bluuebunny/crossref_metadata_2025_split huggingface dataset:
The relationship between stroke severity and prior direct oral anticoagulant therapy in patients with acute ischaemic stroke and non‐valvular atrial fibrillation
Authors: Sakamoto Y. , Okubo S. , Nito C. , Suda S. , Matsumoto N. , Abe A. , Aoki J. , Shimoyama T. , Takayama Y. , Suzuki K. , Mishina M. , Kimura K. 
Published: August 2017

Background and purposeAnticoagulant treatment with a vitamin K antagonist (VKA) has been reported to reduce stroke severity when patients with atrial fibrillation (AF) suffer acute ischaemic stroke (AIS). Direct oral anticoagulant (DOAC) therapy also has the potential to reduce the initial severity of AIS. However, the effect of DOAC therapy on the severity of AIS is not well known. The aim of the present study was to investigate the effect of DOACs on initial stroke severity in patients with AIS and non‐valvular AF.MethodsFrom March 2011 to July 2016, consecutive patients with AIS having non‐valvular AF were recruited. The effects of prior DOAC treatment on severity were assessed by multivariate logistic regression analyses.ResultsA total of 484 patients [208 women; median age 79 (interquartile range, 71–85) years; National Institutes of Health Stroke Scale (NIHSS) score 9 (interquartile range, 3–20)] were enrolled. Of these, 352 (73%) were on no anticoagulant medication, 54 (11%) were undertreated with a VKA, 35 (7%) were sufficiently treated (admission prothrombin time–international normalized ratio: ≥2.0 for patients <70 years old and ≥1.6 for ≥70 years old) with a VKA and 43 (9%) were on a DOAC. The initial NIHSS score (median 10 in patients with no anticoagulation, 13 in undertreated VKA, 7 in sufficient VKA and 6 in DOAC, P = 0.018) was different among the groups. Multivariate analysis showed that DOAC was independently and negatively associated with severe (initial NIHSS score ≥ 10) stroke (odds ratio, 0.39; P = 0.041), compared with no anticoagulant therapy.ConclusionsDirect oral anticoagulant treatment prior to the event should reduce initial stroke severity in patients with AIS and non‐valvular AF.
Wood's lamp for vitiligo disease stability and early recognition of initiative pigmentation after epidermal grafting
Authors: Wang Yen‐Jen , Chang Chang‐Cheng , Cheng Kun‐Lin 
Published: August 2017

AbstractThe prerequisite for a successful vitiligo epidermal grafting surgery is the stable status of the disease. We used Wood's lamp to assess vitiligo activity to determine the disease stability, surgical grafting timing and the early recognition of re‐pigmentation after grafting. Amelanotic lesions with sharply demarcated borders are typically stable and are good candidates for grafting. The re‐pigmentation was first recognised under Wood's lamp as hypochromic islands, which progressed to normally pigmented islands. For patients more prone to relapse, follow up with Wood's lamp also provides more accurate surveillance.
Cost‐effectiveness of the Family Nurse Partnership (FNP) programme in England: Evidence from the building blocks trial
Authors: Corbacho Belen , Bell Kerry , Stamuli Eugena , Richardson Gerry , Ronaldson Sarah , Hood Kerenza , Sanders Julia , Robling Michael , Torgerson David ,   On behalf of the Building Blocks trial group
Published: August 2017

AbstractRational, aims, and objectivesThe Family Nurse Partnership (FNP) is a licensed intensive home visiting intervention developed in the United States. It has been provided in England by the Department of Health since 2006. The Building Blocks trial assessed the effectiveness and cost‐effectiveness of FNP in England.MethodsWe performed a cost‐utility analysis (National Health Service (NHS) perspective) alongside the Building Blocks trial (over 2.5 y). The analysis was conducted in accordance with National Institute for Health and Clinical Excellence (NICE) reference case standards. Health‐related quality of life was elicited from mothers using the EQ‐5D‐3L. Resource‐use data were collected from self‐reported questionnaires, Hospital Episode Statistics, general practitioner records and the central Department of Health FNP database. Costs and quality‐adjusted life years (QALYs) were discounted at 3.5%. The base case analysis used an intention to treat approach on the imputed dataset using multiple imputation.ResultsThe FNP intervention costs on average £1812 more per participant compared to usual care (95% confidence interval: −£2700; £5744). Incremental adjusted mean QALYs are marginally higher for FNP (mean difference 0.0036, 95% confidence interval: −0.017; 0.025). The probability of FNP being cost‐effective is less than 20% given the current NICE willingness to pay threshold of £20 000 per additional QALY. The results were robust to sensitivity analyses.ConclusionGiven the absence of significant benefits of FNP in terms of the primary outcomes of the trial and only marginal maternal QALY gains, FNP does not represent a cost‐effective intervention when compared with existing services already offered to young pregnant women.
Device‐Measured Physical Activity As a Predictor of Disability in Mobility‐Limited Older Adults
Authors: Mankowski Robert T. , Anton Stephen D. , Axtell Robert , Chen Shyh‐Huei , Fielding Roger A. , Glynn Nancy W. , Hsu Fang‐Chi , King Abby C. , Layne Andrew S. , Leeuwenburgh Christiaan , Manini Todd M. , Marsh Anthony P. , Pahor Marco , Tudor‐Locke Catrine , Conroy David E. , Buford Thomas W. ,   LIFE Research Group
Published: August 2017

