bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lupus-anticoagulant testing at NOAC trough levels
Authors: Ratzinger Franz , Lang Mona , Belik Sabine , Jilma-Stohlawetz Petra , Schmetterer Klaus G. , Haslacher Helmuth , Perkmann Thomas , Quehenberger Peter 
Published: April 2016

SummaryNon-vitamin K antagonist oral anticoagulants (NOAC), including rivaroxaban, apixaban or dabigatran, regularly show relevant effects on coagulation tests, making the interpretation of results difficult. The aim of this study was to evaluate possible interferences of NOACs in trough level concentrations in lupus anticoagulant (LA) testing. Citrate plasma specimens of 30 healthy volunteers were spiked with rivaroxaban, apixaban or dabigatran in four plasma concentration levels at or below trough NOAC levels. The NOAC concentration was measured using dedicated surrogate concentration tests and a stepwise diagnostic procedure for LA-testing was applied using screening, mixing and confirmatory testing. Results were compared to NOAC-free specimens. Starting with a plasma concentration of 12.5 ng/ml, dabigatran-spiked specimens showed significant prolongations in the lupus anticoagulant-sensitive activated partial thromboplastin time (aPTT-LA) as well as in the Dilute Russell viper venom time (dRVVT), leading to 43.3% false positives in confirmatory testing in the dRVVT. In contrast, rivaroxaban, beginning with 7.5 ng/ml, exclusively affected dRVVT-based tests. In confirmatory tests, 30.0% of rivaroxaban-spiked specimens showed false positive results. Starting with 18.75 ng/ml apixaban, a significant prolongation of the dRVVT and up to 20.7% false positives in confirmatory tests were found. In contrast to other NOACs tested, apixaban did not present with a dose-dependent increase of the dRVVT ratio. In conclusion, the rate of false positive results in LA-testing is unacceptably high at expected trough levels of NOACs. Even at plasma concentrations below the LLOQ of commercially available surrogate tests, LA testing is best avoided in patients with NOAC therapy.
Low Homoarginine Levels in the Prognosis of Patients With Acute Chest Pain
Authors: Atzler Dorothee , Baum Christina , Ojeda Francisco , Keller Till , Cordts Kathrin , Schnabel Renate B. , Choe Chi‐un , Lackner Karl J. , Münzel Thomas , Böger Rainer H. , Blankenberg Stefan , Schwedhelm Edzard , Zeller Tanja 
Published: April 2016

Background

The endogenous amino acid homoarginine predicts mortality in cerebro‐ and cardiovascular disease. The objective was to explore whether homoarginine is associated with atrial fibrillation (
AF
) and outcome in patients with acute chest pain.

Methods and Results

One thousand six hundred forty‐nine patients with acute chest pain were consecutively enrolled in this study, of whom 589 were diagnosed acute coronary syndrome (
ACS
). On admission, plasma concentrations of homoarginine as well as brain natriuretic peptide (
BNP
), and high‐sensitivity assayed troponin I (hsTnI) were determined along with electrocardiography (
ECG
) variables. During a median follow‐up of 183 days, 60 major adverse cardiovascular events (
MACEs
; 3.8%), including all‐cause death, myocardial infarction, or stroke, were registered in the overall study population and 43
MACEs
(7.5%) in the
ACS
subgroup. Adjusted multivariable Cox regression analyses revealed that an increase of 1
SD
of plasma log‐transformed homoarginine (0.37) was associated with a hazard reduction of 26% (hazard ratio [
HR
], 0.74; 95%
CI
, 0.57–0.96) for incident
MACE
and likewise of 35% (
HR
, 0.65; 95%
CI
, 0.49–0.88) in
ACS
patients. In Kaplan–Meier survival curves, homoarginine was predictive for patients with high‐sensitivity assayed troponin I (hsTnI) above 27 ng/L (
P
<0.05). Last, homoarginine was inversely associated with
QT
c duration (
P
<0.001) and prevalent
AF
(
OR
, 0.83; 95%
CI
, 0.71–0.95).

