bluuebunny/crossref_metadata_2025_split huggingface dataset:
On correlation analysis of many‐to‐many observations: an alternative to Pearson's correlation coefficient and its application to an ecotoxicological study
Authors: Moltchanova Elena , Gerhard Daniel , Mohamed Fathimath , Gaw Sally , Glover Chris N. 
Published: November 2017

SummaryCorrelation studies are an important hypothesis‐generating and testing tool, and have a wide range of applications in many scientific fields. In ecological studies in particular, multiple environmental variables are often measured in an attempt to determine relationships between chemical, physical and biological factors. For example, one may wish to know whether and how soil properties correlate with plant physiology. Although correlation coefficients are widely used, their properties and limitations are often imperfectly understood. This is especially the case when one is interested in correlations between, say, trace element content in sediments and in marine organisms, where no one‐to‐one correspondence exists. We show that evaluating Pearson's correlation coefficient for either site‐specific means or composite samples results in biased estimates, and we propose an alternative estimator. We use simulation studies to demonstrate that our estimator generally has a much smaller bias and mean squared error. We further illustrate its use in a case study of the correlation between trace element content in sediments and in mussels in Lyttelton Harbour, New Zealand.
The Swedish Pregnancy Register – for quality of care improvement and research
Authors: Stephansson Olof , Petersson Kerstin , Björk Camilla , Conner Peter , Wikström Anna‐Karin 
Published: November 2017

AbstractIntroductionThe objective of this study was to present the Swedish Pregnancy Register and to explore regional differences in maternal characteristics, antenatal care, first trimester combined screening and delivery outcomes in Sweden.Material and methodsThe Pregnancy Register (www.graviditetsregistret.se) collects data on pregnancy and childbirth, starting at the first visit to antenatal care and ending at the follow‐up visit to the antenatal care, which usually occurs at around 8–16 weeks postpartum. The majority of data is collected directly from the electronic medical records. The Register includes demographic, reproductive and maternal health data, as well information on prenatal diagnostics, and pregnancy outcome for the mother and the newborn.ResultsToday the Register covers more than 90% of all deliveries in Sweden, with the aim to include all deliveries within 2018. The care providers can visualize quality measures over time and compare results with other clinics, regionally and nationally by creating reports on an aggregated level or using case‐mix adjusted Dash Boards in real time. Detailed data can be extracted after ethical approval for research. In this report, we showed regional differences in patient characteristics, antenatal care, fetal diagnosis and delivery outcomes in Sweden.ConclusionsOur report indicates that quality in antenatal and delivery care in Sweden varies between regions, which warrants further actions. The Swedish Pregnancy Register is a new and valuable resource for benchmarking, quality improvement and research in pregnancy, fetal diagnosis and delivery.
Long‐term development of gait after multilevel surgery in children with cerebral palsy: a multicentre cohort study
Authors: Dreher Thomas , Thomason Pam , Švehlík Martin , Döderlein Leonhard , Wolf Sebastian I , Putz Cornelia , Uehlein Oliver , Chia Kohleth , Steinwender Gerhardt , Sangeux Morgan , Graham H K 
Published: November 2017

AimWe investigated the long‐term efficacy and safety of multilevel surgery (MLS) in ambulatory children with bilateral spastic cerebral palsy (CP).MethodTwo hundred and thirty‐one children were evaluated at short term (1.1y, SD 0.4) and long term (9.1y, SD 3.0) follow‐up using clinical examination and gait analysis. MLS was investigated by studying changes in the Gait Profile Score (GPS) referenced to the minimally important clinical difference.ResultsAmbulatory children aged 10 years and 7 months (SD 2y 11mo) at MLS in Gross Motor Function Classification System levels I (19), II (144), and III (68) showed a decrease (improvement) in preoperative GPS from 16.3° (SD 4.8) to 11.3° (SD 3.2) at short‐term follow‐up, an improvement of 5°. At long‐term follow‐up, GPS was maintained at 11.4° (SD 3.1). Overall, 177 (76.6%) children maintained their improvement in GPS after 9 years.InterpretationMultilevel surgery is a safe and effective surgical intervention, which leads to a significant improvement in gait kinematics in children with bilateral spastic CP. This study improves our understanding of MLS in the long term and will help to inform families and children when planning for MLS.What this paper adds

Largest study of multilevel surgery (MLS) for children with bilateral spastic cerebral palsy, with longest follow‐up.

