)]. Participants reported that scenarios resulting in actual injury or incidents considered to have a learning potential should be reported. Conclusion: The likelihood of underreporting scenarios was high among paediatric nurses and physicians. Nurses and staff with patient safety responsibilities were more likely to assess that scenarios should be reported and to report. Incidents with actual injury or learning potential were more likely to be reported. The potential for improving reporting rates involving MEs seems high.
Trends in clinical outcomes and survival following prehospital thrombolytic therapy given by ambulance clinicians for ST-elevation myocardial infarction in rural sub-arctic Norway
Authors: Mannsverk Jan , Steigen Terje , Wang Harald , Tande Pål Morten , Dahle Birgitte Mannsverk , Nedrejord Maret Lajla , Hokland Ida Olsen , Gilbert Mads 
Published: December 2017

Background:Prehospital thrombolytic therapy given by ambulance emergency medical services to patients with acute ST-segment elevation myocardial infarction (STEMI) may produce earlier reperfusion than percutaneous coronary intervention. Clinical results from prehospital thrombolytic therapy in rural areas are scarce.Methods:We studied outcomes during 11 years of a prehospital thrombolytic therapy system in rural sub-arctic Norway. Ambulance personnel gave protocol basic treatment and transmitted electrocardiograms to hospital physicians who made the decision for prehospital thrombolytic therapy. The study was divided into three time periods; 2000–2003, 2004–2007 and 2008–2011.Results:A total of 385 STEMI patients received prehospital thrombolytic therapy, median patient age was 61.2 years, and 77% were men. Time saved by prehospital reperfusion therapy was 131 minutes. The proportion who got prehospital thrombolytic therapy within 2 hours of symptom onset increased from 21% in 2000–2003 to 39% in 2008–2011 ( P=0.003). The proportion who underwent coronary angiography or percutaneous coronary intervention within 24 hours of first medical contact increased from 56.4% to 95.4% ( P<0.001). Post-STEMI systolic heart failure decreased from 19.4% to 8.1% ( P=0.02), while 1-year mortality fell, non-significantly, by 50% over time to reach 5.6%. Thirteen patients suffered acute out-of-hospital cardiac arrest; all were successfully defibrillated. Ten patients had major bleeding events (2.6%).Conclusion:A decentralised prehospital thrombolytic therapy system based on ambulance personnel, telemetry and centralised 7/24 invasive diagnosis and treatment service, combined with system maturation over time, was associated with earlier reperfusion, improved clinical outcomes and better survival. Prehospital thrombolytic therapy is a feasible and safe intervention used in rural settings with long evacuation lines to percutaneous coronary intervention facilities.
Clostridium difficile fecal toxin level is associated with disease severity and prognosis
Authors: Cohen Nathaniel A , Miller Tamar , Na’aminh Wasef , Hod Keren , Adler Amos , Cohen Daniel , Guzner-Gur Hanan , Santo Erwin , Halpern Zamir , Carmeli Yehuda , Maharshak Nitsan 
Published: December 2017

BackgroundAntibiotic‐associated colitis caused by Clostridium difficile (C. difficile) is the most common cause of hospital‐acquired diarrhea. The pathogenesis of C. difficile colitis is mediated by bacterial toxins. C. difficile infection (CDI) severity may be determined by the fecal level of these toxins.ObjectiveThe objective of this article is to determine whether fecal C. difficile toxin (CDT) levels are associated with disease severity and prognosis.MethodsA cross‐sectional study of patients admitted with CDI in a tertiary center between 2011 and 2015 was conducted. Fecal CDT levels were determined by quantitative ELISA. Severe CDI was defined as a leukocyte count of > 15 × 103 cells/μl, creatinine levels that deteriorated by > 1.5 times the baseline level, or albumin levels < 3 g/dl.ResultsSeventy‐three patients were recruited for this study. Patients with severe CDI (n = 47) had significantly higher toxin levels compared to patients with mild to moderate CDI (n = 26) (651 ng/ml (IQR 138–3200) versus 164 ng/ml (IQR 55.2–400.1), respectively; p = 0.001). A high toxin level (>2500 ng/ml) was associated with an increased mortality rate (odds ratio 11.8; 95% confidence interval 2.5–56).ConclusionsThe fecal CDT level is associated with disease severity and mortality rate. Measuring CDT levels may be an objective and accurate way to define the severity of CDI.
The accuracy and promise of personal breathalysers for research: Steps toward a cost-effective reliable measure of alcohol intoxication?
Authors: Riordan Benjamin C , Scarf Damian , Moradi Saleh , Flett Jayde A M , Carey Kate B , Conner Tamlin S 
Published: December 2017

