bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cluster Headache With Accompanying Migraine‐Like Features: A Possible Clinical Phenotype
Authors: Taga Arens , Russo Marco , Manzoni Gian Camillo , Torelli Paola 
Published: November 2016

BackgroundThere are limited literature data on migraine‐like accompanying features (MLF) in patients with cluster headache (CH). These symptoms are frequently reported by patients and may delay CH diagnosis.ObjectiveThe aim of the present study was to investigate the occurrence of migraine‐like symptoms in an Italian case series of CH patients and to determine whether these features influence the clinical phenotype of CH.MethodsA cross‐sectional study was performed in all consecutive patients referred to the Parma Headache Centre between 1975 and 2013 affected by CH; the cases were subsequently reviewed applying the ICHD3‐beta criteria. Our initial study sample consisted of 785 subjects, 569 men (72.5%) and 216 women (27.5%). We then identified those patients who reported at least one of the migraine accompanying symptoms (ie, nausea or vomiting or photophobia and phonophobia).ResultsWe found 362 patients (46%) with MLF, 250 men (43.9% of the initial male sample) and 112 women (51.9% of the initial female sample), and 423 patients (54%) without MLF, 319 men (56.1% of the initial male sample) and 104 women (48.1% of the initial female sample). Multiple logistic regression analysis highlighted some demographic and clinical features that significantly characterized patients with MLF after adjusting for confounding: they were more frequently female (OR 1.78, CI 1.11–2.80), with a relatively younger age of onset (OR 1.82, CI 1.06–2.91) than expected, attacks were longer in duration (OR 1.85, CI 1.04–2.46) and accompanied by a more frequent ptosis (OR 1.67, CI 1.04–2.34), sweating (OR 1.63, CI 1.02–2.21), and miosis (OR 1.54, CI 1.12–1.93); osmophobia was also more frequently reported (OR 1.76, CI 1.28–2.46).ConclusionOur study confirms the high proportion of CH patients with MLF, which is reported in literature. The presence of MLF seems to relate to some peculiar demographic and clinical characteristics of CH sufferers. Whether these features influence the response to therapy remains to be determined.
Postural Headaches Due to Cerebrospinal Fluid Leakage Through Subarachnoid‐Pleural Fistula: A Case Report
Authors: Lin Sheng‐Feng , Weng Hsing‐Yu 
Published: November 2016

BackgroundPostural headaches are commonly associated with spontaneous intracranial hypotension and cerebrospinal fluid (CSF) leakage from the spine. A subarachnoid‐pleural fistula (SPF) is a very rare and serious type of CSF fistula that has mostly been reported following traumatic causes.Case ReportHere, the case of a 36‐year‐old woman who suffered from postural headaches after chiropractic manipulation of her neck was reported. Brain and spinal magnetic resonance (MR) imaging showed brain sagging, a C7‐T1 dural defect, and overt CSF leakage. Heavy T2‐weighted MR myelography revealed paravertebral fluid collections, communicating with pleural effusions through bilateral SPFs. The postural headaches were relieved by 3 courses of epidural blood patches.DiscussionsFrom the patient's history, her severe SPFs were attributed to rupture of the spinal leptomeninges during vigorous chiropractic manipulation of her neck. Heavy T2‐weighted MR myelography could delineate the route of SPFs and CSF leakages.
Post‐treatment levels of α‐fetoprotein predict long‐term hepatocellular carcinoma development after sustained virological response in patients with hepatitis C
Authors: Tada Toshifumi , Kumada Takashi , Toyoda Hidenori , Kiriyama Seiki , Tanikawa Makoto , Hisanaga Yasuhiro , Kanamori Akira , Kitabatake Shusuke , Yama Tsuyoki , Tanaka Junko 
Published: November 2016

