bluuebunny/crossref_metadata_2025_split huggingface dataset:
Positive antimitochondrial antibody but normal serum alkaline phosphatase levels: Could it be primary biliary cholangitis?
Authors: Berdichevski Tania , Cohen‐Ezra Oranit , Pappo Orit , Ben‐Ari Ziv 
Published: August 2016

AimPrimary biliary cholangitis (PBC) is a chronic cholestatic liver disease, typically diagnosed by elevated cholestatic liver enzymes and a positive antimitochondrial antibody (AMA) test. The clinical significance of AMA positivity in patients with normal cholestatic liver enzymes is uncertain.MethodsCharts of patients with normal cholestatic liver enzymes and AMA positivity who underwent liver biopsy between 2012 and 2015 were retrospectively analyzed.ResultsSix AMA‐positive patients with normal cholestatic liver enzymes who underwent a liver biopsy were identified. Four (67%) showed florid bile duct lesion compatible with early‐stage PBC, whereas the other two showed mild and non‐specific histological findings. The patients with histological findings compatible with PBC had higher enzyme‐linked immunosorbent assay‐determined AMA titers and significantly elevated immunoglobulin M (IgM) level. Patients with non‐specific histological findings (33%) had low‐titer AMA and a borderline elevated IgM level.ConclusionsAntimitochondrial antibody‐positive patients with normal cholestatic liver enzymes should be meticulously evaluated for PBC including a liver biopsy, mainly in patients with high‐titer seropositivity for AMA and a significantly elevated IgM level. More studies are required to clarify the role of liver biopsy in these patients and further follow‐up may elucidate the relationship of these patients to those with more classical forms of PBC.
A multicenter, randomized, split‐face clinical trial evaluating the efficacy and safety of chromophore gel‐assisted blue light phototherapy for the treatment of acne
Authors: Antoniou Christina , Dessinioti Clio , Sotiriadis Dimitrios , Kalokasidis Konstantinos , Kontochristopoulos George , Petridis Athanasios , Rigopoulos Dimitrios , Vezina Denis , Nikolis Andreas 
Published: August 2016

AbstractBackgroundAlthough a variety of laser/light‐based devices have been reported to be effective for the treatment of acne, long‐term data on efficacy and safety in the management of moderate and severe inflammatory acne is lacking. The objective of this 12‐week clinical trial was to evaluate the efficacy and safety of the KLOX BioPhotonic System, a LED blue light device using specific photo‐converter chromophores, in the treatment of moderate to severe acne vulgaris.MethodsOne patient hemiface was randomly selected to receive 6 weeks of treatment (twice weekly) with the LED light and the photo‐converter chromophores whereas the contralateral hemiface was not treated with the BioPhotonic System. All patients were provided with a skin cleanser and a non‐comedogenic cream with ultraviolet protection to be used on the entire face during the treatment period. Following completion of the 6‐week treatment period, the patient was followed for an additional 6 weeks. Efficacy was assessed through changes in acne severity using the Investigator's Global Assessment (IGA) scale and inflammatory acne lesion counts, both evaluated against baseline at weeks 6 and 12. Safety was assessed through physical exam, vital signs, laboratory evaluations, and physician and patient reporting of adverse events.ResultsA reduction of at least two grades in IGA scale severity was demonstrated in 51.7% of patients at week 12. Furthermore, at week 12, subjects with a baseline IGA grade of 3 (moderate) demonstrated a success rate (2 or greater grade drop) of 45.3% whereas patients with a baseline IGA grade of 4 (severe) demonstrated a success rate of 61.1%. Acne inflammatory lesion counts confirmed these results, with a reduction of at least 40% of lesions in 81.6% of treated hemifaces after 12 weeks. Treatment was considered as safe and well tolerated, with no serious adverse event and no patient discontinuation from the study from any adverse event. Patients' quality of life was also improved with a decrease of pain linked to acne after the 6‐week treatment period.ConclusionsThe BioPhotonic System comprised of LED blue‐light phototherapy and photo‐converter chromophores was found to be efficacious and safe, with a sustained clinical response at 12 weeks for the management of moderate to severe facial inflammatory acne.
Week 4 viral load predicts long‐term suppression of hepatitis B virus DNA during antiviral therapy: improving hepatitis B treatment in the real world
Authors: Truong J. , Shadbolt B. , Ooi M. , Chitturi S. , Kaye G. , Farrell G. C. , Teoh N. C. 
Published: August 2016

