bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic Stress, Depressive Symptoms, Anger, Hostility, and Risk of Stroke and Transient Ischemic Attack in the Multi-Ethnic Study of Atherosclerosis
Authors: Everson-Rose Susan A. , Roetker Nicholas S. , Lutsey Pamela L. , Kershaw Kiarri N. , Longstreth W.T. , Sacco Ralph L. , Diez Roux Ana V. , Alonso Alvaro 
Published: July 2014

Background and Purpose—
This study investigated chronic stress, depressive symptoms, anger, and hostility in relation to incident stroke and transient ischemic attacks in middle-aged and older adults.

Methods—
Data were from the Multi-Ethnic Study of Atherosclerosis (MESA), a population-based cohort study of 6749 adults, aged 45 to 84 years and free of clinical cardiovascular disease at baseline, conducted at 6 US sites. Chronic stress, depressive symptoms, trait anger, and hostility were assessed with standard questionnaires. The primary outcome was clinically adjudicated incident stroke or transient ischemic attacks during a median follow-up of 8.5 years.

Results—

One hundred ninety-five incident events (147 strokes; 48 transient ischemic attacks) occurred during follow-up. A gradient of increasing risk was observed for depressive symptoms, chronic stress, and hostility (all
P
for trend ≤0.02) but not for trait anger (
P
>0.10). Hazard ratios (HRs) and 95% confidence intervals indicated significantly elevated risk for the highest-scoring relative to the lowest-scoring group for depressive symptoms (HR, 1.86; 95% confidence interval, 1.16–2.96), chronic stress (HR, 1.59; 95% confidence interval, 1.11–2.27), and hostility (HR, 2.22; 95% confidence interval, 1.29–3.81) adjusting for age, demographics, and site. HRs were attenuated but remained significant in risk factor–adjusted models. Associations were similar in models limited to stroke and in secondary analyses using time-varying variables.

Conclusions—
Higher levels of stress, hostility, and depressive symptoms are associated with significantly increased risk of incident stroke or transient ischemic attacks in middle-aged and older adults. Associations are not explained by known stroke risk factors.
A New Micro–Computed Tomography–Based High-Resolution Blood–Brain Barrier Imaging Technique to Study Ischemic Stroke
Authors: Park Jin-Yong , Lee Su-Kyoung , Kim Jeong-Yeon , Je Kang-Hoon , Schellingerhout Dawid , Kim Dong-Eog 
Published: July 2014

Background and Purpose—
Micro–computed tomography (mCT) offers high-resolution images, but it suffers from low contrast sensitivity and poor soft tissue contrast. We introduce a new mCT imaging technique with improved sensitivity for the dynamic spatial and temporal characterization of poststroke blood–brain barrier (BBB) dysfunction in small animals in vivo.

Methods—
Transient middle cerebral artery occlusion was induced for 1 hour in 10- to 12-week-old C57BL/6 mice (n=35). At 4, 24, and 48 hours after ischemic stroke, serial in vivo mCT imaging was performed 5 minutes after intravenous infusion (n=3) or intracarotid infusion of iopromide (240 μL) for 5 minutes (n=32). After intravenous injection of 2% Evans blue, we performed ex vivo near-infrared fluorescent imaging of parenchymal Evans blue leakage, visual assessment of poststroke parenchymal hematoma, triphenyltetrazolium chloride staining of the brain tissue, and quantitative mapping of stroke-related brain lesions.

Results—
Infarct-related BBB dysfunction could be demonstrated with intra-arterial but not with intravenous infusion of iopromide. Iopromide leakage across the dysfunctional BBB showed a monophasic (not biphasic) course for 48 hours after ischemic insult in both the parenchymal hematoma (n=5) and the non–parenchymal hematoma (n=24) groups, with relatively severe leakiness and greater hemispheric midline shift in animals with hemorrhage. Parenchymal staining on in vivo mCT overlapped with ex vivo fluorescent staining because of Evans blue. Multivariable analyses showed that midline shift and the amount of iopromide leakage at each of the 3 time points predicted the final infarct size at 48 hours.

