bluuebunny/crossref_metadata_2025_split huggingface dataset:
Real‐world stroke prevention strategies in nonvalvular atrial fibrillation in patients with renal impairment
Authors: Mert Kadir U. , Mert Gurbet Ö. , Başaran Özcan , Beton Osman , Dogan Volkan , Tekinalp Mehmet , Aykan Ahmet Ç. , Kalaycıoğlu Ezgi , Bolat Ismail , Taşar Onur , Şafak Özgen , Kalçık Macit , Yaman Mehmet , Kırma Cevat , Biteker Murat ,   RAMSES investigators
Published: April 2017

AbstractBackgroundThe data regarding stroke prevention strategies in nonvalvular atrial fibrillation (NVAF) are limited especially in patients with renal impairment (RI). We sought to evaluate management dilemmas in patients with concurrent NVAF and RI in RAMSES (ReAl‐life Multicenter Survey Evaluating Stroke Prevention Strategies inTurkey) study.MethodsWe conducted a prospective, multicenter, nation‐wide registry in NVAF patients in outpatient cardiology clinics. All consecutive patients with NVAF were enrolled in RAMSES study (ClinicalTrials.gov identifier NCT02344901). The baseline data were collected. Glomerular filtration rate (GFR) was estimated by Cockcroft–Gault equation.ResultsA total number of 6273 patients from 29 provinces of Turkey with the contribution of 83 investigators were enrolled to the study. Of the study population, 1964(33%) patients had RI which was defined as GFR < 60 mL/min. Patients with RI had significantly higher CHA2DS2VASc and HAS‐BLED scores compared to those without RI (3·9 ± 1·5 vs. 2·9 ± 1·5, and 2·0 ± 1 vs. 1·4 ± 1; P < 0·001). Prior history of major bleeding (6·9% vs. 4·1%, P < 0·001) and stroke (16·2% vs. 11·8%, P < 0·001) was significantly higher among individuals with concomitant RI and NVAF. Although RI patients had a higher risk for thromboembolism, number of the patients who did not receive any anticoagulant therapy was higher in patients with RI than without RI (30·1 vs. 26·4%, P = 0·003).ConclusionRAMSES study showed that one‐third of the patients with NVAF had RI in the real‐world setting. Although it is mandatory in most of the patients with concomitant NVAF and RI, nearly one‐third of these patients did not receive any anticoagulant therapy.
Observed survival benefit of mild therapeutic hypothermia reanalysing the Circulation Improving Resuscitation Care trial
Authors: Nürnberger Alexander , Herkner Harald , Sterz Fritz , Olsen Jan‐Aage , Lozano Michael , van Grunsven Pierre M. , Lerner E. Brooke , Persse David , Malzer Reinhard , Brouwer Marc A. , Westfall Mark , Souders Chris M. , Travis David T. , Herken Ulrich R. , Wik Lars 
Published: April 2017

AbstractBackgroundMild therapeutic hypothermia is argued being beneficial for outcome after cardiac arrest.Materials and methodsRetrospective analysis of Circulation Improving Resuscitation Care (CIRC) trial data to assess if therapeutic cooling to 33 ± 1 °C core temperature had an association with survival. Of 4231 adult, out‐of‐hospital cardiac arrests of presumed cardiac origin initially enrolled, eligibility criteria for therapeutic hypothermia were met by 1812. Logistic regression was undertaken in a stepwise fashion to account for the impact on outcome of each significant difference and for the variable of interest between the groups.ResultsOut‐of‐ and in‐hospital cooled were 263 (15%), only after admission cooled were 230 (13%) and not cooled were 357 (20%) patients. The group cooled out of‐ and in hospital had 98 (37%) survivors as compared to the groups cooled in hospital only [80 (35%)] and of those not cooled [68 (19%)]. After adjusting for known covariates (sex, age, witnessed cardiac arrest, no‐ and low‐flow time, shockable initial rhythm, random allocation, bystander cardiopulmonary resuscitation and percutaneous coronary intervention), the odds ratio for survival comparing no cooling to out‐of‐ plus in‐hospital cooling was 0·53 [95% confidence interval (CI): 0·46–0·61, P < 0·001], and comparing to in‐hospital cooling only was 0·67 (95% CI: 0·50–0·89, P = 0·006).ConclusionMild therapeutic hypothermia initiated out of hospital and/or in hospital was associated with improved survival within this secondary analysis of the CIRC cohort compared to no therapeutic hypothermia.
Multidimensional Investigation of Bedrock Heterogeneity/Unconformities at a DNAPL‐Impacted Site
Authors: Steelman Colby M. , Meyer Jessica R. , Parker Beth L. 
Published: April 2017

