bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Disintegrin and Metalloprotease‐22 Attenuates Hypertrophic Remodeling in Mice Through Inhibition of the Protein Kinase B Signaling Pathway
Authors: Ren Lingyun , Wu Chuangyan , Yang Kai , Chen Shanshan , Ye Ping , Wu Jie , Zhang Anchen , Huang Xiaofan , Wang Ke , Deng Peng , Ding Xiangchao , Chen Manhua , Xia Jiahong 
Published: January 2018

Background

Severe cardiac hypertrophy can lead to cardiac remodeling and even heart failure in the end, which is a leading cause of cardiovascular disease–related mortality worldwide. A disintegrin and metalloprotease‐22 (
ADAM
22), a member of the transmembrane and secreted metalloendopeptidase family, participates in many biological processes, including those in the cardiovascular system. However, there is no explicit information on whether
ADAM
22 can regulate the process of cardiac hypertrophy; the effects that
ADAM
22 exerts in cardiac hypertrophy remain elusive.

Methods and Results

We observed significantly increased
ADAM
22 expression in failing hearts from patients with dilated cardiomyopathy and hypertrophic cardiomyopathy; the same trend was observed in mice induced by transaortic constriction and in neonatal rat cardiomyocytes treated by angiotensin
II
. Therefore, we constructed both cardiac‐specific
ADAM
22 overexpression and knockout mice. At 4 weeks after transaortic constriction, cardiac‐specific
ADAM
22 knockout, by the CRISPR/Cas9 (clustered regularly interspaced palindromic repeat (CRISPR)–Cas9) system, deteriorated the severity of cardiac hypertrophy in mice, whereas cardiac‐specific
ADAM
22 overexpression mitigated the degrees of cardiac hypertrophy in mice. Similarly, altered
ADAM
22 expression modulated the angiotensin
II
–mediated cardiomyocyte hypertrophy in neonatal rat cardiomyocytes. After screening several signaling pathways, we found
ADAM
22 played a role in inhibition of protein kinase B (
AKT
) activation. Under the cardiac‐specific
ADAM
22 knockout background,
AKT
activation was enhanced in transaortic constriction–induced mice and angiotensin
II
–stimulated neonatal rat cardiomyocytes, with a severe degree of cardiac hypertrophy. Treatment of a specific
AKT
inhibitor attenuated the transaortic constriction–enhanced
AKT
activation and cardiac hypertrophy in mice.

Conclusions

The findings demonstrated that
ADAM
22 negatively regulates the
AKT
activation and the process of cardiac hypertrophy and may provide new insights into the pathobiological features of cardiac hypertrophy.
National Trends in Nonstatin Use and Expenditures Among the US Adult Population From 2002 to 2013: Insights From Medical Expenditure Panel Survey
Authors: Salami Joseph A. , Warraich Haider J. , Valero‐Elizondo Javier , Spatz Erica S. , Desai Nihar R. , Rana Jamal S. , Virani Salim S. , Blankstein Ron , Khera Amit , Blaha Michael J. , Blumenthal Roger S. , Katzen Barry T. , Lloyd‐Jones Donald , Krumholz Harlan M. , Nasir Khurram 
Published: January 2018

Background
Evidence supporting nonstatin lipid‐lowering therapy in atherosclerotic cardiovascular disease risk reduction is variable. We aim to examine nonstatin utilization and expenditures in the United States between 2002 and 2013.

Methods and Results

We used the Medical Expenditure Panel Survey database to estimate national trends in nonstatin use and cost (total and out‐of‐pocket, adjusted to 2013
US
dollars using a gross domestic product deflator) among adults 40 years or older. Nonstatin users increased from 3 million (2.5%) in 2002‐2003 (20.1 million prescriptions) to 8 million (5.6%) in 2012‐2013 (45.8 million prescriptions). Among adults with atherosclerotic cardiovascular disease, nonstatin use increased from 7.5% in 2002‐2003 to 13.9% in 2012‐2013 after peaking at 20.3% in 2006‐2007. In 2012‐2013, 15.9% of high‐intensity statin users also used nonstatins, versus 9.7% of low/moderate‐intensity users and 3.6% of statin nonusers. Nonstatin use was significantly lower among women (odds ratio 0.80; 95% confidence interval 0.75‐0.86), racial/ethnic minorities (odds ratio 0.41; 95% confidence interval 0.36‐0.47), and the uninsured (odds ratio 0.47; 95% confidence interval 0.40‐0.56). Total nonstatin expenditures increased from $1.7 billion (out‐of‐pocket cost, $0.7 billion) in 2002‐2003 to $7.9 billion (out‐of‐pocket cost $1.6 billion) in 2012‐2013, as per‐user nonstatin expenditure increased from $550 to $992. Nonstatin expenditure as a proportion of all lipid‐lowering therapy expenditure increased 4‐fold from 8% to 32%.

