bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can prehospital Modified Early Warning Score identify non‐trauma patients requiring life‐saving intervention in the emergency department?
Authors: Leung Siu Chung , Leung Ling Pong , Fan Kit Ling , Yip Wai Lam 
Published: November 2015

AbstractObjectiveWe aim to investigate whether prehospital Modified Early Warning Score (MEWS) can identify non‐trauma patients requiring life‐saving intervention (LSI) within 4 h of presentation to the ED.MethodsIt was a prospective study of non‐trauma ED patients by ambulance who were 16 years or older from 1 to 27 November 2013. Prehospital MEWS was calculated according to vital signs measured by the ambulance crew. Data on patients' demographics, triage category, LSI within 4 h of ED presentation and 24 h mortality were retrieved. LSI was defined as emergency interventions to airway, breathing and circulation, emergency procedures and medications administered. The performance of prehospital MEWS was analysed with sensitivity, specificity, predictive values (PV), likelihood ratios (LR) and the receiver operating characteristic curve.ResultsRecruited during the study period were 1493 patients. The median age was 78 years. Of the patients, 49.9% belonged to critical, emergent or urgent triage categories. LSI was required in 321 patients (21.5%). Thirteen died within 24 h of ED presentation. The area under the receiver operating characteristic curve of prehospital MEWS relating to LSI was 0.72 (95% confidence interval 0.69 to 0.75). The sensitivity, specificity, positive PV, negative PV, positive LR and negative LR were 0.57, 0.76, 0.40, 0.87, 2.43 and 0.56, respectively, when prehospital MEWS  ≥3 was chosen as the cut‐off value.ConclusionsPrehospital MEWS is useful in identifying non‐trauma patients requiring LSI within 4 h of ED presentation. This may in turn enhance the triage accuracy in the ED in addition to clinical assessment.
Efficacy and safety of the combination of paclitaxel and platinum in advanced thymic carcinoma
Authors: Xu Jian‐ping , Hao Xue‐zhi , Zhang Xiang‐ru , Yang Sheng , Shi Yuan‐kai 
Published: November 2015

AbstractThis study aimed to assess the efficacy and safety of a combination of paclitaxel and cisplatin/carboplatin for the treatment of advanced thymic carcinoma. Thirty‐seven patients (23 men and 14 women, median age 47 years, performance status score ≤2) with pathologically or cytologically diagnosed advanced thymic carcinoma were recruited. Patients received 175 mg/m2 paclitaxel on day 1 and 75 mg/m2 cisplatin or 300 mg/m2 carboplatin on day 2 of a 21 day cycle for at least two cycles to evaluate efficacy and adverse events. No complete response (CR) was observed; 11 patients had a partial response (PR), 16 patients had no change (NC), and 10 had progressive disease, resulting in an overall response rate of 29.7%, a stable rate of 43.2%, and a disease control rate (CR + PR + NC) of 72.9%. Grade I/II and III/IV neutropenia were observed in 21 (56.7%) and 13 (35.1%) patients, respectively. Four (10.8%) patients developed grade I/II thrombocytopenia. Grade I/II and III/IV nausea and vomiting were observed in 19 (51.2%) and five (13.5%) patients, respectively. Grade I/II liver dysfunction was observed in seven (18.9%) patients. Two patients with grade III liver dysfunction recovered after hepatoprotective treatment. The combination of paclitaxel and platinum was effective and well tolerated in patients with advanced thymic carcinoma.
piecewiseSEM: Piecewise structural equation modelling inr for ecology, evolution, and systematics
Authors: Lefcheck Jonathan S. 
Published: November 2015