Conclusion

Low plasma homoarginine was identified as a risk marker for incident
MACEs
in patients with acute chest pain, in particular, in those with elevated hsTnI. Impaired homoarginine was associated with prevalent
AF
. Further studies are needed to investigate the link to
AF
and evaluate homoarginine as a therapeutic option for these patients.
Towards an Understanding of the Twentieth-Century Cooling Trend in the Southeastern United States: Biogeophysical Impacts of Land-Use Change
Authors: Ellenburg W. L. , McNider R. T. , Cruise J. F. , Christy John R. 
Published: April 2016

Abstract
This paper explores the link between the anomalous warming hole in the southeastern United States and a major land-use/land-cover (LULC) change in the region. Land surface and satellite observations were analyzed to estimate the net radiative forcing due to LULC change. Albedo and latent energy were specifically addressed for the dominant LULC change of agriculture to forests. It was assumed that in the energy-limited environment of the region, the partition of changes in available energy due to albedo will mostly impact the sensible heat. The results show that in the southeastern United States, for the period of 1920 to 1992, the changes in sensible (as a result of albedo) and latent energies are in direct competition with each other. In the spring and early summer months, the croplands are in peak production and the latent energy associated with their evapotranspiration (ET) is comparable to that of the forests so the decrease in radiation due to albedo dominates the signal. However, during the late summer and fall months, most major crops have matured, thus reducing their transpiration rate while forests (particularly evergreens) maintain their foliage and with their deep roots are able to continue to transpire as long as atmospheric conditions are favorable. This later influence of latent energy appears to more than offset the increased radiative forcing from the spring and early summer. Overall, a mean annual net radiative forcing resulting from a LULC change from cropland to forests was estimated to be −1.06 W m−2 and thus a probable contribution to the “warming hole” over the Southeast during the majority of the twentieth century.
Understanding Women’s Needs for Weather and Climate Information in Agrarian Settings: The Case of Ngetou Maleck, Senegal
Authors: Carr Edward R. , Fleming Grant , Kalala Tshibangu 
Published: April 2016

Abstract
While climate services have the potential to reduce precipitation- and temperature-related risks to agrarian livelihoods, such outcomes are possible only when they deliver information that is salient, legitimate, and credible to end users. This is particularly true of climate services intended to address the needs of women in agrarian contexts. The design of such gender-sensitive services is hampered by oversimplified framings of women as a group in both the adaptation and climate services literatures. This paper demonstrates that even at the village level, women have different climate and weather information needs, and differing abilities to act on that information. Therefore, starting with preconceived connections between identities and vulnerability is likely to result in overgeneralizations that hinder the ability to address the climate-related development and adaptation needs of the most vulnerable. Instead, as is demonstrated in this paper, the design and implementation of effective gender-sensitive climate services must start with the relevant social differences that shape people’s livelihoods decisions and outcomes, including but not limited to gender.
Implementation of the enhanced intersectoral links approach to support increased employment outcomes for consumers of a large metropolitan mental health service
Authors: Chang Lucy , Douglas Nadine , Scanlan Justin Newton , Still Megan 
Published: April 2016

Introduction The purpose of this article is to describe the outcomes of the enhanced intersectoral links (EIL) approach to supporting employment outcomes for individuals accessing a large mental health service. Method Based on individual placement and support (IPS) principles, features of EIL included: strong service-level relationships between mental health and local disability employment services; monthly joint meetings to share information; resources to assist mental health clinicians in supporting consumers to access employment services; and provision of training. Programme fidelity was evaluated against IPS principles. Outcome measures included: time from referral to commencement; time to first employment placement; employment placement rate; and duration of employment. Results Seventy-nine consumers were referred to the programme. At the close of data collection, 60 participants remained in the programme and 38 of these (63%) had gained at least one employment placement. Average duration of employment was 10.9 weeks. As expected, the EIL programme demonstrated ‘fair’ fidelity against IPS principles. The average time from referral to commencement was 47 days and from commencement to first placement was 81 days. Conclusion This project demonstrated how EIL can be implemented in a large mental health service. Further development is required to avoid delays in consumers’ commencement with employment services and support better job tenure.
Urinary high-mobility group box-1 associates specifically with lupus nephritis class V
Authors: Jog N R , Blanco I , Lee I , Putterman C , Caricchio R 
Published: April 2016

