bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effects of surface neuromuscular electrical stimulation on post-stroke dysphagia: a systemic review and meta-analysis
Authors: Chen Yi-Wen , Chang Kwang-Hwa , Chen Hung-Chou , Liang Wen-Miin , Wang Ya-Hui , Lin Yen-Nung 
Published: February 2015

Objective: In this study, we intended to evaluate whether swallow treatment with neuromuscular electrical stimulation is superior to that without neuromuscular electrical stimulation, and whether neuromuscular electrical stimulation alone is superior to swallow therapy. Methods: We searched the PubMed and Scopus databases from their earliest record to 31 December 2014 for randomized and quasi-randomized controlled trials that used neuromuscular electrical stimulation to treat post-stroke dysphagia. The Jadad scale was used to assess the quality of the included studies. We extracted the mean differences and standard deviation (SD) between baseline and posttreatment or posttreatment mean and SD for selected outcomes measured in the experimental and control groups for subsequent meta-analyses. Results: Eight studies were identified. For the comparison “swallow treatment with neuromuscular electrical stimulation vs. swallow treatment without neuromuscular electrical stimulation,” we found a significant standardized mean difference (SMD) of 1.27 (95% confidence interval (CI) = 0.51–2.02, P = 0.001) with significant heterogeneity ( I2 = 85%). The meta-analysis for the comparison of neuromuscular electrical stimulation alone and swallow therapy demonstrated a non-significant SMD of 0.25 (95% CI = –0.16–0.65, P = 0.23) without significant heterogeneity ( I2 = 16%). Conclusion: Swallow treatment with neuromuscular electrical stimulation seems to be more effective than that without neuromuscular electrical stimulation for post-stroke dysphagia in the short term considering the limited number of studies available. Evidence was insufficient to indicate that neuromuscular electrical stimulation alone was superior to swallow therapy.
Distal Biceps Brachii Tendon Repairs
Authors: Shields Edward , Olsen Joshua R. , Williams Richard B. , Rouse Lucien , Maloney Michael , Voloshin Ilya 
Published: February 2015

Background: Distal biceps brachii tendon repairs performed with a tension slide technique using a cortical button (CB) and interference screw are stronger than those based on suture fixation through bone tunnels (BTs) in biomechanical studies. However, clinical comparison of these 2 techniques is lacking in the literature. Purpose: To perform a clinical comparison of the single-incision CB and double-incision BT techniques. Study Design: Cohort study; Level of evidence, 3. Methods: Distal biceps tendon ruptures repaired through either the single-incision CB or double-incision BT technique were retrospectively identified at a single institution. Patients >1 year out from surgery were assessed for range of motion, strength, and complications, and they completed a DASH questionnaire (Disabilities of the Arm, Shoulder, and Hand). Results: Patients in the CB group (n = 20) were older (52 ± 9.5 vs 43.7 ± 8.7 years; P = .008), had a shorter interval from surgery to evaluation (17.7 ± 5 vs 30.8 ± 16.5 months; P = .001), and were less likely to smoke (0% vs 28.5%; P = .02) compared with the BT patients (n = 21). DASH scores were similar between groups (4.46 ± 4.4 [CB] vs 5.7 ± 7.5 [BT]; P = .65). Multivariate analysis revealed no differences in range of motion or strength between groups. More CB patients (30%; n = 6) experienced a complication compared with those in the BT group (4.8%; n = 1) ( P = .04), and these complications were predominantly paresthesias of the superficial radial nerve that did not resolve. There were no reoperations or repair failures in either group. Conclusion: Both the single-incision CB and double-incision BT techniques provided excellent clinical results. Complications were more common in the single-incision CB group and most commonly involved paresthesias of the superficial radial nerve.
Economical carbon and cellulosic sheet moulding compounds for semi- and non-structural applications
Authors: Brookbank P , Savage L , Evans KE 
Published: February 2015

The use of discontinuous carbon fibre plastics (DCFP) in automotive applications is increasing. The material offers a light weight and stiff alternative to conventional short-fibre glass-reinforced composites such as sheet moulding compounds (SMC). Prohibiting factors to wider utilisation of this material are cost and formability. Carbon moulding compounds available commercially are expensive containing high fibre volume fractions (Vf) which hinders or stops flow during moulding. This study examines the flexural and impact performance of cheaper carbon fibre (CFSMC) and cellulosic SMC grades produced using a standard, polyester, SMC production route where flow during moulding has be retained. Mechanical properties were assessed relative to increasing fibre length, volume fraction and bundle morphology. It was found that although much lower Vfs were employed, the new CFSMC grades offered superior impact strength when compared to commercially available DCFPs. The optimal impact performance achieved by CFSMC and cellulosic SMC samples were 103 KJ/m2 and 76 KJ/m2, respectively. These CFSMC and cellulosic SMCs had an average density of 1.62 g/cm3 and 1.57 g/cm3 compared to an average commercial value of 1.50 g/cm3, respectively. The developed SMCs have the potential as a cost-effective replacement to commercial carbon fibre SMC grades in semi- and non-structural applications where impact rather than stiffness is paramount.
Effects of airborne Aspergillus on serum aflatoxin B1 and liver enzymes in workers handling wheat flour
Authors: Saad-Hussein A , Taha MM , Fadl NN , Awad A-H , Mahdy-Abdallah H , Moubarz G , Aziz H , El-Shamy KA 
Published: February 2015

