bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of two case definitions to identify pressure ulcers using hospital administrative data
Authors: Ho Chester , Jiang Jason , Eastwood Cathy A , Wong Holly , Weaver Brittany , Quan Hude 
Published: August 2017

ObjectivePressure ulcer development is a quality of care indicator, as pressure ulcers are potentially preventable. Yet pressure ulcer is a leading cause of morbidity, discomfort and additional healthcare costs for inpatients. Methods are lacking for accurate surveillance of pressure ulcer in hospitals to track occurrences and evaluate care improvement strategies. The main study aim was to validate hospital discharge abstract database (DAD) in recording pressure ulcers against nursing consult reports, and to calculate prevalence of pressure ulcers in Alberta, Canada in DAD. We hypothesised that a more inclusive case definition for pressure ulcers would enhance validity of cases identified in administrative data for research and quality improvement purposes.SettingA cohort of patients with pressure ulcers were identified from enterostomal (ET) nursing consult documents at a large university hospital in 2011.ParticipantsThere were 1217 patients with pressure ulcers in ET nursing documentation that were linked to a corresponding record in DAD to validate DAD for correct and accurate identification of pressure ulcer occurrence, using two case definitions for pressure ulcer.ResultsUsing pressure ulcer definition 1 (7 codes), prevalence was 1.4%, and using definition 2 (29 codes), prevalence was 4.2% after adjusting for misclassifications. The results were lower than expected. Definition 1 sensitivity was 27.7% and specificity was 98.8%, while definition 2 sensitivity was 32.8% and specificity was 95.9%. Pressure ulcer in both DAD and ET consultation increased with age, number of comorbidities and length of stay.ConclusionDAD underestimate pressure ulcer prevalence. Since various codes are used to record pressure ulcers in DAD, the case definition with more codes captures more pressure ulcer cases, and may be useful for monitoring facility trends. However, low sensitivity suggests that this data source may not be accurate for determining overall prevalence, and should be cautiously compared with other prevalence studies.
Brain stimulation for arm recovery after stroke (B-STARS): protocol for a randomised controlled trial in subacute stroke patients
Authors: van Lieshout Eline C C , Visser-Meily Johanna M A , Neggers Sebastiaan F W , van der Worp H Bart , Dijkhuizen Rick M 
Published: August 2017

IntroductionMany patients with stroke have moderate to severe long-term sensorimotor impairments, often including inability to execute movements of the affected arm or hand. Limited recovery from stroke may be partly caused by imbalanced interaction between the cerebral hemispheres, with reduced excitability of the ipsilesional motor cortex while excitability of the contralesional motor cortex is increased. Non-invasive brain stimulation with inhibitory repetitive transcranial magnetic stimulation (rTMS) of the contralesional hemisphere may aid in relieving a post-stroke interhemispheric excitability imbalance, which could improve functional recovery. There are encouraging effects of theta burst stimulation (TBS), a form of TMS, in patients with chronic stroke, but evidence on efficacy and long-term effects on arm function of contralesional TBS in patients with subacute hemiparetic stroke is lacking.Methods and analysisIn a randomised clinical trial, we will assign 60 patients with a first-ever ischaemic stroke in the previous 7–14 days and a persistent paresis of one arm to 10 sessions of real stimulation with TBS of the contralesional primary motor cortex or to sham stimulation over a period of 2 weeks. Both types of stimulation will be followed by upper limb training. A subset of patients will undergo five MRI sessions to assess post-stroke brain reorganisation. The primary outcome measure will be the upper limb function score, assessed from grasp, grip, pinch and gross movements in the action research arm test, measured at 3 months after stroke. Patients will be blinded to treatment allocation. The primary outcome at 3 months will also be assessed in a blinded fashion.Ethics and disseminationThe study has been approved by the Medical Research Ethics Committee of the University Medical Center Utrecht, The Netherlands. The results will be disseminated through (open access) peer-reviewed publications, networks of scientists, professionals and the public, and presented at conferences.Trial registration numberNTR6133
Multiple common and rare variants ofABCG2cause gout
Authors: Higashino Toshihide , Takada Tappei , Nakaoka Hirofumi , Toyoda Yu , Stiburkova Blanka , Miyata Hiroshi , Ikebuchi Yuki , Nakashima Hiroshi , Shimizu Seiko , Kawaguchi Makoto , Sakiyama Masayuki , Nakayama Akiyoshi , Akashi Airi , Tanahashi Yuki , Kawamura Yusuke , Nakamura Takahiro , Wakai Kenji , Okada Rieko , Yamamoto Ken , Hosomichi Kazuyoshi , Hosoya Tatsuo , Ichida Kimiyoshi , Ooyama Hiroshi , Suzuki Hiroshi , Inoue Ituro , Merriman Tony R , Shinomiya Nariyoshi , Matsuo Hirotaka 
Published: August 2017

