bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lower urinary pH is useful for predicting renovascular disorder onset in patients with diabetes
Authors: Ogawa Susumu , Nako Kazuhiro , Okamura Masashi , Ito Sadayoshi 
Published: January 2016

Background and objectivesA lower urinary pH (UpH) is closely linked to diabetes. However, its relation to diabetic renovascular damage is unclear. This study aimed to identify the relationship between UpH and the exacerbation of diabetic renovascular disorders.MethodsThis is a 10-year observational study targeting 400 outpatients with diabetes who registered in 2003. We investigated the relationship between UpH in 2003 and renovascular damage from 2003 to 2013.ResultsA total of 350 participants were eligible for the analysis. During their 10-year outpatient treatment, a decrease was seen in glycated hemoglobin levels, blood pressure, and estimated glomerular filtration rates (eGFRs), and an increase was seen in their urinary albumin–creatinine ratios (ACRs), uric acid (UA) levels, and intima-media thickness (IMT). UpH negatively correlated with urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG), body mass index, UA, and ACR, and positively correlated with eGFR. The results of a multiple regression analysis showed that the independent risk factors for UpH were 8-OHdG, UA, eGFR, and ACR. UpH also negatively correlated with the percent change in IMT (%IMT), the percent change in pulse wave velocity (%PWV), and the change in log ACR (Δlog ACR), and positively correlated with the percent change in eGFR. A multiple regression analysis revealed that UpH was an independent risk factor for the %IMT, %PWV and Δlog ACR. Obese patients with low UpH values frequently suffered from sleep apnea syndrome.ConclusionsThese results suggest that UpH is a useful marker for predicting the onset of renovascular disorder in patients with diabetes.
Association between self-stigma and self-care behaviors in patients with type 2 diabetes: a cross-sectional study
Authors: Kato Asuka , Fujimaki Yuko , Fujimori Shin , Isogawa Akihiro , Onishi Yukiko , Suzuki Ryo , Yamauchi Toshimasa , Ueki Kohjiro , Kadowaki Takashi , Hashimoto Hideki 
Published: January 2016

ObjectiveGrowing qualitative evidence reveals that many patients with chronic illnesses struggle to rebuild a positive self-image after diagnosis while attempting to find a balance between their current physical status and their ongoing social duties. One factor destabilizing patients’ identities is self-stigma, which seems to affect their behavioral goals through decreased self-efficacy. We hypothesized that self-stigma would be an independent factor, distinct from self-efficacy, for developing self-care behaviors in patients with type 2 diabetes.MethodsWe used a consecutive sample of 209 outpatients with type 2 diabetes treated by endocrinologists at two university hospitals, one general hospital and one clinic. We performed multiple linear regression analyses to test the relationship between the patients’ activation levels for self-care behaviors (dependent variable) and self-stigma, self-efficacy, and depression symptoms (independent variables), adjusting for covariates involving sociodemographic and clinical characteristics.ResultsIn a multiple linear regression model adjusted for prior covariates, there was significant association between self-stigma and activation levels for self-care behaviors in patients with type 2 diabetes (adjusted R2=0.26, F (12,196)=7.20, p<0.001). The standardized partial regression coefficient of self-stigma was −0.23 (p=0.001), whereas that of self-efficacy was 0.19 (p=0.007).ConclusionsSelf-stigma is a negative independent factor, separate from self-efficacy, affecting the self-care behaviors of patients with type 2 diabetes. Self-stigma also has, at least, a similar impact on self-care behaviors to that of self-efficacy. To optimize treatment outcomes, patients’ self-stigma should be minimized, whereas their self-efficacy should be enhanced.
Lowering levels of bed occupancy is associated with decreased inhospital mortality and improved performance on the 4-hour target in a UK District General Hospital
Authors: Boden D G , Agarwal A , Hussain T , Martin S J , Radford N , Riyat M S , So K , Su Y , Turvey A , Whale C I 
Published: January 2016