Objective Technology is continuing to shape the way we collect health data, including data on alcohol use. A number of technologies are being developed to objectively measure intoxication ‘in the wild’ without relying on self-report; the most immediate solution may be the use of personal breathalysers. In this study, we aimed to determine whether a cost-effective personal breathalyser would perform in a similar manner to a device used for roadside breath testing. Method We intercepted young adults ( n = 337; 45% men) outside three concerts, administered 5-min interviews, and asked for breath samples on two devices (a personal breathalyser and a police-grade breathalyser). Results Participants reported having consumed an average of 7.3 standard drinks before the interview and had a mean Blood Alcohol Content of 0.077 g/dl on the police-grade device and 0.085 g/dl on the personal device. Difference scores suggested the personal breathalyser was more likely to over report Blood Alcohol Content (bias = 0.008 g/dl). Conclusion Although the personal device was more likely to over report Blood Alcohol Content compared with the police-grade device, the results suggest that personal devices could be used as a measure of Blood Alcohol Content when collecting data outside of the lab.
α7-Nicotinic Acetylcholine Receptor Agonist Ameliorates Nicotine Plus High-Fat Diet–Induced Hepatic Steatosis in Male Mice by Inhibiting Oxidative Stress and Stimulating AMPK Signaling
Authors: Hasan Mohammad Kamrul , Friedman Theodore C , Sims Carl , Lee Desean L , Espinoza-Derout Jorge , Ume Adaku , Chalfant Victor , Lee Martin L , Sinha-Hikim Indrani , Lutfy Kabirullah , Liu Yanjun , Mahata Sushil K , Sinha-Hikim Amiya P 
Published: December 2017

Abstractα7-Nicotinic acetylcholine receptor (α7nAChR) agonists confer protection against a wide variety of cytotoxic insults and suppress oxidative stress and apoptosis in various cell systems, including hepatocytes. We recently demonstrated that nicotine, when combined with a high-fat diet (HFD), triggers oxidative stress, activates hepatocyte apoptosis, and exacerbates HFD-induced hepatic steatosis in male mice. This study evaluates whether PNU-282987 (PNU), a specific α7nAChR agonist, is effective in preventing nicotine plus HFD–induced hepatic steatosis. Adult C57BL6 male mice were fed a normal chow diet or HFD with 60% of calories derived from fat and received twice-daily intraperitoneal injections of 0.75 mg/kg body weight (BW) of nicotine, PNU (0.26 mg/kg BW), PNU plus nicotine, or saline for 10 weeks. PNU treatment was effective in attenuating nicotine plus HFD–induced increase in hepatic triglyceride levels, hepatocyte apoptosis, and hepatic steatosis. The preventive effects of PNU on nicotine plus HFD–induced hepatic steatosis were mediated by suppression of oxidative stress and activation of adenosine 5′-monophosphate-activated protein kinase (AMPK) together with inhibition of its downstream target sterol regulatory element binding protein 1c (SREBP1c), fatty acid synthase (FAS), and acetyl-coenzyme A-carboxylase (ACC). We conclude that the α7nAChR agonist PNU protects against nicotine plus HFD–induced hepatic steatosis in obese mice. PNU appears to work at various steps of signaling pathways involving suppression of oxidative stress, activation of AMPK, and inhibition of SREBP1c, FAS, and ACC. α7nAChR agonists may be an effective therapeutic strategy for ameliorating fatty liver disease, especially in obese smokers.
Rap1 acts via multiple mechanisms to position Canoe and adherens junctions and mediate apical-basal polarity establishment
Authors: Bonello Teresa T. , Perez-Vale Kia Z. , Sumigray Kaelyn D. , Peifer Mark 
Published: December 2017

ABSTRACT
Epithelial apical-basal polarity drives assembly and function of most animal tissues. Polarity initiation requires cell-cell adherens junction assembly at the apical-basolateral boundary. Defining the mechanisms underlying polarity establishment remains a key issue. Drosophila embryos provide an ideal model, as 6000 polarized cells assemble simultaneously. Current data place the actin-junctional linker Canoe (fly homolog of Afadin) at the top of the polarity hierarchy, where it directs Bazooka/Par3 and adherens junction positioning. Here we define mechanisms regulating Canoe localization/function. Spatial organization of Canoe is multifaceted, involving membrane localization, recruitment to nascent junctions and macromolecular assembly at tricellular junctions. Our data suggest apical activation of the small GTPase Rap1 regulates all three events, but support multiple modes of regulation. The Rap1GEF Dizzy (PDZ-GEF) is crucial for Canoe tricellular junction enrichment but not apical retention. The Rap1-interacting RA domains of Canoe mediate adherens junction and tricellular junction recruitment but are dispensable for membrane localization. Our data also support a role for Canoe multimerization. These multifactorial inputs shape Canoe localization, correct Bazooka and adherens junction positioning, and thus apical-basal polarity. We integrate the existing data into a new polarity establishment model.
Histogram analysis of apparent diffusion coefficient maps for assessing thymic epithelial tumours: correlation with world health organization classification and clinical staging
Authors: Kong Ling-Yan , Zhang Wei , Zhou Yue , Xu Hai , Shi Hai-Bin , Feng Qing , Xu Xiao-Quan , Yu Tong-fu 
Published: December 2017

Objective:
To investigate the value of apparent diffusion coefficients (ADCs) histogram analysis for assessing World Health Organization (WHO) pathological classification and Masaoka clinical stages of thymic epithelial tumours.

