bluuebunny/crossref_metadata_2025_split huggingface dataset:
The NIH Stroke Scale Has Limited Utility in Accurate Daily Monitoring of Neurologic Status
Authors: Marsh Elisabeth B. , Lawrence Erin , Gottesman Rebecca F. , Llinas Rafael H. 
Published: December 2015

Background and Purpose: The National Institute of Health Stroke Scale (NIHSS) is rapid and reproducible, a seemingly attractive metric for the documentation of clinical progress in patients presenting with ischemic stroke. Many institutions have adopted it into daily clinical practice. Unfortunately, the scale may not adequately capture all forms of functional change. We evaluate its utility as a measure of recovery in patients treated with intravenous tissue plasminogen activator (IV tPA) for ischemic stroke. Methods: We prospectively evaluated the difference in the rate of improvement based on NIHSS (a ≥4 point change based on previous trials) versus physician-documented subjective and objective measures in 41 patients’ status post IV tPA treatment. The NIHSS 24 hours posttreatment, on discharge, and at follow-up were compared to NIHSS on admission using tests of proportions and McNemar tests of paired data. Secondary analyses were performed defining significant improvement as NIHSS changes of 1 to 3 points. Results: The mean NIHSS improved from 9 to 6, 24 hours post-tPA. Of the 41 patients, 29 improved by physician documentation, although only 11 of the 29 met the NIHSS criteria ( P < .001; McNemar P < .001). On discharge, 20 of the 41 patients met the NIHSS criteria; however, the proportion “better” by physician documentation (71%) remained significantly higher ( P = .04; McNemar P = .004). The mean postdischarge follow-up NIHSS was 2. Twenty of the 21 patients improved by documentation versus 16 of the 21 by NIHSS ( P = .08, McNemar P = .125). Using NIHSS changes of 1 to 3 increased sensitivity for detecting improvement but remained lower than physician documentation. Conclusion: The NIHSS has many advantages; however, it may miss functional changes when used in place of a comprehensive neurological examination to measure improvement poststroke.
Development of a Fresh Osteochondral Allograft Program Outside North America
Authors: Tírico Luís Eduardo Passarelli , Demange Marco Kawamura , Santos Luiz Augusto Ubirajara , de Rezende Márcia Uchoa , Helito Camilo Partezani , Gobbi Riccardo Gomes , Pécora José Ricardo , Croci Alberto Tesconi , Bugbee William Dick 
Published: December 2015

Objective To standardize and to develop a fresh osteochondral allograft protocol of procurement, processing and surgical utilization in Brazil. This study describes the steps recommended to make fresh osteochondral allografts a viable treatment option in a country without previous fresh allograft availability. Design The process involves regulatory process modification, developing and establishing procurement, and processing and surgical protocols. Results Legislation: Fresh osteochondral allografts were not feasible in Brazil until 2009 because the law prohibited preservation of fresh grafts at tissue banks. We approved an amendment that made it legal to preserve fresh grafts for 30 days from 2°C to 6°C in tissue banks. Procurement: We changed the protocol of procurement to decrease tissue contamination. All tissues were procured in an operating room. Processing: Processing of the grafts took place within 12 hours of tissue recovery. A serum-free culture media with antibiotics was developed to store the grafts. Surgeries: We have performed 8 fresh osteochondral allografts on 8 knees obtaining grafts from 5 donors. Mean preoperative International Knee Documentation Committee (IKDC) score was 31.99 ± 13.4, improving to 81.26 ± 14.7 at an average of 24 months’ follow-up. Preoperative Knee Injury and Oseoarthritis Outcome Score (KOOS) score was 46.8 ± 20.9 and rose to 85.24 ± 13.9 after 24 months. Mean preoperative Merle D’Aubigne-Postel score was 8.75 ± 2.25 rising to 16.1 ± 2.59 at 24 months’ follow-up. Conclusion To our knowledge, this is the first report of fresh osteochondral allograft transplantation in South America. We believe that this experience may be of value for physicians in countries that are trying to establish an osteochondral allograft transplant program.
Analysis for Prognostic Factors from a Database for the Intra-Articular Hyaluronic Acid (Euflexxa) Treatment for Osteoarthritis of the Knee
Authors: Altman Roy D. , Farrokhyar Forough , Fierlinger Anke , Niazi Faizan , Rosen Jeffrey 
Published: December 2015