AimThe rate of hepatocellular carcinoma (HCC) development is reportedly lower in patients with chronic hepatitis C virus (HCV) who have achieved a sustained virological response (SVR) than in patients who were unresponsive to therapy. However, the development of HCC is sometimes observed in patients with SVR. Therefore, we clarified the predictive power of clinical factors for HCC incidence in patients with SVR using receiver operating characteristic (ROC) curve analysis that takes time dependence into account.MethodsA total of 571 patients with HCV who achieved SVR with interferon‐based therapy were enrolled. Univariate and multivariate Cox proportional hazards models and time‐dependent ROC curves were used to analyze clinical factors associated with the development of HCC.ResultsTwenty‐four patients developed HCC during the follow‐up period (median duration, 9.0 years). The 5‐, 10‐, 15‐, and 20‐year cumulative incidence rates for HCC were 1.7%, 4.8%, 5.8%, and 6.6%, respectively. Multivariate Cox proportional hazards models showed that older age (hazard ratio [HR], 3.648), male sex (HR, 7.560), lower platelet count at 24 weeks after the end of treatment (SVR24) (HR, 3.939), and higher α‐fetoprotein (AFP) at SVR24 (HR, 3.630) were independently associated with HCC development. In addition, time‐dependent ROC analysis showed that, compared to platelet count at SVR24, AFP at SVR24 had higher predictive power for HCC incidence approximately 7 years after SVR.ConclusionsElevated AFP at SVR24 is a risk factor for HCC in patients with HCV, even those who achieve SVR. α‐Fetoprotein is a good predictor of HCC development.
Assessing understanding of individual risk and symptoms of progressive multifocal leukoencephalopathy in patients prescribed natalizumab for multiple sclerosis
Authors: Rath Louise , Vijiaratnam Nirosen , Skibina Olga 
Published: November 2016

BackgroundNatalizumab, a monoclonal antibody directed against α4 integrin, is a highly efficacious treatment commonly used in relapsing remitting multiple sclerosis. Natalizumab is associated with the potentially fatal, rare, demyelinating, opportunistic brain infection, progressive multifocal leukoencephalopathy (PML). Prognosis and disability from PML are determined by early diagnosis.AimsWritten tools are mandated in Australia and other prescribing countries with the aim to help patients understand the risks associated with treatment and ensure familiarity with the early symptoms of PML. We aimed to assess if these tools achieve such an outcome.MethodsA cross‐sectional survey was conducted using a convenience sample of multiple sclerosis patients prescribed natalizumab presenting to the infusion centre at a major tertiary hospital. Patients were offered a multi‐choice questionnaire to assess their knowledge on the treatment risks and surveillance requirements of their therapy. Three specific questions were highlighted by the researchers as crucial to patient understanding of PML and defined as basic knowledge.ResultsA total of 48 patients in our hospital was prescribed natalizumab; 37 responded. A total of 16 (43.2%) patients answered all three basic knowledge questions correctly. There was no difference in the ability to answer these questions based on length of treatment or co‐ownership knowledge between patients with base knowledge and without.ConclusionNatalizumab is associated with an increased risk of PML. Early detection and treatment of PML results in improved patient outcomes. Patient knowledge and co‐partnership in the utilisation of PML risk tools is relevant in ensuring early detection. Our findings question the ability of currently sanctioned tools to inform patients of basic knowledge of PML and their risk of developing PML. A future study with a repetitive education approach and repeating the questionnaire at multiple time points would be of interest.
Ferroptosis, a new form of cell death, and its relationships with tumourous diseases
Authors: Yu Haitao , Guo Pengyi , Xie Xiaozai , Wang Yi , Chen Gang 
Published: November 2016

AbstractFerroptosis is a newly discovered type of cell death that differs from traditional apoptosis and necrosis and results from iron‐dependent lipid peroxide accumulation. Ferroptotic cell death is characterized by cytological changes, including cell volume shrinkage and increased mitochondrial membrane density. Ferroptosis can be induced by two classes of small‐molecule substances known as class 1 (system Xc− inhibitors) and class 2 ferroptosis inducers [glutathione peroxidase 4 (GPx4) inhibitors]. In addition to these small‐molecule substances, a number of drugs (e.g. sorafenib, artemisinin and its derivatives) can induce ferroptosis. Various factors, such as the mevalonate (MVA) and sulphur‐transfer pathways, play pivotal roles in the regulation of ferroptosis. Ferroptosis plays an unneglectable role in regulating the growth and proliferation of some types of tumour cells, such as lymphocytoma, ductal cell cancer of the pancreas, renal cell carcinoma (RCC) and hepatocellular carcinoma (HCC). Here, we will first introduce the discovery of and research pertaining to ferroptosis; then summarize the induction mechanisms and regulatory pathways of ferroptosis; and finally, further elucidate the roles of ferroptosis in human tumourous diseases.
Externalizing problems in childhood and adolescence predict subsequent educational achievement but for different genetic and environmental reasons
Authors: Lewis Gary J. , Asbury Kathryn , Plomin Robert 
Published: November 2016

