bluuebunny/crossref_metadata_2025_split huggingface dataset:
Delayed diagnosis of atrial fibrillation after first‐ever stroke increases recurrent stroke risk: a 5‐year nationwide follow‐up study
Authors: Chou Ping‐Song , Ho Bo‐Lin , Chan Yi‐Hsin , Wu Min‐Hsien , Hu Han‐Hwa , Chao A‐Ching 
Published: November 2017

AbstractBackgroundDelayed detection of atrial fibrillation (AF) is common in patients with stroke. However, it is not well known whether delayed identification of AF in patients with stroke affects the prognosis of patients.AimsTo evaluate the association between the timing of AF diagnosis after stroke and clinical outcomes.MethodsWe identified a cohort of all patients admitted with a primary diagnosis of first‐ever ischaemic stroke, which was categorised into three groups, namely, non‐AF, AF presenting with stroke and delayed AF diagnosis groups. The study patients were individually followed for 5 years to evaluate the occurrence of recurrent stroke and death.ResultsIn total, 17 399 patients were hospitalised with first‐ever ischemic stroke, of whom 16 261 constituted the non‐AF group, 907 the AF presenting with stroke group and 231 the delayed AF diagnosis group. During the 5‐year follow up, 2773 (17.1%), 175 (19.3%) and 68 (29.4%) patients in the non‐AF, AF presenting with stroke and delayed AF diagnosis groups, respectively, were hospitalised for recurrent stroke. The delayed AF diagnosis group exhibited a 1.57‐times higher risk of recurrent stroke than the AF presenting with stroke group, after adjustment for the CHA2DS2‐VASc scores (adjusted hazard ratio (HR): 1.57; 95% confidence interval (CI) = 1.19–2.08; P = 0.002). In addition, delayed diagnosis of AF significantly increased the risk of recurrent stroke in men, but not in women, after adjustment for the CHA2DS2‐VASc scores.ConclusionDelayed diagnosis of AF after stroke increased the risk of recurrent stroke, particularly in men.
Endogenous hormone 2‐methoxyestradiol suppresses venous hypertension‐induced angiogenesis through up‐ and down‐regulating p53 and id‐1
Authors: Zou Xiang , Zhang Li , Yuan Jie , Yang Chunjie , Wu Zehan , Song Jianping , Zhu Wei , Mao Ying , Chen Liang 
Published: November 2017

AbstractBrain arteriovenous malformations (AVMs) which associate with angiogenesis due to local hypertension, chronic cerebral ischaemia and tissue hypoxia usually lead to haemorrhage, however, the therapeutic medicine for the disease is still lacking. 2‐methoxyestradiol (2‐ME) has been shown effective in the anti‐angiogenic treatment. This study was conducted to examine whether and how 2‐ME could improve the vascular malformations. Intracranial venous hypertension (VH) model produced in adult male Sprague‐Dawley rats and culture of human umbilical vein endothelial cells (HUVECs) at the anoxia condition were used to induce in vivo and in vitro angiogenesis, respectively. Lentiviral vectors of ID‐1 and p53 genes and of their siRNA were intracranially injected into rats and transfected into HUVECs to overexpress and down‐regulate these molecules. 2‐ME treatment not only reduced the in vivo progression of brain tissue angiogenesis in the intracranial VH rats and the in vitro increases in microvasculature formation, cellular migration and HIF‐1α expression induced by anoxia in HUVECs but also reversed the up‐regulation of ID‐1 and down‐regulation of p53 in both the in vivo and in vitro angiogenesis models. All of the anti‐angiogenesis effects of 2‐ME observed in VH rats and anoxic HUVECs were abrogated by ID‐1 overexpression and p53 knockdown. Our data collectively suggest that 2‐ME treatment inhibits hypoxia/anoxia‐induced angiogenesis dependently on ID‐1 down‐regulation and p53 up‐regulation, providing a potential alternative medical treatment for un‐ruptured AVM patients.
TRAF6 regulates tumour metastasis through EMT and CSC phenotypes in head and neck squamous cell carcinoma
Authors: Chen Lei , Li Yi‐Cun , Wu Lei , Yu Guang‐Tao , Zhang Wen‐Feng , Huang Cong‐Fa , Sun Zhi‐Jun 
Published: November 2017

