bluuebunny/crossref_metadata_2025_split huggingface dataset:
Performance of the 2‐hour Accelerated Diagnostic Protocol Within the American College of Radiology Imaging Network PA 4005 Cohort
Authors: Mahler Simon A. , Miller Chadwick D. , Litt Harold I. , Gatsonis Constantine A. , Snyder Bradley S. , Hollander Judd E. 
Published: March 2015

AbstractObjectivesThe 2‐hour accelerated diagnostic protocol (ADAPT) is a decision rule designed to identify emergency department (ED) patients with chest pain for early discharge. Previous studies in the Asia‐Pacific region demonstrated high sensitivity (97.9% to 99.7%) for major adverse cardiac events (MACE) at 30 days. The objective of this study was to determine the validity of ADAPT for risk stratification in a cohort of U.S. ED patients with suspected acute coronary syndrome (ACS).MethodsA secondary analysis of participants enrolled in the American College of Radiology Imaging Network (ACRIN) PA 4005 trial was conducted. This trial enrolled 1,369 patients at least 30 years old with symptoms suggestive of ACS. All data elements were collected prospectively at the time of enrollment. Each patient was classified as low risk or at risk by ADAPT. Early discharge rate and sensitivity for MACE, defined as cardiac death, myocardial infarction (MI), or coronary revascularization at 30 days, were calculated.ResultsOf 1,140 patients with complete biomarker data, MACE occurred in 31 patients (2.7%). Among 551 of the 1,140 (48.3%, 95% confidence interval [CI] = 45.4% to 51.3%), ADAPT identified for early discharge; five of the 551 (0.9%, 95% CI = 0.3% to 2.1%) had MACE at 30 days. ADAPT was 83.9% (95% CI = 66.3% to 94.5%) sensitive, identifying 26 of 31 patients with MACE. Of the five patients identified for early discharge by ADAPT with MACE, there were no deaths, one patient with MI, and five with revascularizations.ConclusionsIn this first North American application of the ADAPT strategy, sensitivity for MACE within 30 days was 83.9%. One missed adverse event was a MI, with the remainder representing coronary revascularizations. The effect of missing revascularization events needs further investigation.
Seed size and the regeneration niches of one rare (Melaleuca deanei) and three common (Melaleuca styphelioides,Melaleuca thymifoliaandMelaleuca nodosa)Melaleuca(Myrtaceae) species of theSydney region
Authors: Hewitt Alison , Holford Paul , Renshaw Adrian , Stone Glenn , Morris E. Charles 
Published: March 2015

AbstractMelaleucaspecies occupy varied habitats acrossAustralia with 16 members of the genus occurring in theSydney district including the rare speciesMelaleuca deanei F. Muell. Little is known of their germination and recruitment requirements. This paper reports on experiments assessing the effects of temperature, water potential, fire cues, light and shade levels on germination in four species ofMelaleucanative to theSydney region. For the shade experiment, seedling survival at 12 months is also reported. The experiments tested the hypothesis thatM. deanei, which exhibits few seedlings in the field, has limited seedling recruitment because of its particular requirements for germination and establishment. Further, that it differs in these requirements from three common congenerics:M. nodosa(Sol exGaertn.)Sm.,M. thymifolia Sm. andM. styphelioides Sm. Results indicate thatM. deaneihas a substantially similar temperature and water potential range for germination to the common congeners from 15 to 35°C, and 0 to −0.65 ψ.Melaleuca nodosadisplayed the broadest regeneration niche on all factors assessed. Germination ofM. styphelioideswas significantly reduced in the dark andM. styphelioidesandM. deaneiwere most sensitive to shade in the seedling establishment/post‐germination phase.Melaleuca deaneihad significantly larger seed that was slower to germinate in all experiments. Germination of the four species was unaffected by the application of heat and smoke. The substantially similar germination parameters exhibited by the four species, despite differences in habitat, may reflect their close phylogenetic affinities. The effects of fire on stimulating seed release from the canopy, the high‐light environment post‐fire together with adequate follow‐up rainfall may all be critical in seedling establishment forM. deanei.
Electronic cigarettes in adults in outpatient substance use treatment: Awareness, perceptions, use, and reasons for use
Authors: Peters Erica N. , Harrell Paul T. , Hendricks Peter S. , O'Grady Kevin E. , Pickworth Wallace B. , Vocci Frank J. 
Published: March 2015