ObjectivesTo examine associations between objectively measured physical activity (PA) and incidence of major mobility disability (MMD) and persistent MMD (PMMD) in older adults in the Lifestyle Interventions and Independence for Elders (LIFE) Study.DesignProspective cohort of individuals aged 65 and older undergoing structured PA intervention or health education.SettingThe LIFE Study was a multicenter (eight sites) randomized controlled trial designed to compare the efficacy of a long‐term structured PA intervention with that of a health education (HE) program in reducing the incidence of MMD in mobility‐limited older adults.ParticipantsLIFE Study participants (n = 1,590) had a mean age±standard deviation of 78.9 ± 5.2, low levels of PA, and measured mobility‐relevant functional impairment at baseline.MeasurementsActivity data were collected using hip‐worn 7‐day accelerometers at baseline and 6, 12, and 24 months after randomization to test for associations with incident MMD and PMMD (≥2 consecutive instances of MMD).ResultsAt baseline, every 30 minutes spent being sedentary (<100 accelerometry counts per minute) was associated with higher rate of subsequent MMD (10%) and PMMD (11%) events. Every 500 steps taken was associated with lower rate of MMD (15%) and PMMD (18%). Similar associations were observed when fitting accelerometry‐based PA as a time‐dependent variable.ConclusionAccelerometry‐based PA levels were strongly associated with MMD and PMMD events in older adults with limited mobility. These results support the importance of daily PA and lower amounts of sedentary time levels in this population and suggest that accelerometry may be a useful tool for assessing risk of mobility disability.
Variation in the response of tomato (Solanum lycopersicum) breeding lines to the effects of benzo (1,2,3) thiadiazole‐7‐carbothioic acid S‐methyl ester (BTH) on systemic acquired resistance and seed germination
Authors: Goodwin Paul H. , Trueman Cheryl L. , Loewen Steven A. , Tazhoor Rochelle 
Published: August 2017

AbstractGenetic variation may play a major role in how plants respond to activators of systemic acquired resistance. To examine this, the defence activator benzo(1,2,3)thiadiazole‐7‐carbothioic acid S‐methyl ester (BTH) was applied to seed of different breeding lines of tomato (Solanum lycopersicum) with diverse pedigrees, and the levels of induced resistance against Pseudomonas syringae pv. tomato, changes in defence gene expression and detrimental effects on seed germination and seedling emergence were measured. Two breeding lines, 7007 and 7024, were selected as non‐responsive and responsive to BTH. The SAR‐associated genes, SlPR1a and SlPR3b, were induced earlier or more strongly over the control prior to inoculation for line 7024 but not for line 7007. This was not observed for the ISR‐related genes, SlPin2 and SlPR2b. BTH inhibition of seed germination and seedling emergence was more delayed in line 7024 than 7007. However, applying BTH as a seed or soil drip reduced the delay. Thus, greater levels of BTH response have both positive (i.e., induced resistance and expression of SAR‐related gene expression) and negative (i.e., inhibition of seed germination and seedling emergence) effects and can differ significantly between genotypes. Thus, recommendations for use of induced resistance activators should include plant genotype recommendations and consider possible negative impacts of greater responsiveness.
Smokers have a higher risk of inflammatory peri‐implant disease than non‐smokers
Authors: Gürlek Ö , Gümüş P , Buduneli N 
Published: August 2017