Introduction Intra-articular hyaluronic acid (IA-HA) injections are a treatment for knee osteoarthritis (OA), although current literature provides mixed results with regard to their efficacy. We will review a randomized controlled trial (RCT) and subsequent extension trial in order to identify factors that are associated with outcomes in patients with knee OA who received IA-HA. Methods We used data recorded by the FLEXX trial and extension trial for secondary analysis of potential prognostic factors. Linear regression was used to examine the predictors of outcomes at 6- and 12-month follow-up visits. Results Sixty percent of all patients presented with a Kellgren Lawrence (K-L) grade 3. Patients with high baseline outcome scores and a K-L grade 3 demonstrated less response than individuals within an earlier stage of knee OA, although results for both K-L grade 2 and K-L grade 3 patients still showed benefit. Those with more severe radiographic change K-L grade 3 often had a better response with the second series of IA-HA injections. Significantly greater positive response in all outcomes was demonstrated for the patient subgroup classified as K-L grade 2, when compared with K-L grade 3 patients. Conclusions The results demonstrate that IA-HA for knee OA was of greater benefit in those with less severe radiographic changes. However, those with more severe radiographic change often had a better response with the second course of IA-HA. Similar analyses are required in order to determine if these results are unique to Euflexxa, or if these results are consistent with other available IA-HA agents.
Use of doripenem and risk of seizure and renal impairment in US hospitalized patients: a retrospective cohort study
Authors: Chavers Scott , Magee Glenn , Baumer Dorothy , Pai Helen 
Published: December 2015

Objectives: A large retrospective database study was conducted to assess the incidence rate of treatment-emergent renal impairment/failure, seizure, and hemolytic anemia in doripenem and imipenem intravenous (IV)-exposed patients treated for complicated urinary tract infection (cUTI) and complicated intra-abdominal infection (cIAI) in US hospitals. Methods: Using the Premier Perspective™ Database (PPD), which maintains hospital discharge records for over 309 million patients, the incidence rate of treatment-emergent renal impairment/failure, seizure, and hemolytic anemia in the doripenem-treated compared with imipenem IV-treated population was examined. Results: The unadjusted doripenem rate ratio (RR) for renal impairment/failure relative to imipenem IV was 1.13 [95% confidence interval (CI) 1.07–1.21; p < 0.0001]. The unadjusted doripenem rate ratio for seizure relative to imipenem IV was 0.74 (95% CI 0.52–1.05; p = 0.07). In the comparative safety analysis, adjusted incidence rates of renal impairment/failure between doripenem-exposed patients and a propensity score-matched comparator cohort of imipenem IV-exposed patients showed no statistically significant difference in cUTI [RR = 1.02; 95% CI 0.93–1.12; p = 0.71] or cIAI (RR = 1.17; 95% CI 1.00–1.36; p = 0.05). Likewise, there was no statistically significant difference in adjusted incidence rates for seizures in doripenem-treated versus matched imipenem-treated patients for cUTI (RR = 0.69; 95% CI 0.41–1.14; p = 0.15) or cIAI (RR = 0.45; 95% CI 0.15–1.41; p = 0.17). No hemolytic anemia events were observed in this study. Conclusions: In this large retrospective cohort study of US hospitalized patients, no statistically significant differences in the adjusted relative rates of renal impairment/failure and seizure were observed between doripenem and a propensity score-matched comparator cohort of imipenem IV patients in the treatment of cUTI and cIAI.
Women of low socioeconomic status living with diabetes: Becoming adept at handling a disease
Authors: Boonsatean Wimonrut , Dychawy Rosner Irena , Carlsson Anna , Östman Margareta 
Published: December 2015

