bluuebunny/crossref_metadata_2025_split huggingface dataset:
Familial hypercholesterolaemia in patients with ischaemic stroke or transient ischaemic attack
Authors: Toell T. , Mayer L. , Pechlaner R. , Krebs S. , Willeit K. , Lang C. , Boehme C. , Prantl B. , Knoflach M. , Ferrari J. , Fuchs P. , Prokop W. , Griesmacher A. , Lang W. , Kiechl S. , Willeit J. 
Published: October 2017

Background and purposeIdentification of patients with familial hypercholesterolaemia (FH) is a prerequisite for the appropriate management of their excess cardiovascular risk. It is currently unknown how many patients with acute ischaemic stroke or transient ischaemic attack (TIA) are affected by FH and whether systematic screening for FH is warranted in these patients.MethodsThe prevalence of a clinical diagnosis of FH was estimated in a large representative series of patients with acute ischaemic stroke or TIA (ABCD2 score ≥ 3) using the Dutch Lipid Clinic Network Algorithm (DLCNA; possible FH ≥3, probable/definite FH ≥6).ResultsOut of 1054 patients included in the present analysis, 14 had probable/definite FH (1.3%; 95% confidence interval 0.6–2.0) and 107 possible FH (10.2%; 8.4–12.0) corresponding to an overall prevalence of potential FH of 11.5%. Prevalences were even higher in patients with stroke/TIA manifestation before age 55 in men or 60 in women (3.1%, 0.6–5.6; and 13.1%, 8.3–17.9) and those with a prior history of cardiovascular disease (2.6%, 0.9–4.3; and 15.1%, 11.3–18.9). Of note, in two‐thirds of our patients with probable/definite and possible FH, stroke or TIA was the initial clinical disease manifestation.ConclusionsThe frequency of potential FH, based on clinical criteria, in patients with acute ischaemic stroke or TIA was 11.5% and that of probable/definite FH (1.3%) was similar to recently reported counts for patients with acute coronary syndrome (1.6%). FH screening using the DLCNA is feasible in clinical routine and should be considered as part of the usual diagnostic work‐up.
Epidemiological patterns of tick‐borne encephalitis in Lithuania and clinical features in adults in the light of the high incidence in recent years: a retrospective study
Authors: Radzišauskienė D. , Žagminas K. , Ašoklienė L. , Jasionis A. , Mameniškienė R. , Ambrozaitis A. , Jančorienė L. , Jatužis D. , Petraitytė I. , Mockienė E. 
Published: October 2017

Background and purposeLithuania is one of the countries with the highest incidence of tick‐borne encephalitis (TBE) in Europe. The aim of this study was to describe the epidemiological patterns of TBE in Lithuania, and characterize clinical features in adults in the light of the high incidence in recent years.MethodsSurveillance data available on the website of the Centre for Communicable Diseases and AIDS of Lithuania were used to describe the epidemiological patterns of TBE. The retrospective study included 712 patients hospitalized in the Centre for Infectious Diseases and the Centre for Neurology of Vilnius University in the years 2005–2014.ResultsTick‐borne encephalitis incidence rates have been increasing by 8.5% per year for the 45‐year period from 1970 to 2014. The joinpoint model finds two joinpoints at 1991 and 1994, with a significant decrease of 8.4% per year (P < 0.05) prior to the joinpoint at 1991, and a rise of 195.2% afterwards. TBE presented with meningoencephalitis in 556 cases (81.3%). A total of 129 patients (18%) had a severe case of the disease. The most common neurological signs were ataxia (579, 81.3%), meningeal signs (474, 66.5%) and tremor (338, 47.5%). Limb paresis was observed in 6.3% of patients. Five patients (0.7%) died, and 544 patients (76.7%) were discharged with sequelae.ConclusionsIntensified efforts in promoting TBE vaccination will be needed in the light of the high incidence and expanded spatial distribution. Significant prognostic factors for severe cases of the disease were age above 61 and delayed immune response of specific immunoglobulin G.
Quality and reporting of guidelines on the diagnosis and management of dystonia
Authors: Tamás G. , Abrantes C. , Valadas A. , Radics P. , Albanese A. , Tijssen M. A. J. , Ferreira J. J. 
Published: October 2017