SummaryEcologists and evolutionary biologists rely on an increasingly sophisticated set of statistical tools to describe complex natural systems. One such tool that has gained significant traction in the biological sciences is structural equation models (SEM), a form of path analysis that resolves complex multivariate relationships among a suite of interrelated variables.Evaluation ofSEMs has historically relied on covariances among variables, rather than the values of the data points themselves. While this approach permits a wide variety of model forms, it limits the incorporation of detailed specifications. Recent developments have allowed for the simultaneous implementation of non‐normal distributions, random effects and different correlation structures using local estimation, but this process is not yet automated and consequently, evaluation can be prohibitive with complex models.Here, I present a fully documented, open‐source packagepiecewiseSEM, a practical implementation of confirmatory path analysis for therprogramming language. The package extends this method to all current (generalized) linear, (phylogenetic) least‐square, and mixed effects models, relying on familiarrsyntax. I also provide two worked examples: one involving random effects and temporal autocorrelation, and a second involving phylogenetically independent contrasts.My goal is to provide a user‐friendly and tractable implementation ofSEMthat also reflects the ecological and methodological processes generating data.
boral – Bayesian Ordination and Regression Analysis of Multivariate Abundance Data in r
Authors: Hui Francis K.C. 
Published: November 2015

Summary

Model‐based methods have emerged as a powerful approach for analysing multivariate abundance data in community ecology. Key applications include model‐based ordination, modelling the various sources of correlations across species, and making inferences while accounting for these between species correlations.

boral (version 0.9.1, licence GPL‐2) is an r package available on cran for model‐based analysis of multivariate abundance data, with estimation performed using Bayesian Markov chain Monte Carlo methods. A key feature of the boral package is the ability to incorporate latent variables as a parsimonious method of modelling between species correlation.

Pure latent variable models offer a model‐based approach to unconstrained ordination, for visualizing sites and the indicator species characterizing them on a low‐dimensional plot.

Correlated response models consist of fitting generalized linear models to each species, while including latent variables to account for residual correlation between species, for example, due to unmeasured covariates.
Neurophysiological effects of needle trauma and intraneural injection in a porcine model: a pilot study
Authors: Kirchmair L. , Ströhle M. , Löscher W. N. , Kreutziger J. , Voelckel W. G. , Lirk P. 
Published: November 2015

BackgroundNeurophysiological data are lacking in the research of nerve injury during regional anaesthesia. The aim of this pilot study was to establish a large animal model in order to test the hypothesis that needle trauma alone or in combination with intraneural injection would result in measurable nerve injury.MethodsThe experimental set‐up was elaborated in four pre‐test animals. In the remaining animals (n = 11), 22 sciatic nerves were randomly assigned to one of four groups: needle trauma (n = 5) generated by ultrasound‐guided forced needle advancement; intraneural injection of 2.5 ml saline (n = 6); intraneural injection of 5 ml saline (n = 6); extraneural injection of 5 ml saline (n = 5) as control group. Compound muscle action potential (CMAP) amplitudes as well as latencies were taken as outcome parameter and monitored over 180 min. Sonographic assessments were performed simultaneously.ResultsFollowing needle trauma and intraneural injection, CMAP amplitudes declined significantly over 180 min (P < 0.001). The control group showed no electrophysiological alterations. At 60 min, decreases in amplitude were significant after needle trauma (P = 0.04) and intraneural injection of 2.5 ml (P = 0.045), and highly significant after injection of 5 ml (P = 0.006) when compared to controls. Sustained nerve swelling was observed after intraneural injection, but not after needle trauma and perineural injection.ConclusionsIsolated mechanical trauma caused by forced needle advancement alone or in combination with intraneural injection of saline was followed by a significant decline in CMAP amplitudes indicating conduction block due to disruption of myelin or axon loss (pseudo‐conduction block).
Differential Effects of Alcohol on Excitatory and Inhibitory Puberty‐Related Peptides in the Basal Hypothalamus of the Female Rat
Authors: Srivastava Vinod K. , Hiney Jill K. , Stevener Kristyn , Dees William L. 
Published: November 2015