AbstractOrganic solvent (i.e., dense nonaqueous phase liquid, DNAPL) migration in the subsurface is known to be extremely sensitive to geologic heterogeneity. There is often a focus on heterogeneity that results from changing depositional conditions over short spatial scales. Similar or even more extreme spatial heterogeneity can result postdeposition due to erosional processes. This study applies a synergistic approach based on a combination of high‐resolution lithologic logs of continuous cores, borehole geophysical logs, surface electrical resistivity, and seismic refraction tomography models to assess spatial heterogeneity in a shallow bedrock sequence subject to multiple unconformities and contaminated with a mixture of organic chemicals. The persistence of DNAPL in the source zone and an associated dissolved‐phase plume led to variable impacts on formation resistivity across the study site. Seismic refraction in combination with electrical resistivity tomography improved interpretation of highly irregular erosional boundaries by delineating sharp lateral transitions in lithologic composition near the source zone and across the dissolved‐phase plume. Electrical resistivity was effective at differentiating between clean and mud‐rich sandstones and their unconformable contact with an underlying dolostone. Geophysical measurements revealed eroded dolostone mounds encased by a network of younger mud‐rich sandstones channelized by clean semi‐lithified sand, all of which was buried beneath variable glacial drift. Our synergistic multidimensional approach resulted in the development of a detailed three‐dimensional shallow bedrock geospatial model, which has led to an improved understanding of DNAPL migration and contaminant plume heterogeneity.
Factors affecting smartphone adoption for accessing information in medical settings
Authors: Tahamtan Iman , Pajouhanfar Sara , Sedghi Shahram , Azad Mohsen , Roudbari Masoud 
Published: April 2017

AbstractObjectivesThis study aimed to acquire knowledge about the factors affecting smartphone adoption for accessing information in medical settings in Iranian Hospitals.MethodsA qualitative and quantitative approach was used to conduct this study. Semi‐structured interviews were conducted with 21 medical residents and interns in 2013 to identify determinant factors for smartphone adoption. Afterwards, nine relationships were hypothesised. We developed a questionnaire to test these hypotheses and to evaluate the importance of each factor. Structural equation modelling was used to analyse the causal relations between model parameters and to accurately identify determinant factors.ResultsEight factors were identified in the qualitative phase of the study, including perceived usefulness, perceived ease of use, training, internal environment, personal experience, social impacts, observability and job related characteristics. Among the studied factors, perceived usefulness, personal experience and job related characteristics were significantly associated with attitude to use a smartphone which accounted for 64% of the variance in attitude. Perceived usefulness had the strongest impact on attitude to use a smartphone.ConclusionThe factors that emerged from interviews were consistent with the Technology Acceptance Model (TAM) and some previous studies. TAM is a reliable model for understanding the factors of smartphone acceptance in medical settings.
Effect of formalin fixation and tumour size in small‐sized non‐small‐cell lung cancer: a prospective, single‐centre study
Authors: Park Heae S , Lee Sungsoo , Haam Seokjin , Lee Geun D 
Published: April 2017

