bluuebunny/crossref_metadata_2025_split huggingface dataset:
Attitudes of Lay Stakeholders and Transplant Professionals About Disclosure to Living Kidney Donors in Exchanges and Chains
Authors: Grubbs Allison , Meadow Jaqueline , Thistlethwaite J. Richard , Ross Lainie F. 
Published: August 2016

Background: Current policies require very limited informational disclosure between living kidney donors and recipients regardless of the relationship type. No specific policies exist to suggest that exchange/chain donors and their recipients should be treated differently. We surveyed transplant professionals (surgeons and nephrologists) and members of the National Kidney Foundation (NKF) to determine their support for disclosing to donors the health, health behavior, and social information of their exchange/chain donors and exchange/chain recipients. Methods: Twenty questions regarding disclosing to donors information about both their exchange/chain donors and exchange/chain recipients were included in 2 larger surveys on disclosure about kidney transplantation. Survey A was sent electronically to NKF list-servs, and survey B was sent to transplant professionals both electronically and by postal mail. Results: Survey A yielded 236 valid surveys from NKF donors and recipients (lay stakeholders). Survey B yielded 111 valid surveys from transplant professionals. Both sets of stakeholders support disclosing to donors some health and health behavior information of their exchange/chain donor and exchange/chain recipient, and mostly oppose disclosure of social information. Lay stakeholders favored disclosing significantly more information than transplant professionals. Among lay stakeholders, donor respondents were more supportive than recipient respondents in disclosing to donors health information about the exchange/chain recipient. Among transplant professionals, surgeons were more supportive than nephrologists in disclosing to donors information about the exchange/chain recipient that may impact graft survival. Conclusions: There is broad stakeholder support for disclosing some health and health behavior information to donors about their exchange/chain donors and recipients.
Effects of Acetylcholinesterase Inhibitors on Balance and Gait Functions and Orthostatic Hypotension in Elderly Patients With Alzheimer Disease
Authors: Isik Ahmet Turan , Soysal Pinar , Usarel Cansu 
Published: September 2016

Objective: The present study was designed to evaluate the effect of acetylcholinesterase inhibitor (AchEI) therapy on balance, gait, and orthostatic hypotension (OH) in elderly patients with Alzheimer’s disease (AD). Methods: A total of 102 elderly patients with AD have been recently diagnosed and were treated with AchEI and underwent comprehensive geriatric assessment at baseline and at the end of the sixth month. Results: Timed Up and Go test and Tinetti Performance-Oriented Mobility Assessment values and the prevalence of OH were not different at the end of the sixth month versus baseline ( P > .05). However, it was determined that changes in balance were better in the patients who showed cognitive improvement at the end of the sixth month ( P < .05). Conclusion: Curative effects of AchEIs, which are used in the treatment of AD, on cognitive performance are reflected also in balance functions. Moreover, it was observed that these drugs do not increase the prevalence of OH.
Segmentectomy versus wedge resection for the treatment of high-risk operable patients with stage I non-small cell lung cancer: a meta-analysis
Authors: Hou Bing , Deng Xu-Feng , Zhou Dong , Liu Quan-Xing , Dai Ji-Gang 
Published: September 2016

Background: Although lobectomy is still the preferred treatment for patients with stage I non-small cell lung cancer (NSCLC), segmentectomy or wedge resection is frequently performed on patients who cannot withstand the physiological rigors of lobectomy. The objective of this study was to compare the overall survival (OS), cancer-specific survival (CSS), and disease-free survival outcomes among patients with stage I NSCLC who have undergone these procedures. Methods: A systematic electronic search in three online databases was conducted from their earliest publication dates to June 2015. The studies were evaluated according to rigorous, predefined inclusion criteria. The hazard ratio (HR) was used as the outcome measure for data combining. Results: There were nine eligible studies. These studies included 1181 patients who underwent segmentectomy and 2003 patients who underwent wedge resection. Stage I NSCLC patients who underwent segmentectomy had significantly better OS (HR 0.80; 95% confidence interval [CI], 0.68–0.93; p = 0.004) and CSS (HR 0.42; 95% CI, 0.20–0.88; p = 0.02) rates than those who underwent wedge resection. However, there were no significant differences in OS (HR 0.39; 95% CI, 0.15–1.02; p = 0.06) and CSS (HR 1.87; 95% CI, 0.29–12.06; p = 0.51) rates between segmentectomy and wedge resection in patients with stage Ia NSCLC with tumor size ⩽ 2 cm. Conclusions: For patients with stage I NSCLC, segmentectomy results in higher survival rates than wedge resection, whereas the outcomes of wedge resection are comparable to those of segmentectomy for patients with stage Ia NSCLC with tumor size ⩽ 2 cm. Considering the limitations and heterogeneity of the included studies, this conclusion should be further confirmed by rigorous randomized clinical trials.
Diuretics prevent Rho-kinase activation and expression of profibrotic/oxidative genes in the hypertensive aortic wall
Authors: Araos Patricio , Mondaca David , Jalil Jorge E. , Yañez Cristián , Novoa Ulises , Mora Italo , Ocaranza María Paz 
Published: September 2016