Conclusions
Between 2002 and 2013, nonstatin use increased by 124%, resulting in a 364% increase in nonstatin‐associated expenditures.
Impact of Renal Denervation on Atrial Arrhythmogenic Substrate in Ischemic Model of Heart Failure
Authors: Yamada Shinya , Fong Man‐Cai , Hsiao Ya‐Wen , Chang Shih‐Lin , Tsai Yung‐Nan , Lo Li‐Wei , Chao Tze‐Fan , Lin Yenn‐Jiang , Hu Yu‐Feng , Chung Fa‐Po , Liao Jo‐Nan , Chang Yao‐Ting , Li Hsing‐Yuan , Higa Satoshi , Chen Shih‐Ann 
Published: January 2018

Background

Myocardial infarction increases the risk of heart failure (
HF
) and atrial fibrillation. Renal denervation (
RDN
) might suppress the development of atrial remodeling. This study aimed to elucidate the molecular mechanism of
RDN
in the suppression of atrial fibrillation in a
HF
model after myocardial infarction.

Methods and Results

HF
rabbits were created 4 weeks after coronary ligation. Rabbits were classified into 3 groups: normal control (n=10),
HF
(n=10), and
HF
‐
RDN
(n=6). Surgical and chemical
RDN
were approached through midabdominal incisions in
HF
‐
RDN
. Left anterior descending coronary artery in
HF
and
HF
‐
RDN
was ligated to create myocardial infarction. After electrophysiological study, the rabbits were euthanized and the left atrial appendage was harvested for real‐time polymerase chain reaction analysis and Trichrome stain. Left atrial dimension and left ventricular mass were smaller in
HF
‐
RDN
by echocardiography compared with
HF
. Attenuated atrial fibrosis and tyrosine hydroxylase levels were observed in
HF
‐
RDN
compared with
HF
. The
mRNA
expressions of Cav1.2, Nav1.5, Kir2.1, Kv
LQT
1, phosphoinositide 3‐kinase,
AKT
, and endothelial nitric oxide synthase in
HF
‐
RDN
were significantly higher compared with
HF
. The effective refractory period and action potential duration of
HF
‐
RDN
were significantly shorter compared with
HF
. Decreased atrial fibrillation inducibility was noted in
HF
‐
RDN
compared with
HF
(50% versus 100%,
P
<0.05).

Conclusions

RDN
reversed atrial electrical and structural remodeling, and suppressed the atrial fibrillation inducibility in an ischemic
HF
model. The beneficial effect of
RDN
may be related to prevention of the downregulation of the phosphoinositide 3‐kinase/
AKT
/endothelial nitric oxide synthase signaling pathway.
Gulf Stream Excursions and Sectional Detachments Generate the Decadal Pulses in the Atlantic Multidecadal Oscillation
Authors: Nigam Sumant , Ruiz-Barradas Alfredo , Chafik Léon 
Published: January 2018

Decadal pulses within the lower-frequency Atlantic multidecadal oscillation (AMO) are a prominent but underappreciated AMO feature, representing decadal variability of the subpolar gyre (e.g., the Great Salinity Anomaly of the 1970s) and wielding notable influence on the hydroclimate of the African and American continents. Here clues are sought into their origin in the spatiotemporal development of the Gulf Stream’s (GS) meridional excursions and sectional detachments apparent in the 1954–2012 record of ocean surface and subsurface salinity and temperature observations. The GS excursions are tracked via meridional displacement of the 15°C isotherm at 200-m depth—the GS index—whereas the AMO’s decadal pulses are targeted through the AMO tendency, which implicitly highlights the shorter time scales of the AMO index. The GS’s northward shift is shown to be preceded by the positive phase of the low-frequency North Atlantic Oscillation (LF-NAO) and followed by a positive AMO tendency by 1.25 and 2.5 years, respectively. The temporal phasing is such that the GS’s northward shift is nearly concurrent with the AMO’s cold decadal phase (cold, fresh subpolar gyre). Ocean–atmosphere processes that can initiate phase reversal of the gyre state are discussed, starting with the reversal of the LF-NAO, leading to a mechanistic hypothesis for decadal fluctuations of the subpolar gyre. According to the hypothesis, the fluctuation time scale is set by the self-feedback of the LF-NAO from its influence on SSTs in the seas around Greenland, and by the cross-basin transit of the GS’s detached eastern section; the latter is produced by the southward intrusion of subpolar water through the Newfoundland basin, just prior to the GS’s northward shift in the western basin.
Marginalisation of men in family planning texts: An analysis of training manuals
Authors: Wilson Amanda D , Fylan Fiona , Gough Brendan 
Published: January 2018