AimsFormalin fixation can cause tumour shrinkage. The aim of this study was to prospectively evaluate the effect of overnight formalin fixation on tumour size and the effect of clinicopathological parameters on changes in tumour size in small‐sized non‐small‐cell lung cancer (NSCLC).Methods and resultsOur study included 126 surgically resected NSCLC specimens submitted in a fresh state. We measured the largest cross‐sectional tumour diameters in the fresh and formalin‐fixed specimens. Tumour size significantly differed (mean, 0.66 mm; P < 0.001) and was positively correlated (r2 = 0.982; P < 0.001) between fresh and formalin‐fixed specimens. The percentage difference after fixation was 4.06%. Formalin fixation caused tumour shrinkage in 46.8%, tumour enlargement in 4.8%, and a tumour stage shift in 3.17%. The risk of a > 10% change in tumour size after formalin fixation was increased in tumours with a lepidic pattern [odds ratio (OR): 6.268; P = 0.001], in subsolid tumours (OR: 4.068; P = 0.011), and in the presence of adenocarcinoma in situ (AIS)/minimally invasive adenocarcinoma (MIA) histology (OR: 6.545; P = 0.003). Pleural dimpling lowered the risk of tumour size change after fixation (OR: 0.162; P = 0.019). On multivariate analysis, a lepidic pattern (OR: 4.601; P = 0.010) and AIS/MIA histology (OR: 4.381; P = 0.026) were still significant risk factors. Longer ischaemic time was the single risk factor for tumour shrinkage in the invasive adenocarcinoma subgroup (OR: 5.357; P = 0.021).ConclusionNSCLC tumours shrank or enlarged by 4.06% after overnight formalin fixation. A lepidic pattern and AIS/MIA histology were independent risk factors for both significant tumour shrinkage and growth after fixation. Longer ischaemic time was the single risk factor for significant tumour shrinkage in invasive adenocarcinoma.
Vitamin D receptor gene polymorphisms association with the risk of sepsis and mortality
Authors: Zeljic K. , Elkilany A. , Supic G. , Surbatovic M. , Djordjevic D. , Magic Z. , Bozic B. 
Published: April 2017

SummaryAssociation of vitamin D receptor (VDR) gene polymorphisms with sepsis risk and mortality was studied. VDR FokI CC genotype was associated with increased sepsis risk (OR = 13.396, p = .000009) compared to the TT genotype. Results suggest possible role of VDR FokI (rs2228570) as a molecular biomarker of increased sepsis risk.
Monitoring once‐weekly recombinant factor IX prophylaxis in hemophilia B with thrombin generation assay and factor IX activity
Authors: Nummi V. , Jouppila A. , Lassila R. 
Published: April 2017

SummaryIntroductionProphylaxis is the recommended treatment mode for severe hemophilia B. However, no single treatment regimen fits for all patients. Once‐weekly prophylaxis with high‐dose recombinant factor IX (rFIX) is efficacious, nevertheless, laboratory outcomes following 72 h after administration are lacking.MethodsIn a prospective open‐label noncomparative study, 10 severe/moderate (FIX ≤2 IU/dL) adult patients received rFIX dose (60–100 IU/kg) after >72 h washout on two occasions, separated by 7 days. We measured one‐stage and chromogenic FIX, ROTEM, and thrombin generation (TG) assay in plasma after washout, 30 min after infusion, and at days 3, 4, and 7.ResultsMedian FIX clotting/chromogenic activity increased from 1.5/2.0 to 87/62 IU/dL following rFIX administration, chromogenic assay resulting in 30% lower recovery. Correspondingly TG was severely reduced at baseline and improved at recovery (peak thrombin 6.0 to 54 nm). Standard ROTEM failed to detect FIX deficiency. Both FIX activity and TG remained increased from days 3 to 7, with median trough levels of FIX clotting/chromogenic 3.0/3.0 IU/dL (≥1 IU/dL in all severe patients) and peak thrombin 9.1 nm measured on day 7. FIX and TG assays were equally consistent between weeks 1 and 2.ConclusionsOnce‐weekly rFIX prophylaxis results in favorable laboratory outcome.
Dentists' use of validated child dental anxiety measures in clinical practice: a mixed methods study
Authors: Alshammasi Hussain , Buchanan Heather , Ashley Paul 
Published: April 2017