Background and ObjectivesMost studies on e‐cigarettes have come from population‐based surveys. The current research aimed to provide initial data on e‐cigarette awareness, perceptions, use, and reasons for use among adults seeking substance use treatment.MethodsA survey was conducted among 198 participants ≥18 years old in a community‐based outpatient substance use treatment program.ResultsOf the 198 participants, 69% currently smoked cigarettes, 92% were aware of e‐cigarettes, and 58% had ever used e‐cigarettes. The proportion of the number of participants who had ever used e‐cigarettes to the number who currently smoked (89.7%) appeared higher than the corresponding proportion in the 2012–13 National Adult Tobacco Survey (78.3%). Almost half of the sample who reported ever using e‐cigarettes endorsed quitting or reducing smoking as a reason for use, and 32% endorsed reasons for use relating to curiosity/experimentation. A greater likelihood of e‐cigarette ever‐use was significantly associated with younger age (adjusted odds ratio [AOR] = 0.94, 95%confidence interval [CI] = 0.90, 0.98) and perceptions related to using e‐cigarettes in public places where smoking cigarettes is not allowed (AOR = 2.96, 95%CI = 1.18, 7.42) but was not associated with primary drug of choice.Discussion and ConclusionsE‐cigarette use in adults seeking substance use treatment appears higher than it is in the US general population of smokers. The high frequency of use may be due to curiosity/experimentation or attempts to quit or reduce smoking.Scientific SignificanceFuture research may consider how e‐cigarettes interact with other substance use and affect high rates of nicotine and tobacco use in this population. (Am J Addict 2015;24:233–239)
Increased incidence of admissions for anaphylaxis in Spain 1998–2011
Authors: Tejedor‐Alonso M. A. , Moro‐Moro M. , Mosquera González M. , Rodriguez‐Alvarez M. , Pérez Fernández E. , Latasa Zamalloa P. , Farias Aquino E. , Gil Prieto R. , Gil de Miguel A. 
Published: March 2015

AbstractWe report on trends in anaphylaxis admissions in the Spanish hospital system during the period 1998–2011. Data on admissions for anaphylaxis were obtained from the Spanish Information System for Hospital Data for the period 1998–2011. Patients were selected using the codes for anaphylaxis in the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD‐9‐CM). Poisson regression models were used to estimate incidence rate ratios. We recorded a 1.89‐fold increase in admissions for anaphylaxis in Spanish hospitals during the study period, particularly in patients aged 0–14 years (1.65‐ to 3.22‐fold until 2009 and 4.09‐ to 12.59‐fold until 2011) and in food anaphylaxis in all age groups (2.78‐fold until 2009 and 8.74‐fold until 2011). The incidence of anaphylaxis is perceived as having increased in recent years, especially anaphylaxis caused by food and anaphylaxis affecting the pediatric population.
Higher lifetime chance of spontaneous surface antigen loss in hepatitis B carriers with genotype C infection
Authors: Tseng T.‐C. , Liu C.‐J. , Chen C.‐L. , Yang W.‐T. , Yang H.‐C. , Su T.‐H. , Wang C.‐C. , Kuo S. F.‐T. , Liu C.‐H. , Chen P.‐J. , Chen D.‐S. , Kao J.‐H. 
Published: March 2015