Objective: The present work aimed to investigate the relationship between occupational exposure to airborne molds, serum aflatoxin B1 (AFB1), and liver enzymes of workers handling wheat flour. Methods: The study included 90 bakers, 100 flour milling workers, and 100 controls with no exposure to flour dust. Workplace aspects such as temperature and relative humidity were measured. Airborne fungi were collected and identified. In all subjects included, the serum levels of AFB1, serum albumin (Alb), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP) were measured. Results: Air temperature and relative humidity were found to be higher in bakeries than in flour mill sections. Airborne Aspergillus species were isolated in dust particles <8 µm in size. The concentration of Aspergillus flavus and Aspergillus niger were higher in bakeries than in the flour mill sections. They were higher in the grinding section than in other mill sections. The serum AFB1-Alb adduct and ALP levels were significantly higher in bakers compared to milling workers ( p < 0.0001, p = 0.05), respectively. The liver enzymes AST and ALT were significantly higher among milling workers and bakers than controls ( p < 0.05, p < 0.0001), respectively. The duration of exposure was significantly correlated with serum AFB1 in bakers. Moreover, there was significant correlation between serum AFB1, each of ALT and AST levels in bakers. Conclusions: chronic occupational exposure to high concentrations of Aspergillus in workplaces may cause elevations in serum levels of AFB1 and liver enzymes in workers exposed to flour dust. Hence, worker protection measures should be consistently adopted and enforced at the workplace.
Shift work influences multiple sclerosis risk
Authors: Hedström AK , Åkerstedt T , Olsson T , Alfredsson L 
Published: February 2015

Background: An association between working shift at a young age and subsequent risk for multiple sclerosis (MS) has been observed. Objective: To investigate whether this finding could be replicated, and to further explore the influence of age at first exposure to shift work. Methods: Using a Swedish population-based, case-control study (2337 cases and 4904 controls), the incidence of MS among subjects whom had worked shifts was compared with that of those whom had not, by calculating odds ratios (ORs) with 95% confidence intervals (CIs) by means of logistic regression. Results: The OR of developing MS was 1.5 (95% CI 1.2–1.8) among those whom started working shifts before age 20, whereas a less pronounced association was observed among those whom started working shifts at age 20 or later (OR 1.2; 95% CI 1.1–1.4). The effect of shift work was more pronounced among subjects whom had been exposed at a young age, regardless of the duration between the start of shift work and disease onset. Conclusion: Some aspects of adolescence seem to be of great importance, regarding the impact of shift work on MS risk. Circadian disruption and sleep deprivation may contribute towards explaining the association; however, the exact mechanisms behind our observations remain to be elucidated.
Sources and level of income among individuals with multiple sclerosis compared to the general population: A nationwide population-based study
Authors: Wiberg Michael , Friberg Emilie , Stenbeck Magnus , Alexanderson Kristina , Norlund Anders , Hillert Jan , Tinghög Petter 
Published: February 2015

Introduction: Multiple sclerosis (MS) is associated with reduced work capacity, but there is limited knowledge about MS patients’ sources of income. Objectives: The purpose of this study was to elucidate MS patients’ earnings and social benefits compared to those of the general population. Methods: From nationwide registers of all residents in Sweden aged 21–64 years in 2010 ( n=5,291,764), those with an MS diagnosis ( n=13,979) were compared to a propensity score matched reference group ( n=69,895). Descriptive statistics and regression models were used to estimate the percentage difference between the MS patients and the matched references regarding the following annual incomes: earnings, disability pension, sickness absence, disability allowance, unemployment compensation and social assistance. Results: Both MS patients and the matched references received most of their income from earnings followed by disability pension and sickness absence. MS patients that were diagnosed in 2010 had 15% lower earnings than the matched references, while MS patients diagnosed before 2005 had 38% lower earnings. Corresponding figures regarding summed social benefits were 33% and 130% higher for MS patients, respectively. Conclusion: The results indicate that MS patients are overrepresented, in relative and absolute terms, regarding health-related benefits and have lower levels of earnings. However, the redistributing welfare systems appear to financially compensate the MS patients considerably.
Role of membrane complement regulators in neuromyelitis optica
Authors: Saadoun Samira , Papadopoulos Marios C 
Published: February 2015