Objective: Men’s engagement in family planning has become part of the global health agenda; however, little is known about the training manuals health practitioners’ use and how these manuals describe and explain men’s roles within a family planning context. Design: To further understand engagement, this paper examines how training manuals written for health practitioners describe and define men’s participation within family planning. Setting: The training manuals were written for UK health practitioners and covered men’s contributions to family planning. Method: Discourse analysis was used to examine the three training manuals focused upon. Results: Three main discourses were identified: ‘contraception is a woman’s responsibility’, ‘men disengage with health practitioners’ and ‘men are biologically predisposed to avoid sexual responsibility’. Conclusion: Together, these three discourses function to marginalise men in family planning, constructing them as detached accessories that lack the ability to engage.
Establishing psychological wellbeing metrics for the built environment
Authors: Watson Kelly J 
Published: January 2018

The business case for wellbeing is now an influential agenda in the built environment. Increasing demand for user-centred environments means evidence-based design proven to deliver wellbeing outcomes for end users is essential. The challenge is to effectively capture and disseminate this evidence to a range of expert and non-expert audiences. Further, being able to make the link between increased wellbeing and an increase in the productivity, or performance, of building users requires new definitions and methods. An innovative wellbeing valuation approach is presented, consisting of a multi-item scale to measure and quantify the wellbeing outcomes experienced by building users, and impact reporting techniques using Social Return on Investment to produce transferable, monetised evaluation metrics. This combination has the capability to communicate the value of design in a powerful and accessible manner. Wellbeing valuation metrics represent an opportunity to develop new user-driven knowledge and shape the built environment in positive ways. Practical application: Wellbeing has become an influential agenda in the built environment in recent years, suggesting that user-centred priorities will become increasingly significant to the design and construction sector. The wellbeing valuation approach presented represents an innovative blend of a psychological wellbeing model, quantitative measurement and financial reporting to produce transferable metrics to communicate the value of design in a powerful and transformative manner. Wellbeing valuation is a nascent practice, but it provides the professions with opportunities to collaborate with end users and develop new knowledge about buildings, enhancing the ability of practitioners to shape the built environment in positive ways.
Prospective analysis of glycemic variability in patients with severe traumatic brain injury: modified Leuven’s adjustment process versus conventional adjustment process
Authors: Xue Bing , Ruan Shiyan , Xie Ping , Yan Kaixuan , Gu Zhi'e , Meng Ningning , Zhang Jiannan , Liu Haitao , Lu Juan , Zuo Siqin , Zhang Hengzhu 
Published: January 2018

Objective This study was performed to evaluate the effect of two different methods of controlling glycemic variability (GV) in patients with severe traumatic brain injury (STBI) undergoing surgery. Methods Patients with STBI were randomly grouped into a conventional adjustment process (CAP) group and modified Leuven’s adjustment process (mLAP) group. Each group included 50 patients. Blood glucose levels were continuously monitored and data were recorded and analyzed. Results The mean blood glucose level was stable in both groups for 5 days postoperatively with no significant difference. The standard deviation of the blood glucose level, mean amplitude of glycemic excursions, and glycemic lability index were significantly higher in the CAP than mLAP group for the first 2 days. In the final 3 days, no significant differences were observed between the two groups. The incidence of hypoglycemia was significantly higher in the CAP than mLAP group on the first day. This value gradually declined during the following 4 days, but the difference between the two groups was not significant. Conclusion The mLAP produced more favorable results than the CAP for GV control in the early stage after surgery for STBI.
Comparison of Lurasidone Versus Quetiapine for the Treatment of Delirium in Critically Ill Patients
Authors: Fox Marlena A. , Elefritz Jessica L. , Huang Brandon M. , Hunley Charles 
Published: January 2018

