bluuebunny/crossref_metadata_2025_split huggingface dataset:
ДИНАМІКА ПОКАЗНИКІВ ЛЕПТИНУ, АДИПОНЕКТИНУ ТА ІНТЕРЛЕЙКІНУ-6 ПРИ ПРИЗНАЧЕННІ САРТАНІВ, СТАТИНІВ ТА УРСОДЕЗОКСИХОЛЕВОЇ КИСЛОТИ У ПАЦІЄНТІВ З АРТЕРІАЛЬНОЮ ГІПЕРТЕНЗІЄЮ, ПОЄДНАНОЮ З ОЖИРІННЯМ ТА НЕАЛКОГОЛЬНИМ СТЕАТОГЕПАТИТОМ
Authors: Sklyarov E. Y. , Bochar O. M. , Lapovets L. E. 
Published: November 2017

Метою роботи було оцінити динаміку клініко-лабораторних показників у пацієнтів з артеріальною гіпертензією, поєднаною з ожирінням та неалкогольним стеатогепатитом при комбінованій терапії сартанами, статинами та урсодезоксихолевою кислотою (УДХК).Матеріали та методи. Обстежено 50 пацієнтів із ІІ-ІІІ стадією артеріальної гіпертензії, яких розділено на дві групи. Хворим першої групи призначали телмісартан (20 мг), аторвастатин (20 мг) та УДХК (10 мг/кг) 1 раз на добу. Пацієнтам другої групи призначали олмесартан (10 мг), аторвастатин (20 мг) та УДХК (10 мг/кг) 1 раз на добу. Проведено оцінку клініко-гемодинамічної та лабораторної ефективності комбінації цих препаратів через 12 тижнів лікування.Результати досліджень. Призначення впродовж 12 тижнів комбінації аторвастатину та УДХК в комплексній терапії з олмесартаном або телмісартаном у пацієнтів обох груп відзначено достовірне зниження усіх гемодинамічних показників, суттєве зменшення рівнів холестерину (p<0,01), ліпопротеїдів низької щільності (p<0,05) та аланінамінотрансферази.Також така схема лікування призводила до зниження рівнів інтерлейкіну-6 та лептину в обох групах, однак, зміни рівня лептину виявилися статистично недостовірними за рахунок значного діапазону показників. Відзначено достовірне підвищення концентрації адипонектину (до 25,94±0,65 мкг/мл) у першій групі, що свідчить про прямий вплив телмісартану на рівень адипонектину.Висновки.Призначення комбінації сартанів (телмісартану або олмесартану) в поєднанні з аторвастатином та урсодезоксихолевою кислотою впродовж 12 тижнів пацієнтам з артеріальною гіпертензією, поєднаною з ожирінням та неалкогольним стеатогепатитом, має позитивний вплив на загальний стан хворих за рахунок підтримання оптимального артеріального тиску, зменшення суб'єктивних скарг та покращення гемодинаміки серця.Така комбінація лікарських препаратів покращує показники ліпідного спектру крові (за рахунок зменшення рівнів загального холестерину (p<0,01) та ліпопротеїдів низької щільності (p<0,01)), знижує рівні лептину та інтерлейкіну-6 (p<0,01)Комбінація телмісартану з аторвастатином та урсодезоксихолевою кислотою у пацієнтам з артеріальною гіпертензією, поєднаною з ожирінням та неалкогольним стеатогепатитом призводить до достовірного зростання рівня адипонектину (p<0,01).
РЕГІОНАЛЬНІ МІГРАЦІЙНІ ПРОЦЕСИ ТА ЗАХВОРЮВАНІСТЬ НА ДВОСТУЛКОВИЙ АОРТАЛЬНИЙ КЛАПАН У ДІТЕЙ ЗАПОРІЗЬКОЇ ОБЛАСТІ.
Authors: Kamenshchyk A. V. 
Published: November 2017

