bluuebunny/crossref_metadata_2025_split huggingface dataset:
High-sensitive cardiac troponin-I facilitates timely detection of subclinical anthracycline-mediated cardiac injury
Authors: Jones Melissa , O’Gorman Peter , Kelly Catherine , Mahon Niall , Fitzgibbon Maria C 
Published: May 2016

Background Anthracycline drugs are effective anticancer agents, but their optimal use is limited in many patients by the associated cardiotoxicity, even at designated safe doses. As conventionally sensitive cardiac troponin-I assays fail to reliably quantify concentrations of cardiac troponin-I below 30 ng/L, we investigated the potential role of high-sensitive cardiac troponin-I in the detection of subclinical cardiomyocyte injury in patients treated with anthracycline agents. Methods Serial high-sensitive cardiac troponin-I concentrations were assessed in 84 patients, receiving anthracycline-containing ( n = 38) and non-anthracycline-containing ( n = 46) regimens. Results were assessed for change from pretreatment levels and evaluated according to unisex and gender-specific 99th percentiles (25 ng/L and M: 34 ng/L, F: 16 ng/L, respectively). Results A significant increase in high-sensitive cardiac troponin-I was observed in the anthracycline cohort following five cycles of treatment, with the greatest change correlating to an absolute δ increase of 30.7 ng/L in the early-dose group (early-dose group: P < 0.0001, late-dose group: P < 0.01 and continuous-dose group: P < 0.0001). Doxorubicin dose did not correlate directly with high-sensitive cardiac troponin-I concentrations (Spearman r < −0.22). No significant changes in high-sensitive cardiac troponin-I were reported among the non-anthracycline cohort with all measurements below the 99th percentiles. Conclusions Treatment with anthracycline-based chemotherapeutic regimen demonstrated significant elevations of high-sensitive cardiac troponin-I, indicative of subclinical cardiomyocyte damage. This study demonstrates a role for high-sensitive cardiac troponin-I in evaluating those patients where cardiotoxicity is a concern and a potential future role as a biomarker in optimizing cardioprotective treatments in patients receiving anthracycline therapy.
Variance functions, detectability and bias: a re-evaluation
Authors: Sadler William A 
Published: May 2016

Background A recent study used simulated internal quality control data (4 specimens × 40 replicates) to investigate the use of variance functions in estimating limit of blank and limit of detection, as per ISO definitions. Small systematic negative biases were found (typically <1%), but subsequent investigation has shown that these estimates had unacceptably large uncertainties because of an inadequate simulation size. Methods The previous data generation and variance function estimations were repeated 25 times using a different random number generator seed on each occasion. The study was further extended by increasing data quantities 100-fold and by reducing the number of replicates per specimen (40 through 20, 10, 5 and 2). Results The previously reported negative biases were shown to be an artefact, and this was confirmed by simulations using 100-fold more data. Biases were <|0.1%| throughout with replication ≥20, but positive biases were found at lower replication; up to + 1.23% in the case of duplicates and large variances (e.g. some immunoassays) and up to + 0.2% in the case of duplicates and small variances. Conclusions The variance function provides essentially unbiased estimates of limit of blank and limit of detection at data replication ≥20 (bias: <1 part in 1000) and minimal biases at lower replication when measurement errors are small.
Spinal Decerebrate-Like Posturing After Brain Death
Authors: Kumar Abhay , Tummala Pavan , Feen Eliahu S. , Dhar Rajat 
Published: May 2016

