bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of tacrolimus and mycophenolate mofetil regimen vs. a conventional therapy with steroids on cardiovascular risk in liver transplant patients
Authors: Cuervas‐Mons Valentín , Herrero J. Ignacio , Gomez Miguel A. , González‐Pinto Ignacio , Serrano Trinidad , de la Mata Manuel , Fabregat Joan , Gastaca Mikel , Bilbao Itxarone , Varo Evaristo , Sánchez‐Antolín Gloria , Rodrigo Juan , Espinosa María Dolores 
Published: April 2015

AbstractThe aim of this study was to evaluate the impact of a steroid‐free regimen with tacrolimus and mycophenolate mofetil (modified therapy) vs. a standard regimen of tacrolimus and steroids on the cardiovascular risk score of liver transplant recipients. Patients who received a liver transplant were randomized to a modified therapy (n = 58) or a standard regimen (n = 59). Both groups were balanced at baseline, except for a higher prevalence of diabetes mellitus (DM) (p < 0.01) and a higher serum creatinine concentration (p < 0.05) in the modified therapy group. After 12 months, the prevalence of new‐onset DM, arterial hypertension, hypercholesterolemia, hypertriglyceridemia, and changes in cardiovascular risk factors was similar in both groups. The increase in serum creatinine (mg/dL) compared to baseline at one yr post‐transplantation was numerically lower in the modified therapy group (0.22 ± 0.42) than in the standard regimen group (0.41 ± 0.67) (p = 0.068). Although estimated cardiovascular risk score did not vary significantly compared to baseline in either group, there was a slight reduction in the modified regimen (−0.27 ± 2.87) vs. a mild increase (0.17 ± 2.94) in the standard regimen (p = 0.566). In conclusion, a steroid‐free regimen with tacrolimus and mycophenolate mofetil was associated with a trend toward better preservation of kidney function and reduction of cardiovascular risk score.
Variation in kinematic and spatiotemporal gait parameters by Gross Motor Function Classification System level in children and adolescents with cerebral palsy
Authors: Õunpuu Sylvia , Gorton George , Bagley Anita , Sison‐Williamson Mitell , Hassani Sahar , Johnson Barbara , Oeffinger Donna 
Published: April 2015

AimThe aim of this study was to examine differences in gait kinematics and spatiotemporal parameters in ambulatory children and adolescents with bilateral spastic cerebral palsy (BSCP) among Gross Motor Function Classification System (GMFCS) levels I‐III.MethodA retrospective review was conducted of individuals with BSCP who had three‐dimensional motion analysis (3DGA) at one of seven pediatric hospitals. Means and standard deviations of each gait parameter were stratified by GMFCS levels (I‐III) and for a typically developing comparison group.ResultsData from 292 children and adolescents with BSCP (189 males, 103 females; mean age 13y) were compared to a typically developing comparison group (24 male, 26 female; mean age 10y 6mo). Gait patterns differed from typically developing in all GMFCS levels, with increasing deviation as GMFCS level increased in 21 out of 28 parameters. Despite significant differences in selected mean kinematic parameters among GMFCS levels such as knee angle at initial contact of 24°, 29°, and 41° in GMFCS levels I, II and III respectively, there was also substantial overlap among GMFCS levels.InterpretationGMFCS levels cannot be identified using specific gait kinematics. Treatment decisions should be guided by comprehensive 3DGA that allows measurement of gait impairments at the joint level for each individual.
‘People form their own support systems – like forming their own families’: the role of parents and friends in the first year at dental school
Authors: McMillan W. 
Published: April 2015

AbstractMost students experience the transition from school to university as challenging. Students from backgrounds with little or no experience of higher education are most vulnerable in the transition, and most at risk of academic failure or early departure. This study examined the role that parents and friends play in the transition to university and in the first academic year. The study examines the mechanisms of this support so as to understand the ways in which support is provided. It examines whether – and if so, how – support mechanisms differed for first‐generation students and those with family familiarity of university. Data were collected through focus group and individual interviews with dentistry students in their first and second academic years at a Faculty of Dentistry in South Africa. Concepts from psychology literature – attachment and friendship quality – provided the analytical framework. Findings from the study suggest that the social relationships which students have access to during the transition and the first academic year have the potential to provide emotional resources which ease transition and practical information about appropriate ways of being and doing at university. First‐generation university students are less likely to have access to the latter because their parents have no experience of university. The study concludes with suggestions for ways in which universities and their teachers might provide support for all first‐year students.
The classic P300 encodes a build‐to‐threshold decision variable
Authors: Twomey Deirdre M. , Murphy Peter R. , Kelly Simon P. , O'Connell Redmond G. 
Published: April 2015

