bluuebunny/crossref_metadata_2025_split huggingface dataset:
The ‘weekend effect’ in acute medicine: a protocol for a team-based ethnography of weekend care for medical patients in acute hospital settings
Authors: Tarrant Carolyn , Sutton Elizabeth , Angell Emma , Aldridge Cassie P , Boyal Amunpreet , Bion Julian 
Published: April 2017

IntroductionIt is now well-recognised that patients admitted to hospital on weekends are at higher risk of death than those admitted during weekdays. However, the causes of this ‘weekend effect’ are poorly understood. Some contend that there is a deficit of medical staff on weekends resulting in poorer quality care, whereas others find that patients admitted to hospital on weekends are sicker and therefore at higher risk of adverse outcomes. Clarifying the causal pathway is clearly important in order to identify effective solutions. In this article we describe an ethnographic approach to evaluating the organisation and delivery of medical care on weekends compared with weekdays, with a specific focus on the role of medical staff as part of National Health Service England’s plan to implement 7-day services.Methods and analysisWe will conduct an ethnographic study of 20 acute hospitals in England between April 2016 and March 2018 as part of the High-intensity Specialist-Led Acute Care project (www.hislac.org). Data will be collected through observations and shadowing, and interviews with staff, in 10 hospitals with higher intensity specialist (consultant) staffing on weekends and 10 with lower intensity specialist staffing. Interviews will be conducted with up to 20 patients sampled from two high-intensity and two low-intensity sites. We will coordinate, compare and contrast observations across our team of ethnographers. Analysis will be both in-depth and cross-cutting, exploring specific features within individual sites and making comparisons between them. We outline how data collection and analysis will be facilitated and organised.Ethics and disseminationThe project has received ethics approval from the South West Wales Research Ethics Committee: Reference 13/WA/0372. Informed consent will be obtained for all interview participants. The findings will be disseminated through peer-reviewed publications in high-quality journals and at national and international conferences.
Cyberbullying perpetration and victimisation among junior and senior high school students in Guangzhou, China
Authors: Rao Jiaming , Wang Haiqing , Pang Minhui , Yang Jianwei , Zhang Jiayi , Ye Yunfeng , Chen Xiongfei , Wang Shengyong , Dong Xiaomei 
Published: April 2017

ObjectivesCyberbullying research in China is in early stage. This study describes the cyberbullying experiences of junior and senior high school students in Guangzhou, China, and to examine the risk factors associated with cyberbullying perpetrators, victims and perpetrator-victims among students. We also investigated the frequency of cyberbullying and coping strategies of student victims.MethodsParticipants were 2590 students in grades 7, 8, 9 and 10 from six junior and senior high schools in October 2015 in Guangzhou, in south China, who completed a questionnaire. Data on participants' experiences with cyberbullying perpetration and victimisation during the previous 6 months were collected. Multinomial logistic regression was used to analyse factors associated with being perpetrators, victims and perpetrator-victims.ResultsIn this sample, 28.0% (725) of participants reported being a perpetrator and 44.5% (1150) reported being a victim in the previous 6 months. Specifically, 2.9% (74) reported being perpetrators only, 19.3% (499) reported being victims only and 25.2% (651) reported being perpetrator-victims (both perpetrator and victim). In addition, flaming was the most common form of cyberbullying in both perpetration and victimisation. Logistic regression analyses indicated that online game addiction in participants was associated with increased odds of being a perpetrator only; no democratic parenting style in the mother and physical discipline by parents were associated with increased odds of being a victim only; male students, students with low academic achievement, those spending over 2 hours a day online, experiencing physical discipline from parents and online game addiction were associated with increased odds of both perpetration and victimisation.ConclusionsCyberbullying is a common experience among Chinese junior and senior high school students. These findings add to the empirical data on cyberbullying and reinforce the urgent need for cyberbullying prevention in China. Furthermore, from the perspective of practice, it is important to raise our awareness of cyerbullying and reduce the risk factors.
Energy density of foods and diets in Mexico and their monetary cost by socioeconomic strata: analyses of ENSANUT data 2012
Authors: Mendoza Alfonso , Pérez Ana E , Aggarwal Anju , Drewnowski Adam 
Published: April 2017

