bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of The Paris System to atypical urine cytology samples: correlation with histology and UroVysion® FISH
Authors: Miki Y. , Neat M. , Chandra A. 
Published: September 2016

ObjectivesTo evaluate whether atypical urine cytology cases may be stratified more objectively using The Paris System (TPS) and whether reclassified cases correlate with histology and UroVysion® results.MethodsAtypical urine cytology cases subjected to UroVysion® testing over a period of 6 years were reviewed. Each case was reclassified according to TPS and correlated with histology and UroVysion® results.ResultsA total of 91 cases were identified; 70.3% were reclassified as ‘negative for high‐grade urothelial carcinoma (HGUC)' and 14.3% as ‘atypical urothelial cells (AUC)’. The histological correlation was available in 45 cases. In the ‘negative for HGUC’ category, 67.9% had no histological evidence of malignancy, but 17.9% were diagnosed as HGUC. In the ‘AUC’ category, histology revealed urothelial carcinoma in 70% of the cases (of these, 71.4% were high grade). There was no histological evidence of malignancy in 30% of cases; notably, all of which were from patients under surveillance. The sensitivity and specificity of UroVysion® were 85.7% and 33.3% in the ‘AUC’ group and 62.5% and 100% in the ‘negative for HGUC’ group.ConclusionsThe Paris System is an objective template for reporting urine cytology specimens, and is particularly useful in identifying HGUC cases and refining the category of ‘AUC’.
Tricuspid annular plane systolic excursion in chronic thromboembolic pulmonary hypertension before and after pulmonary thromboendarterectomy
Authors: Wong Darrin J. , Sampat Unnati , Gibson Michael A. , Auger William R. , Madani Michael M. , Daniels Lori B. , Raisinghani Ajit B. , DeMaria Anthony N. , Blanchard Daniel G. 
Published: September 2016

BackgroundRight ventricular function is impaired in chronic thromboembolic pulmonary hypertension (CTEPH). Tricuspid annular plane systolic excursion (TAPSE) and right ventricular fractional area change (RVFAC) have been shown to help assess right ventricular function in pulmonary hypertension. Our goal was to (1) assess TAPSE and RVFAC before and after PTE, and (2) assess correlation of these variables with right heart catheterization data and PVR.MethodsWe evaluated 67 consecutive patients with CTEPH for pulmonary thromboendarterectomy (PTE). Of these 67 patients, 48 were deemed surgical candidates. Preoperative right heart catheterization was performed within 1.3±1.2 days of the preoperative echocardiogram. All postoperative right heart catheterizations were performed on the first postoperative day.ResultsTAPSE dropped from 18±6 to 10±3 mm after PTE (P<.0001). RVFAC remained the same (25%±10% vs 30%±12%). Mean pulmonary artery (mPAP) pressure dropped from 45±12 to 28±6 mm Hg after PTE, and pulmonary vascular resistance (PVR) decreased from 757±406 to 306±147 dyne‐s/cm5 (P<.0001 for both). Before PTE, TAPSE correlated inversely with PVR (r=−.57, P<.0001, TAPSE=−5.904×ln[PVR]+56.318). RVFAC did not correlate well with PVR or mean pulmonary artery pressure. After PTE, both TAPSE and RVFAC correlated poorly with PVR (r=−.12 and .01, respectively).ConclusionIn patients with CTEPH, TAPSE paradoxically decreased by 50% early after PTE. TAPSE correlated inversely with PVR prior to PTE, but this correlation was lost completely after PTE. Thus, despite the immediate and marked decrease in afterload postoperatively, TAPSE did not improve; thus, TAPSE cannot be used as an early marker for surgical success.
Early referral and comorbidity as possible causes of the declining transition rate in subjects at clinical high risk for psychosis
Authors: Lim Kyung‐Ok , Lee Tae Young , Kim Minah , Chon Myong‐Wuk , Yun Je‐Yeon , Kim Sung Nyun , Kwon Jun Soo 
Published: September 2016