AbstractThe P300 component of the human event‐related potential has been the subject of intensive experimental investigation across a five‐decade period, owing to its apparent relevance to a wide range of cognitive functions and its sensitivity to numerous brain disorders, yet its exact contribution to cognition remains unresolved. Here, we carry out key analyses of the P300 elicited by transient auditory and visual targets to examine its potential role as a ‘decision variable’ signal that accumulates evidence to a decision bound. Consistent with the latter, we find that the P300 reaches a stereotyped amplitude immediately prior to response execution and that its rate of rise scales with target detection difficulty and accounts for trial‐to‐trial variance in RT. Computational simulations of an accumulation‐to‐bound decision process faithfully captured P300 dynamics when its parameters were set by model fits to the RT distributions. Thus, where the dominant explanatory accounts have conceived of the P300 as a unitary neural event, our data reveal it to be a dynamically evolving neural signature of decision formation. These findings place the P300 at the heart of a mechanistically principled framework for understanding decision‐making in both the typical and atypical human brain.
Wildfire‐induced alterations of topsoil organic matter and their recovery in Mediterranean eucalypt stands detected with biogeochemical markers
Authors: Faria S. R. , De La Rosa J. M. , Knicker H. , González‐Pérez J. A. , Villaverde J. , Keizer J. J. 
Published: April 2015

SummaryThis study addressed fire‐induced changes in topsoil organic matter (SOM) from a eucalypt plantation in Portugal over 2 years by using three complementary biogeochemical techniques: elemental analysis, analysis of biomarkers from the total extractable lipids (TLE) and solid state 13C nuclear magnetic resonance (NMR) spectroscopy. Direct wildfire effects included a marked decrease in soil total organic carbon (TOC) and total nitrogen (TN) content. However, both contents seem to have recovered during the 2 years. Fire also substantially reduced the TLE, producing noticeable changes in its composition. These included the thermal breakdown and cracking of n‐alkyl compounds. Ratios of short‐to‐long n‐alkanes and n‐fatty acid methyl esters (FAMEs) increased and typical carbon number predominance indices for n‐alkanes (odd‐to‐even) and n‐FAMEs (even‐to‐odd) were altered. Furthermore, the relative abundances of certain markers that are plant‐species specific were modified, especially by decreasing terpenoids such as epiglobulol, ledol and globulol, which are characteristic of Eucalyptus globulus. Other differences observed in the burnt soil were the appearance of levoglucosan, a typical marker for the thermal alteration of polysaccharides, larger relative abundances of lignin‐derived compounds (vanillin and methoxyphenols) and the presence of N‐heteroaromatic structures, which suggested the accumulation of ‘black nitrogen’. The 13C NMR spectra indicated that the wildfire produced a considerable increase in the aromaticity and aromatic condensation of the topsoil SOM. This was reflected in a broadening of the signal of aromatic compounds at the expense of O‐alkyl and alkyl‐C compounds. The continuation of these differences in SOM quality during the 2‐year study suggested a slow recovery of soil properties, possibly influenced by a limited recovery of the vegetation after the fire combined with the fire‐enhanced losses of soil.
Descriptive epidemiology of epilepsy in the U.S. population: A different approach
Authors: Helmers Sandra L. , Thurman David J. , Durgin Tracy L. , Pai Akshatha Kalsanka , Faught Edward 
Published: April 2015