Objective: The objective of this study was to explore how Thai women of low socioeconomic status handle their type 2 diabetes. Methods: A qualitative interpretative method was used to study 19 women with type 2 diabetes in a suburban community in Thailand. Data were collected via semi-structured interviews and were analysed using inductive and constructive processes. Results: Participants’ lives underwent many changes between their initial diagnoses and later stages when they became adept at handling diabetes. Two themes emerged, which involved (1) the transition to handling diabetes and (2) the influences of the social environment. The first theme encompassed confronting the disease, reaching a turning point in the process of adaptation and developing expertise in handling diabetes. The second theme involved threats of loss of status and empowerment by families. These findings showed that becoming adept at handling diabetes required significant changes in women’s behaviours and required taking advantage of influences from the social environment. Conclusion: The process of developing expertise in handling diabetes was influenced by both inner and outer factors that required adjustment to learn to live with diabetes. Furthermore, the reductions found in women’s social statuses when they become patients in the healthcare system might pose a barrier to women of low socioeconomic status becoming adept at handling diabetes. However, the experiences of empowerment received from the women’s families acted as a powerful strategy to strengthen their handling of the disease. To develop accessible and sensitive health care for this population, it is important to pay attention to these findings.
Style of Play and Rate of Concussions in the National Football League
Authors: Teramoto Masaru , Petron David J. , Cross Chad L. , Willick Stuart E. 
Published: December 2015

Background: The majority of studies on concussion in the National Football League (NFL) focus on testing, evaluation, and outcomes. Meanwhile, there is a paucity of research on how a team’s style of play influences the risk of concussion. Hypothesis: Style of play, such as offensive and defensive strategies, is associated with the rate of concussions in the NFL. Study Design: Descriptive epidemiology study. Methods: The current study retrospectively analyzed data from the 2012 to 2014 NFL regular seasons. Reported numbers of concussions were stratified by each team and each position and were compared based on style of play, including offensive scheme (West Coast offense, Air Coryell offense, or other offensive schemes) and defensive alignment (3-4 or 4-3), attempts statistics, per-drive statistics, and offensive and defensive productions, along with strength of schedule (SoS) and team quality measured by simple rating system (SRS). Data analyses included descriptive statistics, 1-way analysis of variance, correlation analysis, and regression analysis. Results: There were 437 documented concussions during the 2012 to 2014 NFL regular seasons, with a mean 4.6 concussions per season per team. In general, players most involved in pass plays reported more concussions. The number of concussions sustained by offensive players was significantly higher among the teams adopting the West Coast offense (mean, 3.0) than among those utilizing the Air Coryell offense (mean, 1.6; P = .006) or those with non–West Coast offenses combined (mean, 1.9; P = .004). The multiple regression analysis revealed that the West Coast offense or not, SoS, and SRS explained 25.3% of the variance in the number of concussions by offensive players. After accounting for SRS, the West Coast offense was found to be a significant predictor of the number of concussions ( P = .007), while there was a tendency for SoS to be inversely associated with the number of concussions ( P = .105). None of the variables for attempts statistics, per-drive statistics, and offensive production were significantly associated with the number of concussions in the regression analysis. Conclusion: In the NFL, players most involved in pass plays appear to be at increased risk for concussions. The West Coast offense may be associated with a greater risk of concussion. Furthermore, teams with easier schedules may have more players sustaining concussions.
Choosing the Right Strategy: Why the Palestinians Were More Successful in the First Intifada than in the Second?
Authors: Frisch Hillel 
Published: December 2015

Choosing a strategy that polarizes the rival’s political center is often critical in determining the relative success of the weaker side in asymmetric conflict. This proposition is tested on two rounds of protracted confrontations between Palestinians and Israel in 1987 and 2000. In the first intifada, the Palestinians limited terrorism primarily to the West Bank and Gaza, polarized the Israeli political center and secured substantial political gains. In the second, the Palestinians employed much more violent means and focused it within Israel. This indiscriminate strategy (which included suicide bombings) united the Israeli public against the Palestinians, justified the Israeli onslaught on the Palestinian Authority, and divided the Palestinians themselves at considerable political, human, and economic cost. The comparison between Palestinian strategy and its consequences in two long rounds of conflict with the Israeli state suggests an important theoretical and empirical finding; it is not so much the strategy employed by the stronger side that determines outcomes as Ivan Arreguin-Toft suggests but the strategy employed by the weaker actor in conflict. Employing a strategy that polarizes the political center of the opponent and weakens its resolve is critical to the insurgent’s ability to succeed against its stronger opponent. In the first intifada, the Palestinians were able to polarize the foe’s political center. In the second intifada, the Palestinians failed to do the same at substantial human, material, and political costs, including a civil war in 2007 and the Hamas’ takeover of Gaza.
Thrombopoietin receptor activation by myeloproliferative neoplasm associated calreticulin mutants
Authors: Chachoua Ilyas , Pecquet Christian , El-Khoury Mira , Nivarthi Harini , Albu Roxana-Irina , Marty Caroline , Gryshkova Vitalina , Defour Jean-Philippe , Vertenoeil Gaëlle , Ngo Anna , Koay Ann , Raslova Hana , Courtoy Pierre J. , Choong Meng Ling , Plo Isabelle , Vainchenker William , Kralovics Robert , Constantinescu Stefan N. 
Published: December 2015