Background: Diuretics are current antihypertensive drugs since they reduce blood pressure and cardiovascular risk. Increased vascular tone is modulated in a relevant way by the RhoA/Rho-kinase (ROCK) pathway, by acting on vascular smooth muscle cell contraction. This pathway has also proremodeling vascular effects. There are few data on the role of diuretics on both vascular ROCK activation and on proremodeling effects. We assessed the effects of hydrochlorothiazide (HCTZ) and spironolactone (spiro) alone and in combination with the ROCK inhibitor fasudil (FAS) on ROCK activation, gene expression of proremodeling markers and on hypertrophy in the aortic wall of hypertensive rats. Methods: Deoxycorticosterone acetate (DOCA)-salt hypertensive rats (male, Sprague–Dawley) were randomized to the specific ROCK inhibitor FAS, HCTZ, spiro or the combinations of FAS/HCTZ or FAS/spiro for 3 weeks. At the end of the study, ROCK activation (by western blot), gene expression of proremodeling markers (by reverse transcription polymerase chain reaction, RT-PCR) and vascular hypertrophy (by morphometry) were determined in the aortic wall. Results: All treatments significantly reduced blood pressure. In the DOCA rats the p-myosin phosphatase target protein-1 (MYPT1)/t-MYPT1 ratio, index of ROCK activation was higher by 2.8 fold ( p < 0.05) compared with control rats. All treatments reduced ROCK activation in the aortic wall to control levels ( p < 0.05). Besides, significantly increased protein levels of transforming growth factor β1 (TGF-β1), gene expression of TGF-β1, connective tissue growth factor (CTGF), p22 phox and gp91 phox subunits of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase, as well as increased media thickness and aortic media area/lumen area (AM/LA) in the untreated hypertensive rats were significantly reduced ( p < 0.05) to control levels by all treatments. Similar effects were observed using both diuretics alone or in combination with FAS. Conclusions: In the aortic wall, both HCTZ and spiro in antihypertensive doses reduce ROCK activation, subsequent expression of genes that promote vascular remodeling and hypertrophy in this experimental model of hypertension. These effects could explain some of their clinical benefits in hypertensive patients.
What Factors Are Predictive of Outcome in the Treatment of Soft Tissue Sarcomas of the Foot and Ankle?
Authors: Houdek Matthew T. , Beahrs Taylor R. , Wyles Cody C. , Rose Peter S. , Sim Franklin H. , Turner Norman S. 
Published: September 2016

Soft tissue sarcomas of the foot and ankle are common. Currently, there exist limited data on prognostic variables. The aim of this study was to review our institution’s experience with soft tissue sarcomas of the foot and ankle to identify factors affecting outcomes and survivorship. We reviewed the records of 62 foot and ankle soft tissue sarcomas treated with definitive surgery at our institution between 1992 and 2013. The cohort consisted of 35 males and 27 females with a mean age at diagnosis of 45 years and a mean follow-up of 7 years. The most common tumor subtype was synovial sarcoma (n = 16). The overall limb salvage rate was 53%. Local recurrence was observed in 9 patients and distant metastases in 15 patients. Tumor size ≥3 cm in maximal dimension was the greatest risk factor in mortality. Posttreatment complications occurred in 15 patients. Local recurrence and development of distant disease was relatively common following wide excision of a soft tissue sarcoma of the foot and ankle. Tumors that were ≥3 cm in maximal dimension were associated with a worse overall survival and patients with neoadjuvant radiation were at increased risk of complications. Levels of Evidence: Level IV: Retrospective Case Series
Editor’s Choice - Impact of initial hospital diagnosis on mortality for acute myocardial infarction: A national cohort study
Authors: Wu Jianhua , Gale Chris P , Hall Marlous , Dondo Tatendashe B , Metcalfe Elizabeth , Oliver Ged , Batin Phil D , Hemingway Harry , Timmis Adam , West Robert M 
Published: August 2016