Background and purposeThe quality of clinical practice guidelines on dystonia has not yet been assessed. Our aim was to appraise the methodological quality of guidelines worldwide and to analyze the consistency of their recommendations.MethodsWe searched for clinical practice guidelines on dystonia diagnosis/treatment in the National Guideline Clearinghouse, PubMed, National Institute for Health and Care Excellence, Guidelines International Network and Web of Science databases. We also searched for guidelines on homepages of international neurological societies. We asked for guidelines from every Management Committee member of the BM1101 Action of the Cooperation between Science and Technology European framework and every member of the International Parkinson and Movement Disorders Society with special interest in dystonia.ResultsFifteen guidelines were evaluated. Among guidelines on treatment, only one from the American Academy of Neurology could be considered as high quality. Among guidelines on diagnosis and therapy, the guideline from the European Federation of Neurological Societies was recommended by the appraisers. Clinical applicability and reports of editorial independence were the greatest shortcomings. The rigor of development was poor and stakeholder involvement was also incomplete in most guidelines. Discrepancies among recommendations may result from the weight given to consensus statements and expert opinions due to the lack of evidence, as well as inaccuracy of disease classification.ConclusionsThe quality of appraised guidelines was low. It is necessary to improve the quality of guidelines on dystonia, and the applied terminology of dystonia also needs to be standardized.
Distinct predictive role of collateral status on clinical outcome in variant stroke subtypes of acute large arterial occlusion
Authors: Zhang X. , Zhang M. , Ding W. , Yan S. , Liebeskind D. S. , Lou M. 
Published: October 2017

Background and purposeClinical trials have shown that robust collateral flow has a relationship with good clinical outcome; however, different stroke subtypes were lumped together. This study explored the relationship between baseline collaterals and the onset‐to‐imaging time (OIT) and the correlation between pre‐treatment collateral status and clinical outcome amongst different subtypes.MethodProspectively collected data from consecutive acute ischaemic stroke patients with acute middle cerebral artery occlusion who received reperfusion therapy were reviewed. The regional leptomeningeal score (20 points) was based on the scoring extent of contrast opacification in the six Alberta Stroke Program Early CT Score (ASPECTS) cortical regions (M1–6), parasagittal anterior cerebral artery territory and the basal ganglia by perfusion‐derived dynamic four‐dimensional computed tomography angiography (4D CTA). Stroke subtype was determined by the TOAST classification criteria. A 3‐months modified Rankin Scale score of 0–2 was defined as a good outcome.ResultsThe analysis included 158 patients: 30 (19.0%) patients had large artery atherosclerotic stroke (LAA), 87 (55.1%) cardioembolic stroke (CE) and 41 (25.9%) stroke of undetermined etiology. Baseline collateral was negatively correlated with OIT (P = 0.0205) in the CE group after adjusting for female sex, smoking, hyperlipidemia, baseline National Institutes of Health Stroke Scale (NIHSS) and baseline mismatch ratio, but not in the LAA group. Baseline collateral showed a strong relationship with good clinical outcome after adjusting for recanalization, baseline NIHSS, age and female sex (odds ratio 1.120, confidence interval 1.013–1.238, P = 0.027) in all patients and in the CE group (odds ratio 3.223, confidence interval 1.212–8.570, P = 0.019), but not in the LAA patients.ConclusionsBased on 4D CTA, sustained good leptomeningeal collaterals may predict good outcome in CE but not in LAA patients. Moreover, the extent of collaterals was associated with OIT in the CE patients, which indicates prompt reperfusion therapy in this group of patients.
Serum complement levels in anti‐N‐methyl‐d‐aspartate receptor encephalitis
Authors: Shu Y. , Chen C. , Chen Y. , Xu Y. , Chang Y. , Li R. , Sun X. , Peng L. , Lu Z. , Qiu W. 
Published: October 2017