Introduction High-mobility group box 1 protein (HMGB-1) has been implicated in the pathogenesis of lupus nephritis (LN). There is increased HMGB-1 expression in the kidneys and increased levels are observed in serum and urine of patients with LN. This study was performed to determine whether the increased urinary HMGB-1 was specific for active lupus or secondary to renal damage. Methods Urine from 61 lupus patients (32 had active LN and 29 had systemic lupus erythematosus (SLE) with no evidence of LN) and 14 control proteinuric patients (all with hypertension and eight also with diabetes) were included in this study. HMGB-1 was detected by Western blot. Urine protein was normalized to urine creatinine to account for volume of the specimen. Results Median normalized urine HMGB-1 levels were significantly elevated in LN patients compared to lupus patients without kidney disease (53.81 vs 9.46, p < 0.001). A difference in median levels was seen between LN classes, with a significant difference between proliferative and membranous disease (33.4 vs 138.8, p = 0.003). Urine protein to urine creatinine ratio (P/C) correlated with urinary HMGB-1 ( r = 0.52, p < 0.001), but across the classes this was true only for membranous disease ( r = 0.71, p = 0.022, proliferative, p = 0.63; mixed, p = 0.34). Conclusions HMGB-1 is elevated in the urine of patients with active LN. Levels are associated with LN class, and higher levels of urinary HMGB-1 are seen in patients with class V when compared to both proliferative and mixed classes. Therefore, urinary HMGB-1 may be suggestive of membranous LN and warrants further evaluation in a large lupus cohort.
The Professional Journeys and Experiences in Leadership of Evangelical Lutheran Church in America Women Bishops
Authors: Tunheim Katherine A. , DuChene Mary Kay 
Published: April 2016

The Problem There are 70.5 million Lutherans in the world, with numbers increasing in Asia and Africa. Currently, only 14% of the Lutheran bishops are women, an increase from 10% in 2011. The role of bishop is a complex leadership position, requiring one to lead up to 150 churches and pastors in a geographical area. With more than 50% of the Lutheran church population comprised of women, their gender and voices are not being represented or heard at the highest levels of the Evangelical Lutheran Church in America (ELCA). With one billion women projected to enter the workforce globally in the next two decades, more needs to be written and understood about women church leaders, such as Lutheran bishops. The purpose of this study was to explore the journeys of women who achieved the office of bishop, to glean what can be learned for the benefit of other women who might be called to these higher levels of leadership in the church. The Solution This research suggests that 70% of the ELCA women bishops interviewed had unique career journeys, important spouse support, few women mentors, many challenges, and key leadership competencies required for the role. These findings can be helpful to future Lutheran and other Christian church leaders. It can help current and future women bishops understand what is expected in the role so they can be more successful in it. Leadership development recommendations are also suggested for seminary and higher education administrators and educators. The Stakeholders This research contributes to the literature in human resource development (HRD) by concentrating on the experiences of women leaders in the church—specifically women who have achieved the office of Bishop of the ELCA. The findings offer insights that can benefit scholars and practitioners alike, as well as current and future women leaders across the globe, in the church setting as well as other settings.
RecurrentNRASmutations in pulmonary Langerhans cell histiocytosis
Authors: Mourah Samia , How-Kit Alexandre , Meignin Véronique , Gossot Dominique , Lorillon Gwenaël , Bugnet Emmanuelle , Mauger Florence , Lebbe Celeste , Chevret Sylvie , Tost Jörg , Tazi Abdellatif 
Published: April 2016

