bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative Laboratory Investigations
Authors: Kirkham Kyle R. , Wijeysundera Duminda N. , Pendrith Ciara , Ng Ryan , Tu Jack V. , Boozary Andrew S. , Tepper Joshua , Schull Michael J. , Levinson Wendy , Bhatia R. Sacha 
Published: January 2016

AbstractAbstract
The cohort included more than 900,000 patients in 119 hospitals who had ophthalmologic and other low-risk procedures. Various risk factors and medical consultation increased use of preoperative testing. The amount of testing varied widely among institutions.
Supplemental Digital Content is available in the text.

Background
Increasing attention has been focused on low-value healthcare services. Through Choosing Wisely campaigns, routine laboratory testing before low-risk surgery has been discouraged in the absence of clinical indications. The authors investigated rates, determinants, and institutional variation in laboratory testing before low-risk procedures.

Methods
Patients who underwent ophthalmologic surgeries or predefined low-risk surgeries in Ontario, Canada, between April 1, 2008, and March 31, 2013, were identified from population-based administrative databases. Preoperative blood work was defined as a complete blood count, prothrombin time, partial thromboplastin, or basic metabolic panel within 60 days before an index procedure. Adjusted associations between patient and institutional factors and preoperative testing were assessed with hierarchical multivariable logistic regression. Institutional variation was characterized using the median odds ratio.

Results
The cohort included 906,902 patients who underwent 1,330,466 procedures (57.1% ophthalmologic and 42.9% low-risk surgery) at 119 institutions. Preoperative blood work preceded 400,058 (30.1%) procedures. The unadjusted institutional rate of preoperative blood work varied widely (0.0 to 98.1%). In regression modeling, significant predictors of preoperative testing included atrial fibrillation (adjusted odds ratio [AOR], 2.58; 95% CI, 2.51 to 2.66), preoperative medical consultation (AOR, 1.68; 95% CI, 1.65 to 1.71), previous mitral valve replacement (AOR, 2.33; 95% CI, 2.10 to 2.58), and liver disease (AOR, 1.69; 95% CI, 1.55 to 1.84). The median odds ratio for interinstitutional variation was 2.43.

Conclusions
Results of this study suggest that testing is associated with a range of clinical covariates. However, an association was similarly identified with preoperative consultation, and significant variation between institutions exists across the jurisdiction.
Down-regulation of MicroRNA-31 in CD4+ T Cells Contributes to Immunosuppression in Human Sepsis by Promoting TH2 Skewing
Authors: van der Heide Verena , Möhnle Patrick , Rink Jessica , Briegel Josef , Kreth Simone 
Published: January 2016

AbstractAbstract
In 23 patients with sepsis, a microRNA termed miR-31 was down-regulated and this was associated with an increased antiinflammatory signaling and a shift in T-helper cells toward a predominance of TH2 (antiinflammatory) subtypes. This suggests that in sepsis, decreased expression of miR-31 contributes to depression of immunity.
Supplemental Digital Content is available in the text.

Background
Immunosuppression has been recognized as a major cause of sepsis-related mortality. Currently, there is much interest in identifying central hubs controlling septic immunoparalysis. In this context, in this study, the authors investigate the role of microRNA-31 (miR-31) as a regulator of T cell functions.

Methods
Primary human T cells were separated from healthy volunteers (n = 16) and from sepsis patients by magnetic beads (n = 23). Expression of mRNA/microRNA (miRNA) was determined by real-time polymerase chain reaction. Gene silencing was performed by small interfering RNA transfection, and miRNA-binding sites were validated by reporter gene assays. Effects of miR-31 or anti-miR-31 transfection were analyzed by real-time polymerase chain reaction, Western blotting, and flow cytometry.

Results
Overexpression of miR-31 in stimulated CD4+ T cells promoted a proinflammatory phenotype with increased levels of interferon-γ (1.63 ± 0.43; P = 0.001; means ± SD) and reduced expression of interleukin (IL)-2 (0.66 ± 0.19; P = 0.005) and IL-4 (0.80 ± 0.2; P = 0.0001). In contrast, transfection of anti-miR-31 directed cells toward a TH2 phenotype. Effects on IL-2 and IL-4 were mediated by targeting of nuclear factor-kappa B–inducing kinase and factor-inhibiting hypoxia-inducible factor-1α. Interferon-γ, however, was influenced via control of signaling lymphocytic activation molecule (SLAM)-associated protein, an essential adaptor molecule of immunomodulatory SLAM receptor signaling, which was identified as a novel target gene of miR-31. In sepsis patients, an epigenetically driven down-regulation of miR-31 was found (0.44 ± 0.25; P = 0.0001), associated with increased nuclear factor-kappa B–inducing kinase, factor-inhibiting hypoxia-inducible factor-1α, SLAM-associated protein expression, and a cytokine shift toward TH2.