Key Points
Calreticulin mutants responsible for myeloproliferative neoplasms specifically activate the thrombopoietin receptor and in turn JAK2. Activation of the thrombopoietin receptor requires the glycan binding site and a novel C-terminal tail of the mutant calreticulin.
Reversal of neutrophil-to-lymphocyte count ratio in early versus late death from septic shock
Authors: Riché Florence , Gayat Etienne , Barthélémy Romain , Le Dorze Matthieu , Matéo Joaquim , Payen Didier 
Published: December 2015

Abstract
Introduction
Septic shock is one of the most frequent causes of admission to the intensive care unit (ICU) and is associated with a poor prognosis. Early and late death in septic shock should be distinguished because they may involve different underlying mechanisms. In various conditions, the neutrophil-to-lymphocyte count ratio (NLCR) has been described as an easily measurable parameter to express injury severity. In the present study, we investigated whether the timing of death was related to a particular NLCR.

Methods
We conducted a prospective, single-center, observational study that included consecutive septic shock patients. Severity scores, early (before day 5) or late (on or after day 5 of septic shock onset) ICU mortality, and daily leukocyte counts were collected during the ICU stay. We assessed the association between leukocyte counts at admission and their evolution during the first 5 days with early or late death. The association between patient characteristics (including cell counts) and prognosis was estimated using Cox proportional cause-specific hazards models.

Results
The study included 130 patients who were diagnosed with abdominal (n = 99) or extra-abdominal (n = 31) septic shock. The median (interquartile range) NLCR was 12.5 (6.5–21.2) in survivors and 6.2 (3.7–12.6) in nonsurvivors (p = 0.001). The NLCR at admission was significantly lower in patients who died before day 5 than in survivors (5 [3.5–11.6] versus 12.5 [6.5–21.2], respectively; p = 0.01). From day 1 to day 5, an increased NLCR related to an increase in neutrophil count and a decrease in lymphocyte count was associated with late death (+34.8 % [−8.2 to 305.4] versus −20 % [−57.4 to 45.9]; p = 0.003). Those results were present in patients with abdominal origin sepsis as well as in those with extra-abdominal sepsis, who were analyzed separately.

Conclusions
In the present study, a reversed NLCR evolution was observed according to the timing of death. Septic shock patients at risk of early death had a low NLCR at admission, although late death was associated with an increased NLCR during the first 5 days.
Ephrin-A2 and ephrin-A5 guide contralateral targeting but not topographic mapping of ventral cochlear nucleus axons
Authors: Abdul-latif Mariam L. , Salazar Jesus A. Ayala , Marshak Sonya , Dinh Minhan L. , Cramer Karina S. 
Published: December 2015

Abstract

Background
In the auditory brainstem, ventral cochlear nucleus (VCN) axons project to the contralateral, but not ipsilateral, medial nucleus of trapezoid body (MNTB), terminating in the calyx of Held. Dorsal VCN neurons, representing high frequencies, synapse with medial MNTB neurons, while low frequency-coding ventral VCN neurons synapse with lateral MNTB neurons, reflecting tonotopic organization. The mechanisms that ensure strictly contralateral targeting and topographic ordering are incompletely understood. Here we examined the roles of ephrin-A signaling in both types of targeting.