AbstractAimA clinical high risk (CHR) for psychosis is regarded as the state of being at risk of developing psychosis. However, the rate of transition to psychosis among CHR subjects has been declining over time. We aimed to investigate the effects of the possible causes of the declining transition rate.MethodsA total of 129 CHR subjects were divided into two groups according to the date of enrollment: the 2005–2009 group and the 2009–2013 group. Baseline demographic and clinical characteristics, including medication prescription, were compared. The duration of untreated prodromal positive symptoms (DUPP) was used to account for early referral.ResultsThe transition rate to psychosis in the 2009–2013 group was significantly lower than that in the 2005–2009 group (χ2 = 4.664, P = 0.031), although the risk factors of transition, intelligence quotient and prodromal positive symptoms did not differ between the two groups. When the DUPP was added to the follow‐up duration, the between‐group difference in the transition rates was no longer significant; however, the P‐value was low (χ2 = 2.761, P = 0.097). After adjusting for axis II comorbidities other than schizotypal personality disorder, the effect of group division on the transition rate disappeared; however, the P‐value was also low (P = 0.072). The mean olanzapine equivalent dose and the proportion of subjects prescribed with antidepressant or anxiolytic did not differ between the two groups.ConclusionsEarly referral and axis II comorbidities other than schizotypal personality disorder were associated with the declining transition rate.
Muscle and motor neuron ciliary neurotrophic factor receptor α together maintain adult motor neuron axons in vivo
Authors: Lee Nancy , Serbinski Carolyn R. , Braunlin Makayla R. , Rasch Matthew S. , Rydyznski Carolyn E. , MacLennan A. John 
Published: September 2016

AbstractThe molecular mechanisms maintaining adult motor innervation are comparatively unexplored relative to those involved during development. In addition to the fundamental neuroscience question, this area has important clinical ramifications given that loss of neuromuscular contact is thought to underlie several adult onset human neuromuscular diseases including amyotrophic lateral sclerosis. Indirect evidence suggests that ciliary neurotrophic factor (CNTF) receptors may contribute to adult motor neuron axon maintenance. To directly address this in vivo, we used adult onset mouse genetic disruption techniques to deplete motor neuron and muscle CNTF receptor α (CNTFRα), the essential ligand binding subunit of the receptor, and incorporated reporters labelling affected motor neuron axons and terminals. The combined depletion of motor neuron and muscle CNTFRα produced a large loss of motor neuron terminals and retrograde labelling of motor neurons with FluoroGold indicated axon die‐back well beyond muscle, together revealing an essential role for CNTFRα in adult motor axon maintenance. In contrast, selective depletion of motor neuron CNTFRα did not affect motor innervation. These data, along with our previous work indicating no effect of muscle specific CNTFRα depletion on motor innervation, suggest that motor neuron and muscle CNTFRα function in concert to maintain motor neuron axons. The data also raise the possibility of motor neuron and/or muscle CNTFRα as therapeutic targets for adult neuromuscular denervating diseases.
Evidence for and cost‐effectiveness of physiotherapy in haemophilia: a Dutch perspective
Authors: de Kleijn P. , Mauser‐Bunschoten E. P. , Fischer K. , Smit C. , Holtslag H. , Veenhof C. 
Published: September 2016

IntroductionMusculoskeletal impact of haemophilia justifies physiotherapy throughout life. Recently the Dutch Health Care Institute constrained their ‘list of chronic conditions’, and withdrew financial coverage of physiotherapy for elderly persons with haemophilia (PWH). This decision was based on lack of scientific evidence and not being in accordance with ‘state of science and practice’.MethodsIn general, evidence regarding physiotherapy is limited, and especially in rare diseases like haemophilia. ‘Evidence based medicine’ classifies and recommends evidence based on meta‐analyses, systematic reviews and randomized controlled trials, but also means integrating evidence with individual clinical expertise. For the evaluation of physiotherapy – usually individualized treatment – case studies, observational studies and Case Based Reasoning may be more beneficial.ResultsOverall annual treatment costs for haemophilia care in the Netherlands are estimated over 100 million Euros, of which 95% is covered by clotting factor concentrates. The cost for physiotherapy assessments in all seven Dutch HTCs (seven centres for adult PWH and seven centres for children) is limited at approximately 500 000 Euros annually. Costs of the actual physiotherapy sessions, carried out in our Dutch first‐line care system, will also not exceed 500 000 Euros. Thus, implementation of physiotherapy in haemophilia care the Netherlands in a most optimal way would cost less than 1% of the total budget.AimThe present paper describes the role of physiotherapy in haemophilia care including available evidence and providing suggestions regarding generation of evidence. Establishing the effectiveness and cost‐effectiveness of physiotherapy in haemophilia care is a major topic for the next decennium.
Acceptability and feasibility of a social entrepreneurship testing model to promote HIV self‐testing and linkage to care among men who have sex with men
Authors: Zhong F , Tang W , Cheng W , Lin P , Wu Q , Cai Y , Tang S , Fan L , Zhao Y , Chen X , Mao J , Meng G , Tucker JD , Xu H 
Published: September 2016