ObjectivePrevious studies have suggested an association between gout susceptibility and common dysfunctional variants in ATP-binding cassette transporter subfamily G member 2/breast cancer resistance protein (ABCG2/BCRP), including rs72552713 (Q126X) and rs2231142 (Q141K). However, the association of rareABCG2variants with gout is unknown. Therefore, we investigated the effects of rareABCG2variants on gout susceptibility in this study.MethodsWe sequenced the exons ofABCG2in 480 patients with gout and 480 healthy controls (Japanese males). We also performed functional analyses of non-synonymous variants ofABCG2and analysed the correlation between urate transport function and scores from the protein prediction algorithms (Sorting Intolerant from Tolerant (SIFT) and Polymorphism Phenotyping v2 (PolyPhen-2)). Stratified association analyses and multivariate logistic regression analysis were performed to evaluate the effects of rare and commonABCG2variants on gout susceptibility.ResultsWe identified 3 common and 19 rare non-synonymous variants ofABCG2. SIFT scores were significantly correlated with the urate transport function, although someABCG2variants showed inconsistent scores. When the effects of common variants were removed by stratified association analysis, the rare variants ofABCG2were associated with a significantly increased risk of gout (OR=3.2, p=6.4×10−3). Multivariate logistic regression analysis revealed that the size effect of these rareABCG2variants (OR=2.7, p=3.0×10−3) was similar to that of the common variants, Q126X (OR=3.4, p=3.2×10−6) and Q141K (OR=2.3, p=2.7×10−16).ConclusionsThis study revealed that multiple common and rare variants ofABCG2are independently associated with gout. These results could support both the ‘Common Disease, Common Variant’ and ‘Common Disease, Multiple Rare Variant’ hypotheses for the association betweenABCG2and gout susceptibility.
Relationship between shift work and the onset of rheumatoid arthritis
Authors: Hedström Anna Karin , Åkerstedt Torbjörn , Klareskog Lars , Alfredsson Lars 
Published: August 2017

BackgroundEnvironmental factors play a prominent role in rheumatoid arthritis (RA) aetiology. Shift work has previously been associated with increased RA risk in females. The aim of this study was to investigate the potential association, including a dose–response association, between permanent night shift work, rotating shift work and day-oriented shift work and risk of developing anticitrullinated peptide antibodies (ACPA)-positive and ACPA-negative RA.MethodsThe present report is based on a population-based, case–control study with incident cases of RA (1951 cases and 2225 controls matched by age, gender and residential area). Using logistic regression, occurrence of RA among subjects who have been exposed to different kinds of shift work was compared with that among those who have never been exposed by calculating the OR with a 95% CI.ResultsRotating shift work and day-oriented shift work increased the risk of developing ACPA-positive RA (OR 1.3, 95% CI 1.0 to 1.7 and OR 1.3, 95% CI 1.0 to 1.6), but not ACPA-negative RA. Permanent night shift work appeared to be a protective factor both against ACPA-positive RA (OR 0.7, 95% CI 0.6 to 0.9) and ACPA-negative RA (OR 0.8, 95% CI 0.6 to 1.0). For both subsets of RA, significant trends showed a lower risk of developing RA with increasing duration of permanent night shift work (p value for trend 0.002 vs 0.04).ConclusionsSleep restriction as a consequence of shift work is associated with several biological effects among which changes in melatonin production may be involved. The present epidemiological findings of a complex relationship between sleep patterns and different forms of RA may be of importance for increasing the understanding of the pathophysiology of RA.
Geo-epidemiology of temporal artery biopsy-positive giant cell arteritis in Australia and New Zealand: is there a seasonal influence?
Authors: De Smit Elisabeth , Clarke Linda , Sanfilippo Paul G , Merriman Tony R , Brown Matthew A , Hill Catherine L , Hewitt Alex W 
Published: August 2017