Background: It is unclear why AQP4-IgG primarily causes central nervous system lesions by activating complement, but generally spares peripheral AQP4-expressing organs. Objectives: To determine whether peripheral AQP4-expressing cells are protected from complement-mediated damage by expressing complement regulators. Methods: Human tissue and cultured human cells were immunostained for aquaporin-4 (AQP4), CD46, CD55 and CD59. We also determined the vulnerability to AQP4-IgG and complement-mediated damage of astrocytes cultured alone or co-cultured with endothelial cells. Results: In normal brain, astrocyte end-feet express AQP4, but are devoid of CD46, CD55 and CD59. Immunoreactivity for CD46, CD55 and CD59 is not increased in or around neuromyelitis optica lesions. In kidney AQP4 is co-expressed with CD46 and CD55, in stomach AQP4 is co-expressed with CD46 and in skeletal muscle AQP4 is co-expressed with CD46. Astrocytes cultured alone co-express AQP4 and CD59 but, in astrocyte-endothelial co-cultures, AQP4 is found in cell processes devoid of CD59. Astrocytes co-cultured with endothelial cells are more vulnerable to AQP4-IgG and complement-mediated lysis than astrocytes cultured alone. Conclusions: Complement regulators protect peripheral organs, but not the central nervous system, from AQP4-IgG and complement-mediated damage. Our findings may explain why neuromyelitis optica primarily damages the central nervous system, but spares peripheral organs.
Simplification improves understanding of informed consent information in clinical trials regardless of health literacy level
Authors: Kim Eun Jin , Kim Su Hyun 
Published: February 2015

Background: This study evaluated the effect of a simplified informed consent form for clinical trials on the understanding and efficacy of informed consent information across health literacy levels. Methods: A total of 150 participants were randomly assigned to one of two groups and provided with either standard or simplified consent forms for a cancer clinical trial. The features of the simplified informed consent form included plain language, short sentences, diagrams, pictures, and bullet points. Results: Levels of objective and subjective understanding were significantly higher in participants provided with simplified informed consent forms relative to those provided with standard informed consent forms. The interaction effects between type of consent form and health literacy level on objective and subjective understanding were nonsignificant. Conclusion: Simplified informed consent was effective in enhancing participant’s subjective and objective understanding regardless of health literacy.
The emerging role of tacrolimus in myasthenia gravis
Authors: Cruz Jennifer L. , Wolff Marissa L. , Vanderman Adam J. , Brown Jamie N. 
Published: February 2015

Objective: To describe and evaluate the available evidence assessing the role of tacrolimus in the management of patients with myasthenia gravis (MG). Data sources: A literature search of MEDLINE (1946 to September 2014) and EMBASE (1947 to September 2014) was performed using the terms ‘tacrolimus’ and ‘myasthenia gravis’. Citations of retrieved articles were examined for relevance. Study selection and data extraction: The search was limited to prospective clinical trials focused on clinical outcomes in patients with generalized MG. Case reports, retrospective evaluations and non-English articles were excluded. Data synthesis: A total of 12 studies met inclusion criteria, of which seven articles evaluated tacrolimus in steroid-dependent patients and two examined the utility of tacrolimus in patients failing corticosteroids and cyclosporine. Other studies evaluated early initiation of tacrolimus after thymectomy, effectiveness of tacrolimus in de novo MG and the effectiveness of tacrolimus post-thymectomy in thymoma patients versus nonthymoma. A total of eight trials showed statistically significant improvements in quantitative MG score (QMGS) and postintervention status criteria – Myasthenia Gravis Foundation of America (PSC-MGFA). Of the trials examining steroid reduction with tacrolimus, two reported high rates of complete withdrawal; however, the most robust trial was unable to detect a difference in mean steroid dose. Long-term effects of tacrolimus (up to 5 years) were assessed in eight trials, which consistently showed positive effects on QMGS or reduction in adjunct therapies. Conclusions: There is limited yet promising information to suggest a beneficial role for tacrolimus in reducing QMGS and corticosteroid burden in patients with refractory symptoms or new-onset MG. Long-term use appears to be safe in this population.
African ancestry, lung function and the effect of genetics
Authors: Menezes Ana Maria B. , Wehrmeister Fernando C. , Hartwig Fernando P. , Perez-Padilla Rogelio , Gigante Denise P. , Barros Fernando C. , Oliveira Isabel O. , Ferreira Gustavo D. , Horta Bernardo L. 
Published: February 2015