Introduction: Criteria for establishing brain death (BD) require absence of all brainstem-mediated reflexes including motor (ie, decerebrate or decorticate) posturing. A number of spinal cord automatisms may emerge after BD, but occurrence of decerebrate-like spinal reflexes may be particularly problematic; confusion of such stereotypic extension–pronation movements with brain stem reflexes may confound or delay definitive diagnosis of BD. We present a case in which we verified the noncerebral (ie, likely spinal) origin of such decerebrate-like reflexes. Methods: Case report and systematic review of literature. Results: A 63-year-old woman presented with large pontine hemorrhage and complete loss of cerebral function, including no motor response to pain. Apnea testing confirmed death by neurologic criteria. Thirty-six hours after BD declaration, during assessment for organ donation, she began to exhibit spontaneous and stimulus-induced stereotypic extension–pronation of the upper extremities. The similarity of these movements to decerebrate posturing prompted concern for retained brain stem function, but repeat neurological examination of cranial nerves and apnea testing did not reveal any cerebral responses. Electrocerebral silence on electroencephalogram and absent perfusion on nuclear medicine brain imaging further confirmed BD. Review of PubMed yielded 5 additional case reports and 4 cohorts describing cases of decerebrate-like extension–pronation movements presenting in a delayed fashion after BD. Conclusion: Extension–pronation movements that mimic decerebrate posturing may be seen in a delayed fashion after BD. Verification of lack of any brain activity (by both examination and multiple ancillary tests) in this case and others prompts us to attribute these movements as spinal cord reflexes and propose they be recognized within the rubric of accepted post-BD automatisms that should not delay diagnosis or necessitate confirmatory testing.
Employment, spillovers and ‘decent work’: Challenging the Productivity Commission’s auto industry narrative
Authors: Barnes Tom , Roose Joshua M , Heap Lisa , Turner Bryan S 
Published: May 2016

AbstractThe 2013 and 2014 announcements by major car manufacturers that they would wind down all their remaining Australian automotive operations by 2016/2017 pre-empted the March 2014 release of the Productivity Commission’s final report into motor vehicle manufacturing. The Commission suggested that government subsidies had only delayed car plant closures and reiterated its longstanding opposition to industry policy and redistributive regional adjustment programmes by government. Industrialists, employer associations, state governments and trade unions have, however, questioned the Commission’s forecasts for both economic spillover effects and social impacts in regions affected by automotive plant closures. In addition to challenging several underlying assumptions used to calculate the Productivity Commission’s forecasts, this article argues that insufficient attention has been paid to the quality of future work. It extends insights from previous studies of industrial decline by proposing a new research agenda based on the idea of ‘social spillovers’.
Retirement Preparation Programs
Authors: Cohen-Mansfield Jiska , Regev Irit 
Published: May 2016

Purpose: This study was designed to examine whether preretirement intervention, through preparation programs conducted by social workers, enhances retirees’ healthy retirement transition, self-mastery, and well-being outcomes. Methods: Data were gathered at preprogram, postprogram, and at 6-month follow-up. A total of 84 participants filled out pre- and postprogram questionnaires, of which 66 also completed follow-up assessment. Participants were 1–3 months before retirement at preassessment and 4–8 months after retirement at follow-up. Results: The preretirement program improved participants’ appraisal of retirement and created lower and more realistic expectations of postretirement work prospects. While these variables changed in the expected direction between pre- and postprogram assessment, participants’ scores at follow-up indicated less self-mastery, greater depressed affect, and less positive feelings regarding retirement. Discussion: The short-term value of retirement programs was supported and revealed the importance of follow-up programs to maintain short-term gains and to address additional long-term developments.
Assessment of platelet function in healthy cats in response to commonly prescribed antiplatelet drugs using three point-of-care platelet function tests
Authors: Ho Kimberly K , Abrams-Ogg Anthony CG , Wood R Darren , O’Sullivan M Lynne , Kirby Gordon M , Blois Shauna L 
Published: May 2016

