bluuebunny/crossref_metadata_2025_split huggingface dataset:
A combined laboratory and field evaluation of the Cholestech LDX and CardioChek PA point-of-care testing lipid and glucose analysers
Authors: Whitehead Simon J , Ford Clare , Gama Rousseau 
Published: July 2013

Background Combined lipid and glucose point-of-care testing (POCT) devices could facilitate widespread population screening for cardiovascular disease (CVD) and diabetes as part of the NHS Vascular Risk Assessment and Management Program (NHS Health Checks). An evaluation of the Cholestech LDX and CardioChek PA POCT analysers was performed in collaboration with the Wolverhampton City Primary Care Trust (PCT). Methods Intra-/inter-batch imprecision, between-analyser variation and the effect of haematocrit and ascorbic acid assay interference were investigated. Accuracy of the POCT capillary whole blood total cholesterol (TC), high-density-lipoprotein cholesterol (HDL-C) and glucose measurements was estimated by comparison with those from the laboratory analysis of paired venous samples. POCT usability and clinical governance were also assessed. Results The LDX exhibited lower intra- and inter-batch imprecision and external quality assessment (EQA) scheme between-analyser variation for the measurement of TC, HDL-C and glucose when compared to the CardioChek. Ascorbic acid negatively interfered in all three assays on both POCT analysers and results reported by the CardioChek were influenced by the specimen haematocrit. The LDX displayed closer agreement with the laboratory methods for the measurement of TC and HDL-C but both the LDX and the CardioChek displayed positive bias for the measurement of glucose. Conclusions POCT has clear advantages for delivering NHS Health Checks over the laboratory-based approach although device performance does differ. Users should also be aware of the potential clinical governance and interference issues associated with these devices.
Elevated pregnancy-associated plasma protein A predicts myocardial dysfunction and death in severe sepsis
Authors: Zhang Zhaocai , Dai Haiwen , Yu Yihua , Yang Jidong , Chen Jin , Wu Liang 
Published: July 2013

Background Pregnancy-associated plasma protein A (PAPPA) is an emerging biomarker used in various medical fields but has yet to be evaluated in critical care medicine. This study evaluates the value of PAPPA as a biomarker in predicting myocardial dysfunction and 28-day mortality in patients with severe sepsis. Methods Serum concentrations of PAPPA and traditional cardiac biomarkers including cardiac troponin I (cTnI) and B-type natriuretic peptide (BNP) were measured on admission in 118 severely septic patients. The value of PAPPA for the diagnosis of sepsis-related myocardial dysfunction (SRMD) and for the prediction of 28-day mortality was subsequently evaluated using statistical methods. Results PAPPA was elevated (≥4.5 ng/mL) in 76 (64.4%) patients; patients with elevated PAPPA were more likely to have SRMD (76.3% vs. 38.1%, P < 0.001). By comparison of the area under the curve (AUC) in receiver operating characteristics analysis, PAPPA had comparable value (AUC 0.661, P = 0.003) to conventional biomarkers (BNP: AUC 0.699, P < 0.001; cTnI: AUC 0.647, P = 0.007) in the diagnosis of SRMD and offered superior value (AUC 0.771, P < 0.001) over them (all AUC<0.7, P > 0.05) in the prediction of 28-day death. Increased PAPPA (≥5.4 ng/mL) was associated with lower 28-day survival (χ2 = 19.78, P < 0.001) and independently predicted 28-day mortality in septic patients. Conclusions Serum PAPPA concentration frequently increases in patients with severe sepsis and appears to be associated with SRMD. PAPPA can be used as a novel biomarker for the diagnosis of SRMD and the prediction of outcomes in critically ill patients.
Classification of falls in stroke rehabilitation – not all falls are the same
Authors: Hanger H Carl , Wills Kate L , Wilkinson Tim 
Published: July 2013