BackgroundChildhood behavior problems predict subsequent educational achievement; however, little research has examined the etiology of these links using a longitudinal twin design. Moreover, it is unknown whether genetic and environmental innovations provide incremental prediction for educational achievement from childhood to adolescence.MethodsWe examined genetic and environmental influences on parental ratings of behavior problems across childhood (age 4) and adolescence (ages 12 and 16) as predictors of educational achievement at age 16 using a longitudinal classical twin design.ResultsShared‐environmental influences on anxiety, conduct problems, and peer problems at age 4 predicted educational achievement at age 16. Genetic influences on the externalizing behaviors of conduct problems and hyperactivity at age 4 predicted educational achievement at age 16. Moreover, novel genetic and (to a lesser extent) nonshared‐environmental influences acting on conduct problems and hyperactivity emerged at ages 12 and 16, adding to the genetic prediction from age 4.ConclusionsThese findings demonstrate that genetic and shared‐environmental factors underpinning behavior problems in early childhood predict educational achievement in midadolescence. These findings are consistent with the notion that early‐childhood behavior problems reflect the initiation of a life‐course persistent trajectory with concomitant implications for social attainment. However, we also find evidence that genetic and nonshared‐environment innovations acting on behavior problems have implications for subsequent educational achievement, consistent with recent work arguing that adolescence represents a sensitive period for socioaffective development.
Development and validation of an eye care educational programme for intensive care unit nurses
Authors: Cho Ok‐Hee , Yoo Yang‐Sook , Yun Sun‐Hee , Hwang Kyung‐Hye 
Published: November 2016

Aims and objectivesTo develop and validate an eye care educational programme for intensive care unit nurses.BackgroundEye care guidelines and protocols have been developed for increasing eye care implementation in intensive care units. However, the guidelines lack consistency in assessment or intervention methodology.DesignThis was a one‐sample pre/postprogramme evaluation study design for testing the effects of the eye care educational programme, developed for and applied to intensive care unit nurses, on their levels of knowledge and awareness.MethodsThe eye care educational programme was developed based on literature review and survey of educational needs. Thirty intensive care unit nurses served as subjects for the study.ResultsThe levels of eye care‐related knowledge, awareness and practice were enhanced following the implementation of the educational programme. Moreover, satisfaction with the educational programme was high.ConclusionIt is necessary to intensify eye care education aimed at new nurses who are inexperienced in intensive care unit nursing and provide continuing education on the latest eye care methods and information to experienced nurses.Relevance to clinical practiceThe eye care educational programme developed in this study can be used as a strategy to periodically assess the eye status of patients and facilitate the appropriate eye care.
Concept analysis of safety climate in healthcare providers
Authors: Lin Ying‐Siou , Lin Yen‐Chun , Lou Meei‐Fang 
Published: November 2016