SummaryBackgroundClearance of hepatitis B surface antigen (HBsAg) indicates clinical control of hepatitis B virus (HBV) infection. However, little is known about the impact of viral genomic variations on HBsAg loss.MethodsWe explored the association between viral genomic factors and HBsAg loss in 2121HBeAg‐negative patients. HBV pre‐core stop codon (1896) and basal core promoter (BCP) (1762/1764) sequences were determined in patients with HBV DNA ≥200 IU/mL (N = 1693). The effect of HBV genotype on HBsAg loss was further validated in the whole cohort of 3445 HBsAg carriers.ResultsThe cumulative lifetime (age 28–75 years) incidence of HBsAg loss was 50.4% in 2121 HBeAg‐negative patients. We found that genotype C, but not pre‐core stop codon or BCP mutants, was associated with HBsAg loss. Compared to genotype B patients, genotype C patients had higher lifetime chance of HBsAg loss, with hazard ratio of 1.8 (95% confidence interval: 1.4–2.4). Multivariable analysis showed that male sex, elevated ALT levels, lower serum HBV DNA and HBsAg levels, and genotype C infection were associated with higher chance of HBsAg loss independently. We then performed sensitivity analysis, which re‐included HBeAg‐positive, cirrhotic and treatment‐experienced patients, and confirmed the robustness of our results in 3445 HBsAg carriers.ConclusionGenotype C infection, compared to genotype B, is associated with a higher lifetime chance of HBsAg loss in Asian HBV carriers.
Incidence and risk factors of hepatocellular carcinoma in patients with hepatic venous outflow tract obstruction
Authors: Paul S. B. , Shalimar  , Sreenivas V. , Gamanagatti S. R. , Sharma H. , Dhamija E. , Acharya S. K. 
Published: March 2015

SummaryBackgroundFrequency of hepatocellular carcinoma (HCC) in hepatic venous outflow tract obstruction (HVOTO) is unclear and risk factors in HVOTO associated with HCC are unknown.AimTo assess the incidence of HCC and to identify risk factors for HCC in primary HVOTO.MethodsIn the consecutive primary HVOTO patients evaluated between 1989 to 2013, the incidence of HCC among HVOTO was assessed in a retrospective cohort study and identification of the risk factors for HCC in HVOTO patients done by a case–control study.ResultsOf the 421 HVOTO patients, 8 had HCC at presentation (prevalence 1.9%). Another 8 of the remaining 413 developed HCC during 2076.2 person‐years follow‐up (mean 5.03 + 4.65 years, range 0.08–20 years). The cumulative incidence of HCC was 3.5% (95% CI 1.28–9.2%) at 10 years. The case–control study included 16 HCC as cases and remaining 405 as controls. Controls were predominantly males (M:F – 230:175), mean age 29 ± 10.3 years. Cases were predominantly females with an older age of 36.2 ± 11.4 years (P < 0.01, OR = 1.06, CI 1.0–1.10%). Presence of cirrhosis (P < 0.001), combined inferior vena cava (IVC) and hepatic vein (HV) block (P < 0.03, OR = 5.58, CI 1.43–25.30%) and long‐segment IVC block (P < 0.02, OR = 6.50, CI 1.32–32.0%) were significantly higher among cases than controls.ConclusionsHepatic venous outflow tract obstruction is a risk factor for HCC. The cumulative incidence of HCC in HVOTO is low and progressively increases over time. Those with liver cirrhosis, combined IVC and HV block and long‐segment IVC block are at risk to develop HCC and need active surveillance.
Review article: applying pharmacokinetics to optimise dosing of anti‐TNF biologics in acute severe ulcerative colitis
Authors: Rosen M. J. , Minar P. , Vinks A. A. 
Published: March 2015