African-Americans have smaller lung function compared with European-Americans. The aim of this study was to disentangle the contribution of genetics from other variables on lung function.A cohort was followed from birth to 30 years of age in Brazil. Several variables were collected: genomic analysis based on DNA; forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) obtained by spirometry; height measured by anthropometrists; and thorax circumference evaluated by photonic scanner. Crude and adjusted linear regression models were calculated according to African ancestry.The sample comprised 2869 participants out of 3701 members of the cohort. Males with higher African ancestry by DNA analysis had a smaller FEV1(−0.13 L, 95% CI −0.23– −0.03 L) and FVC (−0.21 L, 95% CI −0.32– −0.09 L) compared with those with less African ancestry, having accounted for height, sitting to standing height ratio and other confounders. Similar effects were seen in females.After adjustment, ancestry remained significantly associated with lung function, but the large effect of adjustment for confounding among males (but not females) does not allow us to exclude the possibility that residual confounding may still account for these findings.
Management of EGFR mutated nonsmall cell lung carcinoma patients
Authors: Grigoriu Bogdan , Berghmans Thierry , Meert Anne-Pascale 
Published: February 2015

Tyrosine kinase inhibitors (TKIs) targeting the epidermal growth factor receptor (EGFR) are common in the therapeutic armentarium of lung cancer today. Initially tested in an unselected population, they have been of limited usefulness until the identification EGFR gene mutations. Activating mutations generate conformational changes that result in a shift toward an active state of the catalytic domain and are associated with sensitivity to first generation EGFR TKI. Other mutations have been associated with resistance to these drugs, but for rare mutations there is limited data concerning their role in predicting response to EGFR TKI.To date, four molecules have been approved for the treatment of EGFR mutated lung cancer. Gefitinib and/or erlotinib are available in almost all countries. Afatinib has been approved by the US Food and Drug Administration and by the European Medicines Agency, and icotinib has been approved only in China. Other, more active, third generation agents with a higher binding affinity for the receptor, or that are directed against specific mutations, are under development. EGFR TKIs have a favourable impact on progression-free survival when given as first line treatment in mutated patients, but may also have a moderate effect as a salvage therapy and in maintenance in an unselected population.
Wedge resection and radiofrequency ablation for stage I nonsmall cell lung cancer
Authors: Ambrogi Marcello C. , Fanucchi Olivia , Dini Paolo , Melfi Franca , Davini Federico , Lucchi Marco , Massimetti Gabriele , Mussi Alfredo 
Published: February 2015

The main aim of this study was to compare radiofrequency ablation (RFA) and wedge resection in terms of disease recurrence and survival, as intent-to-treat therapy for stage I nonsmall cell lung cancer (NSCLC) in marginal or non-surgical candidates.121 high-risk patients, treated for stage I NSCLC with wedge resection (n=59) or RFA (n=62) in a 7-year period, were analysed. Age, sex, comorbidity score, performance status, forced expiratory volume in 1 s and forced vital capacity values, body mass index, T-stage and histology were evaluated as possible risk factors affecting disease recurrence and survival.At a median follow-up of 36 and 42 months for wedge resection and for RFA (p=0.232), local recurrence rate was 2 and 23%, respectively (p=0.002). The 1-, 2- and 5-year overall survival (disease-free interval) rates were 100% (96%), 96% (90%) and 52% (76%) for wedge resection, and 93% (87%), 72% (63%), and 35% (55%) for RFA (p=0.044 and p=0.01, respectively). None of the analysed parameters was found to be risk factor for disease recurrence and survival, except stage T2, which significantly affected disease-recurrence, overall and cancer-related survival and disease-free interval in the RFA group.Whenever possible, surgical resection, even if limited, should be preferred due to its higher disease control and survival rates. RFA can be considered a valid option for inoperable patients, especially for those with stage T1N0.
How “healthy” should children be when selecting reference samples for spirometry?
Authors: Lum Sooky , Bountziouka Vassiliki , Sonnappa Samatha , Cole Tim J. , Bonner Rachel , Stocks Janet 
Published: February 2015

How “healthy” do children need to be when selecting reference samples for spirometry?Anthropometry and spirometry were measured in an unselected, multi-ethnic population of school children aged 5–11 years in London, UK, with follow-up assessments 12 months later. Parents provided information on children's birth data and health status. Forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were adjusted for sex, age, height and ethnicity using the 2012 Global Lungs Initiative equations, and the effects of potential exclusion criteria on the z-score distributions were examined.After exclusions for current and chronic lung disease, acceptable data were available for 1901 children on 2767 occasions. Healthy children were defined as those without prior asthma or hospitalisation for respiratory problems, who were born at full-term with a birthweight ≥2.5 kg and who were asymptomatic at testing. Mean±sdz-scores for FEV1and FVC approximated 0±1, indicating the 2012 Global Lungs Initiative equations were appropriate for this healthy population. However, if children born preterm or with low birthweight, children with prior asthma or children mildly symptomatic at testing were included in the reference, overall results were similar to those for healthy children, while increasing the sample size by 25%.With the exception of clear-cut factors, such as current and chronic respiratory disease, paediatric reference samples for spirometry can be relatively inclusive and hence more generalisable to the target population.