SummaryObjectiveDetermine prevalence and incidence of epilepsy within two health insurance claims databases representing large sectors of the U.S. population.MethodsA retrospective observational analysis using Commercial Claims and Medicare (CC&M) Supplemental and Medicaid insurance claims data between January 1, 2007 and December 31, 2011. Over 20 million continuously enrolled lives of all ages were included. Our definition of a prevalent case of epilepsy was based on International Classification of Diseases, Ninth Revision, Clinical Modification–coded diagnoses of epilepsy or seizures and evidence of prescribed antiepileptic drugs. Incident cases were identified among prevalent cases continuously enrolled for ≥2 years before the year of incidence determination with no epilepsy, seizure diagnoses, or antiepileptic drug prescriptions recorded.ResultsDuring 2010 and 2011, overall age‐adjusted prevalence estimate, combining weighted estimates from all datasets, was 8.5 cases of epilepsy/1,000 population. With evaluation of CC&M and Medicaid data separately, age‐adjusted prevalence estimates were 5.0 and 34.3/1,000 population, respectively, for the same period. The overall age‐adjusted incidence estimate for 2011, combining weighted estimates from all datasets, was 79.1/100,000 population. Age‐adjusted incidence estimates from CC&M and Medicaid data were 64.5 and 182.7/100,000 enrollees, respectively. Incidence data should be interpreted with caution due to possible misclassification of some prevalent cases.SignificanceThe large number of patients identified as having epilepsy is statistically robust and provides a credible estimate of the prevalence of epilepsy. Our study draws from multiple U.S. population sectors, making it reasonably representative of the U.S.‐insured population.
Advanced hair damage model from ultra‐violet radiation in the presence of copper
Authors: Marsh J. M. , Davis M. G. , Flagler M. J. , Sun Y. , Chaudhary T. , Mamak M. , McComb D. W. , Williams R. E. A. , Greis K. D. , Rubio L. , Coderch L. 
Published: April 2015

SynopsisObjectiveDamage to hair from UV exposure has been well reported in the literature and is known to be a highly complex process involving initiation via absorption of UV light followed by formation and propagation of reactive oxygen species (ROS). The objective of this work was to understand these mechanisms, explain the role of copper in accelerating the formation of ROS and identify strategies to reduce the hair damage caused by these reactive species.MethodsThe location of copper in hair was measured by Transmission electron microscopy–(TEM) X‐ray energy dispersive spectroscopy (XEDS) and levels measured by ICP‐OES. Protein changes were measured as total protein loss via the Lowry assay, and MALDI ToF was used to identify the biomarker protein fragments. TBARS assay was used to measure lipid peroxide formation. Sensory methods and dry combing friction were used to measure hair damage due to copper and UV exposure and to demonstrate the efficacy of N,N' ethylenediamine disuccinic acid (EDDS) and histidine chelants to reduce this damage.ResultsIn this work, a biomarker protein fragment formed during UV exposure is identified using mass spectrometry. This fragment originates from the calcium‐binding protein S100A3. Also shown is the accelerated formation of this peptide fragment in hair containing low levels of copper absorbed from hair during washing with tap water containing copper ions. Transmission electron microscopy (TEM) X‐ray energy dispersive spectroscopy (XEDS) studies indicate copper is located in the sulphur‐poor endo‐cuticle region, a region where the S100A3 protein is concentrated. A mechanism for formation of this peptide fragment is proposed in addition to the possible role of lipids in UV oxidation. A shampoo and conditioner containing chelants (EDDS in shampoo and histidine in conditioner) is shown to reduce copper uptake from tap water and reduce protein loss and formation of S100A3 protein fragment. In addition, the long‐term consequences of UV oxidation and additional damage induced by copper are illustrated in a four‐month wear study where hair was treated with a consumer relevant protocol of hair colouring treatments, UV exposure and regular shampoo and conditioning.ConclusionsThe role of copper in accelerating UV damage to hair has been demonstrated as well as the ability of chelants such as EDDS and histidine in shampoo and conditioner products to reduce this damage.
Critical limits for urgent clinician notification at South African intensive care units
Authors: Schapkaitz E. , Levy B. 
Published: April 2015