MLS resulted in significant long‐term improvements in gait function.

Minor adverse events were common, while events requiring intervention were uncommon (4% of children).

Thirty‐nine per cent of children required additional surgery during follow‐up.

‘Single‐event multilevel surgery’ was changed to the more realistic term ‘multilevel surgery’.
Serum paraoxonase‐1 activity is inversely related to free thyroxine in euthyroid subjects: The PREVEND Cohort Study
Authors: van Tienhoven‐Wind Lynnda J. N. , Gruppen Eke G. , James Richard W. , Bakker Stephan J. L. , Gans Rijk O. B. , Dullaart Robin P. F. 
Published: November 2017

AbstractBackgroundLow‐normal thyroid function within the euthyroid range has been suggested to enhance atherosclerosis susceptibility. Paraoxonase‐1 (PON‐1) may protect against atherosclerotic cardiovascular disease development by attenuating oxidative stress. We evaluated relationships of PON‐1 with thyroid stimulating hormone (TSH), free T4, free T3, lipids and apolipoprotein (apo)A‐I in euthyroid subjects, and assessed whether such relationships are modified in the context of the metabolic syndrome (MetS).Materials and methodsSerum PON‐1 activity (arylesterase activity), TSH, free T4, free T3, lipids and apoA‐I was measured in 2206 euthyroid subjects (aged 28‐75 years; 1138 men (age 49 ± 13 years) and 1068 women (age 46 ± 12 years), recruited from the general population (PREVEND cohort).ResultsIn age‐ and sex‐adjusted analysis, PON‐1 activity (divided into tertiles) was positively related to TSH (β = −0.045, P = .036) and inversely to free T4 (β = −0.042, P = .050) but not to free T3 (β = −0.027, P = .20). PON‐1 activity was positively related to total cholesterol, non‐HDL cholesterol and triglycerides, as well as to HDL cholesterol and apoA‐I (P < .01 to <.001). The inverse relationship of PON‐1 activity with free T4 remained present after adjustment for lipids and other potential confounders (β = −0.066, P = .002), but the positive relationship with TSH lost significance (β = 0.034, P = .11). The inverse relationship of PON‐1 activity with free T4 was not different in subjects with vs without MetS (P = .94), nor modified by the presence of its individual components (P ≥ .22 for each).ConclusionsSerum PON‐1 activity is inversely associated with free T4 in euthyroid subjects, suggesting that low‐normal thyroid function may affect PON‐1 regulation.
Tophus size is associated with hallux valgus deformity in gout
Authors: Blandin Camille , Forien Marine , Gardette Anais , Palazzo Elisabeth , Dieudé Philippe , Ottaviani Sébastien 
Published: November 2017

AbstractObjectiveHallux valgus (HV) and gout are common pathologies of the first metatarsophalangeal joint (MTP1) leading to pain and deformation. In this study, we aimed to determine the correlation between tophus size and characteristics of HV in gouty patients.MethodsIn this case‐control study, we included patients with gout (the presence of monosodium urate crystals in synovial fluid) and control patients with spondyloarthritis, without crystal disease disorders. Radiographic assessment and ultrasound (US) assessment were performed by two blinded operators. US features of gout (double contour [DC] sign and/or tophus) were collected. HV was defined by hallux abductus (HA) angle ≥20° and/or intermetatarsal angle (IM) ≥10°. Correlation between US findings and HV angles was estimated by Spearman correlation coefficient.ResultsWe included 56 gouty patients (87.5% males, mean age of 63.9 ± 12.2 years) and 41 control patients (90% males, mean age of 59.0 ± 12.8 years). HV was more frequent in patients with gout than controls (62% vs 37%, P = .0007). Regardless of HV status, correlations were found between the size of US tophi and IM (r = .3381, P = .003) and HA angles (r = .2344, P = .043).ConclusionsOur results confirm a high prevalence of HV in gouty patients. We also observed a correlation between the size of the US tophus and the angles defining HV, which suggests a link between urate deposition load and HV. Early urate‐lowering therapy for gout could limit the occurrence of HV.
Insular damage, new‐onset atrial fibrillation and outcome after acute intracerebral hemorrhage
Authors: Prats‐Sánchez L. , Guisado‐Alonso D. , Painous C. , Fayos F. , Pascual‐Goñi E. , Delgado‐Mederos R. , Martínez‐Domeño A. , Camps‐Renom P. , Martí‐Fàbregas J. 
Published: November 2017