Objectives The objective was to determine if decreased platelet function could be detected after treatment with aspirin and/or clopidogrel in healthy cats using three point-of-care platelet function tests that evaluate platelet function by different methods: Multiplate (by impedance), Platelet Function Analyzer 100 (by mechanical aperture closure) and Plateletworks (by platelet counting). Methods Thirty-six healthy cats were randomly assigned to receive one of three oral treatments over an 8 day period: (1) aspirin 5 mg q72h; (2) aspirin 20.25 mg q72h; or (3) clopidogrel 18.75 mg q24h. Cats treated with 5 and 20.25 mg aspirin also received clopidogrel on days 4–8. Platelet aggregation in response to adenosine diphosphate and collagen ± arachidonic acid was assessed on days 1 (baseline), 4 and 8. Aspirin and clopidogrel metabolites were measured by high-performance liquid chromatography. Platelet function in response to treatment was analyzed by ANCOVA, linear regression and Spearman correlation. Results The only solitary aspirin effect was detected using Plateletworks with collagen in cats treated with 20.25 mg. The only effect detected by Multiplate was using arachidonic acid in cats treated with both aspirin 20.25 mg and clopidogrel. All clopidogrel treatment effects were detected by Platelet Function Analyzer 100, Plateletworks (adenosine diphosphate) and Plateletworks (collagen). Drug metabolites were present in all cats, but concentrations were minimally correlated to platelet function test results. Conclusions and relevance Platelet Function Analyzer 100 and Plateletworks using adenosine diphosphate ± collagen agonists may be used to detect decreased platelet function in response to clopidogrel treatment. Either aspirin is not as effective an antiplatelet drug as clopidogrel, or the tests used were not optimal to measure aspirin effect. Cats with heart disease are commonly prescribed antiplatelet drugs to decrease the risk of aortic thromboembolism. Platelet Function Analyzer 100 and Plateletworks may be useful for confirming clopidogrel treatment in these cats.
Elevated CSF neurofilament proteins predict brain atrophy: A 15-year follow-up study
Authors: Petzold Axel , Steenwijk Martijn D , Eikelenboom Judith M , Wattjes Mike P , Uitdehaag Bernard MJ 
Published: May 2016

Background: Body fluid and structural imaging biomarkers give information on neurodegeneration. The relationship over time is not known in multiple sclerosis. Objective: To investigate the temporal relationship of elevated cerebrospinal fluid (CSF) neurofilament (Nf) protein levels, a biomarker for axonal loss, with magnetic resonance imaging (MRI) atrophy measures. Methods: In patients with multiple sclerosis, CSF Nf heavy chain (NfH) phosphoform levels were quantified at baseline and dichotomised into ‘normal’ and ‘high’. Atrophy was assessed by MRI at baseline and 15-year follow-up using SIENAX and FreeSurfer software. Results: High baseline CSF NfH SMI35 levels predicted pronounced atrophy at 15-year follow-up (odds ratio (OR): 36, p < 0.01), in the absence of baseline brain atrophy (OR: 28, p < 0.05), for the averaged MRI normalised brain volume (1.44 L vs 1.33 L, p < 0.05), normalised grey matter volume (0.77 L vs 0.69 L, p < 0.01) and putamen (12.7 mL vs 10.7 mL, p < 0.05). Region-specific calculations including the spinal cord showed that a power of >80% is reached with 14–50 patients. Conclusion: These data suggest that high CSF NfH levels are an early predictor of later brain and spinal cord atrophy using structural imaging biomarkers and can be investigated in reasonably sized patient cohorts.
Development of a Duplex Ultrasound Simulator and Preliminary Validation of Velocity Measurements in Carotid Artery Models
Authors: Zierler R. Eugene , Leotta Daniel F. , Sansom Kurt , Aliseda Alberto , Anderson Mark D. , Sheehan Florence H. 
Published: May 2016

Objective: Duplex ultrasound scanning with B-mode imaging and both color Doppler and Doppler spectral waveforms is relied upon for diagnosis of vascular pathology and selection of patients for further evaluation and treatment. In most duplex ultrasound applications, classification of disease severity is based primarily on alterations in blood flow velocities, particularly the peak systolic velocity (PSV) obtained from Doppler spectral waveforms. We developed a duplex ultrasound simulator for training and assessment of scanning skills. Methods: Duplex ultrasound cases were prepared from 2-dimensional (2D) images of normal and stenotic carotid arteries by reconstructing the common carotid, internal carotid, and external carotid arteries in 3 dimensions and computationally simulating blood flow velocity fields within the lumen. The simulator displays a 2D B-mode image corresponding to transducer position on a mannequin, overlaid by color coding of velocity data. A spectral waveform is generated according to examiner-defined settings (depth and size of the Doppler sample volume, beam steering, Doppler beam angle, and pulse repetition frequency or scale). The accuracy of the simulator was assessed by comparing the PSV measured from the spectral waveforms with the true PSV which was derived from the computational flow model based on the size and location of the sample volume within the artery. Results: Three expert examiners made a total of 36 carotid artery PSV measurements based on the simulated cases. The PSV measured by the examiners deviated from true PSV by 8% ± 5% (N = 36). The deviation in PSV did not differ significantly between artery segments, normal and stenotic arteries, or examiners. Conclusion: To our knowledge, this is the first simulation of duplex ultrasound that can create and display real-time color Doppler images and Doppler spectral waveforms. The results demonstrate that an examiner can measure PSV from the spectral waveforms using the settings on the simulator with a mean absolute error in the velocity measurement of less than 10%. With the addition of cases with a range of pathologies, this duplex ultrasound simulator will be a useful tool for training health-care providers in vascular ultrasound applications and for assessing their skills in an objective and quantitative manner.
Parent perspectives of the challenging aspects of disclosing a child’s epilepsy diagnosis to others: Why don’t they tell?
Authors: Benson Ailbhe , Lambert Veronica , Gallagher Pamela , Shahwan Amre , Austin Joan K 
Published: May 2016