Aims: Early and accurate diagnosis of acute myocardial infarction is central to successful treatment and improved outcomes. We aimed to investigate the impact of the initial hospital diagnosis on mortality for patients with acute myocardial infarction. Methods and results: Cohort study using data from the Myocardial Ischaemia National Audit Project of patients discharged with a final diagnosis of ST-elevation myocardial infarction (STEMI, n=221,635) and non-STEMI (NSTEMI, n=342,777) between 1 April 2004 and 31 March 2013 in all acute hospitals ( n = 243) in England and Wales. Overall, 168,534 (29.9%) patients had an initial diagnosis which was not the same as their final diagnosis. After multivariable adjustment, for STEMI a change from an initial diagnosis of NSTEMI (time ratio 0.97, 95% confidence interval 0.92–1.01) and chest pain of uncertain cause (0.98, 0.89–1.07) was not associated with a significant reduction in time to death, whereas for other initial diagnoses the time to death was significantly reduced by 21% (0.78, 0.74–0.83). For NSTEMI, after multivariable adjustment, a change from an initial diagnosis of STEMI was associated with a reduction in time to death of 10% (time ratio 0.90, 95% confidence interval 0.83–0.97), but not for chest pain of uncertain cause (0.99, 0.96–1.02). Patients with NSTEMI who had other initial diagnoses had a significant 14% reduction in their time to death (time ratio 0.86, 95% confidence interval 0.84–0.88). STEMI and NSTEMI with other initial diagnoses had low rates of pre-hospital electrocardiograph (24.3% and 21.5%), aspirin on hospitalisation (61.6% and 48.5%), care by a cardiologist (60.0% and 51.5%), invasive coronary procedures (38.8 % and 29.2%), cardiac rehabilitation (68.9% and 62.6%) and guideline indicated medications at time of discharge from hospital. Had the 3.3% of patients with STEMI and 17.9% of NSTEMI who were admitted with other initial diagnoses received an initial diagnosis of STEMI and NSTEMI, then 33 and 218 deaths per year might have been prevented, respectively. Conclusion: Nearly one in three patients with acute myocardial infarction had other diagnoses at first medical contact, who less frequently received guideline indicated care and had significantly higher mortality rates. There is substantial potential, greater for NSTEMI than STEMI, to improve outcomes through earlier and more accurate diagnosis of acute myocardial infarction.
Prevalence of malnutrition in hospitalised children: retrospective study in a Spanish tertiary-level hospital
Authors: Durá-Travé Teodoro , San Martin-García Isabel , Gallinas-Victoriano Fidel , Vaquero Iñigo Ibone , González-Benavides Aida 
Published: September 2016

Objective To analyse the prevalence of malnutrition among paediatric patients at the time of hospital admission throughout a calendar year in a tertiary-level hospital and to identify those patients and/or groups of pathologies with a higher risk of malnutrition. Design Observational (retrospective evaluation of nutrition status). Setting Navarra Hospital Complex, Pamplona, Spain. Participants A total of 852 patients hospitalised in 2013 in a Spanish tertiary-level paediatric hospital (462 males and 390 females). Main outcome measures Sex, age, body mass index at the moment of admission and days of hospitalisation and diagnosis codified according to the International Classification of Diseases were registered. Results The prevalence of malnutrition patients registered at the moment of admission was 8.2%. Diseases of the nervous system (22.9%), together with diseases of the respiratory system (22.9%), infectious diseases (18.6%), congenital malformations (11.4%) and diseases of the genitourinary system (8.6%) account for 84.4% of the cases with malnutrition. Conclusions The overall prevalence rate for malnutrition in paediatric patients at the moment of admission in our hospital was 8.2%, being a figure similar to those published in occidental countries. It should be mandatory to accomplish an initial screening and follow-up during hospitalisation of younger patients and those suffering from diseases of the nervous and/or respiratory system and, especially, from congenital diseases.
Discussing sudden unexpected death in epilepsy: Are we empowering our patients? A questionnaire survey
Authors: Keddie S , Angus-Leppan H , Parker T , Toescu S , Nash A , Adewunmi O , Liu RSN 
Published: September 2016