Background and purposeCortical insular damage is associated with cardiac arrhythmias and an increased risk of death. We investigated the influence of insular damage on the outcome of patients with acute intracerebral hemorrhage as well as the frequency and predictors of new‐onset atrial fibrillation (nAF).MethodsWe studied consecutive patients with intracerebral hemorrhage from 2013 to 2016. We identified those patients who underwent continuous electrocardiographic monitoring (≥24 h), known atrial fibrillation and recent ischemic stroke. We prospectively collected demographic data, vascular risk factors, neurological severity, vital signs, radiological data, nAF and mortality at 3 months. Bivariate and multivariate regression analyses were performed.ResultsWe evaluated 347 patients whose mean age was 73.5 ± 14.0 years (50.7% of them were men). We selected 183 patients to study the frequency and risk factors of nAF (mean age, 69.1 ± 14.7 years; 52.5% of them were men). We observed that 11/183 (6.0%) had nAF. Insular damage [odds ratio (OR), 7.6; 95% confidence interval (CI), 2.1–27.7] was associated with nAF. A total of 138/347 patients died within the first 3 months and insular damage was detected in 99/347 of them. Predictors of death were age (OR, 1.07; 95% CI, 1.04–1.10), blood glucose (OR, 1.00 per mg/dL;, 95% CI, 1.00–1.01), Glasgow Coma Scale score (OR, 0.85; 95% CI, 0.77–0.92), hematoma volume (OR, 1.02 per mL; 95% CI, 1.01–1.04), intraventricular hemorrhage (OR, 1.93; 95% CI, 1.03–3.64) and insular damage (OR, 3.98; 95% CI, 2.00–7.90).ConclusionsThe frequency of nAF in our patients was 6.0%. Insular damage was a risk factor for nAF and an independent predictor of death at 3 months.
OnabotulinumtoxinA in chronic migraine: predictors of response. A prospective multicentre descriptive study
Authors: Domínguez C. , Pozo‐Rosich P. , Torres‐Ferrús M. , Hernández‐Beltrán N. , Jurado‐Cobo C. , González‐Oria C. , Santos S. , Monzón M. J. , Latorre G. , Álvaro L. C. , Gago A. , Gallego M. , Medrano V. , Huerta M. , García‐Alhama J. , Belvís R. , Leira Y. , Leira R. 
Published: November 2017

Background and purposeOnabotulinumtoxinA is a treatment specifically approved for the prophylaxis of chronic migraine in adults. The aim of this study was to assess the effectiveness of OnabotulinumtoxinA in chronic migraine after 1 year of treatment in a real‐life setting and to identify clinical predictors of outcome.MethodsWe designed a prospective multicentre study performed in 13 hospitals in Spain. Patients underwent a complete medical history and examination. They were treated with OnabotulinumtoxinA every 12 weeks for 1 year. Data about outcome, adverse events, abortive medication use, emergency room use and disability were collected at 3 and 12 months.ResultsA total of 725 subjects completed the study. At 12 months, 79.3% showed >50% reduction in number of headaches per month and 94.9% reported no adverse events. Unilaterality of pain, fewer days of disability per month and milder headache at baseline were correlated with good outcome. Duration of disease <12 months increased the chances of response to treatment with OnabotulinumtoxinA (odds ratio, 1.470; 95% confidence interval, 1.123–2.174; P = 0.045).ConclusionsThis study confirmed the effectiveness of treatment with OnabotulinumtoxinA after 1 year of treatment. The chances of a good outcome may be increased by starting treatment in the first 12 months after chronic migraine diagnosis.
Stroke‐like migraine attacks after radiation therapy: A misnomer?
Authors: Fan Emily Peien , Heiber Gabriel , Gerard Elizabeth E. , Schuele Stephan 
Published: November 2017