SummaryBackgroundCritical value policies are used by clinical laboratories to decide when to notify caregivers of life‐threatening results. There, however, remains much debate regarding which tests should be included in critical value lists and clinically relevant limits.MethodAn electronic survey was designed to determine the critical value policies of specialists for haematology tests in South African intensive care units. Data collected included a demographic component, critical value policies and critical value reporting.ResultsThere were 68 respondents who represented a range of specialists from different disciplines. Four key critical values were identified, namely white cell count (WCC), haemoglobin, platelet count and international normalised ratio (INR). Median low and high adult and paediatric critical limits for the most frequently listed tests were as follows: haemoglobin <7 and >20 g/dL, platelet count <50 and >1000 × 109/L, WCC < 2 and >20 × 109/L and INR > 4. Specific critical limits for neonates were reported by 20 of the respondents. Of the respondents, 95.92% indicated that it was important to be contacted with first‐time critical results and approximately half for repeat critical values. The majority preferred that the person notified of the critical value be the caregiver directly involved with the patient's care.ConclusionIt is important for critical value policies to be reviewed by each discipline to ensure cut‐offs are clinically relevant.
PROBLEMS AND PROGRESS IN GERIATRICS*
Authors: STRAUS BERNARD 
Published: April 2015

Abstract:The problems of old age demand better attempts at solution. Some factors to be considered are: the difference between chronological and biological aging; the multiplicity, duplicity and chronicity of the diseases associated with old age (the law of geriatrics); the high incidence of drug reactions among elderly patients; and the possibility of overlooking acute illnesses in old people. Examples are given. Some recent advances in the treatment of disorders of carbohydrate, lipid and uric acid metabolism, and of the cardiovascular, renal and musculoskeletal systems are outlined. However, injudicious neglect is a continuing danger to the older patient, and calls for further efforts in research and its applications, with increasing emphasis on the holistic approach to therapeutic management.
MYCOPLASMAS (PPLO) AND DISEASE: SERUM ANTIBODY TITERS IN A HOSPITAL POPULATION OF ELDERLY PATIENTS
Authors: COLEMAN SYLVIA E. , COLE MILTON B. , ROBERTS FRANCES E. , McGAUGHEY FAY S. 
Published: April 2015

Abstract:In a random sample of sera from a predominantly male group of hospital patients with an average age of 67, complement‐fixing antibodies were found in 20 per cent to M. hominis type 1, in 16 per cent to Unknown Strain CE 5, in 1 per cent to M. pharyngis and in 2 per cent to M. pneumoniae.These percentages are lower than those reported in the literature for younger populations of patients. Thus the immunological experience with mycoplasmas (pleuropneumonia‐like organisms) varies from one population to another. In general, however, the incidence of mycoplasmal infection seems to be lower in older than in younger populations.The findings also indicate that the mere isolation of these organisms from the sera of patients who manifest a disease process does not constitute evidence of an etiological relationship unless other correlates can be established.
NEUROMUSCULAR SYNDROMES ASSOCIATED WITH CARCINOMA
Authors: Siddiqui N. H. 
Published: April 2015

AbstractThe nonmetastatic neurological and neuromuscular syndromes associated with carcinoma are reviewed under the classifications of encephalopathies (multiple and diffuse), myelopathies (chronic and subacute necrotic), neuropathies (sensory and peripheral sensorimotor) and muscular disorders (polymyopathy, myasthenic‐myopathic syndrome, myasthenia gravis, polymyositis and dermatomyositis). Little is known about the etiology of these syndromes, but auto‐immune reaction, virus infections and nutritional disorders have been suggested as factors.
LOCAL ANESTHESIA FOR GASTRIC SURGERY IN AGED PATIENTS
Authors: Murphy John W. , Riu Ramon , Ponka Joseph L. 
Published: April 2015

AbstractCase reports are presented on 3 surgical‐emergency patients (age range, 79–81 years) in whom the risk of general anesthesia was considered excessive. Local anesthesia was used in the performance of a gastric resection, gastro‐jejunostomy and tube‐gastrostomy respectively. Each patient made a good recovery after operation.Surgeons and other physicians dealing with the elderly should not forget local anethesia when considering major surgical procedures in certain seriously ill aged patients.
USE OF ISOTOPES FOR DEMONSTRATION OF LESIONS IN JOINTS AND BONES AS AN AID IN DIFFERENTIAL DIAGNOSIS
Authors: STRASSER NOEL F. , THRIFT CHESTER B. 
Published: April 2015