Conclusions—
The new mCT BBB imaging technique, based on the intra-arterial infusion of clinically available iopromide, allows serial quantitative visualization of poststroke BBB dysfunction in mice, with high resolution and in a sensitive manner.
Variation of betaine, N,N-dimethylglycine, choline, glycerophosphorylcholine, taurine and trimethylamine-N-oxide in the plasma and urine of overweight people with type 2 diabetes over a two-year period
Authors: McEntyre Christopher J , Lever Michael , Chambers Stephen T , George Peter M , Slow Sandy , Elmslie Jane L , Florkowski Christopher M , Lunt Helen , Krebs Jeremy D 
Published: July 2014

Background Plasma betaine concentrations and urinary betaine excretions have high test-retest reliability. Abnormal betaine excretion is common in diabetes. We aimed to confirm the individuality of plasma betaine and urinary betaine excretion in an overweight population with type 2 diabetes and compare this with the individuality of other osmolytes, one-carbon metabolites and trimethylamine- N-oxide (TMAO), thus assessing their potential usefulness as disease markers. Methods Urine and plasma were collected from overweight subjects with type 2 diabetes at four time points over a two-year period. We measured the concentrations of the osmolytes: betaine, glycerophosphorylcholine (GPC) and taurine, as well as TMAO, and the one-carbon metabolites, N, N-dimethylglycine (DMG) and free choline. Samples were measured using tandem mass spectrometry (LC-MS/MS). Results Betaine showed a high degree of individuality (or test-retest reliability) in the plasma (index of individuality = 0.52) and urine (index of individuality = 0.45). Betaine in the plasma had positive and negative log-normal reference change values (RCVs) of 54% and −35%, respectively. The other osmolytes, taurine and GPC were more variable in the plasma of individuals compared to the urine. DMG and choline showed high individuality in the plasma and urine. TMAO was highly variable in the plasma and urine (log-normal RCVs ranging from 403% to −80% in plasma). Conclusions Betaine is highly individual in overweight people with diabetes. Betaine, its metabolite DMG, and precursor choline showed more reliability than the osmolytes, GPC and taurine. The low reliability of TMAO suggests that a single TMAO measurement has low diagnostic value.
Exploring the applicability of equine blood to bloodstain pattern analysis
Authors: Larkin Bethany A J , Banks Craig E 
Published: July 2014

Bloodstain pattern analysis (BPA) is the forensic application of the interpretation of distinct patterns which blood exhibits during a bloodletting incident, providing key evidence with its ability to map the sequence of events. Here, we explore the use of equine blood and investigate its suitability within the field of BPA. Blood is a complex fluid, and finding a suitable safe substitute to human blood that encompasses all of its characteristics has been the focus of many investigations. Animal blood has been concluded as the closest and therefore the most suitable alternate. However, it seems that currently only porcine blood is most prominently utilised. In this study, equine blood was investigated, using two different anti-clotting methods, where blood impacts were explored over a typical range of varying impact velocities upon a selection of commonly encountered surfaces. Key BPA parameters, such as the diameters of the resulting bloodstains, number of spines and area of origin were measured, which were subsequently applied into previously derived BPA equations. We find that defibrinated equine blood is a suitable alternative and offers the same conclusive outcomes to human blood. This gives bloodstain pattern investigators and researchers an additional choice of blood which can be of benefit when certain bloods are difficult to attain or when the activity involves the usage of a large quantity of blood. Additionally we explore the effect on BPA of aged blood, which revealed a significant decrease in stain diameter of up to 12.78 % when blood has been left for 57 days. A shelf life of no more than 12 days is recommended when blood is refrigerated at 4℃.
Sustainability Assessment of University of Gondar, Gondar, North-west Ethiopia
Authors: Moges Haimanot Gebrehiwot , Kifle Desalegn Woldeyohannes , Lotz-Sisitka Heila , Woldyohhanes Solomon Meseret 
Published: July 2014