Background and purposeThis study aimed to evaluate the relationship between serum complement and anti‐N‐methyl‐d‐aspartate receptor (NMDAR) encephalitis.MethodsSerum complement (C3, C4 and CH50), immunoglobulins (IgG, IgM and IgA) and C‐reactive protein (CRP) were evaluated in 40 patients with anti‐NMDAR encephalitis and 40 controls. Follow‐up evaluations of 11 of the 40 patients with anti‐NMDAR encephalitis were conducted 6 months after admission. Modified Rankin Scale (mRS) scores and clinical and cerebrospinal fluid parameters were evaluated in patients with anti‐NMDAR encephalitis.ResultsSerum C4 levels were significantly higher in patients with anti‐NMDAR encephalitis than in controls (P = 0.003), especially in female patients (P = 0.001) and those with severe impairment (mRS ≥ 4; P < 0.001). Serum CH50 levels were significantly higher in patients with severe impairment (P = 0.007) and limited treatment responses (P = 0.007). Serum C4 was associated with C3 (r = 0.506, P = 0.001), CH50 (r = 0.478, P = 0.002) and mRS score (r = 0.607, P < 0.001). Serum C3 was associated with CH50 (r = 0.339, P = 0.032) and cerebrospinal fluid white blood cells (r = 0.351, P = 0.026). Serum CH50 was associated with age, mRS score and CRP. Follow‐up evaluations revealed that mRS scores were significantly lower than those before treatment, and a significant negative correlation was observed between the change in C3 levels and the change in mRS score.ConclusionOur results demonstrated that serum C4 levels were elevated and associated with C3, CH50 and CRP levels, and disease severity in patients with anti‐NMDAR encephalitis.
Internal aorto‐iliac thrombosis in a Thoroughbred: Unsuccessful surgical thrombectomy, a proposed aetiopathogenesis and spontaneous partial regression
Authors: Lloyd K. A. , Vallance S. A. , Denton M. J. , Steel C. M. 
Published: October 2017

SummaryA 4‐year‐old Thoroughbred gelding with severe left hindlimb lameness and colic‐like signs lasting 30–60 min post‐exercise was diagnosed with unilateral internal aorto‐iliac thrombosis. The thrombus was identified using transrectal ultrasonography in the terminal aorta and was initially thought to extend into the left external iliac artery. However, attempted thrombectomy via a left femoral arteriotomy performed under general anaesthesia using thrombectomy and angioplasty catheters was unsuccessful, as the thrombus was located in the left internal iliac artery. Transrectal ultrasound evaluation was repeated monthly for 12 months post‐operatively during which time the gelding remained asymptomatic at rest. As removal of thrombi in the external but not internal iliac artery may be possible, correct diagnosis of the location of the thrombus is critical in preventing unnecessary attempts at surgical correction. The aetiology remains unknown, but altered haemodynamics within the abdominal aorta with mechanical stresses during intense exercise are proposed as a cause of thrombus formation. The sequential monitoring of this case also conflicts the assumption that thrombi in this location propagate over time as partial regression was observed 6 months after referral and 9 months after onset of clinical signs.
Bloody urine – the list of differential diagnoses lengthens, but diagnostics remain the same
Authors: Schumacher John , Schumacher James 
Published: October 2017

SummaryThe cause of haematuria often can be surmised based on a horse's signalment, recent history, and clinical signs that may accompany haematuria. The site, if not the cause, of haemorrhage can sometimes be revealed by examining that portion of the urinary tract palpable per rectum, by endoscopically examining the urethra and bladder, or by ultrasonographically examining the kidneys. When cystolithiasis or urethrolithiasis is determined to be the cause of haematuria, further examination is indicated to identify disease of one or both kidneys that might have precipitated formation of the urolith. Contrast‐enhanced, cross‐sectional imaging of the abdomen of small equids might be of value when a vascular anomaly of a kidney is suspected. Neoplastic cells can sometimes be found in the urine of horses suffering from neoplasia of the bladder or in peritoneal fluid of horses suffering from renal neoplasia. When a kidney is determined to be the source of haemorrhage, urine can be obtained for bacterial culture and cytological examination by passing tubing through the biopsy port of an endoscope into the ureter draining the kidney in question. Histological examination of tissue obtained by biopsy of the kidney or the mucosa of the bladder may be indicated when neoplasia of one of these organs is suspected. Immunohistochemical examination of endoscopically obtained tissue from a cystic carcinoma can identify whether the neoplastic cells expressCOX‐2 receptors, thereby determining if treating the horse with aCOX‐2 selectiveNSAIDmight be effective.
European butterfly populations vary in sensitivity to weather across their geographical ranges
Authors: Mills Simon C. , Oliver Tom H. , Bradbury Richard B. , Gregory Richard D. , Brereton Tom , Kühn Elisabeth , Kuussaari Mikko , Musche Martin , Roy David B. , Schmucki Reto , Stefanescu Constantí , van Swaay Chris , Evans Karl L. 
Published: October 2017