AbstractEpithelial–mesenchymal transition (EMT) is associated with metastasis formation, generation and maintenance of cancer stem cells (CSCs). However, the regulatory mechanisms of CSCs have not been clarified. This study aims to investigate the role of TNF receptor‐associated factor 6 (TRAF6) on EMT and CSC regulation in squamous cell carcinoma of head and neck (SCCHN). We found TRAF6 was overexpressed in human SCCHN tissues, and high TRAF6 expression was associated with lymphatic metastasis and resulted in poor prognosis in patients with SCCHN. In addition, elevated TRAF6 expression was observed in several HNSCC cell lines, and wound healing and transwell assay results showed that TRAF6 knockdown inhibited the migration and invasion ability of the SCCHN cells. Moreover, the expression of Vimentin, Slug and N‐cadherin was down‐regulated and that of E‐cadherin was elevated after TRAF6 knockdown but decreased by transforming growth factor beta 1 (TGF‐β1) and CAL27 similar to mesenchymal cells formed after TGF‐β1 induction. In addition, the expression levels of CD44, ALDH1, KLF4 and SOX2 were inhibited after TRAF6 knockdown, and the anchor‐dependent colony formation number and sphere number were remarkably reduced. Flow cytometry showed TRAF6 knockdown reduced ALDH1‐positive cancer stem cells. We also demonstrated that TRAF6 is closely associated with EMT process and cancer stem cells using a Tgfbr1/Pten 2cKO mice SCCHN model and human SCCHN tissue microarray. Our findings indicate that TRAF6 plays a role in EMT phenotypes, the generation and maintenance of CSCs in SCCHN, suggesting that TRAF6 is a potential therapeutic target for SCCHN.
Negative HBcAg in immunohistochemistry assay of liver biopsy is a predictive factor for the treatment of patients with nucleos(t)ide analogue therapy
Authors: Huang Mingxing , Liu Jian , Chow Monica , Zhou Xuan , Han Zongping , He Zhenjian , Xue Jinfang , Zhu Zhe , Li Xinhua , Xia Jinyu 
Published: November 2017

AbstractThe hepatitis B core antigen (HBcAg) is an important target for antiviral response in chronic hepatitis B (CHB) patients. However, the correlation between HBcAg in the hepatocyte nucleus and nucleos(t)ide analogue (NA) therapeutic response is unclear. We sought to evaluate the role of HBcAg by analysing liver biopsies for viral response in NA‐naïve hepatitis B e antigen (HBeAg) positive (+) CHB patients via immunohistochemistry (IHC). A total of 48 HBcAg‐negative (−) patients and 48 HBcAg (+) patients with matching baseline characteristics were retrospectively analysed for up to 288 weeks. Virological response (VR) rates of patients in the HBcAg (−) group were significantly higher at week 48 and 96 than the HBcAg (+) group (77.1% versus 45.8% at week 48, respectively, P = 0.002 and 95.3% versus 83.3% at week 96, respectively, P = 0.045). The serological negative conversion rate of HBeAg was significantly higher in the HBcAg (−) than in the HBcAg (+) group from week 96 to 288 (35.4 % versus 14.6% at week 96, respectively, P = 0.018; 60.4% versus 14.6%, respectively, P < 0.001 at week 144; 72.9% versus 35.4%, respectively, P < 0.001 at week 288). The cumulative frequencies of VR and lack of HBeAg were higher in the HBcAg (−) group (both P < 0.05). Binary logistic regression analysis showed that HBcAg (−) was the predictor for the lack of HBeAg (OR 4.482, 95% CI: 1.58–12.68). In summary, the absence of HBcAg in the hepatocyte nucleus could be an independent predictor for HBeAg seroconversion rates during NA‐naïve treatment in HBeAg (+) CHB patients.
From Market Integration to Core State Powers: The Eurozone Crisis, the Refugee Crisis and Integration Theory
Authors: Genschel Philipp , Jachtenfuchs Markus 
Published: November 2017