Conclusions
In this study, the authors provide novel evidence of miR-31 as an emerging key posttranscriptional regulator of sepsis-associated immunosuppression. The study results contribute to a further understanding of septic immunoparalysis and provide new perspectives on miRNA-based diagnostic approaches.
An economic cost analysis of emergency department key performance indicators in Ireland
Authors: Gannon Brenda , Jones Cheryl , McCabe Aileen , O’Sullivan Ronan , Wakai Abel 
Published: January 2016

Objectives
High quality data is fundamental to using key performance indicators (KPIs) for performance monitoring. However, the resources required to collect high quality data are often significant and should usually be targeted at high priority areas. As part of a study of 11 emergency department (ED) KPIs in Ireland, the primary objective of this study was to estimate the relative cost of collecting the additional minimum data set (MDS) elements for those 11 KPIs.

Methods
An economic cost analysis focused on 12 EDs in the Republic of Ireland. The resource use data were obtained using two separate focus group interviews. The number of available MDS elements was obtained from a sample of 100 patient records per KPI per participating ED. Unit costs for all resource use were taken at the midpoint of the relevant staff salary scales.

Results
An ED would need to spend an estimated additional €3561 per month on average to capture all the MDS elements relevant to the 11 KPIs investigated. The additional cost ranges from 14.8 to 39.2%; this range is 13.9–32.3% for small EDs, whereas the range for medium EDs is 11.7–40%. Regional EDs have a higher additional estimated cost to capture all the relevant MDS elements (€3907), compared with urban EDs (€3353).

Conclusion
The additional cost of data collection, contingent on that already collected, required to capture all the relevant MDS elements for the KPIs examined, ranges from 14.8 to 39.2% per KPI, with variation identified between regional and urban hospitals.
Melanoma therapy: Check the checkpoints
Authors: Furue Masutaka , Kadono Takafumi 
Published: January 2016

AbstractRecent mutational and translational studies have revealed that the Ras/Raf/mitogen‐activated protein kinase kinase (MEK)/extracellular signal‐regulated kinase (ERK) pathway plays a key role in melanomagenesis. Mutations in NRAS and BRAF are found in the majority of melanomas resulting in the formation of constitutively active NRAS and BRAF molecules, which leads to the proliferation and survival of melanoma cells through the activation of MEK/ERK signals. Inhibitors of BRAF or MEK significantly extend the progression‐free survival and overall survival of melanoma patients compared with conventional chemotherapies. Combining BRAF and MEK inhibitors further enhances the clinical effectiveness. Cytotoxic T‐lymphocyte‐associated antigen 4 (CTLA‐4) is an immune checkpoint molecule that downregulates T‐cell activation by binding to B7 (CD80/CD86) molecules on antigen‐presenting cells. Programmed death receptor ligand 1 on melanoma cells negatively regulates T‐cell function by binding to the programmed death‐1 (PD‐1) receptor on T cells. Antibodies against CTLA‐4 and PD‐1 also enhance the survival of melanoma patients. In this review, we summarize the clinical effectiveness and adverse events of the BRAF inhibitors, MEK inhibitors and anti‐immune checkpoint antibodies in melanoma treatment.
Accounting Information in Financial Contracting: The Incomplete Contract Theory Perspective
Authors: CHRISTENSEN HANS B. , NIKOLAEV VALERI V. , WITTENBERG‐MOERMAN REGINA 
Published: January 2016

ABSTRACTThis paper reviews theoretical and empirical work on financial contracting that is relevant to accounting researchers. Its primary objective is to discuss how the use of accounting information in contracts enhances contracting efficiency and to suggest avenues for future research. We argue that incomplete contract theory broadens our understanding of both the role accounting information plays in contracting and the mechanisms through which efficiency gains are achieved. By discussing its rich theoretical implications, we expect incomplete contract theory to prove useful in motivating future research and in offering directions to advance our knowledge of how accounting information affects contract efficiency.
Gabapentin misuse, abuse and diversion: a systematic review
Authors: Smith Rachel V. , Havens Jennifer R. , Walsh Sharon L. 
Published: January 2016