Objective: To develop a practical taxonomy of falls and to determine whether these different fall groups have different outcomes. Design: Descriptive study examining patient characteristics at the time of each fall and iterative development of falls taxonomy. Setting: An inpatient stroke rehabilitation ward. Methods: All falls over 21 months were reviewed retrospectively. Case notes were reviewed and each patient’s level of functioning at the time of fall, together with admission profile and discharge outcomes, were collected. Outcomes for fallers (as opposed to falls) were compared using the predominant fall type. Results: There were 241 falls in 122 patients and most falls occurred around the bed (196 (81%) falls). Toileting-related falls occurred in 54 patients (22.4%). The taxonomy proposes seven main fall types. One fall type (‘I’m giving it a go’) appeared quite different and was associated with better functioning at time of fall and better outcomes. Other fall types were related to high dependency needs, visuospatial difficulties or delirium. Medication-related falls were uncommon in this cohort. Conclusions: The falls taxonomy developed showed four main types of falls with different, but overlapping, patient characteristics at time of fall with different outcomes. Different fall-prevention strategies may be required for each group.
Association between interleukin 6 and interleukin 16 gene polymorphisms and coronary heart disease risk in a Chinese population
Authors: Tong Zichuan , Li Qiang , Zhang Jianjun , Wei Yu , Miao Guobin , Yang Xinchun 
Published: July 2013

Objective To investigate the role of interleukin 6 ( IL6) and IL16 single nucleotide polymorphisms (SNPs) in coronary artery disease (CAD) risk in a Chinese population. Methods Patients with CAD and healthy control subjects were recruited. IL6 (rs1800795 and rs1800796) and IL16 (rs8034928, rs3848180, rs4577037, rs1131445, rs4778889 and rs11556218) genotyping was performed on the MassARRAY® platform (Sequenom®, San Diego, CA, USA). Results Frequencies of rs8034928 variant C allele and rs11556218 variant T allele were higher in patients with CAD ( n = 326) than controls ( n = 341). The rs8034928 C/C genotype (odds ratio [OR] 2.03; 95% confidence intervals [CI] 1.16, 3.62) and C allele (OR 1.97; 95%CI 1.15, 3.45) were associated with increased risk of CAD compared with wild type. Similarly, the rs11556218 T/T genotype (OR 2.44; 95%CI 1.15, 5.44) and T allele (OR 2.37; 95%CI 1.13, 5.24) were associated with increased CAD risk compared with wild type. Conclusion The SNPs rs8034928 and rs11556218 are associated with CAD risk in the Chinese population, and may be useful predictive markers for CAD susceptibility.
Financing Reproductive Health in Bangladesh
Authors: Khanna Anoop , Pradhan Jalandhar , Harun-Ar-Rashid  , Beekink Erik , Gupta Manu , Sharma Ajay 
Published: July 2013

Bangladesh is the signatory of both, International Conference on Population and Development (ICPD) programme of action and Millennium Development goals (MDGs). The Government of Bangladesh has set ambitious agendas for improving Reproductive Health (RH) services, to achieve the targets till 2015. In Bangladesh, poor access to services, both primary and tertiary care, low quality services, high rate of maternal mortality and child malnutrition are the key challenges in achieving MGDs. An equitable and efficient use of financial resources is essential for the adequate implementation of these agendas to achieve MGDs for reproductive health. This paper discusses the financing for reproductive health in Bangladesh based on various secondary sources including National Health Accounts. The budget allocation for Reproductive Health (RH) and Family Planning (FP) is around 11 per cent of the total health budget. Among RH providers, nearly 48 per cent of the expenditure is incurred through Family Planning Centres, which are key providers for reproductive health services in Bangladesh. General hospitals and outpatient care centres are providers for 23 per cent and 21 per cent expenditure respectively. A large proportion the total expenditure on service provision for RH is spent through the government system, which includes donor support channelled through the government system under pooled funding. The donor expenditure on population assistance in Bangladesh showed fluctuations in the past, but is showing increasing trend for last three to four years. Of the total donor expenditure, almost half is distributed through multilateral channels, one-third through NGOs in 2008, and remaining through bilateral channels. The role of multilateral channels has increased since 2006. Out of pocket spending constitutes a significant proportion (around 65 per cent) of the total spending on reproductive health. The study suggests that Bangladesh needs to increase spending on RH in order to achieve MDG 5. Due to resource constraints, the GOB is currently in a position to contribute only one-fourth of the total estimated budget needed for implementing the RH related operational plans, while the rest is considered to be the funding gap, and needs to be ensured from external sources.
Interactions between Alcohol and the HIV Entry Inhibitor Maraviroc
Authors: Gruber Valerie A. , Rainey Petrie M. , Lum Paula J. , Beatty George W. , Aweeka Francesca T. , McCance-Katz Elinore F. 
Published: July 2013