AbstractThe Eurozone crisis and the refugee crisis are showcases of the problems associated with the EU's shift from market integration to the integration of core state powers. The integration of core state powers responds to similar demand factors as market integration (interdependence, externalities and spillover) but its supply is more tightly constrained by a high propensity for zero‐sum conflict, a functional requirement for centralized fiscal, coercive and administrative capacities, and high political salience. We show how these constraints structured the initial design of Economic and Monetary Union and of Schengen, made them vulnerable to crisis, and shaped policy options during the crises: they made horizontal differentiation unattractive, re‐regulation ineffective, centralized risk and burden‐sharing unfeasible, and the externalization of adjustment burdens to non‐EU actors necessary by default. In conclusion, we explore possible escape routes from the trap.
The role of S‐nitrosylation of kainate‐type of ionotropic glutamate receptor 2 in epilepsy induced by kainic acid
Authors: Wang Linxiao , Liu Yanyan , Lu Rulan , Dong Guoying , Chen Xia , Yun Wenwei , Zhou Xianju 
Published: November 2017

AbstractEpilepsy is a chronic brain disease affecting millions of individuals. Kainate receptors, especially kainate‐type of ionotropic glutamate receptor 2 (GluK2), play an important role in epileptogenesis. Recent data showed that GluK2 could undergo post‐translational modifications in terms of S‐nitrosylation (SNO), and affect the signaling pathway of cell death in cerebral ischemia‐reperfusion. However, it is unclear whether S‐nitrosylation of GluK2 (SNO‐GluK2) contributes to cell death induced by epilepsy. Here, we report that kainic acid‐induced SNO‐GluK2 is mediated by GluK2 itself, regulated by neuronal nitric oxide synthase (nNOS) and the level of cytoplasmic calcium in vivo and in vitro hippocampus neurons. The whole‐cell patch clamp recordings showed the influence of SNO‐GluK2 on ion channel characterization of GluK2‐Kainate receptors. Moreover, immunohistochemistry staining results showed that inhibition of SNO‐GluK2 by blocking nNOS or GluK2 or by reducing the level of cytoplasmic calcium‐protected hippocampal neurons from kainic acid‐induced injury. Finally, immunoprecipitation and western blotting data revealed the involvement of assembly of a GluK2‐PSD95‐nNOS signaling complex in epilepsy. Taken together, our results showed that the SNO‐GluK2 plays an important role in neuronal injury of epileptic rats by forming GluK2‐PSD95‐nNOS signaling module in a cytoplasmic calcium‐dependent way, suggesting a potential therapeutic target site for epilepsy.
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Depression, Perceived Health, and Right‐of‐Return Hopefulness of Palestinian Refugees
Authors: Alduraidi Hamza , Waters Catherine M. 
Published: November 2017

AbstractPurposeDisplacement is traumatic and often an unwanted social change that can lead to a loss of identity and socioeconomic, physical, and psychological livelihood. The purpose of the study was to describe the association of perceived health and right‐of‐return hopefulness to depressive symptom severity in Palestinian refugees, taking into consideration gender and poverty.DesignThe descriptive, correlational study was framed within a socioecological lens. Data collection occurred between October 2015 and November 2015 in Amman, Jordan, which hosts the most Palestinian refugees in the world. The participants in the sample (N = 177) had a mean age of 36.9 years.MethodsParticipants responded to the Patient Health Questionnaire for depressive symptom severity, the RAND‐36 perceived health item, and a statement about hopefulness to return to Palestine. Descriptive, correlation, and logistic and linear regression analyses were computed.FindingsResults showed that 43% of participants had moderate to severe depressive symptoms, 42% lived in poverty, and 20% had fair or poor health; yet, 60% were hopeful about returning to Palestine. Participants who had better perceived health and right‐of‐return hopefulness were less likely to have symptoms of major depression. Perceived health was the only factor—not gender, poverty, or right‐of‐return hopefulness—that explained the variance in depressive symptoms.ConclusionsPalestinian adult refugees in Jordan exhibited symptoms of major depression that were associated with poorer perceived health and less hopefulness about repatriation to Palestine.Clinical RelevanceNurses with community or mental health specialization can play a major role by systematically screening refugees for depression using worldwide, evidence‐based tools and by advocating for policies that can improve the health and living conditions of refugees.
Amalgamation of Marginal Gains (AMG) as a potential system to deliver high‐quality fundamental nursing care: A qualitative analysis of interviews from high‐performance AMG sports and healthcare practitioners
Authors: Pentecost Claire , Richards David A. , Frost Julia 
Published: November 2017