Methods:
37 patients with histologically confirmed thymic epithelial tumours were enrolled. ADC measurements were performed using hot-spot ROI (ADCHS-ROI) and histogram-based approach. ADC histogram parameters included mean ADC (ADCmean), median ADC (ADCmedian), 10 and 90 percentile of ADC (ADC10 and ADC90), kurtosis and skewness. One-way ANOVA, independent-sample t-test, and receiver operating characteristic were used for statistical analyses.

Results:
There were significant differences in ADCmean, ADCmedian, ADC10, ADC90 and ADCHS-ROI among low-risk thymoma (type A, AB, B1; n = 14), high-risk thymoma (type B2, B3; n = 9) and thymic carcinoma (type C, n = 14) groups (all p-values &lt;0.05), while no significant difference in skewness (p = 0.181) and kurtosis (p = 0.088). ADC10 showed best differentiating ability (cut-off value, ≤0.689 × 10−3 mm2 s–1; AUC, 0.957; sensitivity, 95.65%; specificity, 92.86%) for discriminating low-risk thymoma from high-risk thymoma and thymic carcinoma. Advanced Masaoka stages (Stage III and IV; n = 24) tumours showed significant lower ADC parameters and higher kurtosis than early Masaoka stage (Stage I and II; n = 13) tumours (all p-values &lt;0.05), while no significant difference on skewness (p = 0.063). ADC10 showed best differentiating ability (cut-off value, ≤0.689 × 10−3 mm2 s–1; AUC, 0.913; sensitivity, 91.30%; specificity, 85.71%) for discriminating advanced and early Masaoka stage epithelial tumours.

Conclusion:
ADC histogram analysis may assist in assessing the WHO pathological classification and Masaoka clinical stages of thymic epithelial tumours.

Advances in knowledge:
1. ADC histogram analysis could help to assess WHO pathological classification of thymic epithelial tumours. 2. ADC histogram analysis could help to evaluate Masaoka clinical stages of thymic epithelial tumours. 3. ADC10 might be a promising imaging biomarker for assessing and characterizing thymic epithelial tumours.
Comparison of two-dimensional fast spin echo T
2 weighted sequences and three-dimensional volume isotropic T
2 weighted fast spin echo (VISTA) MRI in the evaluation of triangular fibrocartilage of the wrist
Authors: Park Hee Jin , Lee So Yeon , Kang Kyung A , Kim Eun Young , Shin Hun Kyu , Park Se Jin , Park Jai Hyung , Kim Eugene 
Published: December 2017

Objective:
To compare image quality of three-dimensional volume isotropic T 2 weighted fast spin echo (3D VISTA) and two-dimensional (2D) T 2 weighted images (T2WI) for evaluation of triangular fibrocartilage (TFC) and to investigate whether 3D VISTA can replace 2D T 2 WI in evaluating TFC injury.

Methods:
This retrospective study included 69 patients who received wrist MRIs using both 2D T 2 WI and 3D VISTA techniques for assessment of wrist pathology, including TFC injury. Two radiologists measured the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR) of the two sequences. The anatomical identification score and diagnostic performance were independently assessed by two interpreters. The diagnostic abilities of 3D VISTA and 2D T 2 WI were analysed by sensitivity, specificity and accuracy for diagnosing TFC injury using surgically or clinically confirmed diagnostic reference standards.

Results:
17 cases (25%) were classified as having TFC injury. 2 cases (12%) were diagnosed surgically, and 15 cases (88%) were diagnosed by physical examination. 52 cases (75%) were diagnosed as having intact TFC. 8 of these cases (15%) were surgically confirmed, while the others were diagnosed by physical examination and clinical findings. The 3D VISTA images had significantly higher SNR and CNR values for the TFC than 2D T 2 WI images. The scores of 3D VISTA’s total length, full width and sharpness were similar to those of 2D T 2 WI. We were unable to find a significant difference between 3D VISTA and 2D T 2 WI in the ability to diagnose TFC injury.