ObjectivesHIV self‐testing (HIVST) offers an opportunity to increase HIV testing among people not reached by facility‐based services. However, the promotion of HIVST is limited as a consequence of insufficient community engagement. We built a social entrepreneurship testing (SET) model to promote HIVST linkage to care among Chinese men who have sex with men (MSM) in Guangzhou.MethodsThe SET model includes a few key steps. Each participant first completed an online survey, and paid a US$23 (refundable) deposit to receive an HIVST kit and a syphilis self‐testing (SST) kit. After the testing, the results were sent to the platform by the participants and interpreted by Center for Disease Control and Prevention (CDC) staff. Meanwhile, the deposit was returned to each participant. Finally, the Community based organizations (CBO) contacted the participants to provide counselling services, confirmation testing and linkage to care.ResultsDuring April−June 2015, a total of 198 MSM completed a preliminary survey and purchased self‐testing kits. The majority were aged < 34 years (84.4%) and met partners online (93.1%). In addition, 68.9% of participants had ever been tested for HIV, and 19.5% had ever performed HIVST. Overall, feedback was received from 192 participants (97.0%). Of these participants, 14 people did not use the kits; among those who did use the kits, the HIV and syphilis prevalences were 4.5% (eight of 178) and 3.7% (six of 178), respectively. All of the screened HIV‐positive individuals sought further confirmation testing and were linked to care.ConclusionsUsing an online SET model to promote HIV and syphilis self‐testing among Chinese MSM is acceptable and feasible, and this model adds a new testing platform to the current testing service system.
Analysis of polychlorinated biphenyls (PCBs), heavy metals and omega‐3 fatty acids in commercially available Korean functional fish oil supplements
Authors: Lee Jung‐Bin , Kim Mina K. , Kim Bo‐Kyung , Kim Jyung‐Youn , Lee Kwang‐Geun 
Published: September 2016

SummaryIn this study, the levels of polychlorinated biphenyls (PCBs), heavy metals and omega‐3 polyunsaturated fatty acids (docosahexaenoic acid; DHA and eicosapentaenoic acid; EPA), as well as chemical indices including acid and peroxide values were determined among twenty‐four commercially available functional fish oil supplements. The sum of indicator PCB congeners (congeners 28, 52, 101, 118, 138, 153 and 180) was below the limit of quantification of 0.043 mg kg−1. Metallic compounds (Cd, Pb, Hg and As) were not detected in all fish oil supplement samples. The relative percentages of EPA and DHA in fish oil supplements ranged from 25% to 80%. The acid values ranged from 0.1 to 1.4 mg KOH per g oil, and peroxide values ranged from 2.7 to 28.8 meq per kg oil. All fish oil supplement samples tested in current study met the safety standard for fish oil supplements set by Korean government as well as International standard.
Patient characteristics, interventions and outcomes of 1151 rapid response team activations in a tertiary hospital: a prospective study
Authors: White K. , Scott I. A. , Bernard A. , McCulloch K. , Vaux A. , Joyce C. , Sullivan C. M. 
Published: September 2016

BackgroundThe characteristics of mature contemporary rapid response systems are unclear.AimTo determine the patient characteristics, processes and outcomes, both in‐hospital and post‐discharge, of a well‐established rapid response system in a tertiary adult hospital.MethodsThis is a prospective study of consecutive rapid response team (RRT) activations between 1 July and 25 November 2015. Variables included patient characteristics, timing, location and triggers of RRT activations, interventions undertaken, mortality and readmission status at 28 days post‐discharge.ResultsA total of 1151 RRT activations was analysed (69.1 per 1000 admissions), involving 800 patients, of whom 81.5% were emergency admissions. A total of 351 (30.5%) activations comprised repeat activations for the same patient. Most activations (723; 62.8%) occurred out of hours, and 495 (43%) occurred within 48 h of admission. Hypotension, decreased level of consciousness and oxygen desaturation were the most common triggers. Advanced life support was undertaken in less than 7%; 198 (17.2%) responses led to transfer to higher‐level care units. Acute resuscitation plans were noted for only 29.1% of RRT activations, with 80.3% stipulating supportive care only. A total of 103 (12.6%) patients died in hospital, equalling 14 deaths per 100 RRT activations. At 28 days, 150 (18.8%) patients had died, significantly more among those with multiple versus single RRT activations (24.9 vs 16.6%; odds ratio 1.66, 95% confidence interval 1.31–2.44; P = 0.013).ConclusionRelatively few RRT activations are associated with acute resuscitation plans, and most interventions during RRT responses are low level. The high rate of post‐RRT deaths and transfers to higher‐level care units calls for the prospective identification of such patients in targeting appropriate care.
Influenza B virus outbreak at a religious residential school for boys in Northern Bangladesh, 2011
Authors: Haque Farhana , Sturm‐Ramirez Katharine , Homaira Nusrat , Gurley Emily Suzane , Hossain Md Jahangir , Hasan S. M. Murshid , Chowdhury Sukanta , Sarkar Shamim , Khan Abdul Khaleque Md Dawlat , Rahman Mustafizur , Rahman Mahmudur , Luby Stephen P. 
Published: September 2016