Aim and objectiveTo report an analysis of the concept of safety climate in healthcare providers.BackgroundCompliance with safe work practices is essential to patient safety and care outcomes. Analysing the concept of safety climate from the perspective of healthcare providers could improve understanding of the correlations between safety climate and healthcare provider compliance with safe work practices, thus enhancing quality of patient care.DesignConcept analysis.Data sourcesThe electronic databases of CINAHL, MEDLINE, PubMed and Web of Science were searched for literature published between 1995–2015. Searches used the keywords ‘safety climate’ or ‘safety culture’ with ‘hospital’ or ‘healthcare’.MethodThe concept analysis method of Walker and Avant analysed safety climate from the perspective of healthcare providers.ResultsThree attributes defined how healthcare providers define safety climate: (1) creation of safe working environment by senior management in healthcare organisations; (2) shared perception of healthcare providers about safety of their work environment; and (3) the effective dissemination of safety information. Antecedents included the characteristics of healthcare providers and healthcare organisations as a whole, and the types of work in which they are engaged. Consequences consisted of safety performance and safety outcomes. Most studies developed and assessed the survey tools of safety climate or safety culture, with a minority consisting of interventional measures for improving safety climate.ConclusionMore prospective studies are needed to create interventional measures for improving safety climate of healthcare providers. This study is provided as a reference for use in developing multidimensional safety climate assessment tools and interventional measures.Relevance to clinical practiceThe values healthcare teams emphasise with regard to safety can serve to improve safety performance. Having an understanding of the concept of and interventional measures for safety climate allows healthcare providers to ensure the safety of their operations and their patients.
Prevalence of head injury and medically diagnosed concussion in junior‐level community‐based Australian Rules Football
Authors: Hecimovich Mark D , King Doug 
Published: November 2016

AimFor junior‐level Australian Rules Football there is a paucity of head injury and concussion surveillance data; thus, the primary aim was to document head injury and concussion incidence in participants aged 9–17 years with a secondary aim to identify the mechanism‐of‐injury.MethodsA prospective cohort study in which a designated representative for each of the 41 teams recorded on a weekly basis the number of head injuries suspected of being a concussion, diagnosed concussions and the mechanism‐of‐injury during competition games over the course of a 12‐game season. For analysis three groups were formed – number of Player‐Seasons, Athlete‐Exposures, head injury and concussion incidence per 1000 Athlete‐Exposures – and were calculated. Narrative data was categorised.ResultsThere was 13 reported head injuries resulting in seven concussions in the sample population (n = 976). The incidence rates for head injury and concussion were 1.1 (95% confidence interval: 0.5–1.7) and 0.59 (95% confidence interval: 0.2–1.0) per 1000 Athlete‐Exposures. There were four head injuries resulting in two concussions in the 12–13‐year‐old group and nine head injuries and five concussions in the 14–17‐year‐old group. Two categories emerged for mechanism‐of‐injury: player‐to‐surface and player‐to‐player, with 9 of the 13 head injuries resulting from player‐to‐player contact.ConclusionsThe incidence rates were similar in the two older groups and lower in comparison with American football and rugby. The data collected have advanced our knowledge of head injury incidence and established baseline data which to compare in future years and may assist in development of preventative measures.
Retrograde continence enema in children with spina bifida: Not as effective as first thought
Authors: King Sebastian K , Stathopoulos Lefteris , Pinnuck Loreto , Wells Judy , Hutson John , Heloury Yves 
Published: November 2016

AimThe aim of the study is to investigate the effectiveness of Peristeen retrograde continence enema (RCE) in the management of faecal incontinence in children with spina bifida.MethodsWe identified a homogenous group of spina bifida patients in whom RCE was initiated (Jan 2006–July 2013). Confidential assessments included (i) Fecal Incontinence Quality Of Life (FIQOL), (ii) St Marks Faecal Incontinence score, (iii) Cleveland Clinic Constipation score and (iv) Neurogenic Bowel Dysfunction score.ResultsOf 20 patients, 11 (mean age 14.5 ± 5.3 years) were male. Of 20 patients, nine were still using RCE (mean follow‐up 4.1 years). Three patients ceased RCE within 10 days, six after 4–12 months and two after 36–48 months. Reasons for cessation included balloon difficulties (n = 4), procedure deemed too difficult (n = 4) and pain (n = 3).There were no differences between the groups in length of training time for technique, instillate fluid/volume used and time taken to perform RCE. There were no differences between the groups for quality of life, faecal incontinence or constipation scores.ConclusionsWe demonstrated a high rate of cessation with RCE in patients with spina bifida. This could not be explained by associated conditions, or by enema‐related parameters. One possible explanation is the lack of ongoing outpatient support for the children and their families.
Significant caries and the interactive effects of maternal‐related oral hygiene factors in urban preschool children
Authors: Lin Ying‐Chun , Wang Wen‐Chen , Chen Jen‐Hao , Chen Ping‐Ho , Lee Chien‐Hung , Huang Hsiao‐Ling 
Published: November 2016