Резюме: Формування вроджених вад серця (ВВС) відбувається під впливом генетичних, середовищних та демографічних чинників. Під впливом міграційних процесів, завдяки змінам у внутрішньо популяційній гетерозиготності збільшується мутаційне навантаження, що, у свою чергу, призводить до змін у формуванні захворюваності на вроджені вади серця (ВВС), у тому числі двостулковий аортальний клапан (ДАК).Метою дослідження стало встановлення взаємозв’язків між основними показниками міграції населення та захворюваністю на двостулковий аортальний клапан (ДАК) у мешканців міст та сільських районів Запорізької області, а також внесків у неї міграційних процесів.Матеріали та методи: на підставі даних про захворюваність на найбільш пощирені ВВС серел дитячого населення Запорізької області включаючи двостулковий аортальний клапан (ДАК) та даних обласного управління статистики щодо показників міграції населення регіону, з використанням методів кореляційного та регресійного аналізу, був проаналізований вплив цих показників на захворюваність ДАК.Результати та обговорення: встановлене переважання внутрішньорегіональної та зовнішньої міграції у мешканців міст регіону при достовірному збільшенні в них захворюваності на ДАК. Найбільші внески у захворюваність, у тому числі порівняно з іншими ВВС має число прибулих та вибулих осіб при зовнішньорегіональній міграції. Встановлений вплив окремих міграційних процесів у захворюваність на ДАК може слугувати непрямим показником мутаційного навантаження у окремих субпопуляціях України.
Double‐Dose Versus Standard‐Dose Clopidogrel According to Smoking Status Among Patients With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention
Authors: Bossard Matthias , Granger Christopher B. , Tanguay Jean‐Francois , Montalescot Gilles , Faxon David P. , Jolly Sanjit S. , Widimsky Petr , Niemela Kari , Steg Philippe Gabriel , Natarajan Madhu K. , Gao Peggy , Fox Keith A. A. , Yusuf Salim , Mehta Shamir R. 
Published: November 2017

Background
Prior Studies have suggested better outcomes in smokers compared with nonsmokers receiving clopidogrel (“smoker's paradox”). The impact of a more intensive clopidogrel regimen on ischemic and bleeding risks in smokers with acute coronary syndromes requiring percutaneous coronary interventions remains unclear.

Methods and Results

We analyzed 17 263 acute coronary syndrome patients undergoing percutaneous coronary intervention from the
CURRENT
‐
OASIS
7 (Clopidogrel and Aspirin Optimal Dose Usage to Reduce Recurrent Events—Seventh Organization to Assess Strategies in Ischemic Symptoms) trial, which compared double‐dose (600 mg day 1;150 mg days 2–7; then 75 mg daily) versus standard‐dose (300 mg day 1; then 75 mg daily) clopidogrel in acute coronary syndrome patients. The primary outcome was cardiovascular death, myocardial infarction, or stroke at 30 days. Interactions between treatment allocation and smoking status (current smokers versus nonsmokers) were evaluated. Overall, 6394 patients (37.0%) were current smokers. For the comparison of double‐ versus standard‐dose clopidogrel, there were significant interactions in smokers and nonsmokers for the primary outcome (
P
=0.031) and major bleeding (
P
=0.002). Double‐ versus standard‐dose clopidogrel reduced the primary outcome among smokers by 34% (hazard ratio [
HR
] 0.66, 95% confidence interval [
CI
], 0.50–0.87,
P
=0.003), whereas in nonsmokers, there was no apparent benefit (
HR
0.96, 95%
CI
, 0.80–1.14,
P
=0.61). For major bleeding, there was no difference between the groups in smokers (
HR
0.77, 95%
CI
, 0.48–1.24,
P
=0.28), whereas in nonsmokers, the double‐dose clopidogrel regimen increased bleeding (
HR
1.89, 95%
CI
, 1.37–2.60,
P
<0.0001). Double‐dose clopidogrel reduced the incidence of definite stent thrombosis in smokers (
HR
0.41, 95%
CI
, 0.24–0.71) and nonsmokers (
HR
0.63, 95%
CI
, 0.42–0.93;
P
for interaction=0.19).

Conclusions
In smokers, a double‐dose clopidogrel regimen reduced major cardiovascular events and stent thrombosis after percutaneous coronary intervention, with no increase in major bleeding. This suggests that clopidogrel dosing in patients with acute coronary syndromes should be personalized, taking into consideration both ischemic and bleeding risk.