BackgroundAn increase in development of excitatory inputs along with a decline in inhibitory inputs ultimately govern the timely increased secretion of hypothalamic luteinizing hormone‐releasing hormone (LHRH) at the time of puberty. As chronic alcohol (ALC) exposure acts at the hypothalamic level to suppress LHRH secretion and delay puberty, we assessed its ability to differentially affect the expression of key puberty‐related proteins.MethodsALC was administered to female rats from days 27 to 33, at which time animals were killed and tissues collected for protein expression. In the medial basal hypothalamus (MBH), we assessed kisspeptin (Kp) 10, an excitatory peptide critical for prepubertal LHRH secretion, and Lin28b, a peptide with an inhibitory influence on puberty. As a direct mechanism of action of Lin28b was not known, we determined whether its central administration could induce dynorphin (DYN), a peptide that is inhibitory on LHRH secretion. Also, ALC's effect on DYN protein expression was assessed, as well as its effect on DYN release in vitro.ResultsALC markedly suppressed (p < 0.01) the expression of the excitatory Kp protein, while at the same time increased (p < 0.001) the expression of inhibitory Lin28b protein. Subsequently, we showed for the first time that the central administration of Lin28b stimulated (p < 0.01) the synthesis of DYN. Finally, ALC also induced (p < 0.01) the protein expression and stimulated (p < 0.01) the in vitro release of DYN from the MBH.ConclusionsThese results indicate that ALC can simultaneously and differentially alter both excitatory and inhibitory influences governing pubertal development, show for the first time a mechanism of action by which Lin28b exerts its prepubertal inhibitory tone, and further demonstrate the negative influences of ALC on the pubertal process.
Chemical characterization of milk oligosaccharides of the common wombat (Vombatus ursinus)
Authors: Hirayama Kentaro , Taufik Epi , Kikuchi Megumi , Nakamura Tadashi , Fukuda Kenji , Saito Tadao , Newgrain Keith , Green Brian , Messer Michael , Urashima Tadasu 
Published: November 2015

AbstractPrevious structural characterizations of marsupial milk oligosaccharides have been performed in the tammar wallaby, red kangaroo, koala, common brushtail possum and the eastern quoll. To clarify the homology and heterogeneity of milk oligosaccharides among marsupial species, which could provide information on their evolution, the oligosaccharides of wombat milk carbohydrate were characterized in this study. Neutral and acidic oligosaccharides were isolated from the carbohydrate fractions of two samples of milk of the common wombat and characterized by 1H‐nuclear magnetic resonance spectroscopy. The structures of six neutral saccharides were found to be Gal(β1‐4)Glc (lactose), Gal(β1‐3)Gal(β1‐4)Glc (3'‐galactosyllactose), Gal(β1‐3)Gal(β1‐3)Gal(β1‐4)Glc (3',3”‐digalactosyllactose), Gal(β1‐3)Gal(β1‐3)Gal(β1‐3)Gal(β1‐4)Glc, Gal(β1‐3)Gal(β1‐3)[Gal(β1‐4)GlcNAc(β1‐6)]Gal(β1‐4)Glc (galactosyl lacto‐N‐novopentaose I) and Gal(β1‐3)[Gal(β1‐4)GlcNAc(β1‐6)]Gal(β1‐3)[Gal(β1‐4)GlcNAc(β1‐6)]Gal(β1‐4)Glc (lacto‐N‐novooctaose), while those of six acidic saccharides were Neu5Ac(α2‐3)Gal(β1‐3)Gal(β1‐4)Glc. (sialyl 3'‐galactosyllactose), Neu5Ac(α2‐3)Gal(β1‐3)Gal(β1‐3)Gal(β1‐4)Glc (sialyl 3',3”‐digalactosyllactose), Neu5Ac(α2‐3)Gal(β1‐3)[Gal(β1‐4)GlcNAc(β1‐6)]Gal(β1‐4)Glc (sialyl lacto‐N‐novopentaose a), Gal(β1‐3)[Neu5Ac(α2‐3)Gal(β1‐4)GlcNAc(β1‐6)]Gal(β1‐4)Glc (sialyl lacto‐N‐novopentaose c), Neu5Ac(α2‐3)Gal(β1‐3)Gal(β1‐3)Gal(β1‐3)Gal(β1‐4)Glc,, Neu5Ac(α2‐3)Gal(β1‐3)Gal(β1‐3)[Gal(β1‐4)GlcNAc(β1‐6)]Gal(β1‐4)Glc and Gal(β1‐3)Gal(β1‐3)[Neu5Ac(α2‐3)Gal(β1‐4)GlcNAc(β1‐6)]Gal(β1‐4)Glc. In addition, small amounts of sulfated oligosaccharides but no oligosaccharides containing Neu5Gc or α(2–6) linked Neu5Ac were detected.
Exenatide acutely increases heart rate in parallel with augmented sympathetic nervous system activation in healthy overweight males
Authors: Smits Mark M. , Muskiet Marcel H. A. , Tonneijck Lennart , Hoekstra Trynke , Kramer Mark H. H. , Diamant Michaela , van Raalte Daniël H. 
Published: November 2015