BackgroundAssessing anxiety is an important part of the assessment of a child presenting for dental treatment; however, the use of dental anxiety scales in practice is not well‐documented.AimsTo introduce child dental anxiety scales, and to monitor the extent to which dentists used them; to explore the experience and views of dentists regarding anxiety assessment.DesignA mixed‐methods design was employed.MethodA protocol for child anxiety assessment was introduced to paediatric dentists in Eastman Dental Hospital. After 6 months, 100 patient files were audited to examine compliance with the protocol. Fourteen dentists were interviewed to explore their experience and views regarding anxiety assessment.ResultsOnly five patients were assessed using the scales. Thematic analysis of the dentist interviews revealed three themes: ‘Clinical observations and experience: The gold standard’; ‘Scales as an estimate or adjunct’; and ‘Shortcomings and barriers to using scales’.ConclusionsThe dentists in our study did not use anxiety scales, instead they rely on their own experience/judgement. Therefore, scales should be recommended as an adjunct to judgement. Brief scales are recommended as clinicians lack time and expertise in administering anxiety questionnaires. Advantages of using scales and hands‐on experience could be incorporated more in undergraduate training.
Serum Wisteria floribunda agglutinin‐positive Mac‐2‐binding protein levels and liver fibrosis: A meta‐analysis
Authors: Ito Kiyoaki , Murotani Kenta , Nakade Yukiomi , Inoue Tadahisa , Nakao Haruhisa , Sumida Yoshio , Kamada Yoshihiro , Yoneda Masashi 
Published: April 2017

AbstractBackground and AimA reliable, non‐invasive biomarker for diagnosis of liver fibrosis in chronic liver disease patients is needed. The aim of this study was to assess by meta‐analysis the efficacy of measuring serum levels of Wisteria floribunda agglutinin‐positive Mac‐2‐binding protein (WFA+‐M2BP), a novel and promising biomarker, for staging liver fibrosis and predicting the development of hepatocellular carcinoma and overall survival.MethodsWe performed a meta‐analysis using online journal database searches. We identified 39 studies, 21 of which met the criteria for meta‐analysis. Sensitivity and specificity of WFA+‐M2BP for assessing liver fibrosis staging in chronic liver diseases with broad etiologies were determined. Hazard ratios with 95% confidence intervals were also used for predicting hepatocellular carcinoma development and overall survival.ResultsWith WFA+‐M2BP, the sensitivity and specificity for predicting significant fibrosis (≥ F2), advanced fibrosis (≥ F3), and liver cirrhosis (= F4) were 0.690 and 0.778, 0.764 and 0.758, and 0.818 and 0.839, respectively. Sensitivity and specificity for diagnosing liver fibrosis in patients with hepatitis C virus were mostly higher than those in overall patients. However, sensitivity and specificity for diagnosing liver fibrosis in patients with hepatitis B virus were lower than those in overall patients. Overall, hazard ratios for development of hepatocellular carcinoma and overall survival were 5.946 and 1.068, respectively.ConclusionsThese results suggest that serum WFA+‐M2BP is a reliable predictor for liver fibrosis staging and a good substitute for liver biopsy. It is also useful for predicting both hepatocellular carcinoma development and overall survival.
The six‐spot‐step test – a new method for monitoring walking ability in patients with chronic inflammatory polyneuropathy
Authors: Kreutzfeldt Melissa , Jensen Henrik B. , Ravnborg Mads , Markvardsen Lars H. , Andersen Henning , Sindrup Søren H. 
Published: April 2017

