bluuebunny/crossref_metadata_2025_split huggingface dataset:
How safe are our paediatric emergency departments? Protocol for a national prospective cohort study
Authors: Plint Amy C , Newton Amanda , Stang Antonia , Bhatt Maala , Barrowman Nick , Calder Lisa 
Published: December 2014

IntroductionAdverse events (AEs), defined as unintended patient harm related to healthcare provided rather than an underlying medical condition, represent a significant threat to patient safety and public health. The emergency department (ED) is a high-risk patient safety setting for many reasons including presentation ‘outside of regular hours’, high patient volumes, and a chaotic work environment. Children have also been identified as particularly vulnerable to AEs. Despite the identification of the ED as a high-risk setting and the vulnerability of the paediatric population, little research has been conducted regarding paediatric patient safety in the ED. The study objective is to generate an estimate of the risk and type of AEs, as well as their preventability and severity, for children seen in Canadian paediatric EDs.Methods and analysisThis multicentre, prospective cohort study will enrol patients under 18 years of age from nine paediatric EDs across Canada. A stratified cluster random sampling scheme will be used to ensure patients recruited are representative of the overall ED population. A rigorous, standardised two-stage process will be used for AE identification. The primary outcome will be the proportion of children with AEs associated with ED care in the 3 weeks following the ED visit. Secondary outcomes will include the proportion of children with preventable AEs and the types and severity of AEs. We will aim to recruit 5632 patients over 1 year and this will allow us to detect a proportion of patients with an AE of 5% (to within an absolute margin of error of 0.6%).Ethics and disseminationEthics approval has been obtained from participating sites. Results will be disseminated through presentations, peer review publications, linkages with emergency research network and a webinars for key knowledge user groups.Trial registration numberThis study is registered at Clinicaltrials.gov (NCT02162147;https://clinicaltrials.gov/ct2/show/NCT02162147).
Integrative medicine for subacute stroke rehabilitation: a study protocol for a multicentre, randomised, controlled trial
Authors: Fang Jianqiao , Chen Lifang , Chen Luni , Wang Chao , Keeler Crystal Lynn , Ma Ruijie , Xu Shouyu , Shen Laihua , Bao Yehua , Ji Conghua 
Published: December 2014

IntroductionMany patients with stroke receive integrative medicine in China, which includes the basic treatment of Western medicine and routine rehabilitation, in conjunction with acupuncture and Chinese medicine. The question of whether integrative medicine is efficacious for stroke rehabilitation is still controversial and very little research currently exists on the integrated approach for this condition. Consequently, we will conduct a multicentre, randomised, controlled, assessor-blinded clinical trial to assess the effectiveness of integrative medicine on stroke rehabilitation.Methods and analysis360 participants recruited from three large Chinese medical hospitals in Zhejiang Province will be randomly divided into the integrative medicine rehabilitation (IMR) group and the conventional rehabilitation (CR) group in a 1:1 ratio. Participants in the IMR group will receive acupuncture and Chinese herbs in addition to basic Western medicine and rehabilitation treatment. The CR group will not receive acupuncture and Chinese herbal medicine. The assessment data will be collected at baseline, 4 and 8 weeks postrandomisation, and then at 12 weeks’ follow-up. The primary outcome is measured by the Modified Barthel Index. The secondary outcomes are the National Institutes of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment, the mini-mental state examination and Montreal Cognitive, Hamilton's Depression Scale and Self-Rating Depression Scale, and the incidence of adverse events.Ethics and disseminationEthical approval was obtained from ethics committees of three hospitals. The results will be disseminated in a peer-reviewed journal and presented at international congresses. The results will also be disseminated to patients by telephone, during follow-up calls inquiring on patient's post-study health status.Trial registration numberChinese Clinical Trial Register: ChiCTR-TRC-12001972,http://www.chictr.org/en/proj/show.aspx?proj=2561
Diagnostic accuracy of hyperbilirubinaemia in anticipating appendicitis and its severity
Authors: Muller Sven , Falch Claudius , Axt Steffen , Wilhelm Peter , Hein Dirk , Königsrainer Alfred , Kirschniak Andreas 
Published: December 2014