AbstractBackground and AimsSince its market release, gabapentin has been presumed to have no abuse potential and subsequently has been prescribed widely off‐label, despite increasing reports of gabapentin misuse. This review estimates and describes the prevalence and effects of, motivations behind and risk factors for gabapentin misuse, abuse and diversion.MethodsDatabases were searched for peer‐reviewed papers demonstrating gabapentin misuse, characterized by taking a larger dosage than prescribed or taking gabapentin without a prescription, and diversion. All types of studies were considered; grey literature was excluded. Thirty‐three papers met inclusion criteria, consisting of 23 case studies and 11 epidemiological reports. Published reports came from the United States, the United Kingdom, Germany, Finland, India, South Africa and France, and two analyzed websites not specific to a particular country.ResultsPrevalence of gabapentin misuse in the general population was reported to be 1%, 40–65% among individuals with prescriptions and between 15 and 22% within populations of people who abuse opioids. An array of subjective experiences reminiscent of opioids, benzodiazepines and psychedelics were reported over a range of doses, including those within clinical recommendations. Gabapentin was misused primarily for recreational purposes, self‐medication or intentional self‐harm and was misused alone or in combination with other substances, especially opioids, benzodiazepines and/or alcohol. Individuals with histories of drug abuse were most often involved in its misuse.ConclusionsEpidemiological and case report evidence suggests that the anti‐epileptic and analgesic medication gabapentin is being misused internationally, with substance abuse populations at special risk for misuse/abuse.
Inter‐hospital variations in labor induction and outcomes for nullipara: an Australian population‐based linkage study
Authors: Nippita Tanya A. , Trevena Judy A. , Patterson Jillian A. , Ford Jane B. , Morris Jonathan M. , Roberts Christine L. 
Published: January 2016

AbstractIntroductionThis study aimed to describe variation in inter‐hospital induction of labor (IOL) rates, determine whether variation is explained by individual and hospital factors and examine birth outcomes.Material and methodsNullipara at term with a singleton cephalic birth were identified using linked hospital discharge and birth data for 66 hospitals in New South Wales, Australia, 2010–2011. Random effects multilevel logistic regression models were fitted for early term, full term, and late term births, adjusting for individual and hospital factors. Hospital intrapartum cesarean rates, and severe maternal and neonatal morbidity outcomes were determined according to hospital IOL rate.ResultsOf 69 549 nullipara, 24 673 (35%) had an IOL. For early term births, adjusted hospital IOL (aIOL) rates varied (3.3–13.9%), with 11 of 66 (17%) hospitals having aIOL rates significantly different from the average aIOL rate. For births at full term, the hospital aIOL rates varied (10.6–32.6%), with 29 hospitals (44%) having aIOL rates significantly different from the average aIOL rate. For late term births, the hospital aIOL rates varied (45.1–67.5%), with 11 hospitals (17%) having aIOL rates significantly different from the overall average aIOL rate for women with late term births. There was generally no relationship between higher or lower hospital IOL rates and intrapartum cesarean section rates, or maternal or neonatal adverse outcomes.ConclusionsInter‐hospital IOL rates for nullipara with a singleton cephalic term birth had high unexplained variation, with no clear association with intrapartum cesarean section rates, or maternal or neonatal adverse outcomes.
Episiotomy preferences, indication, and classification – a survey among Nordic doctors
Authors: Fodstad Kathrine , Staff Anne C. , Laine Katariina 
Published: January 2016