BackgroundIn January 2014, Mexico implemented an 8% tax on non-essential foods with energy density ≥275 kcal/100 g, with a view to prevent obesity. This study explored energy density of foods and diets in Mexico and their monetary cost across population subgroups.MethodsDietary intakes for 3057 adults (ages ≥19 years) were obtained from the nationally representative Encuesta Nacional de Salud y Nutrición (ENSANUT 2012). Energy density (kcal/g) was calculated for foods, food groups and total diets. The mean national retail prices for 153 foods were obtained from the National Institute for Geography and Statistics (INEGI). The monetary cost of total diets (MXN/day) was estimated by attaching food prices to dietary intakes from the ENSANUT food frequency questionnaire. A series of descriptive analyses and regression models examined associations among dietary energy density and diet cost by age, gender, rural or urban residence and socioeconomic status (SES).ResultsEnergy-dense grains, fats and sweets cost less per calorie than did milk and dairy, meat, vegetables and fruit. Lower cost diets derived more calories from tortillas, tamales, beans and sugar, whereas higher cost diets contained more non-essential energy-dense processed foods and more sugar sweetened beverages, and fruits and vegetables. At each quintile of energy intake, higher dietary energy density was associated with lower energy-adjusted diet costs. Traditional energy-dense tortillas and tamales, also characterised by lower cost, were consumed more by the rural poor. Urban dwellers had more ‘western-style’ diets.ConclusionsFood patterns in Mexico appear to be driven by monetary cost and SES.
Trends in vertebral augmentation for spinal fractures in myeloma patients: a 2002–2012 population-based study using a large national cancer registry
Authors: Chokshi Falgun H , Howard David H , Jarvik Jeffrey G , Duszak Richard 
Published: April 2017

PurposeTo evaluate temporal trends and factors associated with vertebral augmentation use in myeloma patients with spinal fractures from 2002 to 2012.MethodsThis retrospective cohort study used the Surveillance, Epidemiology and End Results (SEER)-Medicare claims database for 2002 through 2012. We included patients age ≥66 years with myeloma and spinal fractures. First, we evaluated receipt of vertebral augmentation. Second, multivariate logistic regression was used to assess the impact of sociodemographic factors, treatment facility type, and underlying comorbidities on the odds of undergoing vertebral augmentation.ResultsOf 4725 myeloma patients with spinal fractures, 653 underwent vertebral augmentation. Procedures increased initially from <1.7% in 2002 to 21.0% (109/520) in 2007, 18.6% (81/435) in 2008, 21.4% (109/509) in 2009, and 17.5% (76/435) in 2011. Patients with a spinal fracture before myeloma diagnosis were twice as likely to undergo vertebral augmentation as patients with fracture after myeloma diagnosis (OR 2.06, 95% CI 1.55 to 2.75). Black patients were half as likely to undergo vertebral augmentation as white patients (OR 0.48, 95% CI 0.34 to 0.68). Patients with 3–5 comorbidities (OR 0.78, 95% CI 0.64 to 0.96) and ≥6 comorbidities (OR 0.69, 95% CI 0.54 to 0.87) were less likely than patients with 0–2 comorbidities to undergo vertebral augmentation.ConclusionsVertebral augmentation for myeloma patients with spinal fractures peaked between 2007 and 2009 and then declined. Providers may have adopted vertebral augmentation in myeloma patients since its introduction, and potentially modified practice patterns following the publication of trials of vertebral augmentation in patients with osteoporotic spinal fractures.
Sulfated Galactans from Red Seaweed Gracilaria fisheri Target EGFR and Inhibit Cholangiocarcinoma Cell Proliferation
Authors: Sae-Lao Thannicha , Tohtong Rutaiwan , Bates David O. , Wongprasert Kanokpan 
Published: April 2017