AbstractThe aim of this study was to evaluate whether the six‐spot‐step test (SSST) is more suitable for monitoring walking ability in patients with chronic inflammatory polyneuropathy than the timed 25‐foot‐walking test (T25FW). In the SSST, participants have to walk as quickly as possible across a field measuring 1 × 5 m, while kicking blocks out of five circles on the floor. Sixty‐two patients and 61 controls performed the SSST and T25FW. Patients also performed the overall disability sumscore, INCAT sensory sumscore, Medical Research Council sumscore, and 9‐hole‐peg‐test. Twenty‐one patients treated with intravenous immunoglobulin (IVIG) every 4–6 weeks were tested prior to and 2–3 weeks after treatment and judged change in their own clinical condition using the patient global impression of change (PGIC) scale. In patients, SSST ranged from 5.7 to 26.8 s and T25FW ranged from 3.6 to 12.9 s. Intra‐class correlation between repeated tests was 0.97 for SSST and 0.95 for T25FW. Correlation with the additional tests was stronger for SSST than T25FW. In IVIG‐treated patients, the mean change in walking time was −2.3 s for SSST and −0.6 s for T25FW. The SSST showed larger responsiveness in terms of effect size, standardized response means, and relative efficiency. Both ambulation tests correlated moderately to PGIC. The SSST may be superior to the T25FW in terms of dynamic range, floor effect, and responsiveness which makes the SSST a possible alternative for monitoring walking ability in patients with chronic inflammatory polyneuropathy.
Neocolonialism and Health Care Access among Marshall Islanders in the United States
Authors: Duke Michael R. 
Published: April 2017

In the Marshall Islands, a history of extensive nuclear weapons testing and covert biomedical research, coupled with the U.S.’s ongoing military presence in the country, has severely compromised the health of the local population. Despite the U.S.’s culpability in producing ill health along with high rates of emigration from the islands to the mainland United States, the large portion of Marshallese who reside in the United States face substantial barriers to accessing health care. Drawing from ongoing field research with a Marshallese community in Arkansas, this article explores the multifaceted impediments that U.S.‐based Marshall Islanders face in receiving medical treatment. Calling on an expansive and inclusive notion of neocolonialism, I argue that Marshallese structural vulnerability with regard to health and health care treatment derives from their status as neocolonial subjects and from their limited claims to health‐related deservingness associated with this status. [Marshall Islanders, health care access, neocolonialism, radiation exposure, immigrant health]L̗ōmn̗ak ko rōttin̗o: Ilo M̗ajel̗, juon bwebwenato kōn kōmmālmel im nuclear baam̗ ko im ekkatak ko rōttin̗o̗ kōn wāwein an baijin ko jelōt armej, barāinwōt an to an ri tarinae ro an Amedka pād ilo aelōn̄ kein, em̗ōj an jelōt ājmour an armej ro ilo aelōn̄ kein. Men̄e alikkar bwe Amedka in ear jino nan̄inmej kein im ej un eo armej rein rej em̗m̗akūt jān āne kein āne er n̄an ioon Amedka, elōn̄ iaan ri M̗ajel̗ rein rej jelm̗ae elōn̄ apan̄ ko n̄an aer del̗o̗n̄e jikin ājmour ko. Jān ekkatak eo ej bōk jikin kiō, jerbal in ej etali kabōjrak rak kein rōlōn̄ im armej in M̗ajel̗ ro ioon Amedka in rej jelm̗ae ilo aer jibadōk lo̗k jikin taktō. Ilo an kar Amedka jibadōk juon jea eo eutiej imejān lal̗ in, ij kwal̗ok juon aō akweelel bwe apan̄ ko an armej in M̗ajel̗ ikijjeen ājmour im jikin taktō ej itok jān aer kar ri kōm̗akoko ilo an kar Amedka lelōn̄ l̗o̗k etan ilo mejān lal̗ im jān aer jab pukot jipan kein ej aer bwe kōn jōkjōk in.
Phytaspase‐mediated precursor processing and maturation of the wound hormone systemin
Authors: Beloshistov Roman E. , Dreizler Konrad , Galiullina Raisa A. , Tuzhikov Alexander I. , Serebryakova Marina V. , Reichardt Sven , Shaw Jane , Taliansky Michael E. , Pfannstiel Jens , Chichkova Nina V. , Stintzi Annick , Schaller Andreas , Vartapetian Andrey B. 
Published: April 2017