SummaryBackgroundAcute severe ulcerative colitis (ASUC), the most aggressive presentation of ulcerative colitis (UC), occurs in 15% of adults and children with UC. First line therapy with intravenous corticosteroids is ineffective in half of adults and one‐third of children. Therapeutic monoclonal antibodies against TNF (anti‐TNF therapy) are emerging as a common treatment for ASUC due to their similar efficacy to calcineurin inhibitors and more favourable adverse effect profile.AimTo comprehensively review the evidence for anti‐TNF therapy for ASUC in children and adults with regard to outcomes and pharmacokinetics.MethodsPubMed and recent conference proceedings were searched using the terms ‘ulcerative colitis’, ‘acute severe ulcerative colitis’, ‘anti‐TNF’, ‘pharmacokinetics’ and the generic names of specific anti‐TNF agents.ResultsOutcomes after anti‐TNF therapy for ASUC remain suboptimal with about one half of children and adults undergoing colectomy. While several randomised controlled trials have demonstrated the efficacy of anti‐TNF therapy for ambulatory patients with moderate to severely active UC, patients in these studies were less ill than those with ASUC. Patients with ASUC may exhibit more rapid clearance of anti‐TNF biologics due to pharmacokinetic mechanisms influenced by disease severity.ConclusionsConventional weight‐based dosing effective in patients with moderately to severely active UC, may not be equally effective in those with acute severe ulcerative colitis. Personalised anti‐TNF dosing strategies, which integrate patient factors and early measures of pharmacokinetics and response, hold promise for ensuring sustained drug exposure and maximising early mucosal healing in patients with acute severe ulcerative colitis.
Laparoscopic hysterectomy in large uteri: Experience from a tertiary care hospital in Bangladesh
Authors: Jahan Samsad , Jahan Akter , Joarder Mahjabin , Habib Samira Humaira , Sharmin Farzana , Nayer Reefat 
Published: March 2015

AbstractIntroductionThe purpose of this study was to examine the safety and feasibility of laparoscopically assisted vaginal hysterectomy for uteri weighing more than 500 g as compared to uteri weighing less than 500 g in benign gynecological diseases.MethodsThis was a retrospective study. Patients were admitted through the outpatient department. They were divided into two groups: uterine weight ≥500 g (group 1) and uterine weight >500 g (group 2). There were no exclusion criteria based on the size, number, or location of leiomyomas. The patient characteristics for the two groups were compared in terms of demographic and socioeconomic details, operating time, amount of blood loss, requirement of blood transfusion, need for analgesia, and length of hospital stay.ResultsThe characteristics age and BMI were well balanced between the two groups. Uterine weight was 267.2 ± 97.6 g in group 1 and 740.0 ± 371.4 g in group 2 (P < 0.001). Length of operation and amount of blood loss were greater in group 2 than in group 1 (operation: 89.1 ± 26.7 vs 73.3 ± 24.6 min, P < 0.01; blood loss: 570.5 ± 503.6 vs 262.5 ± 270.0 mL, P < 0.001). However, there was no significant difference in hospital stay or incidence of operative complications between the two groups. No patients were switched from laparoscopy to laparotomy during operation. The rate of blood transfusion was lower in group1 than in group 2 (4.9% vs 32.6%; P < 0.001).ConclusionThis study demonstrated that despite the increased operating time and blood loss, laparoscopy should be considered instead of laparotomy in cases of large uteri. Laparoscopically assisted vaginal hysterectomy can be performed safely for a large uterus.
Lithium treatment and hippocampal subfields and amygdala volumes in bipolar disorder
Authors: Hartberg Cecilie Bhandari , Jørgensen Kjetil Nordbø , Haukvik Unn Kristin , Westlye Lars Tjelta , Melle Ingrid , Andreassen Ole Andreas , Agartz Ingrid 
Published: March 2015