Objective To examine patient knowledge about sudden unexpected death in epilepsy (SUDEP) compared to other risks in epilepsy. To explore patients’ experiences surrounding SUDEP disclosure and opinions on how information should be delivered. Design A cross-sectional questionnaire. Setting Royal Free Hospital, London outpatient epilepsy clinics. Participants New and follow-up patients attending epilepsy clinics at a London teaching hospital over six months. Patients identified as being at risk of suffering negative emotional or psychological consequences of SUDEP discussions were excluded. Main outcome measures Patient knowledge about epilepsy risks; patient opinion regarding source, timing and delivery of SUDEP information; impact on health seeking behaviour. Results Ninety-eight per cent of patients were aware of medication adherence, 84% of factors influencing seizure frequency, 78% of driving regulations, 50% of SUDEP and 38% of status epilepticus; 72% of patients felt that SUDEP information should be given to all patients. Preferences for timing of SUDEP discussions varied between those wanting information at diagnosis (40%) and those preferring to receive it after three clinic appointments (18%) to avoid information overload at the first consultation. Emotional responses (48% positive, 38% negative) predominated over measurable behavioural change following SUDEP discussions. Conclusions Less than half the patients knew about SUDEP and status epilepticus. Although the majority of patients with epilepsy wish to be informed about SUDEP early on in their diagnosis, information must be delivered in a way that promotes patient knowledge and empowerment.
Patterns and trends in mortality among HIV-infected and HIV-uninfected patients in a major Internal Medicine Unit in Yaoundé, Cameroon: a retrospective cohort study
Authors: Mbuagbaw Josephine , Jingi Ahmadou M , Noubiap Jean Jacques N , Kaze Arnaud D , Nansseu Jobert Richie N , Bigna Jean Joel R , Wawo Yonta Edvine , Ngu Blackett Kathleen 
Published: September 2016

Objective To describe the trends in mortality and the spectrum of disease in HIV-infected and -uninfected inpatients in a population in Yaoundé. Design A retrospective study. Setting Internal Medicine Unit, University Hospital Centre, Yaoundé, Cameroon. Participants All deaths registered between January 2000 and May 2007 in the unit. Main outcomes measures Sociodemographic characteristics, clinical features and results of all investigations done, cause of death. Results During the study period, 362 deaths were registered, consisting of 281 (77.6%) in HIV-infected patients, 54.4% of which were women. HIV-infected patients were younger (mean age: 40.2 (SD: 11.6) vs. 55.5 (SD: 18.3) years, p < 0.001) and economically active (60.3% vs. 24.4%, p < 0.001). Most HIV-infected patients (77.6%) were classified as WHO stage IV, with the rest being WHO stage III. Most HIV-infected patients (87.8%) had evidence of profound immunosuppression (CD4 < 200 cells/mm3). The mortality trend appeared to be declining with appropriate interventions. The most frequent causes of death in HIV-infected patients were pleural/pulmonary tuberculosis (34.2%), undefined meningoencephalitis (20.3%), other pneumonias (18.2%), toxoplasmosis (16.4%), cryptococcal meningitis (14.2%) and Kaposi sarcoma (15.7%). HIV-uninfected patients died mostly as a result of chronic diseases including liver diseases (17.3%), kidney failure (13.6%), congestive heart failure (11.1%) and stroke (9.9%). Conclusion There was a declining mortality due to HIV with appropriate interventions such as subsidised tests for HIV-infected patients, increased availability of HAART and other medications for prevention and treatment of opportunistic infections. The spectrum of HIV disease was wide and preventable.
Genetic analyses in a cohort of children with pulmonary hypertension
Authors: Levy Marilyne , Eyries Mélanie , Szezepanski Isabelle , Ladouceur Magalie , Nadaud Sophie , Bonnet Damien , Soubrier Florent 
Published: September 2016