Abstract: Scintillation scans of the joints were obtained after intravenous injection of radioiodine in patients with rheumatoid arthritis, lupus, scleroderma, gout and osteoarthritis. Distinct radioactivity (correlated with the severity of the disorder) was observed in the first four diseases, but not in osteoarthritis.In a 72‐year‐old man with prostatic carcinoma and back pain, x‐ray examination of the lumbar region failed to reveal metastases, whereas they were indicated by strontium85 scanning of that area and confirmed at autopsy.Thus scintillation scanning after the injection of a suitable isotope can be of value in differential diagnosis and in estimating the severity of disease. However, the scan must always be interpreted in the light of the clinical situation.
SYNOVIAL FLUID: DIAGNOSTIC FEATURES AND METHODS FOR EXAMINATION
Authors: SCHMID FRANK R. 
Published: April 2015

Abstract: The functions of synovial membrane and synovial fluid are described, as well as the changes that occur during inflammation, particularly in gout and rheumatoid arthritis. Methods for examination of the synovial fluid are given in detail, involving the gross appearance of the fluid, the collection of the specimen, the cytology, fibrin clot formation, mucin clot formation, viscosity, detection of crystals, and simultaneous determination of blood and synovial fluid glucose. Interpretations are discussed.A fairly complete examination of synovial fluid is possible with a minimum of equipment and within a reasonable time. The significance of the findings outweighs the effort of the analysis. Proper interpretation of synovianalysis will greatly aid in diagnosis, offer some insight concerning prognosis, provide a measure of the therapeutic response and add to understanding of the pathogenesis of synovial‐tissue inflammation.
THE ROLE OF SURGERY IN TREATMENT OF ARTHRITIS OF THE HIP
Authors: STEVENS JACK 
Published: April 2015

Abstract: Osteoarthritis and rheumatoid arthritis of the hip are each discussed with regard to clinical considerations, radiographic findings, and available operative procedures.While search continues for an entirely satisfactory hip arthroplasty operation, the careful selection of the appropriate available procedure can be of great benefit to the arthritic patient. Osteotomy, arthroplasty and arthrodesis have fully proved their worth.For patients with rheumatoid arthritis, selection is the more important and difficulties arise from a lack of the same extensive background of clinical experience against which to review a particular patient's clinical state. Increasing interest in this field is manifest, however, and more patients are being helped by surgery than heretofore.It is worth emphasizing again, the importance of a team approach to the arthritic patient, with participation in the team by a rheumatologist or internist, orthopedic surgeon, physical therapist, occupational therapist, social service worker and vocational rehabilitation counsellor. That there is a pressing need for specialized teams of this sort in modern American medicine is obvious to any who have become involved in the field to anything more than a superficial degree.
LIFE HISTORY OF THE STROKE SYNDROME
Authors: MILLER MICHAEL B. 
Published: April 2015

Abstract: A case report is given to illustrate the combination of minor and major strokes in one life history. Recovery of function, prognosis and mortality rates are discussed, with inclusion of data from some of the better reports in the literature.The clinical life history of the stroke syndrome and meaningful studies on prognosis are almost impossible to carry out completely in general medical practice, in community hospitals, or in specialized rehabilitation centers as currently constituted. When criteria for admission to health‐care facilities exclude patients with any degree of organic brain syndrome as being “poor risks” or having “poor rehabilitation potential,” this obviously results in biased studies.Since patients with cerebral infarcts and organic brain syndrome comprise an important segment of the stroke problem, their inclusion in clinical studies dealing with stroke rehabilitation and prognosis is mandatory. All facilities in which the stroke patient may be domiciled, proprietary or voluntary, short‐term and/or long‐term, should be brought into the mainstream of medical knowledge if significant studies of the physical, psychiatric and social problems of stroke patients are to be evaluated properly.A standardized nomenclature for the various syndromes of cerebral ischemia is long overdue.We still need a much more complete understanding of this age‐old phenomenon.
EMOTIONAL CORRELATES OF ANGINA PECTORIS
Authors: Wendkos Martin H. , Wolff Kurt 
Published: April 2015

AbstractAn analysis of the personality traits of 13 patients with proven angina pectoris and 7 patients with authentic rheumatic heart disease but no angina showed that, psychodynamically, there were significant differences between the two groups. The features which characterized the anginal patients included compulsiveness, repressed hostility, unfulfilled oral needs and a strong superego. In contrast, the non‐anginal patients with rheumatic heart disease were passive, non‐hostile persons whose oral needs seem to have been adequately fulfilled. Such factors should be carefully considered in designing a therapeutic program for the rehabilitation of patients with angina pectoris.