Objectives This study aimed to explore the challenges parents of children with epilepsy (CWE) experienced when deciding to disclose their child’s epilepsy diagnosis to others. Methods Using a qualitative exploratory design, interviews were conducted with 34 parents (27 mothers and 7 fathers) of 29 CWE (aged 6–16 years). Parents were recruited from a neurology clinic of a specialist children’s hospital and from a national epilepsy association. Interviews were directed by a semi-structured guide informed by a review of the literature. Data were transcribed verbatim, imported into NVivo, coded and thematically analysed. Results Findings revealed five themes representative of the core disclosure challenges parents encountered, many of which promoted concealment and/or selective disclosure, namely: seeking normalcy for the child, the invisibility of epilepsy, negative reactions to disclosure, contending with poor public perceptions of epilepsy and coming to terms with the diagnosis. Discussion This study presents crucial information for healthcare professionals (HCPs) who help families to navigate the disclosure decision-making process. Providing HCPs working with families living with epilepsy with insight into diagnosis disclosure challenges will enable them to recognise the support needs of parents and work collaboratively with families to tackle such difficulties, ultimately improving their psychosocial wellbeing.
Ipilimumab-induced colitis: experience from a tertiary referral center
Authors: O’Connor Anthony , Marples Maria , Mulatero Clive , Hamlin John , Ford Alexander C. 
Published: May 2016

Background: Ipilimumab is an anticytotoxic T-lymphocyte antigen-4 (CTLA-4) monoclonal antibody used for the treatment of malignant melanoma. It can cause immune-mediated inflammatory adverse events, including diarrhoea and even intestinal perforation or death in clinical trials but there is a dearth of data on postmarketing outcomes. Methods: A total of 546 patients attending for treatment of metastatic melanoma between 1 January 2009 and 31 August 2015 were identified by interrogation of the oncology database. A total of 83 of these patients received ipilimumab. Clinical information was extracted from chart reviews, endoscopy and radiology reports, and prescription data. Results: A total of 83 patients received ipilimumab. Only 19.3% ( n = 16) of patients developed a diarrhoeal illness not attributable to other causes. The median grade of diarrhoea among included patients was 2 (range 1–4). In two cases, diarrhoea settled spontaneously without any specific treatment. A total of 87.5% of patients received antidiarrhoeal agents such as loperamide or codeine. These resolved symptoms in all patients with grade 1 diarrhoea. For other treatment, 50% patients received systemic glucocorticosteroids and 31.3% required infliximab. Infliximab resolved symptoms in 100% of cases compared with 50% for systemic glucocorticosteroids. Conclusions: The rate of diarrhoea related to ipilimumab in real-world practice is substantial, but below the range observed in data from RCTs. Grade 1 colitis can usually be managed symptomatically, without recourse to stopping ipilimumab. When diarrhoea was grade 2 or above, results from glucocorticosteroids use proved disappointing; but infliximab has been shown to work well. Further research is required into the earlier use of infliximab as an effective treatment for ipilimumab-induced diarrhoea.
Endocrinology Telehealth Consultation Improved Glycemic Control Similar to Face-to-Face Visits in Veterans
Authors: Liu Winnie , Saxon David R. , McNair Bryan , Sanagorski Rebecca , Rasouli Neda 
Published: May 2016