BackgroundNational media reported a febrile illness among dormitory residents of a boys' religious school. We investigated the outbreak to identify cause.MethodsIndividuals with fever (>100°F) and cough or sore throat between 1 and 13 August 2011 were influenza‐like‐illness (ILI) case‐patients. We collected histories and specimens from hospitalized case‐patients and visited campus to explore environmental context.ResultsAll 28 case‐patients were dormitory residents including 27 hospitalizations. Accommodation space per resident was <0.8 square metres. Nasal and oropharyngeal swabs from 22 case‐patients were positive for influenza B virus using real‐time reverse transcription polymerase chain reaction (rRT‐PCR).ConclusionsOvercrowding likely facilitated transmission leading to this dormitory outbreak.
How to Implant a Leadless Pacemaker With a Tine‐Based Fixation
Authors: EL‐CHAMI MIKHAEL F. , ROBERTS PAUL R. , KYPTA ALEX , OMDAHL PAMELA , BONNER MATTHEW D. , KOWAL ROBERT C. , DURAY GABOR Z. 
Published: September 2016

Leadless Implant ProcedureTwo major studies have shown that leadless pacemakers are safe and effective for patients requiring right ventricular rate responsive pacing therapy. This positive result recently led to FDA approval of one of the available leadless pacing devices. While this new technology is promising, it requires a different skill set for safe implantation. In this article, we review in detail the different steps required for implantation of tine‐based leadless pacemakers while providing tips and tricks to minimize complications.
What Type of Power has the EU Exercised in the Ukraine–Russia Crisis? A Framework of Analysis
Authors: Cross Mai'a K. Davis , Karolewski Ireneusz Pawel 
Published: September 2016

AbstractWhat impact has the Russia–Ukraine crisis had on the EU as a foreign policy actor? Most studies examine how the EU has evolved as an actor over time of its own initiative, but tend to discount the role that the external context or structure of the international system might play in constraining or enabling the EU's exercise of power. This Special Issue seeks to understand the EU's influence in the world through recognizing its embeddedness in an unpredictable and uncertain international system. Specifically, we ask whether and to what extent the Russia–Ukraine crisis serves as a critical juncture and catalyst for shaping the EU's power.
Efficacy and safety of permethrin 5% topical gel vs. placebo for rosacea: a double‐blind randomized controlled clinical trial
Authors: Raoufinejad K. , Mansouri P. , Rajabi M. , Naraghi Z. , Jebraeili R. 
Published: September 2016

AbstractBackgroundRosacea is a chronic, multifactorial, dermatological condition. Increased density of Demodex folliculorum mites in the skin of rosacea patients suggests a possible role for these mites in the pathophysiology of rosacea.ObjectiveTo evaluate the effects of permethrin 5% topical gel vs. placebo on Demodex density (Dd) and clinical presentations of rosacea patients, and also to further refine the quantitative assessment of Dd in the non‐invasive standard skin surface biopsy (SSSB).MethodsTwenty patients with bilateral papulopustular rosacea and ≥5 mites/cm2 were enrolled in the study. Participants and physicians were blinded to the group assignments. Each patient applied permethrin on one side and placebo on the other side of the face twice daily for 12 weeks. SSSB and photography and Rosacea Clinical Scorecard of the National Rosacea Society were used to assess the patients at the baseline, 2nd, 5th, 8th, and 12th weeks for both sides of the face. Causality and severity of adverse drug reactions (ADRs) were assessed by WHO Scale and Hartwig Scale, respectively.ResultsDd was not significantly different between the two groups at the baseline. In both groups, Dd significantly decreased after 12 weeks compared to the baseline. At the end of the 12th week, the Dd in the permethrin group was significantly lower than the placebo group. Severity of the clinical presentations decreased in both groups at the end of week 12 in comparison to the baseline, particularly in the permethrin group. ADRs were all mild and in most cases unlikely related to permethrin.ConclusionPermethrin 5% gel can significantly reduce the Dd and severity of presentations in rosacea patients and can be a safe and effective option in the management of this chronic disorder. This new SSSB technique offers an easy, quick, inexpensive, and non‐invasive sampling method proper for quantitative assessment of Dd.
Occupational Therapy Predischarge Home Visits in Acute Hospital Care: A Randomized Trial
Authors: Clemson Lindy , Lannin Natasha A. , Wales Kylie , Salkeld Glenn , Rubenstein Laurence , Gitlin Laura , Barris Sarah , Mackenzie Lynette , Cameron Ian D. 
Published: September 2016