The mitogen-activated protein kinase (MAPK) pathway is constantly activated in Langerhans cell histiocytosis (LCH). Mutations of the downstream kinasesBRAFandMAP2K1mediate this activation in a subset of LCH lesions. In this study, we attempted to identify other mutations which may explain the MAPK activation in nonmutatedBRAFandMAP2K1LCH lesions.We analysed 26 pulmonary and 37 nonpulmonary LCH lesions for the presence ofBRAF,MAP2K1,NRASandKRASmutations. Grossly normal lung tissue from 10 smoker patients was used as control. Patient spontaneous outcomes were concurrently assessed.BRAFV600Emutations were observed in 50% and 38% of the pulmonary and nonpulmonary LCH lesions, respectively. 40% of pulmonary LCH lesions harbouredNRASQ61K/Rmutations, whereas noNRASmutations were identified in nonpulmonary LCH biopsies or in lung tissue control. In seven out of 11NRASQ61K/R-mutated pulmonary LCH lesions,BRAFV600Emutations were also present. Separately genotyping each CD1a-positive area from the same pulmonary LCH lesion demonstrated that these concurrentBRAFandNRASmutations were carried by different cell clones.NRASQ61K/Rmutations activated both the MAPK and AKT (protein kinase B) pathways. In the univariate analysis, the presence of concurrentBRAFV600EandNRASQ61K/Rmutations was significantly associated with patient outcome.These findings highlight the importance ofNRASgenotyping of pulmonary LCH lesions because the use of BRAF inhibitors in this context may lead to paradoxical disease progression. These patients might benefit from MAPK kinase inhibitor-based treatments.
Natural variability of lung function in young healthy school children
Authors: Kirkby Jane , Bountziouka Vassiliki , Lum Sooky , Wade Angie , Stocks Janet 
Published: April 2016

Knowledge about long-term variability of lung function in healthy children is essential when monitoring and treating those with respiratory disease over time. The aim of this study was to define the natural variability in spirometry in young children after an interval of 12 months.The Size and Lung function In Children study was a prospective study designed to assess spirometry and body size, shape and composition in a multi-ethnic population of London school children. 14 schools with a wide range of socioeconomic circumstances were recruited. Spirometric and anthropometric assessments and parental questionnaires pertaining to respiratory symptoms, previous medical history, pubertal status and socioeconomic circumstances were completed at baseline and ∼1 year later.Technically acceptable spirometry data on two occasions ∼1 year apart (range 9–16 months) were available in 758 children (39% boys, mean±sdage 8.1±1.6 years), 593 of whom were classified as “healthy”. Mean±sdwithin-subject between-test variability was 0.05±0.6 z-scores, with 95% of all the children achieving a between-test variability within ±1.2 z-scores (equating to ∼13% predicted).Natural variations of up to 1.2 z-scores occur in healthy children over ∼1 year. These must be considered when interpreting results from annual reviews in those with lung disease who are otherwise stable, if unnecessary further investigations or changes in treatment are to be avoided.
Effects of exercise training on sleep apnoea in patients with coronary artery disease: a randomised trial
Authors: Mendelson Monique , Lyons Owen D. , Yadollahi Azadeh , Inami Toru , Oh Paul , Bradley T. Douglas 
Published: April 2016

Overnight fluid shift from the legs to the neck and lungs may contribute to the pathogenesis of obstructive sleep apnoea (OSA) and central sleep apnoea (CSA). We hypothesised that exercise training will decrease the severity of OSA and CSA in patients with coronary artery disease (CAD) by decreasing daytime leg fluid accumulation and overnight rostral fluid shift.Patients with CAD and OSA or CSA (apnoea–hypopnoea index >15 events per h) were randomised to 4 weeks of aerobic exercise training or to a control group. Polysomnography, with measurement of leg, thoracic and neck fluid volumes and upper-airway cross-sectional area (UA-XSA) before and after sleep, was performed at baseline and follow-up.17 patients per group completed the study. Apnoea–hypopnoea index decreased significantly more in the exercise group than in the control group (31.1±12.9 to 20.5±9.4versus28.1±13.5 to 27.0±15.1 events per h, p=0.047), in association with a greater reduction in the overnight change in leg fluid volume (579±222 to 466±163versus453±164 to 434±141 mL, p=0.04) and by a significantly greater increase in the overnight change in UA-XSA in the exercise group (p=0.04).In patients with CAD and sleep apnoea, exercise training decreases sleep apnoea severityviaattenuation of overnight fluid shift and an increase in UA-XSA.
Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia syndrome
Authors: Rossi Giulio , Cavazza Alberto , Spagnolo Paolo , Sverzellati Nicola , Longo Lucia , Jukna Agita , Montanari Gloria , Carbonelli Cristiano , Vincenzi Giada , Bogina Giuseppe , Franco Renato , Tiseo Marcello , Cottin Vincent , Colby Thomas V. 
Published: April 2016