Clinical Trial Registration

URL:
https://www.clinicaltrials.gov
. Unique identifier:
NCT
00335452.
Distribution and diversity of amphibians in Albania: new data and foundations of a comprehensive database
Authors: Szabolcs Márton , Mizsei Edvárd , Jablonski Daniel , Vági Balázs , Mester Béla , Végvári Zsolt , Lengyel Szabolcs 
Published: November 2017

Albania is part of the Mediterranean biodiversity hotspot. Yet its amphibian fauna is poorly known due to little scientific exploration during the long political isolation of the country. To fill this gap, we constructed a georeferenced database with occurrences of all known amphibian species based on records from published sources and personal data collected during expeditions to poorly known areas. Our database includes 1097 records of 16 species collected between 1920 and 2017. Based on aggregated records, we analysed richness patterns of amphibians in 10 × 10 km grid cells as a function of altitude, climate, land cover diversity and distance from the sea. The mean number of species per cell was 1.8 ± 0.11 S.E. (maximum: 10 species) and at least one species occurred in 238 of the 349 cells. Sampling effort was uneven and sampling hotspots were mostly in popular sites of natural heritage. Cells with high amphibian diversity were near the Prokletije Mountains in the North-West, near Lura, Korab and Grammos Mountains and Ohrid and Prespa Lakes in the East, and near Çikës Mountains and in coastal areas of Vlorë in the South-West. General linear models showed that the most important predictors of presence and diversity of amphibian species are land cover diversity and precipitation. Our study presents the largest database of amphibian occurrences in Albania to date that will be useful for biogeographical and ecological studies and for conservation purposes.
Participatory budgeting in a local government in a vertical society: A Japanese story
Authors: Uddin Shahzad , Mori Yuji , Adhikari Pawan 
Published: November 2017

This article examines a case of participatory budgeting in Japanese local government. The article demonstrates how cultural values interact with stages of budgeting (in our case, the co-planning or consultation phase of budgeting). We find three key stakeholders – councillors, administrators and citizens – have varying degree of participation in the budget process. While direct citizen participation has been limited and challenging, we find that local associations and councillors work as lobbyists to influence the budget less publicly. The budget desk led by the mayor plays the dominant role. This article contributes to the broader debate on local government reforms and their translation into varied contexts by problematising such a linear adoption of knowledge from a cultural perspective. Points for practitioners We offer caution to policymakers about the wholesale adoption of knowledge from one context to the other. In the Japanese context, we urge them to draw on the strengths of grouping behaviour. Hence, engagement with associations, communities and various interests groups must be emphasised instead of simply relying on direct yet remote communications to citizens. Political engagements by the departments – perhaps via political parties – can be adopted before budget proposals are made to the local authority council. This will allow more space for the councillors to make their case to citizens, and maintain harmony ( wa) within and between political groups.
Human mast cells release the migraine-inducing factor pituitary adenylate cyclase-activating polypeptide (PACAP)
Authors: Okragly Angela J , Morin S Michelle , DeRosa David , Martin Andrea P , Johnson Kirk W , Johnson Michael P , Benschop Robert J 
Published: November 2017

Background Many patients with migraines suffer from allergies and vice versa, suggesting a relationship between biological mechanisms of allergy and migraine. It was proposed many years ago that mast cells may be involved in the pathophysiology of migraines. We set out to investigate the relationship between mast cell activation and known neurogenic peptides related to migraine. Methods Cultured human mast cells were assayed for the presence of neuropeptides and their receptors at the RNA and protein level. Immunohistochemistry analyses were performed on tissue resident and cultured mast cells. Mast cell degranulation assays were performed and pituitary adenylate cyclase-activating polypeptide (PACAP) activity was measured with a bioassay. Results We found that cultured and tissue resident human mast cells contain PACAP in cytoplasmic granules. No other neurogenic peptide known to be involved in migraine was detected, nor did mast cells express the receptors for PACAP or other neurogenic peptides. Furthermore, mast cell degranulation through classic IgE-mediated allergic mechanisms led to the release of PACAP. The PACAP released from mast cells was biologically active, as demonstrated using PACAP receptor reporter cell lines. We confirmed existing literature that mast cell degranulation can also be induced by several neurogenic peptides, which also resulted in PACAP release. Conclusion Our data provides a potential biological explanation for the association between allergy and migraine by demonstrating the release of biologically active PACAP from mast cells.
Breastfeeding and Risk of Metabolic Syndrome in Children and Adolescents: A Systematic Review
Authors: Wisnieski Lauren , Kerver Jean , Holzman Claudia , Todem David , Margerison-Zilko Claire 
Published: November 2017