BackgroundEntecavir and tenofovir potently suppress hepatitis B virus (HBV) replication so that serum HBV DNA levels <20 IU/mL can be achieved after 2 years. Despite this, inadequate suppression is reported in >20% of cases for unclear reasons.AimWe tested whether 4‐week viral load (VL) assessment could improve 96‐week treatment outcome.MethodsData on all chronic hepatitis B patients treated with entecavir or tenofovir between 2005 and 2014 were entered prospectively. Full data capture included pre‐treatment, weeks 4, 24, 48 and 96 HBV DNA titre, HBeAg, age, gender, antiviral agent and dose escalation. Compliance data were compiled from pharmacy records, doctors’ letters and clinic bookings/attendance. Time to achieve complete viral suppression (HBV DNA < 20 IU/mL) was graphed using Kaplan–Meier curves. Factors affecting this were examined using a multivariate Cox Proportional Hazard model.ResultsAmong 156 patients treated, 72 received entecavir and 84 tenofovir. Pre‐treatment HBV DNA titre, 4‐week assessment and compliance impacted significantly on time to complete viral suppression. At 96 weeks, 90% of those assessed as compliant by 4‐week HBV DNA had complete viral suppression versus 50% followed by 6‐month VL estimation. Continuing care by the same physician was related to 4‐week VL testing and optimal compliance.ConclusionsMedium‐term outcomes of HBV antiviral therapy are improved by early on‐treatment VL testing, facilitating patient engagement and improved compliance. The observation that 90% complete viral suppression after 2 years monotherapy is achievable in a routine clinic setting questions the need for combination therapy in HBV cases with suboptimal response.
Wisdom within: unlocking the potential of big data for nursing regulators
Authors: Blumer L. , Giblin C. , Lemermeyer G. , Kwan J.A. 
Published: August 2016

AimThis paper explores the potential for incorporating big data in nursing regulators' decision‐making and policy development. Big data, commonly described as the extensive volume of information that individuals and agencies generate daily, is a concept familiar to the business community but is only beginning to be explored by the public sector.BackgroundUsing insights gained from a recent research project, the College and Association of Registered Nurses of Alberta, in Canada is creating an organizational culture of data‐driven decision‐making throughout its regulatory and professional functions. The goal is to enable the organization to respond quickly and profoundly to nursing issues in a rapidly changing healthcare environment.Sources of evidenceThe evidence includes a review of the Learning from Experience: Improving the Process of Internationally Educated Nurses' Applications for Registration (LFE) research project (2011–2016), combined with a literature review on data‐driven decision‐making within nursing and healthcare settings, and the incorporation of big data in the private and public sectors, primarily in North America.DiscussionThis paper discusses experience and, more broadly, how data can enhance the rigour and integrity of nursing and health policy.ConclusionNursing regulatory bodies have access to extensive data, and the opportunity to use these data to inform decision‐making and policy development by investing in how it is captured, analysed and incorporated into decision‐making processes.Implications for Nursing and Health PolicyUnderstanding and using big data is a critical part of developing relevant, sound and credible policy. Rigorous collection and analysis of big data supports the integrity of the evidence used by nurse regulators in developing nursing and health policy.
Substrate‐Based Ablation Versus Ablation Guided by Activation and Entrainment Mapping for Ventricular Tachycardia: A Systematic Review and Meta‐Analysis
Authors: KUMAR SAURABH , BALDINGER SAMUEL H. , ROMERO JORGE , FUJII AKIRA , MAHIDA SAAGAR N. , TEDROW USHA B. , STEVENSON WILLIAM G. 
Published: August 2016