ObjectivePrevious studies, although inconclusive, have suggested possible associations of environmental risk factors with the development of giant cell arteritis (GCA). We aim to investigate seasonal influence on the incidence of GCA across Australia and New Zealand.MethodsIn establishing an international study to investigate the molecular aetiology of GCA, archived temporal artery biopsy (TAB) specimens primarily from Australia and New Zealand were obtained. Demographic details including age, sex and date of TAB were collected from collaborating pathology departments. The season in which GCA was diagnosed was determined and compared with previous reports investigating the association between environmental risk factors and GCA.ResultsOur study comprises data from 2224 TAB-positive patients with GCA; 2099 of which were from patients in Australia and New Zealand. The mean age at time of diagnosis was 76.4 years of age. The female-to-male ratio was 2.2:1. We noted equal distribution of the incidence rate across all four seasons (530–580 cases diagnosed every quarter). Statistical analysis of seasonal variation by Poisson regression and cosinor methods showed no incidence preponderance across seasons. Our results do not support a seasonal component contributing to the onset of disease. Our literature search identifies no consistent environmental risk factor in association with GCA.ConclusionThis is the largest GCA data set reported outside of Europe. Our results demonstrate equal distribution of the incidence rate across all four seasons. In contrast to some earlier reports, we did not identify evidence of a seasonal component contributing to the onset of disease.
Metal worker’s lung: spatial association with Mycobacterium avium
Authors: James Phillip L , Cannon Julie , Barber Christopher M , Crawford Laura , Hughes Heather , Jones Meinir , Szram Joanna , Cowman Steven , Cookson William O C , Moffatt Miriam F , Cullinan Paul 
Published: August 2017

BackgroundOutbreaks of hypersensitivity pneumonitis (HP) are not uncommon in workplaces where metal working fluid (MWF) is used to facilitate metal turning. Inhalation of microbe-contaminated MWF has been assumed to be the cause, but previous investigations have failed to establish a spatial relationship between a contaminated source and an outbreak.ObjectivesAfter an outbreak of five cases of HP in a UK factory, we carried out blinded, molecular-based microbiological investigation of MWF samples in order to identify potential links between specific microbial taxa and machines in the outbreak zone.MethodsCustom-quantitative PCR assays, microscopy and phylogenetic analyses were performed on blinded MWF samples to quantify microbial burden and identify potential aetiological agents of HP in metal workers.Measurements and main resultsMWF from machines fed by a central sump, but not those with an isolated supply, was contaminated by mycobacteria. The factory sump and a single linked machine at the centre of the outbreak zone, known to be the workstation of the index cases, had very high levels of detectable organisms. Phylogenetic placement of mycobacterial taxonomic marker genes generated from these samples indicated that the contaminating organisms were closely related to Mycobacterium avium.ConclusionsWe describe, for the first time, a close spatial relationship between the abundance of a mycobacterium-like organism, most probably M. avium, and a localised outbreak of MWF-associated HP. The further development of sequence-based analytic techniques should assist in the prevention of this important occupational disease.
Successful medical management of cutaneousNocardiaspecies infection in a dog receiving ciclosporin (Atopica)
Authors: Ho Karen , Kennis Bob , Sandey Maninder , White Amelia 
Published: August 2017

A two‐year‐old male castrated Shiba Inu with atopic dermatitis presented to the Small Animal Teaching Hospital with a one‐month history of swelling, lameness and crusting on the plantar aspect of the paw of the left hindlimb. At presentation, he was receiving subcutaneous injections of allergen‐specific immunotherapy and oral ciclosporin at 4.3 mg/kg daily for the past 8 and 19 months, respectively. Tissue aerobic culture and susceptibility revealedNocardiaspecies susceptible to multiple antimicrobials. This dog was treated with topical antiseptic and sulphadimethoxine/ormetoprim (Primor). The swelling improved after one week and the dermatological lesions resolved after three months. Fifteen months after resolution of the nocardiosis infection the dog remains in remission. This is a case report describing the successful medical management of cutaneous nocardiosis in a dog with atopic dermatitis receiving daily oral ciclosporin therapy.
A survey of current practices and influences on the choice of suture material, pattern and size used in commonly performed procedures in UK small animal veterinary practice
Authors: Field Elinor Jo , Hebert Suzanna , Friend Ed J , Parsons Kevin J 
Published: August 2017