Cholangiocarcinoma (CCA) is increasing in incidence worldwide and is resistant to chemotherapeutic agents, making treatment of CCA a major challenge. Previous studies reported that natural sulfated polysaccharides (SPs) disrupted growth factor receptor activation in cancer cells. The present study, therefore, aimed at investigating the antiproliferation effect of sulfated galactans (SG) isolated from the red seaweed Gracilaria fisheri (G. fisheri) on CCA cell lines. Direct binding activity of SG to CCA cells, epidermal growth factor (EGF) and epidermal growth factor receptor (EGFR) were determined. The effect of SG on proliferation of CCA cells was investigated. Cell cycle analyses and expression of signaling molecules associated with proliferation were also determined. The results demonstrated that SG bound directly to EGFR. SG inhibited proliferation of various CCA cell lines by inhibiting EGFR and extracellular signal-regulated kinases (ERK) phosphorylation, and inhibited EGF-induced increased cell proliferation. Cell cycle analyses showed that SG induced cell cycle arrest at the G0/G1 phase, down-regulated cell cycle genes and proteins (cyclin-D, cyclin-E, cdk-4, cdk-2), and up-regulated the tumor suppressor protein P53 and the cyclin-dependent kinase inhibitor P21. Taken together, these data demonstrate that SG from G. fisheri inhibited proliferation of CCA cells, and its mechanism of inhibition is mediated, to some extent, by inhibitory effects on EGFR activation and EGFR/ERK signaling pathway. SG presents a potential EGFR targeted molecule, which may be further clinically developed in a combination therapy for CCA treatment.
Phosphatidylcholine transfer protein/StarD2 promotes microvesicular steatosis and liver injury in murine experimental steatohepatitis
Authors: Nicholls Hayley T. , Hornick Jason L. , Cohen David E. 
Published: April 2017

Mice fed a methionine- and choline-deficient (MCD) diet develop steatohepatitis that recapitulates key features of nonalcoholic steatohepatitis (NASH) in humans. Phosphatidylcholine is the most abundant phospholipid in the surfactant monolayer that coats and stabilizes lipid droplets within cells, and choline is required for its major biosynthetic pathway. Phosphatidylcholine-transfer protein (PC-TP), which exchanges phosphatidylcholines among membranes, is enriched in hepatocytes. PC-TP also regulates fatty acid metabolism through interactions with thioesterase superfamily member 2. We investigated the contribution of PC-TP to steatohepatitis induced by the MCD diet. Pctp−/−and wild-type control mice were fed the MCD diet for 5 wk and were then euthanized for histopathologic and biochemical analyses, as well as determinations of mRNA and protein expression. Whereas all mice developed steatohepatitis, plasma alanine aminotransferase and aspartate aminotransferase activities were only elevated in wild-type mice, indicating that Pctp−/−mice were protected from MCD diet-induced hepatocellular injury. Reduced hepatotoxicity due to the MCD diet in the absence of PC-TP expression was further evidenced by decreased activation of c-Jun and reduced plasma concentrations of fibroblast growth factor 21. Despite similar total hepatic concentrations of phosphatidylcholines and other lipids, the relative abundance of microvesicular lipid droplets within hepatocytes was reduced in Pctp−/−mice. Considering that the formation of larger lipid droplets may serve to protect against lipotoxicity in NASH, our findings suggest a pathogenic role for PC-TP that could be targeted in the management of this condition.NEW & NOTEWORTHY Phosphatidylcholine-transfer protein (PC-TP) is a highly specific phosphatidylcholine-binding protein that we previously showed to regulate hepatocellular nutrient metabolism through its interacting partner thioesterase superfamily member 2 (Them2). This study identifies a pathogenic role for PC-TP, independent of Them2, in the methionine- and choline-deficient diet model of experimental steatohepatitis. Our current observations suggest that PC-TP promotes liver injury by mediating the intermembrane transfer of phosphatidylcholines, thus stabilizing more pathogenic microvesicular lipid droplets.
Multinuclear NMR and MRI Reveal an Early Metabolic Response to mTOR Inhibition in Sarcoma
Authors: Di Gialleonardo Valentina , Aldeborgh Hannah N. , Miloushev Vesselin , Folkers Kelly M. , Granlund Kristin , Tap William D. , Lewis Jason S. , Weber Wolfgang A. , Keshari Kayvan R. 
Published: April 2017

Abstract
Biomarkers predicting rapalog responses in sarcomas where PI3K and mTOR are often hyperactivated could improve the suitable recruitment of responsive patients to clinical trials. PI3K/mTOR pathway activation drives energy production by regulating anaerobic glycolysis in cancer cells, suggesting a route toward a monitoring strategy. In this study, we took a multimodality approach to evaluate the phenotypic effects and metabolic changes that occur with inhibition of the PI3K/mTOR pathway. Its central role in regulating glycolysis in human sarcomas was evaluated by short- and long-term rapamycin treatment in sarcoma cell lines. We observed an overall decrease in lactate production in vitro, followed by cell growth inhibition. In vivo, we observed a similar quantitative reduction in lactate production as monitored by hyperpolarized MRI, also followed by tumor size changes. This noninvasive imaging method could distinguish reduced cell proliferation from induction of cell death. Our results illustrate the use of hyperpolarized MRI as a sensitive technique to monitor drug-induced perturbation of the PI3K/mTOR pathway in sarcomas. Cancer Res; 77(11); 3113–20. ©2017 AACR.
Silent Brain Infarctions and Leukoaraiosis in Patients With Retinal Ischemia
Authors: Golsari Amir , Bittersohl Diana , Cheng Bastian , Griem Pia , Beck Christoph , Hassenstein Andrea , Nedelmann Max , Magnus Tim , Fiehler Jens , Gerloff Christian , Thomalla Götz 
Published: April 2017