Substrate vs. Activation/Entrainment Guided VT AblationIntroductionSubstrate‐based ablation for scar‐related ventricular tachycardia (VT) has gained prominence: however, there is limited data comparing it to ablation guided predominantly by activation and entrainment mapping of inducible and hemodynamically tolerated VTs. We compared the acute procedural efficacy and outcomes of predominantly substrate‐based ablation versus ablation guided predominantly by activation and entrainment mapping.Methods and ResultsDatabase searches through April 2016 identified 6 eligible studies (enrolling 403 patients, with 1 randomized study) comparing the 2 strategies. The relative risk of VT recurrence at follow‐up was assessed as the primary outcome using a random‐effects meta‐analysis. Secondary endpoints of acute success (based on noninducibility of VT), procedural complications, and mortality were assessed using weighted mean difference with the random effects model. At a median follow‐up of 18 months, the relative risk (RR) of VT recurrence was not significantly different with substrate‐based versus activation/entrainment guided VT ablation (0.72, 95% confidence interval [CI] 0.44–1.18), P = 0.2). Acute success (RR 1.02, 95% CI 0.95–1.1, P = 0.6), procedural complications (RR 0.8, 95% CI 0.35–1.82, P = 0.5) cardiovascular mortality and total mortality did not differ significantly (RR 0.83, 95% CI 0.38–1.79, P = 0.6 and RR 0.76, 95% CI 0.36–1.59, P = 0.5, respectively).ConclusionsThis meta‐analysis demonstrates similar acute procedural efficacy, and complications, VT recurrence and mortality rates when comparing a predominantly substrate‐based ablation strategy to a strategy guided predominantly by activation and entrainment mapping of inducible and hemodynamically tolerated VTs.
Influence of Genotype on Structural Atrial Abnormalities and Atrial Fibrillation or Flutter in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy
Authors: BOURFISS MIMOUNT , TE RIELE ANNELINE S.J.M. , MAST THOMAS P. , CRAMER MAARTEN J. , VAN DER HEIJDEN JEROEN F. , VAN VEEN TOON A.B. , LOH PETER , DOOIJES DENNIS , HAUER RICHARD N.W. , VELTHUIS BIRGITTA K. 
Published: August 2016

Structural Atrial Involvement in ARVD/CIntroductionArrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is associated with desmosomal mutations. Although desmosomal disruption affects both ventricles and atria, little is known about atrial involvement in ARVD/C.ObjectiveTo describe the extent and clinical significance of structural atrial involvement and atrial arrhythmias (AA) in ARVD/C stratified by genotype.MethodsWe included 71 patients who met ARVD/C Task Force Criteria and underwent cardiac magnetic resonance (CMR) imaging and molecular genetic analysis. Indexed atrial end‐diastolic volume and area‐length‐ejection‐fraction (ALEF) were evaluated on CMR and compared to controls with idiopathic right ventricular outflow tract tachycardia (n = 40). The primary outcome was occurrence of AA (atrial fibrillation or atrial flutter) during follow‐up, recorded by 12‐lead ECG, Holter monitoring or implantable cardioverter defibrillator (ICD) interrogation.ResultsPatients harbored a desmosomal plakophilin‐2 (PKP2) (n = 37) or nondesmosomal phospholamban (PLN) (n = 14) mutation. In 20 subjects, no pathogenic mutation was identified. Compared to controls, right atrial (RA) volumes were reduced in PKP2 (P = 0.002) and comparable in PLN (P = 0.441) mutation carriers. In patients with no mutation identified, RA (P = 0.011) and left atrial (P = 0.034) volumes were increased. Bi‐atrial ALEF showed no significant difference between the groups. AA were experienced by 27% of patients and occurred equally among PKP2 (30%) and no mutation identified patients (30%), but less among PLN mutation carriers (14%).ConclusionGenotype influences atrial volume and occurrence of AA in ARVD/C. While the incidence of AA is similar in PKP2 mutation carriers and patients with no mutation identified, PKP2 mutation carriers have significantly smaller atria. This suggests a different arrhythmogenic mechanism.
Vildagliptin reduces plasma stromal cell‐derived factor‐1α in patients with type 2 diabetes compared with glimepiride
Authors: Park Kyeong Seon , Kwak SooHeon , Cho Young Min , Park Kyong Soo , Jang Hak C , Kim Seong Yeon , Jung Hye Seung 
Published: August 2016