AbstractAimThe aim was to assess the sensitivity of butterfly population dynamics to variation in weather conditions across their geographical ranges, relative to sensitivity to density dependence, and determine whether sensitivity is greater towards latitudinal range margins.LocationEurope.Time period1980–2014.Major taxa studiedButterflies.MethodsWe use long‐term (35 years) butterfly monitoring data from > 900 sites, ranging from Finland to Spain, grouping sites into 2° latitudinal bands. For 12 univoltine butterfly species with sufficient data from at least four bands, we construct population growth rate models that include density dependence, temperature and precipitation during distinct life‐cycle periods, defined to accommodate regional variation in phenology. We use partialR2values as indicators of butterfly population dynamics' sensitivity to weather and density dependence, and assess how these vary with latitudinal position within a species' distribution.ResultsPopulation growth rates appear uniformly sensitive to density dependence across species' geographical distributions, and sensitivity to density dependence is typically greater than sensitivity to weather. Sensitivity to weather is greatest towards range edges, with symmetry in northern and southern parts of the range. This pattern is not driven by variation in the magnitude of weather variability across the range, topographic heterogeneity, latitudinal range extent or phylogeny. Significant weather variables in population growth rate models appear evenly distributed across the life cycle and across temperature and precipitation, with substantial intraspecific variation across the geographical ranges in the associations between population dynamics and specific weather variables.Main conclusionsRange‐edge populations appear more sensitive to changes in weather than those nearer the centre of species' distributions, but density dependence does not exhibit this pattern. Precipitation is as important as temperature in driving butterfly population dynamics. Intraspecific variation in the form and strength of sensitivity to weather suggests that there may be important geographical variation in populations' responses to climate change.
Effects of forest degradation on microbial communities and soil carbon cycling: A global meta‐analysis
Authors: Zhou Zhenghu , Wang Chuankuan , Luo Yiqi 
Published: October 2017

AbstractAimThe aim was to explore how conversions of primary or secondary forests to plantations or agricultural systems influence soil microbial communities and soil carbon (C) cycling.LocationGlobal.Time period1993–2017.Major taxa studiedSoil microbes.MethodsA meta‐analysis was conducted to examine effects of forest degradation on soil properties and microbial attributes related to microbial biomass, activity, community composition and diversity based on 408 cases from 119 studies in the world.ResultsForest degradation decreased the ratios of K‐strategists to r‐strategists (i.e., ratios of fungi to bacteria, Acidobacteria to Proteobacteria, Actinobacteria to Bacteroidetes and Acidobacteria + Actinobacteria to Proteobacteria + Bacteroidetes). The response ratios (RRs) of the K‐strategist to r‐strategist ratios to forest degradation decreased and increased with increased RRs of soil pH and soil C to nitrogen ratio (C:N), respectively. Forest degradation increased the bacterial alpha‐diversity indexes, of which the RRs increased and decreased as the RRs of soil pH and soil C:N increased, respectively. The overall RRs across all the forest degradation types ranked as microbial C (−40.4%) > soil C (−33.3%) > microbial respiration (−18.9%) > microbial C to soil C ratio (qMBC; −15.9%), leading to the RRs of microbial respiration rate per unit microbial C (qCO2) and soil C decomposition rate (respiration rate per unit soil C), on average, increasing by +43.2 and +25.0%, respectively. Variances of the RRs of qMBC and qCO2 were significantly explained by the soil C, soil C:N and mean annual precipitation.Main conclusionsForest degradation consistently shifted soil microbial community compositions from K‐strategist dominated to r‐strategist dominated, altered soil properties and stimulated microbial activity and soil C decomposition. These results are important for modelling the soil C cycling under projected global land‐use changes and provide supportive evidence for applying the macroecology theory on ecosystem succession and disturbance in soil microbial ecology.
Relationship between chronic kidney disease without diabetes mellitus and components of frailty in community‐dwelling Japanese older adults
Authors: Lee Sungchul , Lee Sangyoon , Bae Seongryu , Harada Kazuhiro , Jung Songee , Imaoka Masakazu , Makizako Hyuma , Doi Takehiko , Shimada Hiroyuki 
Published: October 2017