ObjectivesResults from magnetic resonance imaging (MRI) studies are heterogeneous with regard to hippocampal and amygdala volume alterations in bipolar disorder (BD). Lithium treatment may influence both structures. It is unknown if lithium treatment has distinct effects on hippocampal subfield volumes and if subfield volumes change over the course of illness in BD.MethodsMRI scans were obtained for 34 lithium‐treated patients with BD (Li+), 147 patients with BD who were not treated with lithium (Non‐Li), and 300 healthy controls. Hippocampal total and subfield volumes and amygdala volumes were automatically estimated using Freesurfer. General linear models were used to investigate volume differences between groups and the effects of illness course and lithium treatment.ResultsThe Non‐Li BD group displayed significantly smaller bilateral cornu ammonis (CA) 2/3 and CA4/dentate gyrus (DG) subfields, total hippocampal volumes, right CA1 and right subiculum subfields, and left amygdala volume compared to healthy controls. There were no differences between the Li+ BD and either the Non‐Li BD or the healthy control groups. In patients with numerous affective episodes, Non‐Li BD patients had smaller left CA1 and CA2/3 volumes compared to Li+ BD patients and healthy controls. There were positive associations between lithium treatment duration and left amygdala volume.ConclusionsHippocampal subfield and amygdala volumes were reduced in Non‐Li BD patients compared to healthy controls, whereas the Li+ BD volumes were no different from those in Non‐Li BD patients or healthy controls. Over the course of BD, lithium treatment might counteract reductions specifically in the left CA1 and CA2/3 hippocampal subfields and amygdala volumes, in accordance with the suggested neuroprotective effects of lithium.
Characterisation of the contractile dynamics of the resting ex vivo urinary bladder of the pig
Authors: Lentle Roger G. , Reynolds Gordon W. , Janssen Patrick W.M. , Hulls Corrin M. , King Quinten M. , Chambers John Paul 
Published: March 2015

ObjectivesTo characterise the area and movements of ongoing spontaneous localised contractions in the resting porcine urinary bladder and relate these to ambient intravesical pressure (Pves), to further our understanding of their genesis and role in accommodating incoming urine.Materials and MethodsWe used image analysis to quantify the areas and movements of discrete propagating patches of contraction (PPCs) on the anterior, anterolateral and posterior surfaces of the urinary bladders of six pigs maintained ex vivo with small incremental increases in volume. We then correlated the magnitude of Pves and cyclic changes in Pves with parameters derived from spatiotemporal maps.ResultsContractile movements in the resting bladder consisted only of PPCs that covered around a fifth of the surface of the bladder, commenced at various sites, and were of ≈6 s in duration. They propagated at around 6 mm/s, mainly across the anterior and lateral surface of the bladder by various, sometimes circular, routes in a quasi‐stable rhythm, and did not traverse the trigone. The frequencies of these rhythms were low (3.15 cycles/min) and broadly similar to those of cyclic changes in Pves (3.55 cycles/min). Each PPC was associated with a region of stretching (positive strain rate) and these events occurred in a background of more constant strain. The amplitudes of cycles in Pves and the areas undergoing PPCs increased after a sudden increase in Pves but the frequency of cycles of Pves and of origin of PPCs did not change. Peaks in Pves cycles occurred when PPCs were traversing the upper half of the bladder, which was more compliant. The velocity of propagation of PPCs was similar to that of transverse propagation of action potentials in bladder myocytes and significantly greater than that reported in interstitial cells. The size of PPCs, their frequency and their rate of propagation were not affected by intra‐arterial dosage with tetrodotoxin or lidocaine.ConclusionsThe origin and duration of PPCs influence both Pves and cyclic variation in Pves. Hence, propagating rather than stationary areas of contraction may contribute to overall tone and to variation in Pves. Spatiotemporal mapping of PPCs may contribute to our understanding of the generation of tone and the basis of clinical entities such as overactive bladder, painful bladder syndrome and detrusor overactivity.
Human rights of children with intellectual disabilities: comparing self‐ratings and proxy ratings
Authors: Huus K. , Granlund M. , Bornman J. , Lygnegård F. 
Published: March 2015