Background: The beneficial effect of breastfeeding on individual components of the metabolic syndrome in children and adolescents has been reported, but it is unknown if there is an association between being breastfed and metabolic syndrome as a whole. Research aim: This systematic review was performed to assess quality and strength of evidence for the association between being breastfed and the development of metabolic syndrome in children and adolescents. Methods: Articles were obtained from searches using PubMed and Embase databases, as well as from secondary searches through reference lists. Study quality was assessed using a three-level quality rating system. Results: Of 11 studies reviewed, 7 found a protective association between breastfeeding and metabolic syndrome and 4 found no association. There was no clear dose–response relationship between duration of breastfeeding and metabolic syndrome risk and insufficient evidence to demonstrate an added effect of being exclusively breastfed. The overall quality of the articles was moderate. In general, lower quality articles found no significant association, whereas higher quality articles found a significant association. Conclusion: Our review demonstrated a limited amount of high-quality research on the relationship between being breastfed and development of metabolic syndrome in children and adolescents. The evidence presented in this review suggests that being breastfed may be protective against metabolic syndrome, but further research with improvements in study design, such as improved measurement of breastfeeding and the use of prospectively collected data, will improve our understanding of this relationship.
The Influence of Hypothetical Death Scenarios on Multidimensional End-of-Life Care Preferences
Authors: Dassel Kara B. , Utz Rebecca , Supiano Katherine , McGee Nancy , Latimer Seth 
Published: November 2017

Background: Differences in end-of-life (EOL) care preferences (eg, location of death, use of life-sustaining treatments, openness to hastening death, etc) based on hypothetical death scenarios and associated physical and/or cognitive losses have yet to be investigated within the palliative care literature. Aim: The purpose of this study was to explore the multidimensional EOL care preferences in relation to 3 different hypothetical death scenarios: pancreatic cancer (acute death), Alzheimer disease (gradual death), and congestive heart failure (intermittent death). Design: General linear mixed-effects regression models estimated whether multidimensional EOL preferences differed under each of the hypothetical death scenarios; all models controlled for personal experience and familiarity with the disease, presence of an advance directive, religiosity, health-related quality of life, and relevant demographic characteristics. Setting/Participants: A national sample of healthy adults aged 50 years and older (N = 517) completed electronic surveys detailing their multidimensional preferences for EOL care for each hypothetical death scenario. Results: The average age of the participants was 60.1 years (standard deviation = 7.6), 74.7% were female, and 66.1% had a college or postgraduate degree. Results revealed significant differences in multidimensional care preferences between hypothetical death scenarios related to preferences for location of death (ie, home vs medical facility) and preferences for life-prolonging treatment options. Significant covariates of participants’ multidimensional EOL care preferences included age, sex, health-related quality of life, and religiosity. Conclusion: Our hypothesis that multidimensional EOL care preferences would differ based on hypothetical death scenarios was partially supported and suggests the need for disease-specific EOL care discussions.
Self-Assessment Scores Improve After Simulation-Based Palliative Care Communication Skill Workshops
Authors: Brown Crystal E. , Back Anthony L. , Ford Dee W. , Kross Erin K. , Downey Lois , Shannon Sarah E. , Curtis J. Randall , Engelberg Ruth A. 
Published: November 2017