SummaryObjectiveTo understand the frequency of electrographic and clinical seizures in patients with stroke‐like migraine attacks after radiation therapy (SMART), and determine whether SMART warrants comprehensive electroencephalographic (EEG) monitoring and aggressive seizure management.MethodsWe searched our magnetic resonance brain imaging report database for all patients between January 2013 and December 2015 for suspected SMART syndrome. Clinical inclusion criteria were further applied as follows: inpatient adults (>18 years of age) with history of cranial radiation presenting with acute neurologic deficits as primary admission reason who lacked evidence of recurrent or new brain malignancy, stroke, or infectious agents in cerebrospinal fluid. Six patients were identified. All 6 patients underwent prolonged video EEG monitoring as part of our standard protocol.ResultsAll patients but 1 were found to have multiple or prolonged electrographic seizures consistent with status epilepticus during video EEG monitoring. Their neurological deficit and/or mental status change improved in parallel with resolution of the seizure activity.SignificanceSMART is likely a misnomer that underestimates the significance of seizures and status epilepticus in the pathophysiology and clinical presentation of the syndrome. Systematic continuous EEG monitoring and appropriate seizure management is warranted to reduce symptom duration and optimize clinical outcome.
Impact of an integrated process of hot pressurised liquid extraction–macroporous resin purification over the polyphenols, hydroxymethylfurfural and reducing sugars content of Vitis vinifera ‘Carménère’ pomace extracts
Authors: Mariotti‐Celis María Salomé , Martínez‐Cifuentes Maximiliano , Huamán‐Castilla Nils , Pedreschi Franco , Iglesias‐Rebolledo Natalia , Pérez‐Correa José Ricardo 
Published: November 2017

SummaryThermal degradation and generation of objectionable compounds such as hydroxymethylfurfural have been observed in hot pressurised water extraction of polyphenols. Addition of small amounts of ethanol can reduce process temperatures and retain extraction efficiencies. However, ethanol may reduce the recovery of polyphenols in the subsequent purification stage. The overall effect of increasing amounts of ethanol (0–15%) and reduced temperatures (90, 75, 60 °C) in the extraction stage, as well as increasing amounts of ethanol in the desorption eluent (60–80%) were analysed in a combined hot pressurised liquid extraction–resin purification grape pomace polyphenols process for the first time. Without decreasing the polyphenols recovery (~24 mg GAE g−1), ethanol addition (15%) reduced the extraction temperature (from 130 to 90 °C) which not only decreased the reducing sugar extraction (~25%) but also avoided the hydroxymethylfurfural generation in the extraction stage. Additionally, the combined hot pressurised liquid extraction–resin purification process preserved the proanthocyanidin oligomeric distribution and was selective to polyphenols. The operating conditions found for the combined process, efficiently produced purified polyphenols extracts (11 mg GAE g−1), free of hydroxymethylfurfural and reducing sugars.
Building resilience in regional youth: Impacts of a universal mental health promotion programme
Authors: McAllister Margaret , Knight Bruce Allen , Hasking Penelope , Withyman Cathie , Dawkins Jessica 
Published: November 2017

AbstractMental health is a leading health issue facing young people today, particularly those living in rural and regional areas. Although public policy supports schools‐based health promotion, there is limited evidence of the efficacy of such programmes and the elements that enhance successful implementation in rural and regional areas. A study was designed to evaluate a mental health promotion programme, delivered collaboratively by nurses, guidance officers, and teachers, to 850 young people from 23 rural and regional high schools in Queensland, Australia. The study aims were to determine what effect the intervention had on young peoples’ resilience, coping, and self‐efficacy, and to understand the implications of delivering the programme in the regional Queensland school setting. Students completed self‐report measures of self‐efficacy, resilience, and coping strategies pre‐ and postprogramme, as well as at 8‐week follow‐up. We found that after programme completion there was a significant increase in self‐efficacy and in the number of positive coping strategies used by the participating young people. Qualitative data indicated that participants benefited from the collaboration between health and education sectors; that is, nurses, guidance officers, and teachers delivered the programme together in ways that were perceived to be respectful of young people and effectively discussion‐based, and engaging.
Evaluation of the effect of different post materials and adhesive systems on the bonding strength of short‐post technique for primary teeth
Authors: Beldüz Kara Nihal , Kanyilmaz Tunahan , Çankaya Soner , Kara Cankat 
Published: November 2017