ObjectivesA survey of UK veterinarians was conducted to determine factors influencing suture choice and current suture practice for common surgical procedures.MethodsAn online survey was designed and the survey was sent to central practice emails obtained from the 2011 Royal College of Veterinary Surgeons (RCVS) practice database.ResultsTwo hundred and thirty‐nine surveys were completed (203 with no additional postgraduate qualifications (NAQ), 16 with RCVS certificates and 19 with diplomas). Forty‐seven per cent of veterinary surgeons reported they would benefit from Continued Professional Development (CPD) pertaining to suture material selection and techniques. The NAQ group ranked practice policy, colleague influence, cost of suture material and undergraduate teaching significantly greater than diploma and certificate holders. The widest differences between suture material selection, pattern and size were identified when comparing diploma holders and the NAQ group. Diploma holders tended to choose smaller sized suture material when compared with the NAQ group.Clinical significanceIn conclusion, postgraduate qualifications have a significant effect on the choice, pattern and size of suture material used for many routine surgical procedures. Findings suggest that further postgraduate training pertaining to the selection and use of suture material is worthwhile and improved guidance of choice of suture material for commonly performed surgical procedures may be beneficial.
Macrophages Facilitate Resistance to Anti-VEGF Therapy by Altered VEGFR Expression
Authors: Dalton Heather J. , Pradeep Sunila , McGuire Michael , Hailemichael Yared , MA Shaolin , Lyons Yasmin , Armaiz-Pena Guillermo N. , Previs Rebecca A. , Hansen Jean Marie , Rupaimoole Rajesha , Gonzalez-Villasana Vianey , Cho Min Soon , Wu Sherry Y. , Mangala Lingegowda S. , Jennings Nicholas B. , Hu Wei , Langley Robert , Mu Hong , Andreeff Michael , Bar-Eli Menashe , Overwijk Willem , Ram Prahlad , Lopez-Berestein Gabriel , Coleman Robert L. , Sood Anil K. 
Published: August 2017

Abstract
Purpose: VEGF-targeted therapies have modest efficacy in cancer patients, but acquired resistance is common. The mechanisms underlying such resistance are poorly understood.
Experimental Design: To evaluate the potential role of immune cells in the development of resistance to VEGF blockade, we first established a preclinical model of adaptive resistance to anti-VEGF therapy. Additional in vitro and in vivo studies were carried out to characterize the role of macrophages in such resistance.
Results: Using murine cancer models of adaptive resistance to anti-VEGF antibody (AVA), we found a previously unrecognized role of macrophages in such resistance. Macrophages were actively recruited to the tumor microenvironment and were responsible for the emergence of AVA resistance. Depletion of macrophages following emergence of resistance halted tumor growth and prolonged survival of tumor-bearing mice. In a macrophage-deficient mouse model, resistance to AVA failed to develop, but could be induced by injection of macrophages. Downregulation of macrophage VEGFR-1 and VEGFR-3 expression accompanied upregulation of alternative angiogenic pathways, facilitating escape from anti-VEGF therapy.
Conclusions: These findings provide a new understanding of the mechanisms underlying the modest efficacy of current antiangiogenesis therapies and identify new opportunities for combination approaches for ovarian and other cancers. Clin Cancer Res; 23(22); 7034–46. ©2017 AACR.
The Antitumor Effects of Vaccine-Activated CD8+ T Cells Associate with Weak TCR Signaling and Induction of Stem-Like Memory T Cells
Authors: Wu Sha , Zhu Wei , Peng Yibing , Wang Lan , Hong Yuan , Huang Lei , Dong Dayong , Xie Junping , Merchen Todd , Kruse Edward , Guo Zong Sheng , Bartlett David , Fu Ning , He Yukai 
Published: August 2017

AbstractTo understand why vaccine-activated tumor-specific T cells often fail to generate antitumor effects, we studied two α-fetoprotein–specific CD8+ T cells (Tet499 and Tet212) that had different antitumor effects. We found that Tet499 required high antigen doses for reactivation, but could survive persistent antigen stimulation and maintain their effector functions. In contrast, Tet212 had a low threshold of reactivation, but underwent exhaustion and apoptosis in the presence of persistent antigen. In vivo, Tet499 cells expanded more than Tet212 upon reencountering antigen and generated stronger antitumor effects. The different antigen responsiveness and antitumor effects of Tet212 and Tet499 cells correlated with their activation and differentiation states. Compared with Tet212, the population of Tet499 cells was less activated and contained more stem-like memory T cells (Tscm) that could undergo expansion in vivo. The TCR signaling strength on Tet499 was weaker than Tet212, correlating with more severe Tet499 TCR downregulation. Weak TCR signaling may halt T-cell differentiation at the Tscm stage during immune priming and also explains why Tet499 reactivation requires a high antigen dose. Weak TCR signaling of Tet499 cells in the effector stage will also protect them from exhaustion and apoptosis when they reencounter persistent antigen in tumor lesion, which generates antitumor effects. Further investigation of TCR downregulation and manipulation of TCR signaling strength may help design cancer vaccines to elicit a mix of tumor-specific CD8+ T cells, including Tscm, capable of surviving antigen restimulation to generate antitumor effects. Cancer Immunol Res; 5(10); 908–19. ©2017 AACR.
Harmonic Elimination of Seven Level Inverter with Switching Pattern Reconfiguration Technique Using Hybrid BBO/MAS Algorithm
Authors: Kavitha R. , Thottungal Rani , R Brindha. 
Published: August 2017