AimTo comparatively evaluate peri‐implant health status in smokers and non‐smokers.Materials and MethodsA total of 142 implants (74 implants in non‐smokers, 68 in smokers) in 43 smoker or non‐smoker systemically healthy patients were included in the study. Demographic and clinical periodontal data were recorded and analysed by chi‐square and Mann–Whitney U tests.ResultsPeri‐implantitis and mucositis cases were significantly more frequent in the smokers than non‐smokers (p = .001). Suppuration, bleeding and plaque scores around the implants were significantly higher in smokers than non‐smokers (p = .001; p = .002; p < .0001, respectively).ConclusionThe present findings indicate that smokers have a higher risk of inflammatory peri‐implant diseases. Therefore, more frequent recalls may be recommended in smokers with dental implants.
Meanings of troubled conscience and how to deal with it: expressions of Persian‐speaking enrolled nurses in Sweden
Authors: Mazaheri Monir , Ericson‐Lidman Eva , Joakim Öhlén , Norberg Astrid 
Published: August 2017

IntroductionA feature of the healthcare system in Sweden, particularly in the care of older people, is its cultural diversity in terms of having considerable numbers of both caregivers and care recipients with an immigrant background. Considering the influence of culture in ethical decision‐making processes, the idea of conscience and the adverse effects of a troubled conscience, it is important to study the concepts of conscience and troubled conscience in culturally diverse populations. There is no published study regarding troubled conscience among immigrant populations that includes enrolled nurses.AimTo illuminate the meanings of troubled conscience and how to deal with it among enrolled nurses with Iranian backgrounds working in Swedish residential care for Persian‐speaking people with dementia who have emigrated from Iran.MethodThe study was conducted with a phenomenological hermeneutic design. Ten enrolled nurses with an Iranian background, with at least one year's experience of taking care of older people with dementia, were interviewed. The study was reviewed by the Regional Ethical Review Board for ethical vetting of research involving humans. Appropriate measures were taken to ensure confidentiality and voluntary participation.ResultsThe meanings of having a troubled conscience for the participants comprise not being a good person, including being an uncaring person, not acting according to one's values and living in a state of unease. Dealing with a troubled conscience involves trying to compensate for the harm one has caused and trying to prevent similar situations by being a responsible caregiver.ConclusionsThe enrolled nurses understood themselves as caring people and not only caregivers. They knew that they should hear their conscience and respond to it by trying to be a caring person and acting according to their values. The findings should be interpreted in the given specific context.
Mothers' experiences of having a premature infant due to pre‐eclampsia
Authors: Værland Inger Emilie , Vevatne Kari , Brinchmann Berit Støre 
Published: August 2017

AimPre‐eclampsia can lead to premature birth aimed at saving mothers' and infants' lives. Few studies have addressed how women with serious pre‐eclampsia experience to become mothers to a premature infant. The aim was to describe the phenomenon of mothers' experience of being a seriously ill with pre‐eclampsia and on the same time becoming a mother of a premature infant.MethodologyA reflective phenomenological lifeworld approach with a descriptive design was used. Nine mothers were interviewed twice, between 6 and 24 days and 16 days to 16 weeks postpartum. The analysis was done by finding meaning units, and then contemporary clusters were made. The process was a movement between figure and background. The essence with its constituents emerged.FindingsBeing a seriously ill mother of a premature infant requires journeying through physical and psychological suffering to be able to care and take responsibility for their beloved infants. The essence had the following constituents: conflicting feelings concerning giving birth, reflecting upon the borderline of life, longing for the infant, becoming a mother in actuality and experiencing physical exhaustion.ConclusionBecause of the acuteness of the birth and the infant's prematurity, the mothers had various feelings about becoming mothers. Existential issues concerning life and death were triggered regarding their own lives and those of their infants. Their experiences are different from those of other NICU mothers; their illnesses initially restricted them from being with their infants. The mothers found that their own health and the fact that their infants were premature and had to stay in the NICU restricted them from being able to take care of their infants. While they recovered, they strived to act as they felt a real mother should.
The palaeo‐valley infilling glaciogenic Sarah Formation, an example from Rahal Dhab palaeo‐valley, Saudi Arabia
Authors: Michael Nikolaos A. , ZÜhlke Rainer , Hayton Shaun 
Published: August 2017