Aims and objectivesTo investigate the components of the Amalgamation of Marginal Gains (AMG) performance system to identify a set of principles that can be built into an innovative fundamental nursing care protocol.BackgroundNursing is urged to refocus on its fundamental care activities, but little evidence exists to guide practising nurses. Fundamental care is a combination of many small behaviours aimed at meeting a person's care needs. AMG is a successful system of performance management that focusses on small (or marginal) gains, and might provide a new delivery framework for fundamental nursing care.DesignQualitative interview study.MethodsWe undertook in‐depth interviews with healthcare and sports professionals experienced in AMG. We analysed data using open coding in a framework analysis, and then interrogated the data using Normalisation Process Theory (NPT). We triangulated findings with AMG literature to develop an intervention logic model.ResultsWe interviewed 20 AMG practitioners. AMG processes were as follows: focusing on many details to optimise performance, identification of marginal gains using different sources, understanding current versus optimum performance, monitoring at micro and macro level and strong leadership. Elements of normalisation were as follows: whole team belief in AMG to improve performance, a collective desire for excellence using evidence‐based actions, whole team engagement to identify choose and implement changes, and individual and group responsibility for monitoring performance.ConclusionsWe have elicited the processes described by AMG innovators in health care and sport and have mapped the normalisation potential and work required to embed such a system into nursing practice.Relevance to clinical practiceThe development of our logic model based on AMG and NPT may provide a practical framework for improving fundamental nursing care and is ripe for further development and testing in clinical trials.
An integrative review of rural and remote nursing graduate programmes and experiences of nursing graduates
Authors: Fowler Amanda C , Twigg Diane , Jacob Elisabeth , Nattabi Barbara 
Published: November 2017

Aims and objectivesTo examine international studies that specifically focus on transition to practice for graduate registered nurses in rural and remote areas.BackgroundSupportive graduate nursing programmes are essential for enabling nursing graduates’ transition to practice and reducing attrition rates. Literature examining support measures for nursing graduates within metropolitan areas is abundant. However, there is a paucity of evidence on effective graduate programmes for rural and remote‐based nursing graduates.DesignA systematic approach was used to identify robust research within appropriate electronic databases.MethodEligible articles were critically reviewed using the Mixed Method Appraisal Tool critical appraisal tool. Eligible articles were thematically analysed using the Braun and Clark approach.ResultsEight articles met the selection criteria for inclusion. Findings revealed that while most graduate nurses survived the transition process, they often felt overwhelmed and abandoned with intense feelings of frustration. Many suffered transition shock and did not feel ready for the role. Socialisation of graduates to the clinical environment was lacking. Support offered in many graduate programmes was ad hoc and unstructured. Senior staff were inadequately supported in their roles as preceptors to assist with the transition. Critical support measures recommended included both debrief sessions and regular one‐on‐one support.ConclusionsGraduate programmes need to be structured yet flexible to accommodate the needs of rural and remote nurse graduates. Graduates need to be transitioned into practice with decremental support processes for both workloads and education. Preceptors require education on how to mentor before they can provide the appropriate support for graduates. Without these measures in place, a decrease in transition shock may not be possible.Relevance to clinical practiceGraduate programmes need to be structured yet flexible, including assistance with both clinical skills and socialisation. Senior staff require education before they can adequately support new graduates.
The novel echo‐guided ProGlide technique during percutaneous transfemoral transcatheter aortic valve implantation
Authors: Honda Yohsuke , Araki Motoharu , Yamawaki Masahiro , Tokuda Takahiro , Tsutumi Masakazu , Mori Shinsuke , Sakamoto Yasunari , Kobayashi Norihiro , Hirano Keisuke , Ito Yoshiaki 
Published: November 2017