ObjectivesTo determine whether an enhanced occupational therapy discharge planning intervention that involved pre‐ and postdischarge home visits, goal setting, and follow‐up (the HOME program) would be superior to a usual care intervention in which an occupational therapy in‐hospital consultation for planning and supporting discharge to home is provided to individuals receiving acute care.DesignRandomized controlled trial.SettingAcute and medical wards.ParticipantsIndividuals aged 70 and older (N = 400).MeasurementsPrimary outcomes: activities daily living (ADLs; Nottingham Extended Activities of Daily Living) and participation in life roles and activities (Late Life Disability Index (LLDI)).ResultsOccupational therapist recommendations differed significantly between groups (P < .001) (HOME n = 892 recommendations; control n = 329 recommendations). There was no difference between groups in ADLs (Nottingham Extended Activities of Daily Living scale (NEADL): β = −0.17, 95% confidence interval (CI) = −0.99–0.66) or participation (LLDI—Frequency: β = −0.23, 95% CI = −2.05–1.59; LLDI—Limitation: β = −0.14, 95% CI = −2.86–2.58). Both groups maintained prehospital functional status at 90 days, and there was no difference between groups in the number of people with unplanned readmissions (HOME 23.5%, n = 43; control 21.9%, n = 37). When groups were combined, being male (P = .03) or having lower perceived participation because of physical problems (P = .04) resulted in higher risk of unplanned readmissions.ConclusionHOME discharge planning, which had a strong emphasis on task modification, well‐being, and prevention strategies, implemented twice as many occupational therapy recommendations as the in‐hospital only consultation, which had a greater emphasis on equipment provision, but HOME did not demonstrate greater benefit in global measures of ADLs or participation in life tasks than in‐hospital consultation alone. It is not recommended that home visits be conducted routinely as part of discharge planning for acutely hospitalized medical patients. Further work should develop guidelines for quality in‐hospital consultation.
Prevalence and Outcomes of Breathlessness in Older Adults: A National Population Study
Authors: Smith Alexander K. , Currow David C. , Abernethy Amy P. , Johnson Miriam J. , Miao Yinghui , Boscardin W. John , Ritchie Christine S. 
Published: September 2016

ObjectivesTo determine the prevalence and outcomes of breathlessness in older Americans.SettingCommunity‐dwelling older adults.ParticipantsIndividuals aged 70 and older in the nationally representative Health and Retirement Study (2008, follow‐up through 2012) (N = 3,671; mean age 78).MeasurementsBreathlessness was assessed by asking the question, “How often do you become short of breath while awake?” Responses of often or sometimes were considered to represent a level of breathlessness sufficient to warrant clinical attention. The prevalence of breathlessness is described overall and in subpopulations, then rates of associated symptoms, well‐being, and health services use of participants who were breathless are compared with rates of those who were not. The risk of decline in activities of daily living (ADLs) and death through 2012 was estimated by creating a multivariable Cox proportional hazards model, adjusting for age, sex, race and ethnicity, and education.ResultsTwenty‐five percent of participants reported breathlessness. The prevalence of breathlessness was higher in certain subpopulations: chronic lung disease (63%), multimorbidity (≥2 chronic conditions) (45%), current smokers (38%), heart disease (36%), obesity (body mass index ≥30.0 kg/m2) (33%), and education less than high school (32%). Breathlessness was associated with higher rates of depression, anxiety, and severe fatigue; lower ratings of well‐being; and higher rates of clinic and emergency department visits and hospitalizations (all P < .001). Breathlessness predicted ADL decline over 5 years (adjusted hazard ratio (aHR) = 1.43, 95% confidence interval (CI) = 1.22–1.68) and death (aHR 1.62, 95% CI = 1.32–2.02).ConclusionOne in four adults aged 70 and older in the United States experiences breathlessness, which is associated with lack of well‐being, greater health services use, and a 40% greater risk of worsened function and 60% greater risk of death over the next 5 years.