Background and Purpose—
We aimed to determine the incidence of co-occurring cerebral ischemia, extent of cerebral small vessel disease, and vascular risk profile of patients with acute retinal ischemia.

Methods—
RETIS (Frequency of Acute Silent Brain Infarction and Systematic Evaluation of Stroke Risk in Retinal Ischemia) was a single-center, prospective, observational study comprising ophthalmologic examination, brain magnetic resonance imaging, and extensive diagnostic work-up of vascular risk factors and stroke cause. Silent brain infarctions were identified on diffusion-weighted imaging, leukoaraiosis was quantified on fluid-attenuated inversion recovery sequences, and carotid artery stenosis was assessed by carotid ultrasound.

Results—

Of 112 patients with retinal ischemia, 77 (68.8%) had retinal arterial occlusion, and 35 (31.3%) presented with amaurosis fugax. Silent brain infarctions were found in 17 (15.1%) patients. Internal carotid artery stenosis was present in 19 (17.0%) and severe leukoaraiosis in 29 (25.9%) patients. Atrial fibrillation was detected in 14 (12.5%) patients. Patients with silent brain infarctions had higher rates of internal carotid artery stenosis (35.3% versus 13.7%;
P
=0.029) than those without, whereas leukoaraiosis and vascular risk factors were comparable between groups. Internal carotid artery stenosis was the only significant predictor of silent brain infarctions in multivariate analysis (odds ratio, 4.27; 95% confidence interval, 1.06–17.23).

Conclusions—
Silent cerebral ischemia is present in about 1 in 7 patients with retinal ischemia. The high rate of symptomatic internal carotid artery stenosis suggests that large artery atherosclerosis plays a major role in the pathogenesis of acute retinal ischemia.
Changes in the Employment Status and Risk of Stroke and Stroke Types
Authors: Eshak Ehab S. , Honjo Kaori , Iso Hiroyasu , Ikeda Ai , Inoue Manami , Sawada Norie , Tsugane Shoichiro 
Published: April 2017

Background and Purpose—
Because of limited evidence, we investigated a long-term impact of changes in employment status on risk of stroke.

Methods—
This was a prospective study of 21 902 Japanese men and 19 826 women aged 40 to 59 years from 9 public health centers across Japan. Participants were followed up from 1990 to 1993 to the end of 2009 to 2014. Cox proportional hazard ratio of stroke (incidence and mortality) and its types (hemorrhagic and ischemic) was calculated according to changes in the employment status within 5 years interval between 1990 to 1993 and 1995 to 1998 (continuously employed, job loss, reemployed, and continuously unemployed).

Results—
During the follow-up period, 973 incident cases and 275 deaths from stroke in men and 460 cases and 131 deaths in women were documented. Experiencing 1 spell of unemployment was associated with higher risks of morbidity and mortality from total, hemorrhagic, and ischemic stroke in both men and women, even after propensity score matching. Compared with continuously employed subjects, the multivariable hazard ratio (95% confidence interval) for total stroke incidence in job lost men was 1.58 (1.18–2.13) and in job lost women was 1.51 (1.08–2.29), and those for total stroke mortality were 2.22 (1.34–3.68) in men and 2.48 (1.26–4.77) in women. The respective hazard ratio (95% confidence interval) in reemployed men was 2.96 (1.89–4.62) for total stroke incidence and 4.21 (1.97–8.97) for mortality, whereas those in reemployed women were 1.30 (0.98–1.69) for incidence and 1.28 (0.76–2.17) for mortality.