AbstractIntroductionEpisiotomy performance impacts perineal health and rates of obstetric anal sphincter injuries (OASIS). Our objective was to assess self‐reported episiotomy practice and opinions on clinical indication for episiotomy among Nordic physicians and to investigate potential misclassification.Material and methodsA survey was conducted among doctors attending the 2012 Nordic obstetrical and gynecological conference. Participants were asked to draw an episiotomy on a photo of a perineum with a crowning fetal head similarly to their clinical practice if an episiotomy was clinically indicated, and to name the technique drawn. Differences in outcome measures were compared by country of practice and seniority.ResultsThe majority of the 297 participants (47%) drew a lateral episiotomy according to our classification by incision point and angle, but as many as 64% of these 138 doctors misclassified this as mediolateral episiotomy. Only 20% drew a mediolateral episiotomy, the great majority classifying it accurately, but 8% misclassified their mediolateral cut as a lateral episiotomy. One‐third of episiotomies were nonclassifiable. In general, doctors in Finland, Sweden, and Norway more often favored lateral episiotomies compared with doctors in Denmark and Iceland. There were significant differences between Finnish and Norwegian vs. Danish and Swedish doctors in perception of clinical indications for episiotomy.ConclusionsThe great variation in self‐reported episiotomy performance between Nordic physicians and large misclassification rates indicate that educational programs are warranted. Use of uniform classification and appropriate techniques may be crucial to investigate the role of episiotomies in preventing OASIS.
Influence of Instruments Used in Root Canal Preparation on Amount of Apically Extruded Debris
Authors: Karataş Ertuğrul , Ersoy İbrahim , Gündüz Hicran Ateş , Uygun Ahmet Demirhan , Kol Elif , Çakıcı Fatih 
Published: January 2016

AbstractThe aim of the present study was to compare the effects of ProTaper Gold, WaveOne Gold, ProTaper Universal, and WaveOne instruments on the amount of apically extruded debris. Eighty mandibular premolar teeth with straight root canals were selected and assigned to four groups (n = 20). The root canals were instrumented using ProTaper Gold, WaveOne Gold, ProTaper Universal, and WaveOne systems. Eppendorf tubes containing apically extruded debris were weighed three times, and mean values were calculated. The net mass of the extruded debris was calculated by subtracting the initial mass from the final mass. The groups were compared using one‐way analysis of variance and Tukey's post hoc tests at a significance level of P < 0.05. The PTG group extruded less debris than the PTU group, and the WOG group extruded less debris than the WO group (P < 0.05). All the instrumentation systems tested in the present study were associated with apical extrusion of debris.
Does Implant Selection Impact Postoperative Complications Following Hip Arthroplasty for Failed Intertrochanteric Fractures? A Retrospective Comparative Study
Authors: Tsai Shang‐Wen , Chen Cheng‐Fong , Wu Po‐Kuei , Huang Ching‐Kuei , Chen Wei‐Ming , Chang Ming‐Chau 
Published: January 2016

AbstractThe purpose of this study is to compare postoperative complications among different acetabular and femoral components of hip arthroplasty for failed intertrochanteric fractures. A total of 79 patients were included and followed‐up for an average of 75.6 months (range, 24–244). Fifty‐five patients underwent total hip arthroplasty, and 24 had bipolar hemiarthroplasty. Cementless metaphyseal locking, cementless diaphyseal locking, and cemented standard stems were used in 41, 29, and 9 patients, respectively. Dislocation and wear rate were not different between the total hip arthroplasty and bipolar hemiarthroplasty groups. Stem subsidence or loosening was more frequently found in the cementless, metaphyseal locking stem groups. In conclusion, cemented standard stem and cementless diaphyseal locking stem might be better implant choices. With regard to dislocation rate, our results were insufficient to conclude a better implant choice of total hip arthroplasty or bipolar hemiarthroplasty than the other.
Inhibition of CaMKII Attenuates Progressing Disruption of Ca2+ Homeostasis Upon Left Ventricular Assist Device Implantation in Human Heart Failure
Authors: Fischer Thomas H. , Kleinwächter Astrid , Herting Jonas , Eiringhaus Jörg , Hartmann Nico , Renner André , Gummert Jan , Haverich Axel , Schmitto Jan D. , Sossalla Samuel 
Published: January 2016