AimClinical use of glucagon‐like peptide‐1 receptor agonists (GLP‐1RA) is consistently associated with heart rate (HR) acceleration in type 2 diabetes patients. We explored the mechanisms underlying this potential safety concern.MethodsTen healthy overweight males (aged 20–27 years) were examined in an open label, crossover study. Automated oscillometric blood pressure measurements and finger photoplethysmography were performed throughout intravenous administration of placebo (saline 0.9%), exenatide (targeting therapeutic concentrations) and a combination of exenatide and the nitric oxide synthase inhibitor L‐NG‐monomethyl arginine (L‐NMMA). Sympathetic nervous system (SNS) activity was measured by heart rate variability and rate‐pressure product.ResultsExenatide increased HR by a mean maximum of 6.8 (95% CI 1.7, 11.9) beats min–1 (P < 0.05), systolic blood pressure (SBP) by 9.8 (95% CI 3.5, 16.1) mmHg (P < 0.01) and markers of SNS activity (P < 0.05). No changes in total peripheral resistance were observed. Increases in HR, SBP and sympathetic activity were preserved during concomitant L‐NMMA infusion.ConclusionsOur data argue against exenatide‐induced reflex tachycardia as a response to vasodilation and rather suggest the involvement of SNS activation in humans.
Inter‐Role Conflict, Role Strain and Role Play in Chile's Relationship with Brazil
Authors: WEHNER LESLIE E. 
Published: November 2015

This article assesses the relationship between Brazil and Chile, focusing on the fields of economic and security cooperation from Chile's perspective. Chile plays a number of different roles, the most salient of which is ‘global trader’. This role stretches beyond Brazil's expectations, but it converges with the social demands of Mexico and the United States as well as with the cues of the global market. Such a salient role – alongside that of mediator, bridge builder, and partner of Argentina in security cooperation issues – influences Chile's patterns of cooperation with and distance from Brazil as the regional power in South America.
Influence of race/ethnicity on cardiovascular risk factors in polycystic ovary syndrome, the Dallas Heart Study
Authors: Chang Alice Y. , Oshiro June , Ayers Colby , Auchus Richard J. 
Published: November 2015

SummaryObjectivePolycystic ovarian syndrome (PCOS) is estimated to affect up to 20% of women. PCOS is associated with insulin resistance and cardiovascular (CV) risk factors. We aimed to evaluate the impact of race/ethnicity on the prevalence of CV risk factors and subclinical predictors of CV events.DesignCross‐sectional analysis of data collected by the Dallas Heart Study, an urban, population‐based cohort oversampled for blacks.PatientsA previously described cohort of women with PCOS and control subjects of the same racial/ethnic group, matched for age and body mass index.MeasurementsHormonal and clinical measures associated with PCOS and CV risk factors.ResultsThe study included 117 women with PCOS and 204 controls. Women with PCOS had significant differences across racial/ethnic groups in the prevalence of hypertension, hypercholesterolaemia, hypertriglyceridaemia and impaired fasting glucose (P < 0·05). Controls showed significant racial/ethnic differences in the prevalence of hypertension and impaired fasting glucose (P < 0·05). The odds of hypertension were significantly greater among women with PCOS than controls after adjusting for race/ethnicity (odds ratio, 1·50 [95% CI, 1·03–2·30]; P = 0·04). However, we did not see an interaction of race/ethnicity that significantly changed CV risk factor prevalence between PCOS and controls. In addition, subclinical measures of CV disease were not different between women with PCOS vs controls, even among hypertensive women.ConclusionsRace/ethnicity affects the prevalence of CV risk factors for women with and without PCOS. However, race/ethnicity does not interact with PCOS to additionally increase CV risk factor prevalence or subclinical CV disease.
Transforming child and family services in urban communities in South Africa: lessons from the South
Authors: Patel Leila , Schmid Jeanette Elizabeth , Venter Hendrik Jacobus 
Published: November 2015