Conclusion:
3D VISTA image quality is similar to that of 2D T 2 WI for TFC evaluation and is also excellent for tissue contrast. 3D VISTA can replace 2D images in TFC injury assessment.

Advances in knowledge:
3D VISTA image quality is similar to that of 2D T 2 WI for TFC evaluation and is also excellent for tissue contrast. 3D VISTA can replace 2D images in TFC injury assessment.
Measuring and Modeling the Water Balance in Low-Rainfall Cropping Systems
Authors: Whitbread Anthony M. , Hoffmann Munir P. , Davoren C. William , Mowat Damian , Baldock Jeffrey A. 
Published: December 2017

Abstract. In low-rainfall cropping systems, understanding the water balance, and in particular the storage of soil water in the rooting zone for use by crops, is considered critical for devising risk management strategies for grain-based farming. Crop-soil modeling remains a cost-effective option for understanding the interactions between rainfall, soil, and crop growth, from which management options can be derived. The objective of this study was to assess the error in the prediction of soil water content at key decision points in the season against continuous, multi-layer soil water measurements made with frequency domain reflectometry (FDR) probes in long-term experiments in the Mallee region of South Australia and New South Wales. Field estimates of the crop lower limit or drained upper limit were found to be more reliable than laboratory-based estimates, despite the fact that plant-available water capacity (PAWC) did not substantially differ between the methods. Using the Agricultural Production Systems sIMulator (APSIM) to simulate plant-available water over three-year rotations, predicted soil water was within 7 mm (PAWC 64 to 99 mm) of the measured data across all sowing events and rotations. Simulated (n = 46) wheat grain production resulted in a root mean square error (RMSE) of 492 kg ha-1, which is only marginally smaller than that of other field studies that derived soil water limits with less detailed methods. This study shows that using field-derived data of soil water limits and soil-specific settings for parameterization of other properties that determine soil evaporation and water redistribution enables APSIM to be widely applied for managing climate risk in low-rainfall environments. Keywords: APSIM, Climate risk management, Crop models, Decision support, Soil moisture.
The Radicalization of Heritage in Tunisia
Authors: Rey Virginie 
Published: December 2017

Abstract
Since the so-called ‘Jasmine Revolution’ of 2009 in Tunisia, the idea of heritage has been destabilized following a series of attacks on religious and cultural sites across the country by militant Salafi groups. Thus far, sites of Jewish heritage have been the most affected. Cultural heritage from Tunisia’s rich ancient history, redolent for certain Islamists with associations of Jahiliyya, has also been targeted. The well-publicized attack on the Bardo Museum in March 2015 was perhaps the most famous symbol of this trend. However, less publicized have been attempts to reclaim some sacred sites, resulting in the occupation of local mosques on the island of Djerba and in the town of Le Kef. In the wake of these events, some Djerbian civilians have stood up to defend what they consider as intrinsic parts of the patrimonial identity of their island. But as they have been defending these mosques against extremist groups, new considerations related to their preservation have surfaced, calling into question their very patrimonialization. In the context of this radical politicization of Tunisian heritage, this article explores the struggle over who defines the meanings and uses of heritage in Tunisia and the new challenges and opportunities that Salafi attacks have created for the heritage sector since the revolution.
POLYPHENOLS OF WOODY BARK – ORGANIC PRECURSORS TO PRODUCE ON THEIR BASIS OF POLYMER AEROGELS
Authors: Микова (Mikova) Надежда (Nadezhda) Михайловна (Mikhailovna)) , Гришечко (Grishechko) Людмила (Lyudmila) Ивановна (Ivanovna) , Скворцова (Skvortsova) Галина (Galina) Павловна (Pavlovna) , Кузнецов (Kuznetsov) Борис (Boris) Николаевич (Nikolaevich) 
Published: December 2017

New method for preparation of organic aerogels by sol-gel polymerization of formaldehyde with polyphenols (PFs), isolated from larch bark of and inner birch bark, was developed. The functional composition and properties of the original PFs were studied by thermogravimetry methods and FTIR- spectroscopy. It was found that larch polyphenol substances possess greater thermal stability in the temperature range 25-700 °C, while the process of thermal decomposition of birch bark polyphenols completes to 600 °C. It has been established that polyphenol larch compounds in their composition contain more aromatic structures and hydroxyl groups. The effect of the pH value of gelation solutions in the range of values from 4 to 12 on the porous structure of organic gels synthesized on the basis of polyphenols was studied. Porous structures and adsorption properties of polyphenol-formaldehyde organic gels were studied using BET method, scanning electron microscopy and sorption (methylene blue and gelatin). It is shown that an increase in pH contributes to the formation of a product with a more compacted texture. The electron microscopic images of polymer gels demonstrate a uniform granular texture with visible micro globules with an average particle size of ≈ 50-70 nm.