Background: Alcohol use is common among people with HIV, and beliefs about alcohol interactions with medications predict decreased medication adherence, risking drug-resistant mutations. Maraviroc is an HIV entry inhibitor approved for treatment of both drug-sensitive and drug-resistant HIV strains. The present study evaluated the effects of alcohol on maraviroc pharmacokinetics and the effects of maraviroc on alcohol pharmacokinetics. Methods: Ten healthy adults completed alcohol (1 g/kg) and placebo alcohol pharmacokinetics sessions before and after 7 days of maraviroc administration. Results: Alcohol concentrations increased 12% following maraviroc. Maraviroc pharmacokinetics were unaffected by alcohol. Conclusions: Maraviroc treatment should not be interrupted if alcohol is consumed.
Computational model to design plastic multi-layer films for food packaging to assure a shelf life at the best cost
Authors: Noriega María del Pilar , Estrada Omar , López Iván 
Published: July 2013

A computational model to design plastic food packaging is proposed. The model minimizes the cost of the multi-layer structure satisfying the specific product requirements, using a heuristic optimization algorithm. The product requirements are defined by the expected shelf life, the storage conditions, the water sorption isotherms of foods and the maximum allowable gain or loss of gases (O2, CO2, N2, etc.) and moisture for the packaged food. In order to assure the food shelf life, these product requirements should be fulfilled to estimate the maximum permeance values of the plastic package. The computational algorithm automatically generates different multi-layer film structures that satisfy the product requirements. This algorithm combines different polymeric materials taking into account the barrier properties and cost of each layer, the compatibility between layers, the maximum number of layers and the minimum and maximum film thickness for each layer. Temperature and relative humidity corrections for the permeance calculations are considered. Permeance calculations of several barrier films are compared with oxygen transmission rate (OTR) and water vapor transmission rate (WVTR) measurements. The optimization model algorithm is evaluated by means of standard numerical routines and numerical benchmarking.
Factors affecting pediatric isotonic fluid resuscitation efficiency: a randomized controlled trial evaluating the impact of syringe size
Authors: Harvey Greg , Foster Gary , Manan Asmaa , Thabane Lehana , Parker Melissa J 
Published: July 2013

Abstract

Background
Goal-directed therapy guidelines for pediatric septic shock resuscitation recommend fluid delivery at speeds in excess of that possible through use of regular fluid infusion pumps. In our experience, syringes are commonly used by health care providers (HCPs) to achieve rapid fluid resuscitation in a pediatric fluid resuscitation scenario. At present, it is unclear which syringe size health care providers should use when performing fluid resuscitation to achieve maximal fluid resuscitation efficiency. The objective of this study was therefore to determine if an optimal syringe size exists for conducting manual pediatric fluid resuscitation.

Methods
This 48-participant parallel group randomized controlled trial included 4 study arms (10, 20, 30, 60 mL syringe size groups). Eligible participants were HCPs from McMaster Children’s Hospital, Hamilton, Canada blinded to the purpose of the trial. Consenting participants were randomized using a third party technique. Following a standardization procedure, participants administered 900 mL (60 mL/kg) of isotonic saline to a simulated 15 kg child using prefilled provided syringes of the allocated size in rapid sequence. Primary outcome was total time to administer the 900 mL and this data was collected through video review by two blinded outcome assessors. Sample size was predetermined based upon a primary outcome analysis using one-way ANOVA.

Results
12 participants were randomized to each group (n=48) and all completed trial protocol to analysis. Analysis was conducted according to intention to treat principles. A significant difference in fluid resuscitation time (in seconds) was found between syringe size group means: 10 mL, 563s [95% CI 521; 606]; 20 mL, 506s [95% CI 64; 548]; 30 mL, 454s [95% CI 412; 596]; 60 mL, 455s [95% CI 413; 497] (p<0.001).

Conclusions
The syringe size used when performing manual pediatric fluid resuscitation has a significant impact on fluid resuscitation speed, in a setting where fluid filled syringes are continuously available. Greatest efficiency was achieved with 30 or 60 mL syringes.