AbstractBackgroundA child rights‐based approach to research articulates well with Article 12 of the United Nations Convention on the Rights of the Child (CRC) and highlights the importance and value of including children's own views about aspects that concern them. The aim of this study is to compare children with intellectual disability's own ratings (as self‐raters) to those of their primary caregivers (as proxy raters) regarding human rights of children. The study also aims to establish whether there is an inter‐rater agreement between the self‐raters and proxy raters concerning Maslow's hierarchy of needs.MethodThis study is nested in a larger study examining the human rights of children with intellectual disability in South Africa. In total, 162 children with intellectual disability from 11 schools across three provinces and their primary caregivers participated by answering parts of a Children's Rights Questionnaire (CRQ) developed by the researchers based on the United Nation's CRC. We compared the answers for six questions in the questionnaire that were addressed to self‐raters (children) and proxy raters (primary caregivers) in the same way.ResultsQuestions regarding basic needs, such as access to clean water or whether the child had food to eat at home, were answered similarly by self‐raters and proxy raters. Larger differences were found when self‐raters and proxy raters were asked about whether the child had things or friends to play with at home. Socio‐economic variables seemed to affect whether self‐raters and proxy raters answered similarly.ConclusionThe results underscore the importance of promoting children's rights to express themselves by considering the opinions of both the children as self‐raters and their primary caregivers as proxy raters – not only the latter. The results indicate that it is especially important to include children's own voices when more complex needs are surveyed. Agreement between self‐ and proxy ratings could be affected by socio‐economic circumstances.
Changing prevalence of wheeze, rhinitis and allergic sensitisation in late childhood: findings from 2 Isle of Wight birth cohorts 12 years apart
Authors: Patil V. K. , Kurukulaaratchy R. J. , Venter C. , Grundy J. , Roberts G. , Dean T. , Arshad S. H. 
Published: March 2015

SummaryBackgroundWhile the prevalence of asthma in children is decreasing or remaining the same, time trends in the prevalence of rhinitis in children are not known. Understanding sensitisation trends may help inform about trends in asthma and rhinitis prevalence.ObjectiveTo assess time trends of wheeze, rhinitis and aero‐allergen sensitisation prevalence at 10 years of age, we compared two birth cohorts established 12 years apart. To gain insight into differences in disease prevalence, we assessed association of family history, early life exposures and sensitisation with wheeze and rhinitis in each cohort.MethodsThe IoW (Isle of Wight) and FAIR (Food Allergy and Intolerance Research) unselected birth cohorts were established in 1989 and 2001 respectively in IoW. Identical ISAAC questionnaire and skin prick test data were collected and compared at 10 years of age.ResultsOver the 12‐year period from 2001 to 2012, prevalence of lifetime wheeze, current wheeze and those ever treated for asthma decreased by 15.9% (45.5 vs. 29.6, P < 0.001), 3.9% (18.9 vs. 15, P = 0.020) and 8.2% (31.7 vs. 23.5, P = 0.001), respectively. Conversely, current rhinitis and lifetime rhinitis prevalence increased by 5.5% (22.6 vs. 28.1, P = 0.004) and 13% (18.6 vs. 31.7, P < 0.001), respectively. Atopic status remained stable; however, house dust mite (HDM) sensitisation decreased by 5.6% (19.2 vs. 13.6, P = 0.004) and grass sensitisation increased by 3.5% (12.9 vs. 16.4, P = 0.054). Male sex, parental history of asthma and HDM sensitisation were significantly associated with lifetime wheeze in both cohorts, while maternal smoking during pregnancy was a significant risk factor only in the earlier IoW cohort. Parental history of rhinitis and grass sensitisation was significantly associated with lifetime rhinitis in both cohorts, while HDM sensitisation was significant only for the IoW cohort.ConclusionContrasting changes were noted with falling wheeze and HDM sensitisation but rising rhinitis and grass sensitisation prevalence. Changing prevalence of aero‐allergen sensitisations may explain the different time trends observed in these cohorts.