ObjectivesThe aim of this study was to assess clinical benefit of the Echo‐guided ProGlide technique in patients undergoing percutaneous transfemoral transcatheter aortic valve implantation (TF‐TAVI).BackgroundThe efficacy of the Echo‐guided ProGlide technique during percutaneous TF‐TAVI was not previously clarified.MethodsA total of 121 consecutive patients who underwent percutaneous TF‐TAVI at our institution between February 2014 and July 2017 were enrolled in this study. According to the introduction of this novel technique in March 2016, patients were divided into two groups (echo‐guided group who underwent TAVI from March 2016 to July 2017, n = 63; not echo‐guided group who underwent TAVI from February 2014 to February 2016, n = 58). The incidence of major vascular complications, defined per the Valve Academic Research Consortium‐2 criteria, and ProGlide complications including acute femoral artery stenosis or occlusion and bleeding requiring any intervention.ResultsThe incidence of major vascular complication and ProGlide complication were significantly lower in the echo‐guided group than in not echo‐guided group (1.6% vs 17.2%, P < 0.002; 1.6% vs 15.5%, P = 0.003; respectively). Use of the Echo‐guided ProGlide technique was independently associated with prevention of ProGlide complications (odds ratio, 0.11; 95% confidential interval, 0.01‐0.76; P = 0.03).ConclusionsThis novel Echo‐guided ProGlide technique was associated with a lower rate of major vascular complications, particularly ProGlide complications during percutaneous TF‐TAVI.
Tibiotarsus bone characteristics and tibial dyschondroplasia incidence of broilers fed diets supplemented with leucine and valine
Authors: Ospina‐Rojas I. C. , Murakami A. E. , Duarte C. R. A. , Sakamoto M. I. , Aguihe P. C. , Pozza P. C. , Santos T. C. 
Published: November 2017

SummaryTwo experiments were conducted to study the effect of standardized ileal digestible (SID) leucine and valine levels on tibiotarsus bone characteristics and the incidence of tibial dyschondroplasia of broilers from day 1 to 21 (Experiment I) and day 21 to 42 post‐hatch (Experiment II). Each experimental phase was evaluated independently. In both experiments, a total of 1,500 one‐day‐old Cobb 500 male broiler chickens were distributed in a completely randomized design 5 × 5 factorial arrangement for a total of 25 treatments. The SID leucine and valine levels were ranged from 10.0 to 19.6 g/kg, and 6.0 to 12.0 g/kg from day 1 to 21 post‐hatch, respectively, while day 21 to 42 post‐hatch ranged from 10.0 to 18.0 g leucine/kg, and 5.2 to 11.2 g valine/kg. Serum calcium and phosphorus, bone concentrations of calcium, phosphorus and ash, diameter and Seedor index of the tibiotarsus were not affected (p > .05) by the treatments at 21 or 42 days of age. There was an interaction (p ≤.06) between the SID levels of leucine and valine on tibiotarsus breaking strength at 21 days, but not at 42 days of age (p > .05). Tibiotarsus breaking strength was maximized in broilers from day 1 to 21 with the dietary levels of leucine and valine at 14.2 and 9.0 g/kg respectively. Dietary leucine levels reduced linearly (p < .05) the hypertrophic zone of tibiotarsus cartilage at 21 days of age. Therefore, leucine and valine supplementation interact positively on bone strength of broilers from day 1 to 21 post‐hatch. Leucine can be a useful amino acid for reducing the hypertrophic cartilage zone in broilers from day 1 to 21, but not from day 21 to 42 post‐hatch.
The Power of Population Health Data on Aging and Intellectual and Developmental Disabilities: Reactions of Knowledge Users
Authors: Martin Lynn , Ouellette‐Kuntz Hélène , McKenzie Katherine 
Published: November 2017

AbstractRecent work in Ontario (Canada) revealed that adults with intellectual and developmental disabilities experience higher rates of frailty and use of aging care services at earlier ages than the general population, and that the subset aged 65+ years is increasing. This paper describes the reaction of knowledge users to study findings and implications for policy and practice. A knowledge transfer webinar was held with nearly 200 people representing different regions of the province, participant types (family members, service providers, decision makers, researchers), and sectors (health and developmental services). Most participants viewed health and developmental services systems as not ready for the aging population with intellectual and developmental disabilities for two main reasons: insufficient cross‐sector expertise and inadequate funding. The need for healthcare, challenged informal supports, lack of services, and the desire for independence were thought to drive higher use of home care among younger adults, while inadequacies within the developmental services sector, challenged informal supports, medical and care needs, lack of community supports, and the need for coordinated cross‐sector services were noted as contributing to admissions to long‐term care. There is a lack of evidence‐based information on aging and intellectual and developmental disabilities. Ongoing access to quality, population‐level data on the number and needs of persons with intellectual and developmental disabilities is needed to improve policies and practices to support aging in the community. Persons working in health and developmental services had a shared understanding of the need for system reform, better collaboration, and integration of resources. Both sectors also viewed admission to long‐term care as particularly problematic. The province‐wide webinar brought together persons with various levels of responsibility from different sectors. Future exchanges should focus on identifying and promoting best practices.