AbstractObjectivesThis study examined significant caries (SiC) and the interactive effects of maternal‐related oral hygiene factors in urban preschool children.MethodsA cross‐sectional study was designed to collect data from a cluster of randomly selected samples in 2011. A total of 495 child‐mother pairs from the San‐Ming District of Kaohsiung City, Taiwan, participated in the study. Children aged 4‐6 years received dental examinations, and their mothers completed a self‐administered questionnaire. The SiC Index indicated the highest caries values in participants. The association between 3 groups – dmft (decayed, missing, and filled teeth)‐free, non‐SiC, and SiC – and the mothers’ and their children's factors were examined using polytomous logistic regression analysis.ResultsAmong the SiC children, caries experience was most frequent in the mandibular molars (64.5‐84.9 percent), and almost 50 percent of these children had central incisor caries. The significant factors associated with the SiC children were lower maternal self‐efficacy in oral hygiene [adjusted odds ratio (aOR) = 2.04], child's intake of sugar‐sweetened beverages (SSBs) more than once per day (aOR = 2.27), and irregular child dental checkups (aOR = 2.32). Significant interaction effects were detected among children who received irregular dental checkups and whose SSBs intake was more than once per day and whose mothers had lower self‐efficacy in oral hygiene (P for interaction term = 0.034 and 0.004, respectively).ConclusionsCaries prevention programs should prioritize enhancing maternal self‐efficacy in oral hygiene and emphasize childhood SSBs intake management and regular dental checkups to mothers to prevent severe caries in preschool‐aged children.
DYNAMIC DEFAULTABLE TERM STRUCTURE MODELING BEYOND THE INTENSITY PARADIGM
Authors: Gehmlich Frank , Schmidt Thorsten 
Published: November 2016

AbstractThe two main approaches in credit risk are the structural approach pioneered by Merton and the reduced‐form framework proposed by Jarrow and Turnbull and by Artzner and Delbaen. The goal of this paper is to provide a unified view on both approaches. This is achieved by studying reduced‐form approaches under weak assumptions. In particular, we do not assume the global existence of a default intensity and allow default at fixed or predictable times, such as coupon payment dates, with positive probability. In this generalized framework, we study dynamic term structures prone to default risk following the forward‐rate approach proposed by Heath, Jarrow, and Morton. It turns out that previously considered models lead to arbitrage possibilities when default can happen at a predictable time. A suitable generalization of the forward‐rate approach contains an additional stochastic integral with atoms at predictable times and necessary and sufficient conditions for an appropriate no‐arbitrage condition are given. For efficient implementations, we develop a new class of affine models that do not satisfy the standard assumption of stochastic continuity. The chosen approach is intimately related to the theory of enlargement of filtrations, for which we provide an example by means of filtering theory where the Azéma supermartingale contains upward and downward jumps, both at predictable and totally inaccessible stopping times.
EspC forms a filamentous structure in the cell envelope of Mycobacterium tuberculosis and impacts ESX‐1 secretion
Authors: Lou Ye , Rybniker Jan , Sala Claudia , Cole Stewart T. 
Published: November 2016

SummaryPathogenicity of Mycobacterium tuberculosis (M. tb) is mediated by the ESX‐1 secretion system, which exports EsxA and EsxB, the major virulence factors that are co‐secreted with EspA and EspC. Functional information about ESX‐1 components is scarce. Here, it was shown that EspC associates with EspA in the cytoplasm and membrane, then polymerizes during secretion from M. tb. EspC was localized by immuno‐gold electron microscopy in whole cells or cryosections as a surface‐exposed filamentous structure that seems to span the cell envelope. Consistent with these findings, purified EspC homodimerizes via disulphide bond formation, multimerizes and self‐assembles into long filaments in vitro. The C‐terminal domain is required for multimerization as truncation and selected point mutations therein impact EspC filament formation, thus reducing secretion of EsxA and causing attenuation of M. tb. The data are consistent with EspC serving either as a modulator of ESX‐1 function or as a component of the secretion apparatus.