The purpose of this article is to provide an overview of the cross-institutional assessment of sustainable development practices in the University of Gondar (UoG). The focus of the assessment was the level of UoG academic departments’ integration of sustainability concerns in teaching, research and community service. Management contributions to sustainable development, student initiatives on sustainability issues and policy statements about sustainable development of UoG were also considered in the assessment. The data collection was based on the Unit-based Sustainability Assessment Tool (USAT); in addition, supplementary information was collected through observations across the four campuses of UoG from January to February 2012. The result of the assessment showed that only a few academic departments have incorporated sustainability concerns in their curricula and teaching approach. The initiation and commitment of academic departments in mainstreaming sustainability concerns in the research and community service delivered were relatively poor. The operation and management of UoG showed inadequate sustainable development practices on waste management, energy utilization and purchasing from environment-friendly companies. In addition, the written policy and statements of UoG did not reflect sustainability in an explicit manner. The university is expected to respond to the key themes defined through sustainability declarations on higher education; there is also a need to establish the relevance of these in relation to the systemic environment. From the study undertaken, we have learnt that sustainability assessment of universities using USAT will be more valuable, if universities have already initiated the embedding of sustainability so that USAT can be used to benchmark the continual improvement.
Multiple sclerosis and psychiatric disorders: Comorbidity and sibling risk in a nationwide Swedish cohort
Authors: Johansson Viktoria , Lundholm Cecilia , Hillert Jan , Masterman Thomas , Lichtenstein Paul , Landén Mikael , Hultman Christina M 
Published: July 2014

Background: Psychiatric disorders are known to be prevalent in multiple sclerosis (MS). Objective: The objective of this paper is to study comorbidity between MS and bipolar disorder, schizophrenia and depression in a nationwide cohort and to determine whether shared genetic liability underlies the putative association. Methods: We identified ICD-diagnosed patients with MS ( n = 16,467), bipolar disorder ( n = 30,761), schizophrenia ( n = 22,781) and depression ( n = 172,479) in the Swedish National Patient Register and identified their siblings in the Multi-Generation Register. The risk of MS was compared in psychiatric patients and in matched unexposed individuals. Shared familial risk between MS and psychiatric disorders was estimated by sibling comparison. Results: The risk of MS was increased in patients with bipolar disorder (hazard ratio (HR) 1.8, 95% confidence interval (CI) 1.6–2.2, p < 0.0001) and depression (HR 1.9, 95% CI 1.7–2.0, p < 0.0001). MS risk in schizophrenia was decreased (HR 0.6, 95% CI 0.4–0.9, p = 0.005). The association between having a sibling with a psychiatric disorder and developing MS was not significant. Conclusion: We found a strong positive association between MS and bipolar disorder and depression that could not be explained by genetic liability. The unexpected negative association between MS and schizophrenia might be spurious or indicate possible protective mechanisms that warrant further exploration.
Use of intravesical valrubicin in clinical practice for treatment of nonmuscle-invasive bladder cancer, including carcinoma in situ of the bladder
Authors: Cookson Michael S. , Chang Sam S. , Lihou Christine , Li Thomas , Harper Samira Q. , Lang Zhihui , Tutrone Ronald F. 
Published: July 2014

Objectives: The objective was to conduct a US multicenter, retrospective medical record study examining the effectiveness, safety, and patterns of use of valrubicin for treatment of nonmuscle-invasive bladder cancer (NMIBC) by clinicians since the 2009 reintroduction of valrubicin. Methods: Patients ≥ 18 years with NMIBC who received had one or more instillations of valrubicin (October 2009– September 2011) were eligible. The primary endpoint was event-free survival (EFS). Safety and tolerability were also assessed. Results: The medical records of 113 patients met the inclusion criteria; 100 patients (88.5%) completed valrubicin treatment. The median age was 75 years (range 42–95 years). The median NMIBC duration was 31 months since diagnosis: 51.3% (58/113) had carcinoma in situ (CIS) alone, and 31.9% (36/113) had unspecified NMIBC. Most patients, 94.7% (107/113), had more than three valrubicin instillations and 70.8% (80/113) completed a full course. The EFS rate (95% confidence interval) was 51.6% (40.9–61.3%), 30.4% (20.4–41.1%), and 16.4% (7.9–27.5%) at 3, 6, and 12 months, respectively. Median time to an event was 3.5 (2.5–4.0) months after the first valrubicin instillation. Local adverse reactions (LARs) were experienced by 49.6% (56/113) of patients; most LARs were mild (93.6%). The most frequent LARs were hematuria, pollakiuria, micturition urgency, bladder spasm, and dysuria. In total, 4.4% (5/113) of patients discontinued valrubicin because of adverse events or LARs. Conclusions: Data from the present retrospective study are consistent with previous prospective clinical trials that demonstrated valrubicin effectiveness and tolerability for select patients with CIS, before considering cystectomy. Additional prospective studies are warranted to evaluate valrubicin safety and efficacy in the broader patient population with NMIBC.
Group forum counselling for vasectomy: A consistent and cost-effective improvement in patient care
Authors: Roushias S , Jones P , Rajkumar V , Pandit A , Bailey D 
Published: July 2014