AbstractAims/IntroductionDipeptidyl peptidase‐4 inhibitors might have pleiotropic protective effects on cardiovascular disease (CVD), in contrast to sulfonylureas. Therefore, we compared various CVD risk factors between vildagliptin and glimepiride.Materials and MethodsWe carried out a randomized, prospective and crossover trial. A total of 16 patients with type 2 diabetes whose glycated hemoglobin was >7% were randomized to add vildagliptin or glimepiride. After 12‐week treatment, each drug was replaced with the other for another 12 weeks. Before and after each treatment, glucose homeostasis and CVD risk factors were assessed, and the continuous glucose monitoring system was applied to calculate glycemic variability.ResultsThe mean age of the participants was 60 years, 31% were men, body mass index 25.5 kg/m2 and HbA1c 8.41%. Both vildagliptin and glimepiride significantly decreased glycated hemoglobin and glycemic variability indices. Despite the improved glucose homeostasis, favorable change of CVD markers was not prominent in both the arms, along with significant weight gain. Only plasma stromal cell‐derived factor (SDF)‐1α decreased by 30% in the vildagliptin arm. According to regression analyses, the reduction of SDF‐1α was independently associated with vildagliptin usage and serum interleukin‐6 changes, but white blood cells were not related with the SDF‐1α changes.ConclusionCompared with glimepiride, vildagliptin arrestingly decreased plasma SDF‐1α, and its clinical implications should be further investigated.
Exercise and BMI z‐score in Overweight and Obese Children and Adolescents: A Systematic Review and Network Meta‐Analysis of Randomized Trials
Authors: Kelley George A. , Kelley Kristi S. , Pate Russell R. 
Published: August 2016

AbstractAimExamine the effects of selected types of exercise (aerobic, strength training, both) on BMI z‐score in overweight and obese children and adolescents.MethodsRandomized exercise intervention trials ≥ 4 weeks were included. Studies were retrieved by searching six electronic databases, cross‐referencing and expert review. Dual selection and abstraction occurred. Risk of bias and confidence in cumulative evidence were assessed. Network meta‐analysis was performed using multivariate random‐effects meta‐regression models while surface under the cumulative ranking curves were used to calculate a hierarchy of exercise treatments. The number needed to treat (NNT) and percentile improvement (U3) were also calculated.ResultsThirty‐four studies representing 2,239 participants were included. Median exercise occurred 3 times per week, 50 minutes per session over a 12‐week period. Statistically significant reductions in BMI z‐score were found for aerobic exercise and combined aerobic and strength exercise, but not strength training alone (M±SD, 95% CI: aerobic, ‐0.10, ‐0.15 to ‐0.05; aerobic and strength, ‐0.11, ‐0.19 to ‐0.03; strength, 0.04, ‐0.07 to 0.15). Combined aerobic and strength training was ranked best, followed by aerobic exercise and strength training. The NNT was 2 for both aerobic exercise and combined aerobic exercise and strength training. Percentile improvements were 28.8% for aerobic exercise and 31.5% for combined aerobic exercise and strength training. Confidence in effect estimates was ranked as low for aerobic exercise and very low for combined aerobic and strength training as well as strength training.ConclusionsAerobic exercise and combined aerobic exercise and strength training are associated with reductions in BMI z‐score.
Colonic N‐methyl‐d‐aspartate receptor contributes to visceral hypersensitivity in irritable bowel syndrome
Authors: Qi Qingqing , Chen Feixue , Zhang Wenxue , Wang Peng , Li Yanqing , Zuo Xiuli 
Published: August 2016

AbstractBackground and AimsN‐methyl‐d‐aspartate receptor (NMDAR) in brain, spinal cord, and enteric nervous system is involved in visceral hypersensitivity. This study aimed to reveal the functional expression of NMDAR on mucosal cells in colon and to investigate the downstream signal pathway from colonic NMDAR activation to visceral hypersensitivity in irritable bowel syndrome (IBS).MethodsThe expression of mucosal NMDAR in IBS patients and healthy controls was assessed by immunohistochemistry and Western blot and correlated with abdominal pain/discomfort scores quantified by a validated questionnaire. Electromyography recording in response to colorectal distension was recorded to measure the colonic sensitivity of mice receiving NMDA administration intracolonically. Brain‐derived neurotrophic factor (BDNF) expression and extracellular signal‐regulated kinase (ERK) pathway activation were examined in human colonic epithelial HT29 cells after NMDA stimulation, with or without MK801 or U0126 pretreatment.ResultsA significant upregulation of mucosal NMDAR was observed in IBS patients compared with controls, which was significantly correlated with abdominal pain/discomfort scores. Intracolonic administration of NMDA in normal mice produced increased colonic sensitivity to colorectal distension and elevated expression of BDNF and activation of ERK. Activation of NMDAR in colonic epithelial HT29 cells in vitro induced increased BDNF secretion in cell supernatants and higher BDNF expression in cells, as well as elevated phosphorylated ERK.ConclusionsThis study demonstrated that the activation of mucosal NMDAR in colon may contribute to the visceral hypersensitivity in IBS, by increasing production of BDNF in an ERK‐dependent pathway.
The socialisation of new graduate nurses during a preceptorship programme: strategies for recruitment and support
Authors: Lalonde Michelle , McGillis Hall Linda 
Published: August 2016