Objective: To evaluate the efficacy and safety of lurasidone compared with quetiapine for treatment of delirium in critically ill patients. Design: Prospective, observational cohort study. Setting: Single-center community teaching hospital. Patients: Forty adult intensive care unit (ICU) patients with delirium (Confusion Assessment Method in the ICU positive), tolerating enteral nutrition, and without active alcohol withdrawal or prior use of atypical antipsychotics. Interventions: Patients were treated at the discretion of the prescriber with either lurasidone or quetiapine for delirium. Dose escalation and/or discontinuation were determined at the discretion of individual providers. Results: Baseline characteristics differed with a higher severity of illness in patients in the quetiapine group (n = 20) and a higher baseline QTc interval in the lurasidone group (n = 20). No significant difference was seen in the time to delirium resolution (3.2 vs 3.4 days), average daily haloperidol requirements (5.7 vs 6.9 mg), hospital length of stay (LOS; 23.6 vs 27.9 days), or ICU LOS (12.1 vs 14.2 days). Lurasidone was associated with fewer ventilator support days (4.0 [interquartile range, IQR: 2.3-6.8] days vs 7 [IQR: 4.0-9.8; P = .0295] days) but also a fewer number of delirium-free days (0 [IQR: 0-1.0] days vs 2 [IQR: 0-3.0; P = .0231] days). Additionally, no difference was seen for ICU mortality (20% vs 20%), percentage of time oversedated (2.8% vs 2.7%), or incidence of QTc prolongation (10.0% vs 10.0%). Conclusions: Lurasidone for the treatment of delirium in critically ill patients did not differ in the time to delirium resolution when compared to quetiapine. Additionally, the incidence of QTc prolongation between agents does not appear to be different. Future randomized trials should evaluate dose escalation schemes and a larger proportion of patients to evaluate differences in mortality, efficacy, and life-threatening arrhythmias associated with atypical antipsychotic use.
The development and implementation of a discharge checklist for psychiatric inpatients: a pilot study
Authors: Khanbhai Yasmin , Nance Michael , Smith David 
Published: January 2018

Objectives: Readmission rates are a routinely used measure of patient and service outcomes, potentially improved by discharge planning. This pilot study aimed to develop a discharge checklist for psychiatric inpatients, exploring its feasibility, applicability, and impact on readmission rates. Methods: The study used a quasi-experimental, pre–post intervention design. The checklist was designed from an evidence-based literature review, and introduced for a three-month period, comparing 28-day readmission rates with the previous three months using interrupted time series analysis. Results: Checklists were completed for 80% of patients in the trial period, with 100% completion of checklist items. Demographic and clinical details for pre- and post-intervention groups were closely aligned. There was a small, but statistically non-significant, reduction in readmission rates. Conclusions: There was a high rate of checklist completion. The lack of significant reductions in readmission rates supports more development of the checklist application and design before a longer implementation period and re-evaluation.
How to Raise Different Game Collaboration Activities: The Association Between Game Mechanics, Players’ Roles and Collaboration Processes
Authors: Hämäläinen Raija H. , Niilo-Rämä Mikko , Lainema Timo , Oksanen Kimmo 
Published: January 2018

Background. Designing collaborative three-dimensional (3D) learning games is one way to enhance the quality of learning and respond to the needs of working life. However, there is little research on how to apply different game mechanics to support different educational aims. Aim. This study determines how game mechanics implemented within computer-supported collaboration roles (scripted vs. emergent) are associated with the emergence of collaboration. Method. The research at hand applies both qualitative and quantitative content analysis. The target group consisted of 15 vocational school students. The data were gathered by recording the groups’ discussions and saving the game logs. A total of 8,128 transcribed utterances were eligible for content analysis to shed light on the characteristics in knowledge construction under scripted and emergent role situations. Results. We found differences between the players’ utterances in tasks with scripted and emergent roles. At the scripted-role level, providing knowledge was the most dominant type of utterance. Further, students with similar roles performed actions and applied similar activities. In the level based on emerging collaboration processes, shared problem solving was the most actively used speech activity. Conclusions. Emphasizing and applying different game mechanics with different collaboration roles (scripted vs. emergent) can be used to support different educational aims of games. Recommendation. Collaboration is needed among professionals from technological and educational sites of game research to fully understand how to apply game mechanics in educational games.
Leadership of international schools and the International Baccalaureate learner profile
Authors: Gardner-McTaggart Alexander 
Published: January 2018