AbstractPost‐apartheid, South African agencies have been required to shift their services in fundamental ways, including offering services in previously un‐resourced areas, honouring the rights of children and families, ensuring that users, staff and governing bodies are representative of the population and providing developmental social welfare services in place of child protection‐oriented interventions only. A study of urban South African child welfare agencies provides insight into the complex task of managing and leading change. In view of overloaded change agenda and resource constraints, managers focused on effecting incremental change and prioritized the most ‘rewarding’ change efforts. Transforming practice towards a developmental approach was less successful. Structural interventions were also not prioritized. Child welfare agencies internationally face demands to transform in response to the effects of local change and globalization. The study's insights might resonate with agencies working for change in other societal contexts.
Solar urticaria
Authors: Goetze Steven , Elsner Peter 
Published: November 2015

SummarySolar urticaria is a rare IgE‐mediated and chromophore‐dependent photodermatosis. In some cases, these chromophores, designated as “serum factor”, may be detected in serum or plasma. To date, the exact pathogenesis of solar urticaria has, however, not been elucidated. Typical clinical features include the onset of urticarial lesions within a few minutes after light exposure, which already raises diagnostic suspicion. The most common triggers are UVA and visible light. Determination of the action spectrum as well as the minimal urticarial dose (MDU) is diagnostically crucial. Other photodermatoses such as polymorphic light eruption or porphyrias (especially erythropoietic protoporphyria) have to be ruled out. Apart from sunlight avoidance, which is always required, further therapeutic options used include nonsedating antihistamines as well as light hardening. Newer treatment modalities such as plasmapheresis or the anti‐IgE antibody omalizumab are reserved for severe, recalcitrant forms of solar urticaria.
MAL‐PDT mit Tageslicht – Aktuelle Datenlage und praxisorientierte Empfehlungen eines Expertentreffens
Authors: Philipp‐Dormston Wolfgang G. , Karrer Sigrid , Petering Holger , Ulrich Claas , Dirschka Thomas , Berking Carola , Lonsdorf Anke S. , Gerber Peter Arne , Radakovic Sonja , Hunger Robert E. , Szeimies Rolf‐Markus 
Published: November 2015

ZusammenfassungDie photodynamische Therapie (PDT) gehört zu den Standardverfahren in der Therapie aktinischer Keratosen (AK). Bei der Tageslicht‐PDT (Daylight PDT, DL‐PDT) mit MAL‐Creme handelt es sich um eine neuere Entwicklung, bei der anstelle eines Belichtungssystems das Tageslicht zur Aktivierung des Photosensibilisators genutzt wird. Der vorliegende Review fasst die aktuelle Studienlage basierend auf einer selektiven Literaturrecherche zusammen, fokussiert auf praktische Aspekte in der Durchführung und reflektiert insbesondere auch die Expertenerfahrung der Autoren mit der DL‐PDT. Studiendaten zeigen, dass die DL‐PDT der konventionellen PDT in ihrer Wirksamkeit nicht unterlegen ist. Sie ist jedoch signifikant besser verträglich, da sie zu deutlich weniger Schmerzen während der Therapie führt. Sie kann in Mitteleuropa von März bis Oktober sowohl an bewölkten als auch an sonnigen Tagen durchgeführt werden. Hierbei ist auf UV‐Schutz auch der nicht behandelten Körperareale zu achten. Die Außentemperatur sollte 10°C nicht unterschreiten. An heißen Tagen sollte ein Aufenthalt im Schatten, soweit erforderlich, eingeplant werden. Die DL‐PDT mit MAL ist u. a. für Patienten mit Feldkanzerisierung und/oder negativer Schmerzerfahrung bei der cPDT geeignet und stellt eine sinnvolle Ergänzung der aktuellen Therapiemöglichkeiten dar.
Clinical implications of nonsarcomeric gene polymorphisms in hypertrophic cardiomyopathy
Authors: García‐Honrubia Antonio , Hernández‐Romero Diana , Orenes‐Piñero Esteban , Romero‐Aniorte Ana Isabel , Climent Vicente , García Miriam , Garrigos‐Gómez Noemí , Moro Concepción , Valdés Mariano , Marín Francisco 
Published: November 2015