Objective: The objective of this article is to improve patient care pathways for vasectomy referrals by offering a group forum pre-operative education and consent process. This should prove more consistent and efficient than traditional outpatient appointments, resulting in a high standard of information provision, reduction in waiting times and cost savings. Subjects/patients and methods: All vasectomy referrals were offered a group counselling seminar with subsequent individual examination instead of a routine outpatient appointment. Patient satisfaction questionnaires were completed and analysed at the forum conclusion. Results: During the pilot, 38/40 patients opted for group-based counselling. Subsequent forums had provision to counsel, examine and consent 45 patients within one hour. Patient satisfaction survey scores were consistently high and 100% gave scores >8/10 in overall satisfaction. The wait from GP referral to consultation dropped by 61% from 23 to 9 weeks. Conclusions: There has been a significant reduction in waiting times to consultation and improved efficiency of care provision. Standardised quality information should minimise dissatisfaction and litigation based on poor pre-operative counselling. Satisfaction surveys indicate that there have been no detrimental effects to patient care. One-hour group clinical sessions are adaptable to flexible working hours which may feature increasingly within the NHS.
Syndecan-3 is selectively pro-inflammatory in the joint and contributes to antigen-induced arthritis in mice
Authors: Kehoe Oksana , Kalia Neena , King Sophie , Eustace Andrew , Boyes Charlotte , Reizes Ofer , Williams Anwen , Patterson Angela , Middleton Jim 
Published: July 2014

Abstract
Introduction
Syndecans are heparan sulphate proteoglycans expressed by endothelial cells. Syndecan-3 is expressed by synovial endothelial cells of rheumatoid arthritis (RA) patients where it binds chemokines, suggesting a role in leukocyte trafficking. The objective of the current study was to examine the function of syndecan-3 in joint inflammation by genetic deletion in mice and compare with other tissues.

Methods
Chemokine C-X-C ligand 1 (CXCL1) was injected in the joints of syndecan-3−/−and wild-type mice and antigen-induced arthritis performed. For comparison chemokine was administered in the skin and cremaster muscle. Intravital microscopy was performed in the cremaster muscle.

Results
Administration of CXCL1 in knee joints of syndecan-3−/−mice resulted in reduced neutrophil accumulation compared to wild type. This was associated with diminished presence of CXCL1 at the luminal surface of synovial endothelial cells where this chemokine clustered and bound to heparan sulphate. Furthermore, in the arthritis model syndecan-3 deletion led to reduced joint swelling, leukocyte accumulation, cartilage degradation and overall disease severity. Conversely, CXCL1 administration in the skin of syndecan-3 null mice provoked increased neutrophil recruitment and was associated with elevated luminal expression of E-selectin by dermal endothelial cells. Similarly in the cremaster, intravital microscopy showed increased numbers of leukocytes adhering and rolling in venules in syndecan-3−/−mice in response to CXCL1 or tumour necrosis factor alpha.

Conclusions
This study shows a novel role for syndecan-3 in inflammation. In the joint it is selectively pro-inflammatory, functioning in endothelial chemokine presentation and leukocyte recruitment and cartilage damage in an RA model. Conversely, in skin and cremaster it is anti-inflammatory.
Outcome prediction in sepsis: Speckle tracking echocardiography based assessment of myocardial function
Authors: Orde Sam R , Pulido Juan N , Masaki Mitsuru , Gillespie Shane , Spoon Jocelyn N , Kane Garvan C , Oh Jae K 
Published: July 2014

Abstract
Introduction
Speckle tracking echocardiography (STE) is a relatively novel and sensitive method for assessing ventricular function and may unmask myocardial dysfunction not appreciated with conventional echocardiography. The association of ventricular dysfunction and prognosis in sepsis is unclear. We sought to evaluate frequency and prognostic value of biventricular function, assessed by STE in patients with severe sepsis or septic shock.

Methods
Over an eighteen-month period, sixty patients were prospectively imaged by transthoracic echocardiography within 24 hours of meeting severe sepsis criteria. Myocardial function assessment included conventional measures and STE. Association with mortality was assessed over 12 months.