ObjectiveTo evaluate whether there is an association between an intervention to reduce medical bed occupancy and performance on the 4-hour target and hospital mortality.MethodsThis before-and-after study was undertaken in a large UK District General Hospital over a 32 month period. A range of interventions were undertaken to reduce medical bed occupancy within the Trust. Performance on the 4-hour target and hospital mortality (hospital standardised mortality ratio (HSMR), summary hospital-level mortality indicator (SHMI) and crude mortality) were compared before, and after, intervention. Daily data on medical bed occupancy and percentage of patients meeting the 4-hour target was collected from hospital records. Segmented regression analysis of interrupted time-series method was used to estimate the changes in levels and trends in average medical bed occupancy, monthly performance on the target and monthly mortality measures (HSMR, SHMI and crude mortality) that followed the intervention.ResultsMean medical bed occupancy decreased significantly from 93.7% to 90.2% (p=0.02). The trend change in target performance, when comparing preintervention and postintervention, revealed a significant improvement (p=0.019). The intervention was associated with a mean reduction in all markers of mortality (range 4.5–4.8%). SHMI (p=0.02) and crude mortality (p=0.018) showed significant trend changes after intervention.ConclusionsLowering medical bed occupancy is associated with reduced patient mortality and improved ability of the acute Trust to achieve the 95% 4-hour target. Whole system transformation is required to create lower average medical bed occupancy.
Perceptions of racism in healthcare among patients with systemic lupus erythematosus: a cross-sectional study
Authors: Vina Ernest R , Hausmann Leslie R M , Utset Tammy O , Masi Christopher M , Liang Kimberly P , Kwoh C Kent 
Published: January 2016

BackgroundRacial disparities in the clinical outcomes of systemic lupus erythematosus (SLE) exist. Perceived racial discrimination may contribute to disparities in health.ObjectivesTo determine if perceived racism in healthcare differs by race among patients with SLE and to evaluate its contribution to racial disparities in SLE-related outcomes.Methods163 African–American (AA) and 180 white (WH) patients with SLE were enrolled. Structured interviews and chart reviews were done to determine perceptions of racism, SLE-related outcomes (Systemic Lupus International Collaborating Clinics (SLICC) Damage Index, SLE Disease Activity, Center for Epidemiologic Studies-Depression (CES-D)), and other variables that may affect perceptions of racism. Serial hierarchical multivariable logistic regression models were conducted. Race-stratified analyses were also performed.Results56.0% of AA patients compared with 32.8% of WH patients had high perceptions of discrimination in healthcare (p<0.001). This difference remained (OR 4.75 (95% CI 2.41 to 8.68)) after adjustment for background, identity and healthcare experiences. Female gender (p=0.012) and lower trust in physicians (p<0.001) were also associated with high perceived racism. The odds of having greater disease damage (SLICC damage index ≥2) were higher in AA patients than in WH patients (crude OR 1.55 (95% CI 1.01 to 2.38)). The odds of having moderate to severe depression (CES-D ≥17) were also higher in AA patients than in WH patients (crude OR 1.94 (95% CI 1.26 to 2.98)). When adjusted for sociodemographic and clinical characteristics, racial disparities in disease damage and depression were no longer significant. Among AA patients, higher perceived racism was associated with having moderate to severe depression (adjusted OR 1.23 (95% CI 1.05 to 1.43)) even after adjusting for sociodemographic and clinical variables.ConclusionsPerceptions of racism in healthcare were more common in AA patients than in WH patients with SLE and were associated with depression. Interventions aimed at modifiable factors (eg, trust in providers) may reduce higher perceptions of race-based discrimination in SLE.
Predicting emergency coronary artery bypass graft following PCI: application of a computational model to refer patients to hospitals with and without onsite surgical backup
Authors: Syed Zeeshan , Moscucci Mauro , Share David , Gurm Hitinder S 
Published: January 2016

BackgroundClinical tools to stratify patients for emergency coronary artery bypass graft (ECABG) after percutaneous coronary intervention (PCI) create the opportunity to selectively assign patients undergoing procedures to hospitals with and without onsite surgical facilities for dealing with potential complications while balancing load across providers. The goal of our study was to investigate the feasibility of a computational model directly optimised for cohort-level performance to predict ECABG in PCI patients for this application.MethodsBlue Cross Blue Shield of Michigan Cardiovascular Consortium registry data with 69 pre-procedural and angiographic risk variables from 68 022 PCI procedures in 2004–2007 were used to develop a support vector machine (SVM) model for ECABG. The SVM model was optimised for the area under the receiver operating characteristic curve (AUROC) at the level of the training cohort and validated on 42 310 PCI procedures performed in 2008–2009.ResultsThere were 87 cases of ECABG (0.21%) in the validation cohort. The SVM model achieved an AUROC of 0.81 (95% CI 0.76 to 0.86). Patients in the predicted top decile were at a significantly increased risk relative to the remaining patients (OR 9.74, 95% CI 6.39 to 14.85, p<0.001) for ECABG. The SVM model optimised for the AUROC on the training cohort significantly improved discrimination, net reclassification and calibration over logistic regression and traditional SVM classification optimised for univariate performance.ConclusionsComputational risk stratification directly optimising cohort-level performance holds the potential of high levels of discrimination for ECABG following PCI. This approach has value in selectively referring PCI patients to hospitals with and without onsite surgery.
Long-lasting luminescence in ZnGa2O4: Cr3+ through persistent energy transfer
Authors: Li Lei , Wang Yinhai , Huang Haiju , Li Hong , Zhao Hui 
Published: January 2016