<p>A hybrid optimization algorithm is proposed in this paper to find the optimum switching angles in a Cascaded Multilevel Inverter (CMLI). A seven level cascaded inverter is considered and optimum switching angles are found by hybrid Biogeographical Based Optimization search (BBO) / Mesh Adaptive Direct Search (MAS) algorithm. The fundamental frequency Selective Harmonic Elimination-Pulse Width Modulation (SHE-PWM) technique is applied in order to reduce the switching losses.Reconfiguration technique is also proposed to achieve harmonic elimination for entire Modulation index(M). The various performance indices like phase THD, line THD, lower order harmonics eliminated in a CMLI are calculated based on the optimized switching angles. A seven level CMLI is simulated in MATLAB/SIMULINK by using switching angles calculated from BBO/MAS algorithm and the FFT analysis of traditional SHE-PWM and reconfiguration SHE-PWM methods are compared and verified with the calculated values from BBO/MAS algorithm.</p>
Fully Transradial Versus Transfemoral Approach for Percutaneous Intervention of Coronary Chronic Total Occlusions Applying the Hybrid Algorithm
Authors: Bakker Erik Jan , Maeremans Joren , Zivelonghi Carlo , Faurie Benjamin , Avran Alexandre , Walsh Simon , Spratt James C. , Knaapen Paul , Hanratty Colm G. , Bressollette Erwan , Kayaert Peter , Bagnall Alan J. , Egred Mohaned , Smith David , McEntegart Margaret B. , Smith William H.T. , Kelly Paul , Irving John , Smith Elliot J. , Strange Julian W. , Dens Joseph , Agostoni Pierfrancesco 
Published: August 2017

Background—
Small observational studies demonstrate the feasibility of transradial approach for chronic total occlusion (CTO) percutaneous coronary intervention. The aim of the current study is to assess technical success, complication rates, and procedural efficiency in fully transradial approach (fTRA) and transfemoral approach (TFA) in a large prospective European registry adopting the hybrid algorithm for CTO percutaneous coronary intervention (Registry of CrossBoss and Hybrid Procedures in France, the Netherlands, Belgium and United Kingdom, RECHARGE registry).

Methods and Results—

We analyzed 1253 CTO percutaneous coronary intervention procedures performed according to the hybrid protocol in 17 European centers, comparing fTRA (single or biradial access) and TFA (single or bifemoral or combined radial and femoral access). fTRA was applied in 306 (24%) and TFA in 947 (76%) cases. The average Japanese CTO score was 2.1±1.2 in fTRA and 2.3±1.1 in TFA (
P
=0.06). Technical success was achieved in 85% in fTRA and 86% in TFA (
P
=0.51). Technical success was comparable for fTRA and TFA in different Japanese CTO score subgroups after multivariable analysis and after propensity adjustment. In-hospital major adverse cardiac and cerebral events occurred in 2.0% in fTRA and 2.9% in TFA (
P
=0.40). Major access site bleeding occurred in 0.3% in fTRA and 0.5% in TFA (
P
=0.66). fTRA compared with TFA had similar procedural duration (80 minutes [54–120 minutes] versus 90 minutes [60–121 minutes];
P
=0.07), similar radiation dose (dose area product 89 Gray×cm
2
[52–163 Gray×cm
2
] versus 101 Gray×cm
2
[59–171 Gray×cm
2
];
P
=0.06), and lower contrast agent use (200 mL [150–310 mL] versus 250 mL [200–350 mL];
P
<0.01).

Conclusions—
fTRA CTO percutaneous coronary intervention is a valid alternative to TFA with a high rate of success, low complication rates, and no decrease in procedural efficiency.