BackgroundHyperbilirubinaemia is reported to be a positive predictor in diagnosing appendicitis and especially appendiceal perforation. We, therefore, analysed the diagnostic accuracy of serum bilirubin in anticipating appendicitis and its severity.MethodsAll consecutive patients undergoing appendectomy for suspected appendicitis from May 2009 to August 2011 were analysed. Patients were classified based on final histopathological findings into the groups: no appendiceal inflammation, non-perforated appendicitis and perforated appendicitis. Primary outcome was the diagnostic accuracy of serum bilirubin levels in discriminating between no appendiceal inflammation and any appendicitis (perforated and non-perforated appendicitis) and non-perforated and perforated appendicitis.ResultsOf 493 analysed patients, 125 (25%) had no appendiceal inflammation, 312 (64%) had non-perforated appendicitis and 56 (11%) had perforated appendicitis. The proportion of patients with bilirubin elevation (>1.1 mg/dL) was different between those with no appendiceal inflammation (14%) and any appendicitis (36%) (p<0.0001), and between non-perforated appendicitis and perforated appendicitis 48% (p=0.04). However, the positive and negative likelihood ratios (LRs) for an elevated bilirubin were poor at discriminating the groups: no appendiceal inflammation versus any appendicitis (LR+ 2.62 (95% CI 1.65 to 4.16) and LR− 0.75 (95% CI 0.67 to 0.83)) and non-perforated appendicitis versus perforated appendicitis (LR+ estimate 1.74 (95% CI 1.28 to 2.38) and LR− 0.72 (95% CI 0.55 to 0.93)).ConclusionsHyperbilirubinaemia is present in acute appendicitis but has a low diagnostic accuracy in discriminating between any appendicitis versus no appendiceal inflammation and perforated versus non-perforated appendicitis and is, therefore, of limited value in clinical routine.Trial registration numberNCT01698099.
Impaired affective and cognitive theory of mind and behavioural change in amyotrophic lateral sclerosis
Authors: van der Hulst Egberdina-Józefa , Bak Thomas H , Abrahams Sharon 
Published: December 2014

ObjectivesExecutive and behavioural changes are well-recognised in classical amyotrophic lateral sclerosis (ALS), indicating a subclinical behavioural-variant frontotemporal dementia (bvFTD) in some patients. Social cognitive deficits in ALS have been recently described and an impairment was identified on a simple Theory of Mind (ToM) test, which assesses the judgement of the preference of another through direction of eye gaze. The present study further delineated this deficit, by distinguishing between Affective and Cognitive subcomponents, and determining the relationship to behavioural change, levels of empathy and self-awareness.MethodsThe Cognitive–Affective Judgement of Preference Test was administered to 33 patients with ALS and 26 controls. Furthermore, a comprehensive neuropsychological battery and detailed behavioural assessment, with measures of empathy and awareness, were included.ResultsPatients with ALS showed a significant impairment in Affective ToM only when compared with healthy controls, with a deficit in 36% of patients; 12% showed an isolated Affective ToM deficit while 24% showed more generic ToM dysfunction. A Cognitive ToM deficit was found in 27% of patients, with 3% showing an isolated Cognitive ToM deficit. The patients with ALS showed reduced empathy (Fantasy scale) and increased behavioural dysfunction with high levels of apathy. In addition, patients with either an Affective and/or Cognitive ToM deficit exhibited poor self-awareness of their performance and abnormalities on verbal fluency, while those with an Affective ToM deficit also displayed higher levels of apathy and a naming deficit.ConclusionsDysfunctional ToM is a prominent feature of the cognitive profile of ALS. This specific difficulty in identifying and distinguishing the feelings and thoughts of another from a self-perspective may underpin the social behavioural abnormalities present in some patients with ALS, manifest as apathy and loss of awareness.
Improving the quality of documentation of paediatric post-take ward rounds: the impact of an acrostic
Authors: Newnham Amanda L , Hine Christopher , Rogers Camila , Agwu Juliana Chizo 
Published: December 2014

ABSTRACT

Background
Review of patients’ notes while investigating clinical incidents showed a recurring problem of poor documentation of important aspects of the paediatric post-take ward round.

Purpose of the study
To evaluate the impact of an acrostic (type of mnemonic), created to reflect the aspects of care that should be documented after every ward round, on the completeness of note keeping.

Study design
The acrostic, ‘Please Verify Information For Doctors, Please Note Every Plan, was developed in 2010 to make it easy to remember the important aspects of post-take ward round, which are: Problem; Vital signs; Investigations; Fluids; Drugs; Patient/Parental concerns; Nursing concerns; Examination; Plan. The acrostic was introduced to doctors at a teaching session and included in the mandatory induction programme for all new doctors. Impact of use of the acrostic was evaluated in 2011 by audit of case notes before and after its introduction, with re-audit 2 years later. A survey of junior doctors on their attitude to its use was carried out in 2014.