AimTo evaluate the relationship between kidney function without diabetes and components of the frailty phenotype in community‐dwelling Japanese older adults.MethodsParticipants were 8343 residents who completed baseline assessments, classified into four categories according to eGFR. Frailty status was defined using five criteria: (i) slow gait speed; (ii) muscle weakness; (iii) low physical activity; (iv) exhaustion; and (v) unintentional weight loss.ResultsAfter multivariate adjustment, participants with the lowest kidney function were at higher risk of frailty (OR 1.57, 95% CI 1.02–3.50) than those with normal kidney function. In addition, after adjustment for multiple confounders, estimated glomerular filtration rate <30 was associated with a greater risk of the individual frailty components of weight loss (OR 2.14, 95% CI 1.11–4.12), low physical activity (OR 1.35, 95% CI, 1.01–2.54) and slowness (OR 1.82, 95% CI 1.36–3.77) compared with estimated glomerular filtration rate ≥60.ConclusionsLower kidney function was associated with a higher risk of weight loss, low physical activity and slowness among community‐dwelling Japanese older adults. Geriatr Gerontol Int 2018; 18: 286–292.
Cross‐cultural adaptation and validation of the Comprehensive Frailty Assessment Instrument in Chinese community‐dwelling older adults
Authors: Qiao Xiaoxia , Wang Cuili , Tian Xiaoyu , Dong Lijuan , Liu Na , Jin Yaru , Si Huaxin 
Published: October 2017

AimTo cross‐culturally adapt and validate the Comprehensive Frailty Assessment Instrument (CFAI) among Chinese community‐dwelling older adults.MethodsThe Chinese CFAI was developed through forward–backward translations. An urban sample of 1235 community‐dwelling older adults received face‐to‐face interviews to examine the validity (construct validity and criterion validity) and reliability (internal consistency and test–retest reliability).ResultsThe Chinese CFAI achieved semantic and idiomatic equivalence, and showed acceptable reliability and an expected factor structure, except for the social support domain. The exploratory factor analysis extracted five factors explaining 53.8% of the total variance of frailty. The confirmatory factor analysis showed that the data fit well to the second‐order factor theoretical model, with a root mean square error of approximation of 0.05, Tucker‐Lewis Index of 0.93 and Comparative Fit Index of 0.95. The receiver operating characteristic analysis presented an acceptable criterion validity using the Rockwood Frailty Index as an external criterion (area under the curve 0.80), with balanced sensitivity (65.31%) and specificity (81.19%) at the optimal 39‐point frailty cut‐off of the CFAI.ConclusionsThe Chinese CFAI has good validity and reliability as a practical frailty measure in Chinese community‐dwelling older adults. Geriatr Gerontol Int 2018; 18: 301–307.
Relationship between physical activity levels and depressive symptoms in community‐dwelling older Japanese adults
Authors: Jung Songee , Lee Sangyoon , Lee Sungchul , Bae Seongryu , Imaoka Masakazu , Harada Kazuhiro , Shimada Hiroyuki 
Published: October 2017

AimThe aim of the present study was to investigate the relationship between physical activity (PA) and depressive symptoms in community‐dwelling older Japanese adults.MethodsA cross‐sectional study design was used to obtain data from 3191 community‐dwelling older Japanese adults aged 70–95 years. Depressive symptoms were assessed using self‐reported scores on the Geriatric Depression Scale‐15. PA was objectively measured using an accelerometer worn for a maximum of 40 days, and average daily durations of light‐intensity PA (LPA), moderate‐to‐vigorous intensity PA (MVPA) and step count were calculated. PA was compared between participants with and without depressive symptoms by carrying out analysis of covariance and multivariable logistic regression analysis adjusted for all covariates by using propensity scores.ResultsDepressive symptoms were present in 598 participants (19.6%). A comparison of propensity‐score adjusted PA showed that step count (5059.6 ± 53.7 vs 5003.0 ± 112.1 count/day; P = 0.652) and moderate‐to‐vigorous intensity PA duration (23.0 ± 0.4 vs 23.8 ± 0.7 min/day; P = 0.358) were not significantly different between participants with and without depressive symptoms, respectively. However, participants without depressive symptoms had a significantly higher LPA duration than those with depressive symptoms (39.4 ± 0.3 vs 37.3 ± 0.7 min/day, respectively; P < 0.01).ConclusionsThe present results suggest that individuals with lower LPA have a higher risk of depressive symptoms. These findings imply that PA recommendations, especially for older adults, should emphasize LPA, which appears to be especially effective at preventing depressive symptoms. Geriatr Gerontol Int 2018; 18: 421–427.