Background: We conducted a randomized trial of a simulation-based multisession workshop to improve palliative care communication skills (Codetalk). Standardized patient assessments demonstrated improved communication skills for trainees receiving the intervention; however, patient and family assessments failed to demonstrate improvement. This article reports findings from trainees’ self-assessments. Aim: To examine whether Codetalk resulted in improved self-assessed communication competence by trainees. Design: Trainees were recruited from the University of Washington and the Medical University of South Carolina. Internal medicine residents, medicine subspecialty fellows, nurse practitioner students, or community-based advanced practice nurses were randomized to Codetalk, a simulation-based workshop, or usual education. The outcome measure was self-assessed competence discussing palliative care needs with patients and was assessed at the start and end of the academic year. We used robust linear regression models to predict self-assessed competency, both as a latent construct and as individual indicators, including randomization status and baseline self-assessed competency. Results: We randomized 472 trainees to the intervention (n = 232) or usual education (n = 240). The intervention was associated with an improvement in trainee’s overall self-assessment of competence in communication skills ( P < .001). The intervention was also associated with an improvement in trainee self-assessments of 3 of the 4 skill-specific indicators—expressing empathy, discussing spiritual issues, and eliciting goals of care. Conclusion: Simulation-based communication training was associated with improved self-assessed competency in overall and specific communication skills in this randomized trial. Further research is needed to fully understand the importance and limitations of self-assessed competence in relation to other outcomes of improved communication skill.
Teaching Medical Students About “The Conversation”: An Interactive Value-Based Advance Care Planning Session
Authors: Lum Hillary D. , Dukes Joanna , Church Skotti , Abbott Jean , Youngwerth Jean M. 
Published: November 2017

Background: Advance care planning (ACP) promotes care consistent with patient wishes. Medical education should teach how to initiate value-based ACP conversations. Objective: To develop and evaluate an ACP educational session to teach medical students a value-based ACP process and to encourage students to take personal ACP action steps. Design: Groups of third-year medical students participated in a 75-minute session using personal reflection and discussion framed by The Conversation Starter Kit. The Conversation Project is a free resource designed to help individuals and families express their wishes for end-of-life care. Setting and Participants: One hundred twenty-seven US third-year medical students participated in the session. Measurements: Student evaluations immediately after the session and 1 month later via electronic survey. Results: More than 90% of students positively evaluated the educational value of the session, including rating highly the opportunities to reflect on their own ACP and to use The Conversation Starter Kit. Many students (65%) reported prior ACP conversations. After the session, 73% reported plans to discuss ACP, 91% had thought about preferences for future medical care, and 39% had chosen a medical decision maker. Only a minority had completed an advance directive (14%) or talked with their health-care provider (1%). One month later, there was no evidence that the session increased students’ actions regarding these same ACP action steps. Conclusion: A value-based ACP educational session using The Conversation Starter Kit successfully engaged medical students in learning about ACP conversations, both professionally and personally. This session may help students initiate conversations for themselves and their patients.
Patterns and Yearly Time Trends in the Use of Radiation Therapy During the Last 30 Days of Life Among Patients With Metastatic Rectal Cancer in the United States From 2004 to 2012
Authors: Becerra Adan Z. , Probst Christian P. , Fleming Fergal J. , Xu Zhaomin , Aquina Christopher T. , Justiniano Carla F. , Boodry Courtney I. , Swanger Alex A. , Noyes Katia , Katz Alan W. , Monson John R. , Jusko Todd A. 
Published: November 2017

Purpose: Although radiation therapy (RT) can provide palliative benefits for patients with metastatic rectal cancer, its role at the end of life remains unclear. The objective of this study was to assess sociodemographic and clinical factors associated with the use of RT during the last 30 days of life and to evaluate yearly time trends in RT utilization among stage IV patients with rectal cancer. Methods: The 2004 to 2012 National Cancer DataBase was queried for patients with metastatic rectal cancer who had a documented death during follow-up. A Bayesian multilevel logistic regression model was used to characterize predictive factors and yearly time trends associated with RT use in the last 30 days of life. Results: Among 10 431 patients who met inclusion criteria, 345 (3%) received RT during the last 30 days of life. Factors independently associated with RT use included older age, female sex, African American race, nonprivate insurance, higher comorbidity burden, and worse grade. The odds of RT use at the end of life decreased by 28% between 2007 and 2009 (odds ratio [OR] = 0.72, 95% Credible Interval (CI) = 0.58-0.93), but then increased by 16% from 2010 to 2012 (OR = 1.16, 95% CI = 1.13-1.33), relative to 2004 to 2006. Conclusion: Radiation therapy use for patients with metastatic rectal cancer is beneficial, and efforts to optimize its appropriate use are important. Several factors associated with RT use during the last 30 days of life included disparities in sociodemographic and clinical subgroups. Research is needed to understand the underlying causes of these inequalities and the role of predictive models in clinical decision-making.