AbstractThe Sarah Formation is a glaciogenic sedimentary unit deposited along the Gondwana margin during the latest Ordovician ice age and represents a major hydrocarbon reservoir in northern Saudi Arabia. Large‐scale glacial palaeo‐valleys cut into the Qasim Formation and were infilled by the Sarah Formation. Post‐glacial transgression in the earliest Silurian resulted in the deposition of the Qusaiba Shale Member and associated organic‐rich basal source rocks, which cap the Sarah Formation infilled palaeo‐valleys. This unique setting makes the Sarah Formation an important emerging exploration target in Saudi Arabia. This study focuses on the facies and depositional architecture in seismic‐scale outcrops of the Sarah Formation in north‐western Saudi Arabia. The Rahal Dhab palaeo‐valley provides a 100 km long dip‐oriented cross‐section which has been covered by 24 vertical sections, sedimentary architectural analyses at metre to kilometre scale and by three cored shallow boreholes. In the Rahal Dhab palaeo‐valley, the Sarah Formation was deposited in a proglacial setting that ranged from marginal marine to offshore prodelta and is made up of three units: (i) the Sarah Sandstone; (ii) the Sarah Shale; and (iii) the Uqlah Member. This study shows the relationships between these three units and architectural controls on reservoir quality in this system. This paper contributes to the regional understanding of the Sarah Formation, and the new depositional model of the Rahal Dhab palaeo‐valley provides an outcrop‐reservoir analogue for hydrocarbon exploration in adjacent areas.
A Comparison of Clinical and Immunologic Phenotypes in Familial and Sporadic Forms of Common Variable Immunodeficiency
Authors: Valizadeh A. , Yazdani R. , Azizi G. , Abolhassani H. , Aghamohammadi A. 
Published: August 2017

AbstractCommon variable immunodeficiency (CVID) is the most frequent symptomatic primary immunodeficiency disease, and its prevalence varies significantly among different population. Minority of CVID patients present a familial aggregation suggesting a higher probability of heritable genetic defects. A total of 235 registered CVID patients were evaluated in this cohort study. Familial and sporadic patients were stratified, and demographic information, clinical records, laboratory and molecular data were compared among these two groups of patients. Multiple cases were identified in 12 families (30 patients) and sporadic presentation in 120 cases. The rate of parental consanguinity (83.3%) and clinical presentation of lymphoid malignancy (20.7%) were predominant in familial CVID patients, whereas significantly increased recurrent upper respiratory infections were recorded in sporadic patients (0.3 infections per year). Probands of familial group were presented with a higher severity score resulting in a profound mortality rate (41.7% after 30‐year follow‐up) comparing to the non‐proband CVID patients in the same families with a lowered diagnostic delay. Familial CVID patients had a specific signature in clinical presentation and immunologic profile, and a high consanguinity in this group of patients suggests a Mendelian trait with an autosomal recessive inheritance pattern. Diagnosis of an index patient within a multiple case families significantly improves the diagnostic process and outcomes of the yet asymptomatic patients.
Two Complete Genome Sequences of
Squash mosaic virus
from 20-Year-Old Cucurbit Leaf Samples from Australia
Authors: Maina Solomon , Edwards Owain R. , Jones Roger A. C. 
Published: August 2017

ABSTRACT

We present the first complete Australian
Squash mosaic virus
(SqMV) genome sequences. We compared the 2 Australian genomes from 20-year-old cucurbit samples with 8 other SqMV genomes. The Australian genomes shared >99.0% nucleotide identities, and their RNA1 and RNA2 sequences most closely resembled isolates Y and Kimbe from Japan, respectively.
Do non-targeted gastric biopsies affect the management of patients, and can a simple protocol and education reduce the rate?
Authors: Gibson Victoria , Needham Stephanie , Nayer Manu , Thompson Nick P 
Published: August 2017