AbstractIn heart failure, left ventricular assist device (LVAD) implantation is performed to ensure sufficient cardiac output. Whereas some patients are subsequently weaned from LVAD support, other patients still need heart transplantation. To elucidate underlying mechanisms, we assessed the arrhythmogenic SR‐Ca2+ leak at the time of LVAD implantation (HF‐Im) and heart transplantation (HF‐Tx) and evaluated the effects of CaMKII‐inhibition. Human left‐ventricular cardiomyocytes were isolated, paced at 1 Hz for 10 beats to ensure SR‐Ca2+ loading and scanned for diastolic Ca2+ sparks (confocal microscopy). In HF‐Im, the high diastolic spark frequency (CaSpF) of 0.76 ± 0.12 × 100 μm−1 × s−1 could be reduced to 0.48 ± 0.10 × 100 μm−1 × s−1 by CaMKII inhibition (AIP, 1 μM). The amplitude of Ca2+ sparks, width, and length was not significantly altered. In sum, CaMKII inhibition yielded a clear tendency toward a reduction of the SR‐Ca2+ leak (n cells/patients = 76/6 vs. 108/6, P = 0.08). In HF‐Tx, we detected an even higher CaSpF of 1.00 ± 0.10 100 μm−1 × s−1 and a higher SR‐Ca2+ leak compared with HF‐Im (increase by 81 ± 33%, n cells/patients = 156/7 vs. 130/7, P < 0.05), which fits to the further decreased LV function. Here, CaMKII inhibition likewise reduced CaSpF (0.35 ± 0.09 100 μm−1 × s−1, P = 0.06) and significantly reduced spark duration (n sparks/patients = 58/3 vs. 159/3, P < 0.05). Conclusively, the SR‐Ca2+ leak was reduced by 69 ± 12% in HF‐Tx upon CaMKII inhibition (n cells/patients = 53/3 vs. 91/3, P < 0.05). These data show that the SR‐Ca2+ leak correlates with the development of LV function after LVAD implantation and may represent an important pathomechanism. The fact that CaMKII inhibition reduces the SR‐Ca2+ leak in HF‐Tx suggests that CaMKII inhibition may be a promising option to beneficially influence clinical course after LVAD implantation.
Swedish children with hereditary angioedema report good overall health and quality of life despite symptoms
Authors: Nygren Anders , Nordenfelt Patrik , Lindfors Anders , Mallbris Lotus , Björkander Janne , Wahlgren Carl‐Fredrik 
Published: January 2016

AbstractAimFew studies have been published on children with hereditary angioedema (HAE), an autosomal dominant disease caused by mutations on chromosome 11. This study explored various aspects of the disease in the Swedish paediatric population.MethodsA retrospective questionnaire was sent to all 36 Swedish children known to have HAE, and a physician carried out follow‐up telephone interviews.ResultsMost of the questionnaires were completed by the parents of 31 (86%) children with HAE, with or without their input, at a median age of nine years (range 1–17), and the physician also interviewed 29. HAE symptoms were experienced by 23 children, including abdominal attacks (96%), skin swelling (78%) and swelling in the mouth and/or upper airways (52%). Psychological stress was the most common trigger for abdominal attacks and trauma and sports triggered skin swelling. The majority (n = 19) had access to complement‐1 esterase inhibitor concentrate at home. Current health and quality of life were generally rated as good, independent of whether the child had experienced HAE symptoms or not.ConclusionMost children with HAE had experienced abdominal attacks and skin swelling, but their overall health and quality of life were generally perceived to be good.
Raw beef bones as chewing items to reduce dental calculus in Beagle dogs
Authors: Marx FR , Machado GS , Pezzali JG , Marcolla CS , Kessler AM , Ahlstrøm Ø , Trevizan L 
Published: January 2016

ObjectiveEvaluate the effect of raw bovine cortical bone (CB) (medullary bone cross‐sectioned) and marrow or epiphyseal ‘spongy’ bone (SB) as chew items to reduce dental calculus in adult dogs.MethodsEight 3‐year‐old Beagle dogs were observed in two study periods. In the first study, the dogs each received a piece of bovine femur CB (122 ± 17 g) daily and in the second study, a piece of bovine femur SB (235 ± 27 g). The first study lasted 12 days and the second 20 days. Dental calculus was evaluated using image integration software.ResultsAt the start of the studies, dental calculus covered 42.0% and 38.6% of the dental arcade areas, respectively. In study one, the chewing reduced the established dental calculus area to 27.1% (35.5% reduction) after 3 days and after 12 days the dental calculus covering was reduced to 12.3% (70.6% reduction). In study two, the dental calculus covered 16.8% (56.5% reduction) after 3 days, 7.1% (81.6% reduction) after 12 days and 4.7% (87.8% reduction) after 20 days. The CB remained largely intact after 24 h, but SB was reduced to smaller pieces and in some cases totally consumed after 24 h. No complications such as tooth fractures, pieces of bone stuck between teeth or intestinal obstructions were observed during the studies.ConclusionsChewing raw bovine bones was an effective method of removing dental calculus in dogs. The SB bones removed dental calculus more efficiently in the short term.