AbstractBackgroundHypertrophic cardiomyopathy (HCM) is characterized by cardiomyocyte hypertrophy and fibrosis. Although is an autosomal dominant trait, a group of nonsarcomeric genes have been postulated as modifiers of the phenotypic heterogeneity.Material and methodsWe prospectively recruited 168 HCM patients and 136 healthy controls from three referral centres. Patients and controls were clinically stable at entry in the study. Nine polymorphisms previously associated with ventricular remodelling were determined: I/D ACE, AGTR1(A1666C), CYP11B2(C344T), PGC1‐α(G482S), COLIA1(G2046T), ADRB1(R389G), NOS3(G894T), RETN(‐420C>G) and CALM3(‐34T>A). Their potential influence on prognosis, assessed by hospital admissions, and their cause were recorded.ResultsThe median follow‐up time was 49·5 months. Allele and genotype frequencies did not differ between patients and controls. Thirty‐six patients (21·5%) required urgent hospitalization (18·5% for heart failure, 22·2% for atrial arrhythmias, 11·1% for ventricular arrhythmias, 29·6% for ischaemic heart disease, 14·8% for stroke and 3·7% for other reasons) with a hospitalization rate of 8·75% per year. Multivariate analysis showed an independent predictive value for noncarriers of polymorphic COL1A1 allele [HR: 2·76(1·26–6·05), P = 0·011] and a trend in homozygous carriers of ADRB1 Arg389 variant [HR: 1·98(0·99–4·02); P = 0·057].ConclusionOur study suggests that COL1A1 polymorphism (2046G>T) is an independent predictor of prognosis in HCM patients supporting the importance of nonsarcomeric genes on clinical prognosis in HCM.
Prospective study of signalling pathways in myeloma bone disease with regard to activity of the disease, extent of skeletal involvement and correlation to bone turnover markers
Authors: Minarik Jiri , Hermanova Zuzana , Petrova Pavla , Hrbek Jan , Zapletalova Jana , Krhovska Petra , Flodr Patrik , Pika Tomas , Bacovsky Jaroslav , Flodrova Pavla , Herman Miroslav , Scudla Vlastimil 
Published: November 2015

AbstractAimsThe aim of our study was to address the utility of serum levels of selected parameters of myeloma bone disease (MBD) signalling with regard to the pathogenesis of multiple myeloma (MM), activity, markers of bone turnover and extent of skeletal changes.Patients and methodsWe assessed prospectively 77 individuals with monoclonal gammopathies – 46 patients with active MM (AMM), 12 patients with smouldering MM (SMM) and 19 individuals with monoclonal gammopathy of undetermined significance (MGUS) to determine the role of HGF, MIP‐1α, Syndecan‐1, osteoprotegerin, Activin A, DKK1, Annexin A2 and NF‐κB.ResultsWe found significant differences of most of the parameters between MGUS and AMM, and with respect to the activity of MM assessed by International Staging System. Most of the parameters of MBD signalling correlated with traditional markers of bone turnover.ConclusionsAll the signalling pathways were activated in MM with more pronounced osteoclastogenesis in comparison with bone formation but not in MGUS regardless of its risk category, suggesting that MBD is not activated in MGUS until the process of transformation into MM. The parameters of MBD signalling might precede the increase of conventional parameters of bone turnover suggesting their possible role in early indication of anti‐resorption therapy.