Results
Introduction of the acrostic led to significant improvement in the documentation of problem (84% vs 94%), investigations (26% vs 72%), fluids (16% vs 74%), drugs (26% vs 76%), patient/parental concerns (16% vs 72%) and nursing concerns (4% vs 48%). Most (95% (19/20)) of the junior doctors agreed that the acrostic provided them with an easy format to document important aspects of post-take ward rounds.

Conclusions
Our patient notes now reflect much more clearly the input of patients and their parents/carers and the involvement of the multiprofessional team.
Single-File Diffusion of Driven Interacting Colloids
Authors: Euán-Díaz Edith C. , Herrera-Velarde Salvador , Misko Vyacheslav R. , Peeters François M. , Castañeda-Priego Ramón 
Published: December 2014

The dynamical properties of interacting colloids spatially restricted to move in one-dimensional channels [J. Chem. Phys. 133, 114902 (2010)] and subjected to external periodic energy landscapes [Phys. Rev. E 86, 081123 (2012)] have been recently reported in terms of the long-time self-diffusion behavior. However, the full description of the mean-square displacement, ranging from short times to long times, is still missing. Thus, by means of Brownian dynamics computer simulations, we revisit the process known as single-file diffusion in driven interacting colloidal systems at all time scales. In particular, we review three different pair potentials, namely, Weeks–Chandler–Andersen, Yukawa and superparamagnetic potentials. We mainly focus on the importance of the correlation between particles via the coupling among hydrodynamic interactions and the external periodic field, resulting in nontrivial particle dynamics along the file in systems composed of repulsively interacting particles.[Formula: see text] Special Issue Comments: This article reviews results on the dynamical properties of interacting colloids in a single file when they are subjected to external periodic energy landscapes presented before in [J. Chem. Phys. 33, 114902 (2010)] and [ Phys. Rev. E 86, 081123 (2012)]. We analyze different interactions that cover from short to long ranges of the interparticle potentials. We mainly focus on the importance of the correlation between particles via the coupling among the hydrodynamic interactions and the external periodic field.Note from Publisher: In the captions of Figs. 1 through 4, "??" has appeared where the number 9 should appear.In table 1, in the WCA section, the variable "φ" shows the values: 0.2,0.3,0.3,0.3,0.3,0.3.The correct values are: 0.2, 0.3, 0.4, 0.5 , 0.6 , 0.7.
On discontinuity of planar optimal transport maps
Authors: Chodosh Otis , Jain Vishesh , Lindsey Michael , Panchev Lyuboslav , Rubinstein Yanir A. 
Published: December 2014

Consider two bounded domains Ω and Λ in ℝ2, and two sufficiently regular probability measures μ and ν supported on them. By Brenier's theorem, there exists a unique transportation map T satisfying T#μ = ν and minimizing the quadratic cost ∫ℝn ∣T(x) - x∣2 dμ(x). Furthermore, by Caffarelli's regularity theory for the real Monge–Ampère equation, if Λ is convex, T is continuous. We study the reverse problem, namely, when is T discontinuous if Λ fails to be convex? We prove a result guaranteeing the discontinuity of T in terms of the geometries of Λ and Ω in the two-dimensional case. The main idea is to use tools of convex analysis and the extrinsic geometry of ∂Λ to distinguish between Brenier and Alexandrov weak solutions of the Monge–Ampère equation. We also use this approach to give a new proof of a result due to Wolfson and Urbas. We conclude by revisiting an example of Caffarelli, giving a detailed study of a discontinuous map between two explicit domains, and determining precisely where the discontinuities occur.
H3K9 Histone Methyltransferase, KMT1E/SETDB1, Cooperates with the SMAD2/3 Pathway to Suppress Lung Cancer Metastasis
Authors: Wu Pei-Chun , Lu Jeng-Wei , Yang Jer-Yen , Lin I-Hsuan , Ou Da-Liang , Lin Yu-Hsiang , Chou Kuan-Hsien , Huang Wen-Feng , Wang Wan-Ping , Huang Yih-Leh , Hsu Chiun , Lin Liang-In , Lin Yueh-Min , Shen C.-K. James , Tzeng Tsai-Yu 
Published: December 2014