The term diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) may be used to describe a clinico-pathological syndrome, as well as an incidental finding on histological examination, although there are obvious differences between these two scenarios. According to the World Health Organization, the definition of DIPNECH is purely histological. However, DIPNECH encompasses symptomatic patients with airway disease, as well as asymptomatic patients with neuroendocrine cell hyperplasia associated with multiple tumourlets/carcinoid tumours. DIPNECH is also considered a pre-neoplastic lesion in the spectrum of pulmonary neuroendocrine tumours, because it is commonly found in patients with peripheral carcinoid tumours.In this review, we summarise clinical, physiological, radiological and histological features of DIPNECH and critically discuss recently proposed diagnostic criteria. In addition, we propose that the term “DIPNECH syndrome” be used to indicate a sufficiently distinct patient subgroup characterised by respiratory symptoms, airflow obstruction, mosaic attenuation with air trapping on chest imaging and constrictive obliterative bronchiolitis, often with nodular proliferation of neuroendocrine cells with/without tumourlets/carcinoid tumours on histology. Surgical lung biopsy is the diagnostic gold standard. However, in the appropriate clinical and radiological setting, transbronchial lung biopsy may also allow a confident diagnosis of DIPNECH syndrome.
Measurement duration impacts variability but not impedance measured by the forced oscillation technique in healthy, asthma and COPD subjects
Authors: Watts Joanna C. , Farah Claude S. , Seccombe Leigh M. , Handley Blake M. , Schoeffel Robin E. , Bertolin Amy , Dame Carroll Jessica , King Gregory G. , Thamrin Cindy 
Published: April 2016

The forced oscillation technique (FOT) is gaining clinical acceptance, facilitated by more commercial devices and clinical data. However, the effects of variations in testing protocols used in FOT data acquisition are unknown. We describe the effect of duration of data acquisition on FOT results in subjects with asthma, chronic obstructive pulmonary disease (COPD) and healthy controls.FOT data were acquired from 20 healthy, 22 asthmatic and 18 COPD subjects for 60 s in triplicate. The first 16, 30 and 60 s of each measurement were analysed to obtain total, inspiratory and expiratory resistance of respiratory system (Rrs) and respiratory system reactance (Xrs) at 5 and 19 Hz.With increasing duration, there was a decrease in total and expiratoryRrsfor healthy controls, total and inspiratoryRrsfor asthmatic subjects and magnitude of total and inspiratoryXrsfor COPD subjects at 5 Hz. These decreases were small compared to the differences between clinical groups. Measuring for 16, 30 and 60 s provided ≥3 acceptable breaths in at least 90, 95 and 100% of subjects, respectively. The coefficient of variation for totalRrsandXrsalso decreased with duration. Similar results were found forRrsandXrsat 19 Hz.FOT results are statistically, but likely minimally, impacted by acquisition duration in healthy, asthmatic or COPD subjects.
How do rigid labor markets absorb immigration? Evidence from France
Authors: Edo Anthony 
Published: April 2016

Abstract
This paper investigates how immigration can affect the labor market outcomes of native workers when their wages are rigid. I use a rich dataset for France and decompose the native workers according to whether they are covered by fixed-term or indefinite-term contracts. Indefinite-term contracts are associated with higher wage protection than fixed-term contracts that allow firms to adjust wages as contracts expire. I use an empirical methodology which captures the direct effects of an immigrant-induced increase in labor supply on the labor market outcomes of natives who have similar skills. I find that the monthly wage of native workers covered by fixed-term contracts decreases in response to immigration, while employment is the margin through which native workers on indefinite-term contracts is affected.