Cr[Formula: see text]-doped zinc gallate (ZnGa2O4) near-infrared (NIR) phosphors were synthesized via a high temperature solid state method. The luminescence properties of the phosphors were studied systematically. A significant spectra overlap between the emission of ZnGa2O4and the absorption of Cr[Formula: see text] was observed and 300 nm excitation exhibited the most excellent long-lasting luminescence properties among the three main excitation bands. Luminescence intensity was changed with the ratio of Ga[Formula: see text]/Cr[Formula: see text] and the blue host emission of ZnGa2O4was suppressed when doping Cr[Formula: see text] into ZnGa2O4. The fluorescence decay curves of blue emission of ZnGa2O4with different Cr[Formula: see text] doping concentrations indicated that the lifetime of ZnGa2O4at 505 nm become shorter with the increase of the Cr[Formula: see text] concentration. Herein, a possible mechanism of long-lasting luminescence in ZnGa2O4: Cr[Formula: see text] was proposed that the NIR long-lasting luminescence in ZnGa2O4: Cr[Formula: see text] comes from the persistent energy transfer from ZnGa2O4to Cr[Formula: see text].
Effects of Mn doping on electrical properties of ZnO thin films
Authors: Motevalizadeh Leili , Shohany Boshra Ghanbari , Abrishami Majid Ebrahimizadeh 
Published: January 2016

In this paper, we have investigated the effect of Mn doping on the electrical properties of ZnO thin films. ZnO thin films with different amounts of Mn concentrations (0, 5, 10 and 15 mol.%) were prepared by spray pyrolysis technique. The crystal structure was examined by X-ray diffraction (XRD) analysis. XRD patterns showed that all the samples were crystallized in wurtzite structure while a decrease in crystallinity and switch in preferential orientations were observed in Mn-doped thin films comparing to undoped ZnO. The element composition of all thin films was detected by energy dispersive X-ray (EDX). The surface morphology of the films was investigated using field emission scanning electron microscope (FESEM) and optical properties were studied using UV-vis spectroscopy. UV-vis study revealed that the band gap blueshifts with the increase in Mn content and [Formula: see text] increases with the increase in Mn concentration. The resistivity and activation energy were measured at room temperature and ranging from 373 K to 573 K. Comparing to undoped ZnO thin film, the resistivity of Mn-doped ZnO films increased because of different parameters such as increasing barrier height energy and reducing the oxygen deficiency.
Endothelial erosion of plaques as a substrate for coronary thrombosis
Authors: Newby Andrew C. , Johnson Thomas W. , White Stephen J. 
Published: January 2016

SummaryMyocardial infarction is a prevalent, life-threatening consequence of athero-thrombosis. Post-mortem histology and intravascular imaging in live patients have shown that approximately one third of myocardial infarctions are caused by a thrombus overlying an intact, non-ruptured atherosclerotic plaque. Histology identifies erosion of luminal endothelial cells from smooth muscle and proteoglycan-rich, thick fibrous cap atheromas as the underlying pathology. Unlike plaque ruptures, endothelial erosions tend to occur on thick-capped atherosclerotic plaques and may or may not be associated with inflammation. Smoking and female gender are strong risk factors for erosion. Multiple mechanisms may contribute to endothelial erosion, including endothelial dysfunction, TLR signalling, leukocyte activation and modification of sub-endothelial matrix by endothelial or smooth muscle cells, which may trigger loss of adhesion to the extracellular matrix or endothelial apoptosis. Diagnosis of endothelial erosion by intravascular imaging, especially high resolution optical coherence tomography, may influence treatment strategies, offering prognostic value and utility as an endpoint in trials of agents designed to preserve an intact coronary endothelium.
O lugar da função poética na poli(a)fonia do objeto voz em Psicanálise
Authors: Ramos Conrado 
Published: January 2016