Results
Ephrin-A2 and ephrin-A5 are expressed in VCN cells during late embryonic and early postnatal development. At these ages ephrin-A2 is expressed in axons surrounding MNTB and ephrin-A5 is expressed in MNTB principal neurons. Ephrin-A2/A5 double knockout mice displayed axon targeting errors in which VCN axons project to MNTB on both sides of the brainstem, where they terminate in calyceal endings. Ephrin-A2 and ephrin-A5 single knockout mice showed a similar phenotype. In contrast to effects on contralateral targeting, ephrin-A2/A5 double knockout mice showed no defects in formation of tonotopically ordered projections from VCN to MNTB.

Conclusions
These findings demonstrate that distinct mechanisms regulate targeting of VCN axons to the contralateral MNTB and targeting to appropriate tonotopic locations. Ephrin-A signaling plays a similar role to ephrin-B signaling in the VCN-MNTB pathway, where both classes normally prevent formation of calyceal projections to ipsilateral MNTB. These classes may rely in part on common signaling pathways.
About periodicity of impulsive evolution equations through fixed point theory
Authors: Liang Jin , Xiao Ti-Jun , Yang He 
Published: December 2015

AbstractBy processing the problem through fixed point theory and propagator theory, we investigate the periodicity of solutions to a class of impulsive evolution equations in Hilbert spaces and establish some existence theorems for periodic solutions. Moreover, the asymptotic stability of periodic solutions is obtained under suitable conditions. As one will see, the concept of an impulsive propagator is introduced for the first time in the paper.
Energy efficiency in big data complex systems: a comprehensive survey of modern energy saving techniques
Authors: Majeed Abdul , Shah Munam Ali 
Published: December 2015

AbstractThe growing need of computation and processing has led to the generation of data centers. These data centers are usually comprised of hundreds of thousands of servers and other components. This complicated arrangement of the systems lead to the adoption of complex systems. Complex systems prevail in our society as combination of lots of entities, e.g., immune system, human brain and ecosystems. The adoption and interaction of the entities is possible through nonlinear interactions. The interaction between the components of the complex system is carried out in distributed fashion. Big data which is comprised of thousands of machines is also considered to be a form of complex adaptive systems which makes use of large entities, components and nonlinear interactions with each other. The development of such a complex systems raises certain challenges. Apart from management, energy is the most concerned one which is the core discussion of this research. This paper, surveys the state of the art on modern tools, techniques, architectures and algorithms which has been proposed and deployed to achieve energy efficiency in big data over the period of 2007–2015. We group existing approaches aimed at achieving energy efficiency in the complex paradigm of big data. In this categorization, we aim to provide an easy and concise view of the underlined model adapted by each approach in the context of big data.
Reg3g overexpression promotes β cell regeneration and induces immune tolerance in nonobese-diabetic mouse model
Authors: Xia Fei , Cao Hui , Du Jiao , Liu Xiulan , Liu Yang , Xiang Ming 
Published: December 2015

Abstract
The regenerating islet-derived gene was first isolated in regenerated pancreas tissues, greatly contributing to β cell regeneration. It is an anti-inflammatory in response to cellular stress. This encouraged us to investigate the exact role of a novel member of Reg family, regenerating islet-derived gene γ, in type 1 diabetes of nonobese-diabetic mice. For this, Reg3g gene was overexpressed in pancreatic islets, and conferred beneficial effects on β cell regeneration through activating the Janus kinase 2/signal transducer and activator of transcription 3/nuclear factor κB signaling pathway. Lentiviral vector-encoding regenerating islet-derived gene γ treatment also decreased lymphocyte infiltrates of the intra-islet and peri-islet by inducing both differentiation of regulatory T cell and immature dendritic cells of tolerogenic properties, which attenuated autoimmunity. This treatment further contributed to rebalanced levels of type 1/2 helper T cell cytokines and elevated α1-antitrypsin levels in the serum. These results were not observed in phosphate-buffered saline-treated mice or in lentivirus-control mice. We have shown, for the first time, to our knowledge, that regenerating islet-derived gene γ promotes β cell regeneration and preserves β cells from autoimmunity damage by increasing regulatory T cell differentiation and inducing tolerated dendritic cells. This regenerating islet-derived gene γ infusion could probably be developed into an optimal gene therapy for the prevention and reversal of type 1 diabetes.