Abstract
Aberrant histone methylation is a frequent event during tumor development and progression. KMT1E (also known as SETDB1) is a histone H3K9 methyltransferase that contributes to epigenetic silencing of both oncogenes and tumor suppressor genes in cancer cells. In this report, we demonstrate that KMT1E acts as a metastasis suppressor that is strongly downregulated in highly metastatic lung cancer cells. Restoring KMT1E expression in this setting suppressed filopodia formation, migration, and invasive behavior. Conversely, loss of KMT1E in lung cancer cells with limited metastatic potential promoted migration in vitro and restored metastatic prowess in vivo. Mechanistic investigations indicated that KMT1E cooperates with the TGFβ-regulated complex SMAD2/3 to repress metastasis through ANXA2. Together, our findings defined an essential role for the KMT1E/SMAD2/3 repressor complex in TGFβ-mediated lung cancer metastasis. Cancer Res; 74(24); 7333–43. ©2014 AACR.
PD-1 Blockade in Renal Cell Carcinoma: To Equilibrium and Beyond
Authors: Harshman Lauren C. , Drake Charles G. , Choueiri Toni K. 
Published: December 2014

AbstractThe past several years have witnessed a resurgence of interest in cancer immunotherapy. The development of blocking antibodies against the inhibitory programmed death-1 (PD-1) pathway represents a clinical breakthrough in the treatment of solid tumors such as melanoma, and these agents show great promise in renal cell carcinoma (RCC). The early data have been surprising in that they demonstrate that blockade of a single immune checkpoint can elicit objective responses in patients with RCC, despite the recognized complexity of the immunosuppressive tumor microenvironment. Reinvigorating the patient's own immune cells to reactivate and to target the tumor has the potential advantages of more selective killing and thus decreased toxicity. In addition, checkpoint blockade immunotherapy has the advantage of inducing a memory response that is unattainable with our current cytotoxic and targeted therapies. This Crossroads overview will highlight the emerging investigation of PD-1 blockade in RCC and how this T cell–targeted strategy may thwart the tumor's escape mechanisms and shift the immune system/tumor balance back to a state of equilibrium and even to tumor elimination. Cancer Immunol Res; 2(12); 1132–41. ©2014 AACR.
Notch3 Is Necessary for Blood Vessel Integrity in the Central Nervous System
Authors: Henshall Tanya L. , Keller Annika , He Liqun , Johansson Bengt R. , Wallgard Elisabet , Raschperger Elisabeth , Mäe Maarja Andaloussi , Jin Shaobo , Betsholtz Christer , Lendahl Urban 
Published: December 2014

Objective—

Vascular smooth muscle cells (VSMC) are important for contraction, blood flow distribution, and regulation of blood vessel diameter, but to what extent they contribute to the integrity of blood vessels and blood–brain barrier function is less well understood. In this report, we explored the impact of the loss of VSMC in the
Notch3
−/−
mouse on blood vessel integrity in the central nervous system.

Approach and Results—

Notch3
−/−
mice showed focal disruptions of the blood–brain barrier demonstrated by extravasation of tracers accompanied by fibrin deposition in the retinal vasculature. This blood–brain barrier leakage was accompanied by a regionalized and patchy loss of VSMC, with VSMC gaps predominantly in arterial resistance vessels of larger caliber. The loss of VSMC appeared to be caused by progressive degeneration of VSMC resulting in a gradual loss of VSMC marker expression and a progressive acquisition of an aberrant VSMC phenotype closer to the gaps, followed by enhanced apoptosis and cellular disintegration in the gaps. Arterial VSMC were the only mural cell type that was morphologically affected, despite Notch3 also being expressed in pericytes. Transcriptome analysis of isolated brain microvessels revealed gene expression changes in
Notch3
−/−
mice consistent with loss of arterial VSMC and presumably secondary transcriptional changes were observed in endothelial genes, which may explain the compromised vascular integrity.

Conclusions—
We demonstrate that Notch3 is important for survival of VSMC, and reveal a critical role for Notch3 and VSMC in blood vessel integrity and blood–brain barrier function in the mammalian vasculature.
Mini-Cog Performance
Authors: Patel Apurva , Parikh Roosha , Howell Erik H. , Hsich Eileen , Landers Steven H. , Gorodeski Eiran Z. 
Published: December 2014

Background—
Heart failure (HF) guidelines recommend screening for cognitive impairment (CI) but do not identify how. The Mini-Cog is an ultrashort cognitive “vital signs” measure that has not been studied in patients hospitalized for HF. The purpose of this study was to evaluate whether CI as assessed by the Mini-Cog is associated with increased readmission or mortality risk after hospitalization for HF.