Background: Rates of diabetes for veterans who receive health care through the Veterans Health Administration are higher than rates in the general population. Furthermore, many veterans live in rural locations, far from Veterans Affairs (VA) hospitals, thus limiting their ability to readily seek face-to-face endocrinology care for diabetes. Telehealth (TH) technologies present an opportunity to improve access to specialty diabetes care for such patients; however, there is a lack of evidence regarding the ability of TH to improve glycemic control in comparison to traditional face-to-face consultations. Methods: This was a retrospective cohort study of all new endocrinology diabetes consultations at the Denver VA Medical Center over a 1-year period. Results: A total of 189 patients were included in the analysis. In all, 85 patients had received face-to-face (FTF) endocrinology consultation for diabetes and 104 patients had received TH consultation. Subjects were mostly males (94.7%) and the mean age was 62.8 ± 10.1 years old. HbA1c improved from 9.76% (9.40% to 10.11%) to 8.55% (8.20% to 8.91%) ( P < .0001) for the TH group and from 9.56% (9.16% to 9.95%) to 8.62% (8.22% to 9.01%) ( P < .0001) for the FTF group after 1 visit. This change in HbA1c was not significantly different in the TH and FTF groups ( P = .24). TH visits were associated with a hypothetical savings in median distance traveled of 231.2 miles per trip (which equates to $94.79 saved per trip). Conclusions: Endocrinology TH consultations improved short-term glycemic control as effectively as traditional FTF visits in a veteran population with diabetes.
A comparison of the direct medical costs for individuals with or without basal or squamous cell skin cancer: A study from Australia
Authors: Rowell David , Gordon Louisa G , Olsen Catherine M , Whiteman David C 
Published: May 2016

Objectives: The composition of the medical costs incurred by people treated for basal cell and squamous cell carcinomas (hereafter keratinocyte cancers) is not adequately understood. We sought to compare the medical costs of individuals with or without keratinocyte cancers. Methods: We used national health insurance data to analyze the direct medical costs of 2000 cases and 2000 controls nested within the QSkin prospective cohort study (n = 43,794) conducted in Australia. We reconstructed the medical history of patients using medical and pharmaceutical item codes and then compared the health service costs of individuals treated for keratinocyte cancers with those not treated for keratinocyte cancers. Results: Individuals treated for keratinocyte cancers consumed on average AUD$1320 per annum more in medical services than those without keratinocyte cancers. Only 23.2% of costs were attributed to the explicit treatment of keratinocyte cancers. The principal drivers of the residual costs were medical attendances, surgical procedures on the skin, and histopathology services. We found significant positive associations between history of treatment for keratinocyte cancers with treatments for other health conditions, including melanoma, cardiovascular disease, lipidemia, osteoporosis, rheumatoid arthritis, colorectal cancer, prostate cancer, and tuberculosis. Conclusion: Individuals treated for keratinocyte cancers have substantially higher medical costs overall than individuals without keratinocyte cancers. The direct costs of skin cancer excision account for only one-fifth of this difference.
Modular reorganization of the global network of gene regulatory interactions during perinatal human brain development
Authors: Monzón-Sandoval Jimena , Castillo-Morales Atahualpa , Urrutia Araxi O. , Gutierrez Humberto 
Published: May 2016

Abstract
Background
During early development of the nervous system, gene expression patterns are known to vary widely depending on the specific developmental trajectories of different structures. Observable changes in gene expression profiles throughout development are determined by an underlying network of precise regulatory interactions between individual genes. Elucidating the organizing principles that shape this gene regulatory network is one of the central goals of developmental biology. Whether the developmental programme is the result of a dynamic driven by a fixed architecture of regulatory interactions, or alternatively, the result of waves of regulatory reorganization is not known.

Results
Here we contrast these two alternative models by examining existing expression data derived from the developing human brain in prenatal and postnatal stages. We reveal a sharp change in gene expression profiles at birth across brain areas. This sharp division between foetal and postnatal profiles is not the result of pronounced changes in level of expression of existing gene networks. Instead we demonstrate that the perinatal transition is marked by the widespread regulatory rearrangement within and across existing gene clusters, leading to the emergence of new functional groups. This rearrangement is itself organized into discrete blocks of genes, each targeted by a distinct set of transcriptional regulators and associated to specific biological functions.

Conclusions
Our results provide evidence of an acute modular reorganization of the regulatory architecture of the brain transcriptome occurring at birth, reflecting the reassembly of new functional associations required for the normal transition from prenatal to postnatal brain development.