Conclusions—
Job lost men and women and reemployed men had increased risks for both hemorrhagic and ischemic stroke incidence and mortality.
Separating Event-related Potential Effects for Conceptual Fluency and Episodic Familiarity
Authors: Bader Regine , Mecklinger Axel 
Published: April 2017

Abstract
ERP old/new effects have been associated with different subprocesses of episodic recognition memory. The notion that recollection is reflected in the left parietal old/new effect seems to be uncontested. However, an association between episodic familiarity and the mid-frontal old/new effect is not uncontroversial. It has been argued that the mid-frontal old/new effect is functionally equivalent to the N400 and hence merely reflects differences in conceptual fluency between old and new items. Therefore, it is related to episodic familiarity only in situations in which conceptual fluency covaries with familiarity. Alternatively, the old/new effect in this time window reflects an interaction of episodic familiarity and conceptual processing with each making a unique functional contribution. To test this latter account, we manipulated conceptual fluency and episodic familiarity orthogonally in an incidental recognition test: Visually presented old and new words were preceded by either conceptually related or unrelated auditory prime words. If the mid-frontal old/new effect is functionally distinguishable from conceptual priming effects, an ERP contrast reflecting pure priming (correct rejections in the related vs. unrelated condition) and a contrast reflecting priming plus familiarity (hits in the related vs. correct rejections in the unrelated condition) should differ in scalp distribution. As predicted, the pure priming contrast had a right-parietal distribution, as typically observed for the N400 effect, whereas the priming plus familiarity contrast was significantly more frontally accentuated. These findings implicate that old/new effects in this time window are driven by unique functional contributions of episodic familiarity and conceptual processing.
Modulation of Oscillatory Power and Connectivity in the Human Posterior Cingulate Cortex Supports the Encoding and Retrieval of Episodic Memories
Authors: Lega Bradley , Germi James , Rugg Michael D. 
Published: April 2017

Abstract
Existing data from noninvasive studies have led researchers to posit that the posterior cingulate cortex (PCC) supports mnemonic processes: It exhibits degeneration in memory disorders, and fMRI investigations have demonstrated memory-related activation principally during the retrieval of memory items. Despite these data, the role of the PCC in episodic memory has received only limited treatment using the spatial and temporal precision of intracranial EEG, with previous analyses focused on item retrieval. Using data gathered from 21 human participants who underwent stereo-EEG for seizure localization, we characterized oscillatory patterns in the PCC during the encoding and retrieval of episodic memories. We identified a subsequent memory effect during item encoding characterized by increased gamma band oscillatory power and a low-frequency power desynchronization. Fourteen participants had stereotactic electrodes located simultaneously in the hippocampus and PCC, and with these unique data, we describe connectivity changes between these structures that predict successful item encoding and that precede item retrieval. Oscillatory power during retrieval matched the pattern we observed during encoding, with low-frequency (below 15 Hz) desynchronization and a gamma band (especially high gamma, 70–180 Hz) power increase. Encoding is characterized by synchrony between the hippocampus and PCC, centered at 3 Hz, consistent with other observations of properties of this oscillation akin to those for rodent theta activity. We discuss our findings in light of existing theories of episodic memory processing, including the information via desynchronization hypothesis and retrieved context theory, and examine how our data fit with existing theories for the functional role of the PCC. These include a postulated role for the PCC in modulating internally directed attention and for representing or integrating contextual information for memory items.
Estimating Range-Dependent Evaporation Duct Height
Authors: Zhao Xiaofeng , Yardim Caglar , Wang Dongxiao , Howe Bruce M. 
Published: April 2017

AbstractThe refractivity from clutter (RFC) technique has been proved to be an effective way to estimate atmospheric duct structure. An important issue for RFC is how to make the estimate more robust, especially in range-dependent ducting conditions. Traditionally, statistical inversion methods need a large number of forward propagation model runs to obtain an acceptable result. Especially when the parameter search space is multidimensional, these methods are prone to being trapped into local optimal solutions. Recently published results (Zhao and Huang) indicate that the adjoint parabolic equation (PE) method holds promise for real-time estimation of one-dimensional refractive index structure from radar sea clutter returns. This paper is aimed at extending the adjoint PE method to range-dependent evaporation duct cases, with a log-linear relationship describing duct structures. Numerical simulations are used to test the performance of this method and the results are compared with that retrieved using a genetic algorithm. Both noise-free and 3-dB additive Gaussian noise clutter simulations are considered, as well as linearly and nonlinearly varying duct height with range.