Methods and Results—

We analyzed 720 consecutive patients who completed the Mini-Cog as a part of routine clinical care during hospitalization for HF. Our primary outcome was time between hospital discharge and first occurrence of readmission or mortality. There was a high prevalence of CI as quantified by Mini-Cog performance (23% of cohort). During a mean follow-up time of 6 months, 342 (48%) patients were readmitted, and 24 (3%) died. Poor Mini-Cog performance was an independent predictor of composite outcome (adjusted hazard ratio, 1.90; 95% confidence interval, 1.47–2.44;
P
<0.0001) and was identified as the most important predictor among 55 variables by random survival forest analysis. Inclusion of Mini-Cog performance in risk models improved accuracy (bootstrapped
c
-index, 0.602 versus 0.624) and risk reclassification (category-free net reclassification improvement, 27%; 95% confidence interval, 14%–40%;
P
<0.001). Secondary analysis of initial 30 days post discharge showed effect modification by venue of discharge, whereby patients with CI discharged to a facility had longer time to outcome as compared with those discharged home.

Conclusions—
Mini-Cog performance is a novel marker of posthospitalization risk. Discharge to facility rather than home may be protective for those patients with HF and CI. It is unknown whether structured in-home support would yield similar outcomes.
Computed Tomography Identifies Patients at High Risk for Stroke After Transient Ischemic Attack/Nondisabling Stroke
Authors: Wasserman Jason K. , Perry Jeffrey J. , Sivilotti Marco L.A. , Sutherland Jane , Worster Andrew , Émond Marcel , Jin Albert Y. , Oczkowski Wieslaw J. , Sahlas Demetrios J. , Murray Heather , MacKey Ariane , Verreault Steve , Wells George A. , Dowlatshahi Dar , Stotts Grant , Stiell Ian G. , Sharma Mukul 
Published: December 2014

Background and Purpose—
Ischemia on computed tomography (CT) is associated with subsequent stroke after transient ischemic attack. This study assessed CT findings of acute ischemia, chronic ischemia, or microangiopathy for predicting subsequent stroke after transient ischemic attack.

Methods—
This prospective cohort study enrolled patients with transient ischemic attack or nondisabling stroke that had CT scanning within 24 hours. Primary outcome was subsequent stroke within 90 days. Secondary outcomes were stroke at ≤2 or >2 days. CT findings were classified as ischemia present or absent and acute or chronic or microangiopathy. Analysis used Fisher exact test and multivariate logistic regression.

Results—

A total of 2028 patients were included; 814 had ischemic changes on CT. Subsequent stroke rate was 3.4% at 90 days and 1.5% at ≤2 days. Stroke risk was greater if baseline CT showed acute ischemia alone (10.6%;
P
=0.002), acute+chronic ischemia (17.4%;
P
=0.007), acute ischemia+microangiopathy (17.6%;
P
=0.019), or acute+chronic ischemia+microangiopathy (25.0%;
P
=0.029). Logistic regression found acute ischemia alone (odds ratio [OR], 2.61; 95% confidence interval [CI[, 1.22–5.57), acute+chronic ischemia (OR, 5.35; 95% CI, 1.71–16.70), acute ischemia+microangiopathy (OR, 4.90; 95% CI, 1.33–18.07), or acute+chronic ischemia+microangiopathy (OR, 8.04; 95% CI, 1.52–42.63) was associated with a greater risk at 90 days, whereas acute+chronic ischemia (OR, 10.78; 95% CI, 2.93–36.68), acute ischemia+microangiopathy (OR, 8.90; 95% CI, 1.90–41.60), and acute+chronic ischemia+microangiopathy (OR, 23.66; 95% CI, 4.34–129.03) had greater risk at ≤2 days. Only acute ischemia (OR, 2.70; 95% CI, 1.01–7.18;
P
=0.047) was associated with a greater risk at >2 days.

Conclusions—
In patients with transient ischemic attack/nondisabling stroke, CT evidence of acute ischemia alone or acute ischemia with chronic ischemia or microangiopathy was associated with increased subsequent stroke risk within 90 days.