Trial registration
ClinicalTrials.gov, NCT01494116
DNA methylation of the glucagon-like peptide 1 receptor (GLP1R) in human pancreatic islets
Authors: Hall Elin , Dayeh Tasnim , Kirkpatrick Clare L , Wollheim Claes B , Dekker Nitert Marloes , Ling Charlotte 
Published: July 2013

Abstract

Background
Insulin secretion is enhanced upon the binding of Glucagon-like peptide-1 (GLP-1) to its receptor (GLP1R) in pancreatic β cells. Although a reduced expression of GLP1R in pancreatic islets from type 2 diabetic patients and hyperglycaemic rats has been established, it is still unknown if this is caused by differential DNA methylation of GLP1R in pancreatic islets of type 2 diabetic patients.

Methods
In this study, DNA methylation levels of 12 CpG sites close to the transcription start site of GLP1R were analysed in pancreatic islets from 55 non-diabetic and 10 type 2 diabetic human donors as well as in β and α cells isolated from human pancreatic islets. DNA methylation of GLP1R was related to GLP1R expression, HbA1c levels and BMI. Moreover, mRNA expression of MECP2, DNMT1, DNMT3A and DNMT3B was analysed in pancreatic islets of the non-diabetic and type 2 diabetic donors.

Results
One CpG unit, at position +199 and +205 bp from the transcription start site, showed a small increase in DNA methylation in islets from donors with type 2 diabetes compared to non-diabetic donors (0.53%, p=0.02). Furthermore, DNA methylation levels of one CpG site located 376 bp upstream of the transcription start site of GLP1R correlated negatively with GLP1R expression (rho=−0.34, p=0.008) but positively with BMI and HbA1c (rho=0.30, p=0.02 and rho=0.30, p=0.03, respectively). This specific CpG site is located in an area with known SP1 and SP3 transcription factor binding sites. Moreover, when we compared the DNA methylation of the GLP1R promoter in isolated human β and α cells, we found that it was higher in α- compared with β-cells (p=0.009). Finally, there was a trend towards decreased DNMT3A expression (p=0.056) in type 2 diabetic compared with non-diabetic islets.

Conclusions
Together, our study shows that while BMI and HbA1c are positively associated with DNA methylation levels of GLP1R, its expression is negatively associated with DNA methylation of GLP1R in human pancreatic islets.
Using a multi-staged strategy based on machine learning and mathematical modeling to predict genotype-phenotype risk patterns in diabetic kidney disease: a prospective case–control cohort analysis
Authors: Leung Ross KK , Wang Ying , Ma Ronald CW , Luk Andrea OY , Lam Vincent , Ng Maggie , So Wing Yee , Tsui Stephen KW , Chan Juliana CN 
Published: July 2013

Abstract

Background
Multi-causality and heterogeneity of phenotypes and genotypes characterize complex diseases. In a database with comprehensive collection of phenotypes and genotypes, we compared the performance of common machine learning methods to generate mathematical models to predict diabetic kidney disease (DKD).

Methods
In a prospective cohort of type 2 diabetic patients, we selected 119 subjects with DKD and 554 without DKD at enrolment and after a median follow-up period of 7.8 years for model training, testing and validation using seven machine learning methods (partial least square regression, the classification and regression tree, the C5.0 decision tree, random forest, naïve Bayes classification, neural network and support vector machine). We used 17 clinical attributes and 70 single nucleotide polymorphisms (SNPs) of 54 candidate genes to build different models. The top attributes selected by the best-performing models were then used to build models with performance comparable to those using the entire dataset.

Results
Age, age of diagnosis, systolic blood pressure and genetic polymorphisms of uteroglobin and lipid metabolism were selected by most methods. Models generated by support vector machine (svmRadial) and random forest (cforest) had the best prediction accuracy whereas models derived from naïve Bayes classifier and partial least squares regression had the least optimal performance. Using 10 clinical attributes (systolic and diastolic blood pressure, age, age of diagnosis, triglyceride, white blood cell count, total cholesterol, waist to hip ratio, LDL cholesterol, and alcohol intake) and 5 genetic attributes (UGB G38A, LIPC -514C > T, APOB Thr71Ile, APOC3 3206T > G and APOC3 1100C > T), selected most often by SVM and cforest, we were able to build high-performance models.