Purpose: this study offers a rare insight into senior leadership in International Baccalaureate (IB) international schools. The IB international school profits from the perceived quality and consistency of the IB brand; international schools, however, suffer from an endemic culture of change and reinterpretation. The IB learner profile (IBLP) offers scope for consistency and an overarching ethos, and research finds that ‘buy-in’ to the IBLP and modelling of it in all aspects of school life are essential in achieving this. It emerges that buy-in to the IBLP in directors is split between the personal and the operational. Research method: This interpretive study explores IB directors in multiphase research over two years employing an aspect of critical phenomenology through the lens of the IBLP and Global Citizenship Education (GCE). Findings: Only one in six directors uses the IBLP in leadership. Generally, directors attribute the IBLP a junior status. Analysis through Bourdieu finds IB directors have higher loyalty to (loosely defined) GCE through their Christian values. A foregrounding of individual values over the secular IBLP places IB directors as primary catalysts for the change culture unravelling the consistency of the IB international school, confirming the value of the IBLP in leadership.
Apparent diffusion coefficient value for a B-cell central nervous system lymphoma in a cat
Authors: Tanaka Toshiyuki , Akiyoshi Hideo , Shimazaki Hitoshi , Kawakami Ryo , Mie Keiichiro , Yamada Yuki , Ohashi Fumihito 
Published: January 2018

Case summary This report involves a 10-year-old male mixed-breed cat with a B-cell central nervous system (CNS) lymphoma. The cat presented with ataxia progressing to left hemiparesis. While haematological findings were normal, serum biochemistry showed a high creatine phosphokinase concentration. MRI revealed a homogeneously enhancing well-demarcated extra-axial lesion involving the region of the left lateral aperture with oedema in left flocculus and left medulla oblongata. On diffusion-weighted imaging, the lesion margins showed marked hyperintensity relative to the right cerebellar hemisphere. On an apparent diffusion coefficient map, the lesion appeared hypointense, with an apparent diffusion coefficient value of 0.57 ± 0.01 × 10−3 mm2/s. Cerebrospinal fluid (CSF) analysis and cytology, and genetic analysis of CSF lymphoblasts confirmed a diagnosis of B-cell lymphoma. The owner opted for palliative treatment with prednisolone (1 mg/kg q12h); however, the cat died of dyspnoea 10 days after presentation. Relevance and novel information CNS lymphomas, which are the second most common intracranial tumours in cats, are highly infiltrative lesions and radical surgical excision is not recommended. Therefore, accurate diagnosis is crucial. However, contrast-enhanced MRI cannot always differentiate these lesions from other conditions, including other CNS tumours and strokes. To the best of our knowledge, this is the first report to document the diffusion-weighted imaging features and apparent diffusion coefficient value for a feline CNS lymphoma. These findings are expected to improve the diagnostic accuracy of these lesions in cats.
Prevalence of Non-AIDS Comorbidities and Factors Associated with Metabolic Complications among HIV-Infected Patients at a Thai Referral Hospital
Authors: Nakaranurack Chotirat , Manosuthi Weerawat 
Published: January 2018

Objectives: The prevalence of non-AIDS-related comorbidities is increasing in HIV-infected patients receiving antiretroviral therapy. In Thailand, data regarding the prevalence of non-AIDS comorbidities and factors associated with metabolic complications in HIV-infected patients have not been well-documented. Methods: This cross-sectional study was conducted in 2011 and included 874 HIV-infected patients. Results: The age of patients was 45(8) years represented as mean (standard deviation [SD]). The current CD4 count was 502(247) cells/mm3. In all, 388 (44%) of the included patients had at least 1non-AIDS comorbidity. The most frequently documented comorbidities were hyperlipidemia in 271 (70%) patients. Using multivariate analysis, older age(odds ratio [OR] = 1.82, 95% confidence interval [CI] = 1.51-2.19), male sex (OR = 1.55, 95%CI = 1.14-2.11), high current CD4 count(OR = 1.00, 95%CI = 1.00-1.00), and taking abacavir (ABC)-containing(OR = 2.59, 95%CI = 1.16-5.78)and didanosine (ddI)-containing antiretroviral regimens (OR = 4.16, 95%CI = 1.09-15.84)were associated with the presence of metabolic complications (all Ps<.05). Conclusion: The prevalence of comorbidities is substantially high. Clinical monitoring and effective management of these comorbidities and metabolic complications are recommended, especially in HIV-infected patients who present with these associated factors.