Summary

Peptide hormones are implicated in many important aspects of plant life and are usually synthesized as precursor proteins. In contrast to animals, data for plant peptide hormone maturation are scarce and the specificity of processing enzyme(s) is largely unknown. Here we tested a hypothesis that processing of prosystemin, a precursor of tomato (Solanum lycopersicum) wound hormone systemin, is performed by phytaspases, aspartate‐specific proteases of the subtilase family.

Following the purification of phytaspase from tomato leaves, two tomato phytaspase genes were identified, the cDNAs were cloned and the recombinant enzymes were obtained after transient expression in Nicotiana benthamiana.

The newly identified tomato phytaspases hydrolyzed prosystemin at two aspartate residues flanking the systemin sequence. Site‐directed mutagenesis of the phytaspase cleavage sites in prosystemin abrogated not only the phytaspase‐mediated processing of the prohormone in vitro, but also the ability of prosystemin to trigger the systemic wound response in vivo.

The data show that the prohormone prosystemin requires processing for signal biogenesis and biological activity. The identification of phytaspases as the proteases involved in prosystemin maturation provides insight into the mechanisms of wound signaling in tomato. Our data also suggest a novel role for cell death‐related proteases in mediating defense signaling in plants.
Late Quaternary multiple incised valley systems: An unusually well‐preserved stratigraphic record of two interglacial valley‐fill successions from the Arno Plain (northern Tuscany, Italy)
Authors: Rossi Veronica , Amorosi Alessandro , Sarti Giovanni , Mariotti Sara 
Published: April 2017

AbstractUn‐fragmented stratigraphic records of late Quaternary multiple incised valley systems are rarely preserved in the subsurface of alluvial‐delta plains due to older valley reoccupation. The identification of a well‐preserved incised valley fill succession beneath the southern interfluve of the Last Glacial Maximum Arno palaeovalley (northern Italy) represents an exceptional opportunity to examine in detail evolutionary trends of a Mediterranean system over multiple glacial–interglacial cycles. Through sedimentological and quantitative meiofauna (benthic foraminifera and ostracods) analyses of two reference cores (80 m and 100 m long) and stratigraphic correlations, a mid‐Pleistocene palaeovalley, 5 km wide and 50 m deep, was reconstructed. Whereas valley filling is chronologically constrained to the penultimate interglacial (Marine Isotope Stage 7) by four electron spin resonance ages on bivalve shells (Cerastoderma glaucum), its incision is tentatively correlated with the Marine Isotope Stage 8 sea‐level fall. Above basal fluvial‐channel gravels, the incised valley fill is formed by a mud‐prone succession, up to 44 m thick, formed by a lower floodplain unit and an upper unit with brackish meiofauna that reflects the development of a wave‐dominated estuary. Subtle meiofauna changes towards less confined conditions record two marine flooding episodes, chronologically linked to the internal Marine Isotope Stage 7 climate‐eustatic variability. After the maximum transgressive phase, recorded by coastal sands, the interfluves were flooded around 200 ka (latest Marine Isotope Stage 7). The subsequent shift in river incision patterns, possibly driven by neotectonic activity, prevented valley reoccupation guiding the northward formation of the Last Glacial Maximum palaeovalley. The applied multivariate approach allowed the sedimentological characterization of the Marine Isotope Stage 7 and Marine Isotope Stage 1 palaeovalley fills, including shape, size and facies architecture, which revealed a consistent river‐coastal system response over two non‐consecutive glacial–interglacial cycles (Marine Isotope Stages 8 to 7 and Marine Isotope Stages 2 to 1). The recurring stacking pattern of facies documents a predominant control exerted on stratigraphy by Milankovitch and sub‐Milankovitch glacio‐eustatic oscillations across the late Quaternary period.