Conclusions
Amongst different machine learning methods, svmRadial and cforest had the best performance. Genetic polymorphisms related to inflammation and lipid metabolism warrant further investigation for their associations with DKD.
Functional promoter -31G/C variant of Survivin gene predict prostate cancer susceptibility among Chinese: a case control study
Authors: Chen Jiawei , Cui Xinhai , Zhou Hai , Qin Chao , Cao Qiang , Ju Xiaobing , Li Pu , Cai Hongzhou , Zhu Jian , Meng Xiaoxin , Wang Meilin , Zhang Zhengdong , Shao Pengfei , Li Jie , Yin Changjun 
Published: July 2013

Abstract

Background
Abnormal expression of Baculoviral inhibitor of apoptosis repeat-containing 5 (BIRC5, also called as survivin), a novel member of the inhibitor of apoptosis protein (IAP) family, has implications in many types of cancer and is considered as a new therapeutic target. We suppose that genetic variant rs9904341 in the 5′ UTR region of survivin gene may be associated with the development and progression of prostate cancer (PCa) in Chinese population.

Methods
TaqMan assay method was used to genotype the polymorphism in the hospital-based case–control analysis of 665 patients with PCa and 710 age-matched cancer-free controls. The genetic associations with the occurrence and progression of PCa were calculated by logistic regression.

Results
Our results indicated that compared with GG genotypes, there was a statistically significant increased risk of PCa associated with those with CC genotypes [odds ratios (ORs) = 1.57, 95%confidence intervals (CIs) = 1.17-2.13, P = 0.004]. Moreover, stratification analysis revealed that the association was more pronounced in subgroups of nondrinkers, nonsmokers and those without a family history of cancer (all P < 0.05). In addition, we observed that PSA ≥ 20 was more frequent in patients carrying GC/CC genotypes than in those with a wild type genotype.

Conclusion
The functional survivin rs9904341 genetic variant may have a substantial influence on the PCa susceptibility and evolution.
Potassium channel openers and prostacyclin play a crucial role in mediating the vasorelaxant activity of Gynura procumbens
Authors: Ng Hien-Kun , Poh Ting-Fung , Lam Sau-Kuen , Hoe See-Ziau 
Published: July 2013

Abstract

Background
Previous studies of Gynura procumbens (G. procumbens) have shown that partially purified fractions of the leaves are capable of lowering the blood pressure of rats by inhibiting angiotensin-converting enzymic activity and causing vasodilatation. The objectives of this study were therefore to further purify the active compounds that exhibited selective effects on blood vessels, determine the mechanism of actions, and to qualitatively analyse the putative compounds present.

Methods
The butanolic fraction (BU) of the crude ethanolic extract was purified using column chromatography to obtain several sub-fractions of different polarities. The in vitro effects of BU and the sub-fractions on vascular tension were subsequently determined using isolated rat thoracic aortic rings. The most potent sub-fraction (F1) alone was then investigated for its mechanisms of the vasorelaxant activity. In another experiment, thin-layer chromatography was used to qualitatively analyse the active compounds found in F1.

Results
The BU and the sub-fractions ranging from 10-7 to 10-2 g/ml significantly (p < 0.05) inhibited the sustained tonic contractions induced by phenylephrine and potassium chloride in a concentration-dependent manner with various degree of potency. The most potent sub-fraction (F1) antagonised the calcium-induced vasocontractions (1 x 10-4 – 1 x 10-2 M) in calcium-free with high concentration of potassium as well as in calcium- and potassium-free Krebs-Henseleit solutions. Contractions induced by noradrenaline and caffeine were not affected by F1. The vasorelaxing effect caused by F1 was significantly attenuated with preincubation of potassium channel blockers (glibenclamide and 4-aminopyridine) and prostacyclin inhibitor (indomethacin) while it was not affected by preincubation with tetraethylammonium, l-nitro-arginine methyl esther, propanolol, atropine, oxadiazolo quinoxalin one and methylene blue. The qualitative phytochemical analysis of F1 indicated the presence of flavonoids.

Conclusion
These results confirm previous findings that G. procumbens causes vasodilatory effects by blocking calcium channels. In addition, the present study further demonstrates that the vasodilatory effect of G. procumbens may also be due to the opening of potassium channels and the stimulation of prostacyclin production. The putative compounds are probably flavonoids in nature.