<p>Este trabalho, produto de um cartel de uma Escola de Psicanálise, pretende desenvolver a concepção do objeto voz como objeto perdido da pulsão invocante, segundo Jacques Lacan, e buscar as manifestações subjetivas e formas clínicas nas quais pode-se encontrar a recuperação da voz como objeto mais-de-gozar. Neste percurso discute-se a alucinação sonora, a ruminação obsessiva e o insulto entre outros fenômenos. Num segundo momento discute-se o lugar da função poética na interpretação psicanalítica, tomando a materialidade sonora, a assonância e os afetos provocados pela poesia como recuperação imaginária de um gozo perdido. Conclui-se que, uma vez que a voz se faça estruturalmente objeto perdido, não há emissão significante que não carregue um enigma, não há endereçamento não atravessado pelo oracular, não há comunicação em que o equívoco não seja possível.</p><p> </p>
"A criação fora do tempo”
Authors: Goldfeder André 
Published: January 2016

<p align="center">WILLEMART, Philippe. <em>Psicanálise e teoria literária: o tempo lógico e as rodas </em>da<em> escritura e da leitura</em>. São Paulo: Perspectiva, 2014. </p><p> </p><p> </p>
Schiller e a continuidade idealista na teoria do realismo burguês alemão
Authors: Bonomo Daniel 
Published: January 2016

<p>O ensaio procura mostrar manutenções idealistas em textos do realismo programático alemão na década de 1850 buscando no pensamento de Schiller, em fins do século XVIII, escolhas e conteúdos atualizados em Theodor Fontane, Otto Ludwig e Julian Schmidt, três dos principais nomes da teoria realista em apreço, também conhecida como teoria do realismo burguês. A opção por determinadas conciliações, nesses autores, conduz o debate.</p><p> </p>
Apolipoprotein E Receptor 2 Mediates Activated Protein C–Induced Endothelial Akt Activation and Endothelial Barrier Stabilization
Authors: Sinha Ranjeet K. , Yang Xia V. , Fernández José A. , Xu Xiao , Mosnier Laurent O. , Griffin John H. 
Published: January 2016

Objective—

Activated protein C (APC), a plasma serine protease, initiates cell signaling that protects endothelial cells from apoptosis and endothelial barrier disruption. Apolipoprotein E receptor 2 (ApoER2;
LRP8
) is a receptor known for mediating signaling initiated by reelin in neurons. ApoER2 contributes to APC-initiated signaling in monocytic U937 cells. The objective was to determine whether ApoER2 is required for APC’s beneficial signaling in the endothelial cell surrogate EA.hy926 line.

Approach and Results—
We used small interfering RNA and inhibitors to probe requirements for specific receptors for APC’s antiapoptotic activity and for phosphorylation of disabled-1 by Src family kinases and of Akt. When small interfering RNA for ApoER2 or endothelial cell protein C receptor or protease activated receptor 1 was used, APC’s antiapoptotic activity was ablated, indicating that each of these receptors was required. In EA.hy926 cells, APC induced a 2- to 3-fold increased phosphorylation of Ser473-Akt and Tyr232-disabled-1, a phosphorylation known to trigger disabled-1–mediated signaling in other cell types. Ser473-Akt phosphorylation was inhibited by ApoER2 small interfering RNA or by inhibitors of Src (PP2), phosphatidylinositol-3 kinase (LY303511), and protease activated receptor 1 (SCH79797). ApoER2 small interfering RNA blocked the ability of APC to prevent thrombin-induced endothelial barrier disruption in TransEndothelial Resistance assays. Binding studies using purified APC and purified immobilized wild-type and mutated ApoER2 ectodomains suggested that APC binding involves Lys49, Asp50, and Trp64 on the surface of the N-terminal LA1 domain of ApoER2.

Conclusions—
ApoER2 contributes cooperatively with endothelial cell protein C receptor and protease activated receptor 1 to APC-initiated endothelial antiapoptotic and barrier protective signaling.
Stroke Severity Is a Crucial Predictor of Outcome: An International Prospective Validation Study
Authors: Rost Natalia S. , Bottle Alex , Lee Jin‐Moo , Randall Marc , Middleton Steven , Shaw Louise , Thijs Vincent , Rinkel Gabriel J. E. , Hemmen Thomas M. ,   the Global Comparators Stroke GOAL collaborators
Published: January 2016

Background
Stroke is among the leading causes of morbidity and mortality worldwide. Without reliable prediction models and outcome measurements, comparison of care systems is impossible. We analyzed prospectively collected data from 4 countries to explore the importance of stroke severity in outcome prediction.