The prevalence of germline mutations in paediatric pulmonary hypertension (PH) is poorly documented. The objective of this study was to determine the mutation frequency in PH genes in a paediatric cohort and describe the clinical characteristics of mutation carriers.The study involved 66 index cases with PH: 35 children with idiopathic pulmonary arterial hypertension (IPAH); five children with familial PAH (FPAH); three children with pulmonary veno-occlusive disease (PVOD); and 23 children with PAH associated with congenital heart disease (APAH-CHD).No mutations were found in the 23 children with APAH-CHD. In the 40 children with IPAH or FPAH, 12 mutations were found: five onBMPR2; four onACVRL1; and three onTBX4.In the three PVOD cases, two carried theEIF2AK4mutation. Mutation carriers had a more severe disease at diagnosis and more aggressive first-line therapy was required. The three patients with PVOD had a very severe disease at diagnosis and required a lung transplantation.The genetic architecture of paediatric PAH is enriched inACVRL1andTBX4mutations compared to adult PAH, but further studies are required to confirm these results. Childhood-onset PAH in children carrying a mutation in one of the genes tested has a more severe presentation at diagnosis but a similar outcome to that observed in non-carriers.
Risk-conscious correction of batch effects: maximising information extraction from high-throughput genomic datasets
Authors: Oytam Yalchin , Sobhanmanesh Fariborz , Duesing Konsta , Bowden Joshua C. , Osmond-McLeod Megan , Ross Jason 
Published: September 2016

AbstractBackgroundBatch effects are a persistent and pervasive form of measurement noise which undermine the scientific utility of high-throughput genomic datasets. At their most benign, they reduce the power of statistical tests resulting in actual effects going unidentified. At their worst, they constitute confounds and render datasets useless. Attempting to remove batch effects will result in some of the biologically meaningful component of the measurement (i.e. signal) being lost. We present and benchmark a novel technique, calledHarman. Harman maximises the removal of batch noise with the constraint that the risk of also losing biologically meaningful component of the measurement is kept to a fraction which is set by the user.ResultsAnalyses of three independent publically available datasets reveal that Harman removes more batch noise and preserves more signal at the same time, than the current leading technique. Results also show that Harman is able to identify and remove batch effects no matter what their relative size compared to other sources of variation in the dataset. Of particular advantage for meta-analyses and data integration is Harman’s superior consistency in achieving comparable noise suppression - signal preservation trade-offs across multiple datasets, with differing number of treatments, replicates and processing batches.ConclusionHarman’s ability to better remove batch noise, and better preserve biologically meaningful signal simultaneously within a single study, and maintain the user-set trade-off between batch noise rejection and signal preservation across different studies makes it an effective alternative method to deal with batch effects in high-throughput genomic datasets. Harman is flexible in terms of the data types it can process. It is available publically as an R package (https://bioconductor.org/packages/release/bioc/html/Harman.html), as well as a compiled Matlab package (http://www.bioinformatics.csiro.au/harman/) which does not require a Matlab license to run.
Effective cleaning of copper stained calcareous stone
Authors: Spile Sanne , Suzuki Takayoshi , Bendix Jesper , Simonsen Kim Pilkjær 
Published: September 2016

Abstract

Background
Light calcareous stone materials used in connection with cultural heritage objects, such as pedestals, or used as wall facings in connection with bronze statues or joints often show green staining due to the corrosion products from the bronze elements. The green stains alter the appearance of the monument and thus disrupt the original intention. Due to this, several cleaning methods, often involving ammonia, have been developed for removal of copper stains from stone surfaces. This paper describes a new, highly efficient method for cleaning copper stains from calcareous stone by introducing the chelating agent ethylenediamine in a poultice consisting of Laponite® RD, Arbocel® BC1000 and CMC.

Results
Cleaning experiments were performed on marble and on a calcareous sandstone plinth contaminated with natural copper corrosion products due to outdoor exposure of an untreated bronze statue. The cleaning results were evaluated by visual observations.

Conclusion
The chemical cleaning of copper stained calcareous stone surfaces has been investigated and a new method for removal of copper stains has been developed. A solution of 0.1 M ethylenediamine in a poultice consisting of Laponite® RD/Arbocel® BC1000/CMC has shown to be an effective, economical, and fast do-it-yourself method.