BackgroundThe most important process in treating grossly decayed teeth, including decay in the pulp, is the ability to hold a retainer in for a short time.AimThe aim of this study was to investigate the bond strengths of different adhesive systems and post materials on primary teeth.DesignOne hundred and twenty extracted maxillar primary central incisor teeth were randomly divided into two main groups (total‐etch and self‐etch adhesive systems) and five subgroups (1: control–nanohybrid composite resin, 2: pre‐impregnated glass fiber, 3: unsaturated glass fiber, 4: polyethylene fiber, 5: short‐fiber reinforced composite resin). The push‐out test was performed using a universal testing machine with a crosshead speed of 0.5 mm/min.ResultsNo statistically significant difference was detected between the two different adhesive systems and five different materials in terms of the maximum values measured for fractures in the specimens when both the adhesive materials and the short‐post materials were evaluated separately (P > 0.05). However, as a result of multiple comparisons made, it was found that statistical differences between the groups applying the total‐etch adhesive system occurred in Groups 3 and 5. The highest push‐out test values were measured in Group 5 and Group 1, and the lowest value in Group 3. Although the fracture type distribution in the total‐etch adhesive system groups was not statistically different based on the material used (χ2 = 11,865; P = 0.309), the self‐etch adhesive systems did show differences (χ2 = 28,463; P < 0.001). Both the total‐etch and the self‐etch adhesive system groups showed mostly adhesive failures.ConclusionThe fiber‐reinforced and nanohybrid composite resin had higher values in the short‐post technique, and there was no significant difference between the different fiber posts.
Mechanical effects of negative pressure wound therapy on abdominal wounds – effects of different pressures and wound fillers
Authors: Torbrand Christian , Anesäter Erik , Borgquist Ola , Malmsjö Malin 
Published: November 2017

AbstractThe mechanical deformation of the wound edge resulting from negative pressure wound therapy (NPWT) at the standard setting of around −120 mmHg has positive effects in promoting wound healing. However, it may cause pain to the patient during treatment. It is therefore important to study the mechanical effects of the wound edges using lower pressure and different wound fillers. Abdominal wounds were created on eight pigs. The wounds were sealed for NPWT using foam or gauze. Negative pressures between −20 and −160 mmHg were applied, and the decrease in wound diameter and the force with which the edges of the wound were drawn together (wound edge force) were measured. Increasing levels of negative pressure resulted in a gradual decrease in wound diameter and increase in wound edge force and reached a maximum at −120 mmHg, which is the pressure commonly used in clinical practice. Both the decrease in wound diameter and the increase in wound edge force was greater with foam than with gauze. A pressure of −80 mmHg has only 15% less effect than −120 mmHg, while a lower pressure (−40 mmHg) diminished the effects on diameter and force markedly. The NPWT‐induced decrease in wound diameter and increase in wound edge force are greater at higher levels of negative pressure and when using foam than when using gauze as a wound filler. It may be possible to tailor the type of wound filler and level of negative pressure to obtain the best balance between wound healing and patient comfort.
Unilateral pectoralis major muscle flap for the treatment of sternal wounds due to Ludwig's angina
Authors: Albacete Neto Antonio , Coltro Pedro S , Horácio Grazielle S , Almeida Ivan R , Farina Junior Jayme A 
Published: November 2017

AbstractNecrotising descending mediastinitis may rarely originate from Ludwig's angina, which is an infection of the submandibular space. The use of the bilateral pectoralis major muscle flap for the treatment of sternal wound dehiscence is common, but reports of the unilateral application of this flap are scarce. This study aims to report the use of the unilateral pectoralis major muscle flap for the treatment of sternotomy dehiscence in a patient with mediastinitis due to Ludwig's angina. A 21‐year‐old male patient underwent an exploratory cervicotomy and median sternotomy for drainage of a submandibular infection that extended to the anterior, retropharyngeal and mediastinal cervical spaces. The patient had dehiscence of the sternal wound, and the unilateral pectoralis major muscle flap was used for reconstruction of the defect. This flap was able to completely cover the area of dehiscence of the sternotomy, and the patient presented a good postoperative evolution, without complications. The reconstruction technique using the unilateral pectoralis major muscle flap was considered a good option for the treatment of sternotomy dehiscence. It is an adjuvant method in the treatment of infections such as mediastinitis and osteomyelitis of the sternum secondary to Ludwig's angina, allowing a stable coverage of the sternum.