Results
Mortality was 33% at 30 days (n = 20) and 48% at 6 months (n = 29). 32% of patients had right ventricle (RV) dysfunction based on conventional assessment compared to 72% assessed with STE. 33% of patients had left ventricle (LV) dysfunction based on ejection fraction compared to 69% assessed with STE. RV free wall longitudinal strain was moderately associated with six-month mortality (OR 1.1, 95% confidence interval, CI, 1.02-1.26, p = 0.02, area under the curve, AUC, 0.68). No other conventional echocardiography or STE method was associated with survival. After adjustment (for example, for mechanical ventilation) severe RV free wall longitudinal strain impairment remained associated with six-month mortality.

Conclusion
STE may unmask systolic dysfunction not seen with conventional echocardiography. RV dysfunction unmasked by STE, especially when severe, was associated with high mortality in patients with severe sepsis or septic shock. LV dysfunction was not associated with survival outcomes.
Suspicious young minds: paranoia and mistrust in 8- to 14-year-olds in the UK and Hong Kong
Authors: Wong Keri K. , Freeman Daniel , Hughes Claire 
Published: July 2014

BackgroundResearch on paranoia in adults suggests a spectrum of severity, but this dimensional approach has yet to be applied to children or to groups from different countries.AimsTo investigate the structure, prevalence and correlates of mistrust in children living in the UK and Hong Kong.MethodChildren aged 8–14 years from the UK (n= 1086) and Hong Kong (n= 1412) completed a newly developed mistrust questionnaire as well as standard questionnaire measures of anxiety, self-esteem, aggression and callous–unemotional traits.ResultsConfirmatory factor analysis of the UK data supported a three-factor model – mistrust at home, mistrust at school and general mistrust – with a clear positive skew in the data: just 3.4%, 8.5% and 4.1% of the children endorsed at least half of the mistrust items for home, school and general subscales respectively. These findings were replicated in Hong Kong. Moreover, compared with their peers, ‘mistrustful’ children (in both countries) reported elevated rates of anxiety, low self-esteem, aggression and callous–unemotional traits.ConclusionsMistrust may exist as a quantitative trait in children, which, as in adults, is associated with elevated risks of internalising and externalising problems.
Discharges to prison from medium secure psychiatric units in England and Wales
Authors: Doyle Michael , Coid Jeremy , Archer-Power Laura , Dewa Lindsay , Hunter-Didrichsen Alice , Stevenson Rachel , Wainwright Verity , Kallis Costas , Ullrich Simone , Shaw Jenny 
Published: July 2014

BackgroundEarly findings from a national study of discharges from 32 National Health Service medium secure units revealed that nearly twice as many patients than expected were discharged back to prison.AimsTo compare the characteristics of those discharged back to prison with those discharged to the community, and consider the implications for ongoing care and risk.MethodProspective cohort follow-up design. All forensic patients discharged from 32 medium secure units across England and Wales over a 12-month period were identified. Those discharged to prison were compared with those who were discharged to the community.ResultsNearly half of the individuals discharged to prison were diagnosed with a serious mental illness and over a third with schizophrenia. They were a higher risk, more likely to have a personality disorder, more symptomatic and less motivated than those discharged to the community.ConclusionsFindings suggest that alternative models of prison mental healthcare should be considered to reduce risks to the patient and the public.
Patterns of fuel use during locomotion in mammals revisited: the importance of aerobic scope
Authors: Schippers Marie-Pierre , Le Moine Christophe M.R. , McClelland Grant B. 
Published: July 2014

Abstract
Fuel selection patterns during exercise are thought to be conserved among sea-level native mammals when intensity is expressed relative to maximum aerobic capacity (VO2max). However, this claim is based on data from only a few species larger than rats, and has never been tested statistically. Thus, we investigated fuel use in a small mammal (Mus musculus, CD-1 strain), and combined these with published data on rats, dogs, goats, and humans to evaluate the robustness of the mammalian fuel selection model. We found mice rely less on carbohydrates to power moderate intensity exercise at the same % VO2max than larger mammals. We suggest this difference is due to a decline in aerobic scope (O2 available for exercise above resting metabolism) as body size decreases. We propose a redefined fuel use model that reflects changes in fractional aerobic scope with body size. We find exercise defined as % aerobic scope is a better predictor of fuel use across a wide range of quadruped species from mice to dogs and to running humans.