Aims and objectivesThe purpose of this study is to gain greater understanding of new graduate nurses' organisational socialisation and to help inform recruitment and support strategies for this population. To this end, it uses Van Maneen and Schein's theory of organisational socialisation to explore new graduate nurses' perceptions of role conflict, role ambiguity, job satisfaction and turnover intent at the end of their preceptorship programme.BackgroundThe literature on new graduate nurses reflects concerns with high turnover rates during early work experiences. Under‐preparation of and lack of support for new graduate nurses are often‐reported reasons for these high turnover rates. Preceptorship programmes have been implemented to specifically address these challenges.DesignThis study uses a cross‐sectional multisite design with a survey.MethodsA sample of 45 new graduate nurses completed a quantitative survey at the end of their preceptorship programme. Descriptive statistics and Pearson's correlation analyses were conducted to explore the relationships.ResultsNew graduate nurses in this study experienced low role ambiguity, role conflict and turnover intent and high job satisfaction. Their job satisfaction was associated with low role conflict and role ambiguity. Working in their first job of choice was related to less role conflict and role ambiguity. Having previous experience on the unit was not a meaningful variable.ConclusionsNew graduate nurses who reported a greater understanding of their work roles and less role conflict and were working in their first job of choice were generally more satisfied with their job. Previous experience on the unit was not related to any of the socialisation outcomes in this study. However, the transition experienced during clinical placements and early work experiences may be different.Relevance to clinical practiceThe results of this study provide managers and educators with greater insight into the socialisation of new graduate nurses, as well as concrete strategies for recruitment and support.
Conflict and Compatibility? Developmental Idealism and Gendered Differences in Marital Choice
Authors: Allendorf Keera 
Published: August 2016

AbstractDevelopmental idealism (DI) theory suggests that individuals who endorse DI schemas about marriage are more likely to choose their own spouses and do so for love. Such DI schemas conflict with South Asian gender schemas about marriage for women, but not for men. In turn, such conflict and compatibility may create gender differences in incorporating DI into expectations and experiences of marital choice and love in South Asia. Connections between endorsing DI as an abstract model of the world and using DI as a concrete guide for marriage may also differ by gender. Using survey data from Nepal, the author finds that men are more likely than women to expect to choose their own spouse and do so for love. Their parents' expectations show the same gender differences. Men are also more likely to choose their own spouses in practice. Connections between abstract and concrete DI are not stronger among men though.
Performance, metabolic variables and enteric methane production of Santa Inês hair lambs fed Orbignya phalerata and Combretum leprosum
Authors: Abdalla Filho A. L. , Dineshkumar D. , Barreal M. , McManus C. , Vasconcelos V. R. , Abdalla A. L. , Louvandini H. 
Published: August 2016

SummaryIn this study, the possibility of using Babassu (Orbignya phalerata) and Mofumbo (Combretum leprosum) leaves for lambs feed was verified. Performance, biochemical and haematological parameters, microbial protein synthesis, nutrient apparent digestibility and enteric production of methane (CH4) were evaluated. The experimental treatments included diets with forage‐to‐concentrate ratios of 50:50, with the leaves of the experimental plants replacing 33% of the Cynodon dactylon (Tifton‐85) hay with three treatments: control (no hay replacement) and substitution with Babassu or Mofumbo. For the performance study, 24 Santa Inês lambs were used, in a randomized experimental design with eight repetitions (5 male and 3 female) for each treatment and 48 days of experimental trial. After this period, for nine days, six animals from each treatment were allocated in metabolic cages to determine the apparent nutrient digestibility, microbial protein synthesis and nitrogen balance. Simultaneously, enteric CH4 was measured in vivo. The control group showed higher (p < 0.05) apparent digestibility of acid detergent fibre. Enteric CH4 production of lambs fed Mofumbo leaves did not differ from that of the control group, but was lower (p < 0.05) than in those fed with Babassu. The inclusion of Babassu and Mofumbo leaves showed no negative effects on animal health and did not compromise performance. Mofumbo also presented CH4 mitigating potential, indicating that those plants can be used as ingredients in the composition of lamb diets with the advantage of reducing methane production.