Methods and Results
For 2 months, all acute ischemic stroke patients from the hospitals participating in the Global Comparators Stroke GOAL (Global Outcomes Accelerated Learning) collaboration received a National Institutes of Health Stroke Scale (NIHSS) score on admission and a modified Rankin Scale score at 30 and 90 days. These data were added to the administrative data set, and risk prediction models including age, sex, comorbidity index, and NIHSS were derived for in‐hospital death within 7 days, all in‐hospital death, and death and good outcome at 30 and 90 days. The relative importance of each variable was assessed using the proportion of explained variation. Of 1034 admissions for acute ischemic stroke, 614 had a full set of NIHSS and both modified Rankin Scale values recorded; of these, 507 patients could be linked to administrative data. The marginal proportion of explained variation was 0.7% to 4.0% for comorbidity index, and 11.3 to 25.0 for NIHSS score. The percentage explained by the model varied by outcome (16.6–29.1%) and was highest for good outcome at 30 and 90 days. There was high agreement between 30‐ and 90‐day modified Rankin Scale scores (weighted κ=0.82).

Conclusions
In this prospective pilot study, the baseline NIHSS score was essential for prediction of acute ischemic stroke outcomes, followed by age; whereas traditional comorbidity index contributed little to the overall model. Future studies of stroke outcomes between different care systems will benefit from including a baseline NIHSS score.
Intravenous Thrombolysis in Patients Dependent on the Daily Help of Others Before Stroke
Authors: Gensicke Henrik , Strbian Daniel , Zinkstok Sanne M. , Scheitz Jan F. , Bill Olivier , Hametner Christian , Moulin Solène , Zini Andrea , Kägi Georg , Pezzini Alessandro , Padjen Visnja , Béjot Yannick , Corbiere Sydney , Zonneveld Thomas P. , Seiffge David J. , Roos Yvo B. , Traenka Christopher , Putaala Jukka , Peters Nils , Bonati Leo H. , Curtze Sami , Erdur Hebun , Sibolt Gerli , Koch Peter , Vandelli Laura , Ringleb Peter , Leys Didier , Cordonnier Charlotte , Michel Patrik , Nolte Christian H. , Lyrer Philippe A. , Tatlisumak Turgut , Nederkoorn Paul J. , Engelter Stefan T. ,   for the Thrombolysis in Stroke Patients (TriSP) Collaborators
Published: January 2016

Background and Purpose—
We compared outcome and complications in patients with stroke treated with intravenous thrombolysis (IVT) who could not live alone without help of another person before stroke (dependent patients) versus independent ones.

Methods—
In a multicenter IVT-register–based cohort study, we compared previously dependent (prestroke modified Rankin Scale score, 3–5) versus independent (prestroke modified Rankin Scale score, 0–2) patients. Outcome measures were poor 3-month outcome (not reaching at least prestroke modified Rankin Scale [dependent patients]; modified Rankin Scale score of 3–6 [independent patients]), death, and symptomatic intracranial hemorrhage. Unadjusted and adjusted odds ratios (ORs) with 95% confidence intervals (OR [95% confidence interval]) were calculated.

Results—

Among 7430 IVT-treated patients, 489 (6.6%) were dependent and 6941 (93.4%) were independent. Previous stroke, dementia, heart, and bone diseases were the most common causes of preexisting dependency. Dependent patients were more likely to die (OR
unadjusted
, 4.55 [3.74–5.53]; OR
adjusted
, 2.19 [1.70–2.84]). Symptomatic intracranial hemorrhage occurred equally frequent (4.8% versus 4.5%). Poor outcome was more frequent in dependent (60.5%) than in independent (39.6%) patients, but the adjusted ORs were similar (OR
adjusted
, 0.95 [0.75–1.21]). Among survivors, the proportion of patients with poor outcome did not differ (35.7% versus 31.3%). After adjustment for age and stroke severity, the odds of poor outcome were lower in dependent patients (OR
adjusted
, 0.64 [0.49–0.84]).

Conclusions—
IVT-treated stroke patients who were dependent on the daily help of others before stroke carry a higher mortality risk than previously independent patients. The risk of symptomatic intracranial hemorrhage and the likelihood of poor outcome were not independently influenced by previous dependency. Among survivors, poor outcome was avoided at least as effectively in previously dependent patients. Thus, withholding IVT in previously dependent patients might not be justified.