ObjectiveTo determine whether development of localised protocol could reduce the number of non-targeted gastric biopsies taken at endoscopy, without risking harm from non-detection of malignant conditions.DesignRetrospective analysis of patient records over a 3-month period in 2013, repeated in 2015 following intervention.SettingTwo UK teaching hospitalsPatientsPatient record data on indication for endoscopy, endoscopy findings, histopathology results and patient outcome.InterventionsGuidance on upper gastrointestinal biopsy in the form of a new trust-wide protocol, as well as lecture-based education.Main outcome measuresRates of non-targeted and targeted biopsies before and after intervention, and differences between grade of endoscopist.ResultsBetween 2013 and 2015, there was a 36% reduction in non-targeted biopsies (10.4% vs 6.7%, p=0.001), predominantly within registrar and nurse endoscopist groups, with reduction in non-targeted biopsies of 9.5% and 64%, respectively. Percentage of targeted biopsies remained relatively static, 7.9% and 8.2%. In 2013, 92% of non-targeted biopsies had no management change based on histology; in 2015 this was 90%. Of patients with alteration to management, only 0.4% and 0.7% were due to malignancy, in known high-risk patients. Reduction in non-targeted biopsies resulted in estimated annual savings in this trust of £36,000.ConclusionDevelopment of local protocol reduces the numbers of non-targeted biopsies taken, without risk of harm from non-detection of malignant conditions, enabling a significant reduction in workload within busy histopathology services, with significant cost savings. Localised protocols are adaptable to local population demographics.
Confounding by Pre-Morbid Functional Status in Studies of Apparent Sex Differences in Severity and Outcome of Stroke
Authors: Renoux Christel , Coulombe Janie , Li Linxin , Ganesh Aravind , Silver Louise , Rothwell Peter M. 
Published: August 2017

Background and Purpose—
Several studies have reported unexplained worse outcomes after stroke in women but none included the full spectrum of symptomatic ischemic cerebrovascular events while adjusting for prior handicap.

Methods—
Using a prospective population-based incident cohort of all transient ischemic attack/stroke (OXVASC [Oxford Vascular Study]) recruited between April 2002 and March 2014, we compared pre-morbid and post-event modified Rankin Scale score (mRS) in women and men and change in mRS score 1 month, 6 months, 1 year, and 5 years after stroke. Baseline stroke-related neurological impairment was measured with the National Institutes of Health Stroke Scale.

Results—
Among 2553 patients (50.6% women) with a first transient ischemic attack/ischemic stroke, women had a worse handicap 1 month after ischemic stroke (age-adjusted odds ratio for mRS score, 1.35; 95% confidence interval, 1.12–1.63). However, women also had a higher pre-morbid mRS score compared with men (age-adjusted odds ratio, 1.58; 95% confidence interval, 1.36–1.84). There was no difference in stroke severity when adjusting for age and pre-morbid mRS (odds ratio, 1.10; 95% confidence interval, 0.90–1.35) and no difference in the pre-/poststroke change in mRS at 1 month (age-adjusted odds ratio, 1.00; 95% confidence interval, 0.82–1.21), 6 months, 1 year, and 5 years. Women had a lower mortality rate, and there was no sex difference in risk of recurrent stroke.

Conclusions—
We found no evidence of a worse outcome of stroke in women when adjusting for age and pre-morbid mRS. Failure to account for sex differences in pre-morbid handicap could explain contradictory findings in previous studies. Properties of the mRS may also contribute to these inconsistencies.
Relationship between Tropical Cyclone Intensification and Cloud-Top Outflow Revealed by Upper-Tropospheric Atmospheric Motion Vectors
Authors: Oyama Ryo 
Published: August 2017

AbstractThe temporally dense geostationary satellite observations made possible by recent technological advances enable atmospheric motion vectors (AMVs) to be derived that are suitable for capturing atmospheric flows even of mesoscale phenomena, for which in situ data are scarce. Tropical cyclone (TC) outflows around the cloud top, reflecting TC secondary circulation, were computed by using AMVs derived from successive Multifunctional Transport Satellite (MTSAT) imagery, and the relationship between TC intensification rate (defined as the change of the best-track maximum sustained wind in the previous 24 h) and the outflow was investigated for 44 TCs occurring during 2011–14. During the TC intensification phase, temporal changes in the outflow were generally synchronous with changes in the cloud-top temperature of TC inner-core convective clouds detected by MTSAT infrared band. It was noteworthy that the intensification rates of 66% of the TCs peaked 0–36 h after outflow maximization and that the intensification rate for TCs with a maximum rate of >15 m s−1 day−1 peaked after the outflow maximum. Furthermore, TCs with a large intensification rate and latent-heat release around the midlevel tended to have a large outflow during the intensification phase. A comparison of TCs with and without convective bursts (CBs) revealed that the correlation between outflow and the TC intensification rate was higher for TCs accompanied by CBs than for those without CBs, implying that a rapid deepening of inner-core convection is important for intensification of a TC’s secondary circulation. The outflow tended to be most correlated with the TC intensification rate 0–6 h earlier.